Diabetes, Obesity, and Erectile Dysfunction

ArticleinGender Medicine 6 Suppl 1(Suppl 1):4-16 · December 2009with5 Reads
DOI: 10.1016/j.genm.2008.12.003 · Source: PubMed
Diabetes mellitus (DM) and obesity affect large parts of the population in the United States and around the world. These disorders are among the most common risk factors for erectile dysfunction (ED), because of their effects on the vasculature and the hormonal milieu. This article reviews the current literature on the connection between DM, obesity, and ED. Using the search terms erectile dysfunction, endothelial dysfunction, hypogonadism, diabetes, and obesity, a systematic review of the available literature in the PubMed database was conducted. Relevant English-language publications (to August 2008) were identified. ED is highly prevalent in men with both DM and obesity, and may act as a harbinger for cardiovascular disease (CVD) in this high-risk population. In addition to male hypogonadism and macrovascular disease, endothelial dysfunction is central to the connection between the metabolic syndrome and ED. Conversely, improved glycemic control and weight loss have been found to improve erectile function. ED is very prevalent in men with DM and obesity. It is increasingly being recognized as an early clinical indicator and motivator for patients with CVD. The role of pharmacologic ED treatments in improving endothelial function is currently being investigated.
    • "The high prevalence of ED in overweight and obese men was due to the effect on blood vessels and reduced testosterone. [16] The limitation in this retrospective study was that the BMI of 24.7% of men with ED were not documented. Therefore, we cannot conclusively state what proportions of men with ED in this study that were normal, overweight, or obese. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Erectile dysfunction is becoming a public health issue with high incidences reported in community studies. Objective: To evaluate the characteristics and outcome of treatment in men with erectile dysfunction in a tertiary center in Ibadan southwestern Nigeria. Methods: Data of men with erectile dysfunction was retrieved between July 2004 and June 2014 and analyzed using SPSS version 16 statistical software. Results: Eighty-nine men with erectile dysfunction were managed which constituted 2% of all urological cases seen during the study period. Their median and mean ages were 39 years and 39.6 ± 1.2SD (range 19-76 years). The peak age incidence at 30-44 years was 41.6% and reduced with increasing age after 65 years to 4.5%. The etiologies were psychogenic in 55%, organic in 27%, idiopathic in 17% and 1% was familial. 67.5%, 31.5% and 3.4% were married, single and separated respectively. Seventy percent neither smoked cigarette nor drank alcohol, 21.3% drank alcohol and 9% took both alcohol and smoked cigarette. Seventy seven and half percent of men presented within 5 years of their symptom. The treatments offered were PDE type 5 inhibitors alone or in combination with psychotherapy or modification of medications. The outcome of these treatments ranged from 89% to 91% success rate. Conclusion: The number of men with erectile dysfunction managed in the tertiary hospital is very low though the outcome of treatment is within acceptable range. Increase public enlightenment may encourage increase hospital patronage and access to the available treatments for erectile dysfunction.
    Full-text · Article · Jan 2016
    • "In particular, IL-6 and TNF-alpha disrupt the penile endothelium by creating high levels of ROS, which decrease Nitric Oxide Synthase (NOS) cofactor tetrahydrobiopterin and delay the hydrolysis of NOS inhibitor asymmetric dimethylarginine (ADMA). Obesity induced interference with such molecules cause erectile dysfunction because nitric oxide facilitates normal erection (Tamler, 2009). Another cytokine IL-18, a member of the IL-1 family is known for its role in inflammation as activation of inflammation leads to caspase 1 mediated cleavage of pro-IL-18 into mature IL-18. "
    [Show abstract] [Hide abstract] ABSTRACT: The aim of this review was to provide current scenario linking obesity and male fertility. Obesity has been linked to male fertility because of lifestyle changes, internal hormonal environment alterations, and sperm genetic factors. A few studies assessing the impact of obesity on sperm genetic factor have been published, but they did not lead to a strong consensus. Our objective was to explore further the relationship between sperm genetic factor and obesity. There are emerging facts that obesity negatively affects male reproductive potential not only by reducing sperm quality, but in particular it alters the physical and molecular structure of germ cells in the testes and ultimately affects the maturity and function of sperm cells. Inhibition of microRNA in the male pronucleus of fertilized zygotes produces offspring of phenotypes of variable severity depending on miRNAs ratios. Hence, these RNAs have a role in the oocyte development during fertilization and in embryo development, fetal survival, and offspring phenotype. It has been reported that the miRNA profile is altered in spermatozoa of obese males, however, the impact of these changes in fertilization and embryo health remains as yet not known.
    Full-text · Article · Oct 2014
    • "[15] Notably, endothelial dysfunction caused by independent or concomitant cardiovascular risk factors not only results in atherosclerosis but is also a common denominator among the comorbidities of T2DM. It has also been established that dysfunction in the nitric oxide cascade is the primary link between insulin resistance, coronary artery disease, and ED. [16] Moreover, in DM the cavernosal tissue is under the attack in DM by harmful oxygen free radicals, such as 0 2 . This agent reacts with nitric oxide, forming peroxynitrite, which reacts with lipids, proteins, and nucleic acids. "
    [Show abstract] [Hide abstract] ABSTRACT: To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years. Between April 2000 and December 2012, we retrospectively investigated data from patients who were diagnosed with organic ED and undergone penile prosthesis implantation (PPI). Of the 239 patients, 235 of them were included in the study. Four patients who were operated on for trans-sexuality were excluded from the study. All patients were divided into two groups as those with (Group 1) or without DM (Group 2). Data, including age, body mass index (BMI) in kg/m(2), surgical history, comorbidities, International Index of Erectile Function (IIEF) questionnaire scores, combined intracavernous injection and stimulation (CIS) test results, length of corpus cavernosum while implanting the penile prosthesis, complications, operative times, mean hospital stay, and satisfaction of the patient and partner, were recorded. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. A p-value of <0.05 was considered to be statistically signifcant. The mean age was 57.9±10.5 years. Study population consisted of patients with DM (n=65), hypertension (n=21), DM, and hypertension (n=28), hyperlipidemia (n=5), a history of previous radical pelvic surgery with (n=4) or without DM (n=51) or cases without any comorbidity (n=62). Mean length of the corpus cavernosum was 17.277±0.1509 cm in Group 1 and 17289±0.1598 cm in Group 2 (p<0.05). Additionally, the other parameters, including age, operative time, and the satisfaction of the patient and partner, were not different between these groups (p>0.05). The length of the corpus cavernosum and the destruction of cavernosal tissues do not depend only on DM. We conclude that these features may have multifactorial causes.
    Article · Jun 2014
Show more