Erectile dysfunction or commonly shortened to ‘ED’ can affect many men at any age but typically is more common in men as they grow older. We know that ED can be caused by psychological or physical issues or both. For older men, it is usually a physical cause.

Obesity or excess weight is a major contributing factor to ED. This is because obesity is a major risk factor for the development of type 2 diabetes, heart disease and some cancers, which all on their own can cause ED.

ED is caused by obesity due to the damage of vital blood vessels from heart disease and diabetes. If the vital blood supply is clogged up or inflamed from atherosclerosis, then this will impede blood flow to the penis. Diabetes that is insufficiently controlled means that there is an excess glucose “sugar” in the blood which slowly destroys the fine blood vessels and nerves. Obesity also decreases testosterone levels which is essential to achieve an erection and maintain a healthy libido or sex drive. In addition to all of this, having excess weight can affect the ability to sufficiently control or manage these chronic conditions. Therefore, it is so important to live an active lifestyle and eat a well-balanced diet.

Losing weight should be considered as first line treatment to help restore erectile function in overweight men. Not only does it help with erectile function, losing weight is also known to help increase mental health and self-esteem. This is a bonus for performance!

weight-management-erectile-dysfunction

Well, there are many options available and should be tailored to each individual. This can be discussed at your appointment

Most people who are overweight don’t actively chose to be this way. Consequently, telling them that it is as simple as “eat less and move more” isn’t helpful and often not realistic. It can be offensive as it doesn’t take the individuals issues into account. We all don’t live the same 24-hour day. Also, our daily lives are being made easier with electronic gadgets and working from home now (thank you COVID), therefore, our actual energy requirements that we need are lowered but we often still eat the same amount.

Relatively new research has increased our understanding of the role genes and hormones play in a person’s weight. For instance, there are some individuals that when they start to decrease their food intake they get overrun by the ‘hungry hormone’ ghrelin. This hormone can undermine the weight loss process. Ghrelin is believed to be your body’s way of trying to protect you from starvation and in some individuals, it is an over performer! This is a very simplified way of looking at it and the researchers are still trying to work out the nuances of all the hormones and genes at play. But there are things that we do know that help. This is where medical weight loss management can benefit.

When undertaking diet and exercise to lose weight and it is unsuccessful, medication may address weight loss issues by helping regulate appetite, reduce hunger cravings, and slow gastric emptying so you feel fuller for longer. Weight loss medications should be combined with diet and exercise in people who have a body mass index (BMI) >30 or >27 combined with an obesity related condition such as high blood pressure, type 2 diabetes, sleep apnoea, and high cholesterol. Medications can also be used to assist in reducing weight regain. Current medications that can be prescribed in Australia:

  • Liraglutide (Saxenda) daily injection
  • Phentermine (Duromine) daily appetite suppressant and central nervous system stimulant tablet
  • Bupropion/Naltrexone (Contrave) daily appetite suppressant and reduces addictive eating behaviour combination tablet
  • Semaglutide (Ozempic) weekly injection that works similar to Liraglutide for people with Type 2 Diabetes, however, can be prescribed ‘off label’ for weight loss with informed consent