Obesity has a lot of implications on general health, including one’s sexual health. Several studies have suggested that it can be a major risk factor behind erectile dysfunction. Men with obesity are at higher risk of developing health complications like high blood pressure, diabetes, high cholesterol and heart disease, which can cause erectile dysfunction or ED.
Dr Poosha Darbha, a sexologist based in Hyderabad, Telangana, says erectile dysfunction is an inability to consistently, for six months, have a strong-enough erection to complete sexual intercourse.
Obesity and risk of developing erectile dysfunction
The causes of ED include psychological, physical, relational or situational.
Dr Abhishek Katakwar, surgeon for obesity and metabolic syndrome, AIG Hospitals, Hyderabad, says men with obesity have three times greater risk of developing erectile dysfunction. “Obesity can lead to a lot of physical and mental health issues. One can develop body-image issues and feel that the size of their penis is not good enough. [These men then] tend to get sceptical and lose confidence,” he says, adding that obesity can also cause hormonal imbalance.
Obesity can increase levels of the stress hormone cortisol, which depresses the secretion of testosterone. “One may lose the desire to indulge in physical intimacy as it affects their sex drive,” he says. “The sperm count can also go down.”
Dr Darbha says that many people develop metabolic syndrome (high blood pressure, cholesterol and diabetes) due to obesity, which reduces the testosterone levels and increases estrogen levels. “The fat cells metabolise testosterone to estrogen, reducing the testosterone levels,” he says. “Sometimes, testosterone levels may remain normal, but estrogen levels might increase. So, the ratio between both the hormones should also be looked at.”
If the person is diabetic or prediabetic, there might be some neurovascular changes, where nerves required for erection may be compromised. “There can be insufficient blood supply to the penis,” says Dr Katakwar. “If someone has heart problems, he might get tired soon, affecting his performance. Oxidative stress, inflammation, insulin resistance, high cholesterol, low HDL [high-density lipoprotein cholesterol] and low lipoprotein can lead to low testosterone levels.”
Dr Darbha adds that if one has atherosclerosis (plaque build-up in arteries), it can make erection difficult as the accumulation of plaque reduces blood flow in the penis.
Can belly fat cause erectile dysfunction?
Dr Katakwar says that the fat distribution in, for example, the European population with obesity is symmetrical, while abdominal or central obesity is more common among the Asian population with obesity. “With belly fat, the penis gets buried in that fat and look sunk inside, which can make a man lose confidence and affect his sex life,” he says.
Sometimes people might think that they are obese and have body-image issues despite having proper fat distribution. That may also lead to erectile dysfunction, says Dr Darbha.
Can losing weight help?
Experts say losing weight can help with ED — and an individual may not even need any medication. Dr Darbha says if a person is overweight by 25kg, losing even 10kg of that can help improve the condition. Any exercises to lose weight can help increase testosterone levels and reduce estrogen levels, but Dr Darbha also recommends some intense workout like some sports and weightlifting in the gym to help cure ED. “Exercises to build muscles can help as building muscles is required for testosterone synthesis. Some ab exercises are also good to improve blood flow to the pelvis,” he says.
Dr Katakwar adds that it is important to evaluate an individual with ED for any psychological condition and also do a biochemical test to check for diabetes, testosterone levels, etc.
- Men with obesity are at higher risk of erectile dysfunction.
- Obesity can lead to stress, diabetes, high blood pressure and heart disease, which can cause erectile dysfunction.
- Obesity can lead to low testosterone levels, and hence low sex drive.
- In case of diabetes, the nerves required for erection may be compromised, affecting sex life.
- Those with a heart condition could be low on energy, which can affect confidence levels.
- Atherosclerosis can also cause erectile dysfunction as the plaque build-up can restrict blood flow in the penis.
- Exercises can help improve the condition — sometimes even without medicines.