Sex Hormones and Sexual Function in Obese Men Losing Weight

Abstract

KAUKUA, JARMO, TUULA PEKKARINEN, TIMO SANE, AND PERTTI MUSTAJOKI. Sex hormones and sexual function in obese men losing weight. Obes Res. 2003;11:689-694. Objective: To study the impact of a weight-loss program on sex hormones and sexual function among 38 middle-aged obese men (BMI Ն35 kg/m 2 ). Research Methods and Procedures: A randomized controlled clinical trial was conducted. The treatment group (n ϭ 19) participated in a 4-month weight-loss program including 10 weeks on a very-low-energy diet (VLED) and 17 behavior modification visits. There was no intervention in the control group (n ϭ 19). Both groups were followed for 8 months, i.e., 22 weeks after the active weight loss in the treatment group. The outcome measures (weight, sex hormones, sexual function, leptin, and metabolic variables) were obtained at baseline and at three time-points during follow-up. Results: The mean weight loss in the treatment group was 21 kg at the end of the 10-week VLED. At the end of follow-up, the maintained weight loss was 17 kg of baseline weight. The control group was weight stable throughout the study. In the treatment group, increases in sex hormonebinding globulin, testosterone, and high-density lipoproteincholesterol, as well as decreases in insulin and leptin, were maintained until the end of follow-up, although with VLED, the level of several hormones and metabolic variables improved transiently during the rapid weight loss. There were no significant changes in the questionnaire scores on sexual function in either group. Discussion: We conclude that obese men lose weight and increase their serum testosterone level on a weight-loss program with VLED and behavior modification. However, they do not change their sexual function scores.

Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

“…5 Weight loss was associated with a decrease in fasting insulin levels, increased mean plasma SHBG and total testosterone levels in both diabetic and nondiabetic intervention subjects, and free testosterone only in the diabetic men. This finding is concordant with that of other studies, which demonstrated improvements in total, 29 bioavailable 16 and free 29 testosterone levels after caloric restriction. For example, in a mixed group of diabetic and nondiabetic obese men, SHBG, total and free testosterone levels increased in response to a mean weight loss of 21 kg after 10 weeks of LCD.…”

“…27 In contrast to these data, an LCDinduced decrease in mean body mass index from 39.3 to 33.8 kg m À2 over 10 weeks failed to improve erectile function or sexual desire in middle-aged men with no history of ED. 16 Our study also showed strong associations between the increases in IIEF-5 and SDI scores with each other, and with the magnitude of reduction in weight and WC. Abdominal obesity is a marker of insulin resistance, and has strong epidemiological links with ED.…”

“…The International Prostate Symptom Scale (IPSS) is a series of questions used to assess the severity of irritative (frequency, urgency, nocturia) and obstructive LUTSs (incomplete emptying, intermittency, weak stream, straining), attributable to bladder outlet obstruction caused by prostatic enlargement. 19 Symptoms are classified as mild (score 0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

“…14 The effects of rapid diet-induced weight are less clear: in one study, a third of obese men with ED reported improvement in erectile function and increased sexual desire with low-calorie diets (LCDs) and physical activity, 15 but another group demonstrated increased testosterone levels without improvement in sexual function scores in obese men with and without ED. 16 Moreover, there are little data on the effect of weight loss in ameliorating LUTSs in obese men with ED. Therefore, our study investigated the effects of rapid weight loss induced by a modified LCD, on ED, sexual desire, androgen levels and LUTS, and the relationships between improvements in weight, abdominal adiposity and metabolic parameters, with changes in sexual function and LUTS.…”

Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

“…For example, weight loss has been shown to improve testosterone levels, reducing fat mass and estrogen levels [135,136]. Modification may apply to changing prescription or nonprescription drug use and/or altering psychosocial factors [4].…”