Obesity and Erectile Dysfunction
The main risk factor for erectile dysfunction development (ED) in men with obesity is, first of all, hormonal and vascular disorders on the background of arterial hypertension. In this case, erectile dysfunction has organic (mainly endocrine) origin.
The leading causes of endocrine erectile dysfunction traditionally include:
- testosterone deficiency;
- hypo- and hyperthyroidism (rarely).
The frequency of nocturnal erection in men with decreased testosterone blood level decreases. To increase number of nocturnal erection in men suffering from hypogonadism, is by introducing testosterone, which leads to increased sexual motivation and sexual fantasies.
The interrelation between erection and testosterone is explained by the fact that lowered level of testosterone reduces synthesis of nitric oxide (NO), and this is the main chemical transmitter of relaxation signals of cavernous bodies smooth muscles, without corresponding relaxation of which erection can not occur.
Moreover, above-described connection between obesity and androgen deficiency is associated with:
- violations of lipid blood profile;
- vascular diseases.
These diseases only further complicate problem of erectile dysfunction.
Atherosclerotic changes in genital and cavernous arteries are the most frequent organic cause of erectile dysfunction development in general population and one of the main causes in obese men.
Male obesity (including abdominal obesity) can cause erectile dysfunction also because of local pathological changes in cavernous bodies, similar to diabetic microangiopathy.
Additional factors of ED exacerbation include hypercholesterolemia, which is found in many ED patients and leads to changes in cavernous tissues structure.
Thus, overweight in men not only leads to metabolic disorders of sex hormones, but also increases sexual dysfunction and decreased androgens release because of secondary vascular pathologies development. This proves pathological effect of visceral and abdominal obesity on metabolic disorders of sex hormones development.
Domestic and foreign researchers of obesity pathogenesis in men have prepared experience that indicates significant progress in identifying mechanisms of pathological processes appearance. However, there are some moments of hormonal metabolism and erectile dysfunction in obese men which need further study.