Impact of Bariatric Surgery on Male Sex Hormones and Sperm Quality: a Systematic Review and Meta-Analysis

Lee, Yung; Dang, Jerry; Switzer, Noah; Yu, James; Tian, Chunjie; Birch, Daniel W.; Karmali, Shahzeer

doi:10.1007/s11695-018-3557-5

Cited by 64 publications

(50 citation statements)

References 74 publications

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“…Furthermore, obesity has been shown to be associated with impaired spermatogenesis and erectile function, which may be secondary to increased peripheral aromatisation of testosterone to oestrogen (El Salam, ). This postulate has been further supported in a meta‐analysis that reported increased TT levels, reduced serum E2 levels and improved erectile function after patients underwent bariatric surgery (Lee et al, ). Given the inconsistent reports on the effect of serum E2 on erectile function, an exploratory analysis in men presenting for andrological evaluation was performed to determine whether elevated serum E2 may contribute to clinically significant ED.…”

Section: Introductionmentioning

confidence: 76%

The association between elevated serum oestradiol levels and clinically significant erectile dysfunction in men presenting for andrological evaluation

et al. 2019

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The goal of this study was to investigate the association between serum oestradiol levels and clinically significant erectile dysfunction in a cohort of men presenting for andrological evaluation. Retrospective review was conducted of patients that presented to a urologist with practice in andrology over an 18-month period. Patients completed the Male Sexual Health Questionnaire and had serum total testosterone and oestradiol measurements prior to 10:30 a.m. via immunoassay. t Tests, chi-square tests and multivariate logistic regression were used to compare clinical characteristics between those with adequate erectile function (erection scale score > 2) vs. clinically significant erectile dysfunction (erection scale score ≤ 2). Among 256 patients, average age was 49 years (SD 15), average serum oestradiol was 22.3 pg/ml (SD 10.6), and average serum total testosterone was 465.9 pg/ml (SD 206.3). On multivariate logistic regression, serum oestradiol was associated with clinically significant erectile dysfunction (OR 1.52 per SD increase, 95% CI 1.11-2.09, p = 0.009) when controlling for serum total testosterone, age, body mass index and smoking status. These results warrant future studies on the utility of measuring serum oestradiol in patients with erectile dysfunction and the use of aromatase inhibitors in patients with erectile dysfunction and elevated serum oestradiol.

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Section: Introductionmentioning

confidence: 76%

The association between elevated serum oestradiol levels and clinically significant erectile dysfunction in men presenting for andrological evaluation

et al. 2019

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“…In addition, hypogonadal men with obesity submitted to bariatric surgery are reported to lose more weight than eugonadal men (136). However, despite the improvement in gonadal function, this is no warranty that sperm characteristics will also improve (137,138).…”

Section: Reasoningmentioning

confidence: 99%

European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

Pasquali

Casanueva

Haluzı́k

et al. 2020

European Journal of Endocrinology

107

156

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Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed – which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.

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“…So far, five systematic meta-analyses [11,23,[46][47][48] have been published concerning changes in sex hormone levels upon bariatric surgery. Despite differences in the number of studies analyzed and in the inclusion criteria for the study selection (Table 2), all the metaanalyses found a significant, sustained increase in TT and free T after bariatric surgery, as compared with the pre-surgical values ( Fig.…”

Section: Effect Of Bariatric Surgery-induced Weight Loss On Functionamentioning

confidence: 99%

Treatment of Functional Hypogonadism Besides Pharmacological Substitution

Corona

Rastrelli

Morelli

et al. 2020

World J Mens Health

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Impact of Bariatric Surgery on Male Sex Hormones and Sperm Quality: a Systematic Review and Meta-Analysis

Cited by 64 publications

References 74 publications

The association between elevated serum oestradiol levels and clinically significant erectile dysfunction in men presenting for andrological evaluation

The association between elevated serum oestradiol levels and clinically significant erectile dysfunction in men presenting for andrological evaluation

European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

Treatment of Functional Hypogonadism Besides Pharmacological Substitution

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