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Urology, University of Wisconsin - Madison

Original URL: http://www.jsonline.com/alive/news/jun04/239716.asp

Weight Loss Touted for Erectile Dysfunction

By JOHN FAUBER
June 27, 2004

For years, doctors have known that obesity not only increases a man's chances of developing heart disease, but also the odds that he will have erectile dysfunction.

Now, they have proof that by losing weight obese men can improve their condition.

Italian researchers, whose work appears in the latest issue of the Journal of the American Medical Association, said that about one-third of men with erectile dysfunction, or ED, in their study who lost weight through a diet and exercise program were able to regain normal erectile function.

The finding comes at a time when American men have never been heavier, and television and the Internet are bulging with commercials and unsolicited offers for impotence drugs.

"This treatment strategy produces many benefits for the patient if it is successful and incurs no untoward risk if it is not," Christopher Saigal, a urologist at the University of California-Los Angeles, wrote in an accompanying editorial.

"Unfortunately, however, this is one treatment for ED that will not be accompanied by free pens, free notepads and its own Super Bowl commercial."

In recent years, several studies have suggested that by modifying risk factors such as excessive body weight, physical inactivity and smoking, middle-aged men can substantially decrease the odds that they will develop erectile dysfunction.

Last year, the ongoing Health Professionals Follow-up Study, which involved 31,742 men between the ages of 53 and 90, found that obesity increased the risk of erectile dysfunction by about 30%. Smokers also had a 30% increased risk compared with men who never smoked.

Physically active men had a 30% reduced risk compared with inactive men.

And men who watched more than 20 hours a week of television had between a 20% and 30% greater risk than men who watched less than one hour.

Losing pounds made difference

In the latest study, a group of 110 obese men were assigned to either of two groups, one that received detailed advice on how to lose 10% or more of their weight and the other that received general information about healthy food choices and exercise.

After two years, the men who received the detailed advice reduced their body mass index from a mean of 36.9 to 31.2. The other group dropped from 36.4 to 35.7.

BMI is a formula that relates weight to height. A person with a BMI of 30 or more is considered obese.

The men in the intervention group dramatically increased their level of exercise, compared with only a modest increase in the other group.

When rated on an erectile dysfunction index, the men in the intervention improved their scores but the other group did not.

In total, 17 of the men in the intervention group returned to normal erectile function compared with only three men in the other group.

"This is actually a very important piece of data," said David Paolone, an erectile dysfunction specialist and clinical assistant professor in the department of urology at the University of Wisconsin-Madison Medical School.

Paolone said the study will help doctors persuade men to make lifestyle changes such as losing weight, exercising and quitting smoking.

"Everything that is good for your overall health is good for your penis," he said.

A lot of men are surprised to hear that, he said.

It is believed that obesity contributes to erectile dysfunction because it has a detrimental effect on blood vessels.

"The penis is a vascular organ," said Peter Langenstroer, an erectile dysfunction specialist and associate professor of urology at the Medical College of Wisconsin and Froedtert Memorial Lutheran Hospital. "An erection is simply increased blood flow to the penis."

Blood vessel health

In the JAMA study, several measures of blood vessel health improved substantially more in the men who lost weight than those who did not.

One caveat to the study: Even though the men were obese, they did not have other conditions such as diabetes, high blood pressure and unhealthy cholesterol, which can contribute to blood vessel damage.

Still, the authors said losing weight through diet and exercise improved erectile function.

"Interventions focused on modifiable health behaviors may represent a safe strategy to improve erectile function and reduce cardiovascular risk in obese patients," they wrote.

In a separate study, researchers in Italy reported last week that men with type 2 diabetes who have difficulty getting an erection also could have undetected heart disease.

The study found that 33.8% of diabetic men with undetected heart disease also had erectile dysfunction, compared with only 4.7% of diabetic men who did not have heart disease.

The study was published in Circulation: Journal of the American Heart Association.