Particularities of sexual function in men with obesity

Abstract

Introduction: Obesity has become a worldwide public health problem of epidemic proportions. In 1980, about 5 % of men worldwide were obese, by 2008 the rate was nearly 10%. It's no secret that obesity is hazardous to health. Men pay an extra price for excess weight, since obesity takes a special toll on male hormones and sexuality. Purpose and Objectives: The objective of the study was to show the peculiarities of sexual function and sex hormones profile in men with obesity. Materials and Methods: 42 male patients were included in the study. Young age (20-30 years) and BMI > 30 kg/m2 were including criteria. Patients were divided into three groups according to degree o f obesity: group 1 - 1 1 patients (BMI from 30 to 34.9 kg/m2); group 2 - 1 3 patients (BMI from 35 to 39.9 kg/m2) and 18 patients displayed to morbid obesity (BMI > 40 kg/m2) - group 3. The following analyses were done: anthropometric study (waist circumference, body weight, BMI), common blood test, serum lipid, hormonal profile (total and free testosterone, LH, estradiol), SHBG. Results and Discussion: The prevalence of androgen deficiency (circulating total testosterone <12 nmol/L) is different for the three groups and increases with BMI. Thus, in men from group 1 the prevalence of androgen deficiency was 45.5%, in men from group 2 and 3 was 69.2% and 86%, respectively. The total testosterone levels decrease linearly with the increasing o f BMI, from the average value of 11.8±1.6 nmol/1 in group 1 to 9.5±1.9 and 7.3±0.4 nmol/1 in men from group 2 and 3, respectively (p<0.05, r=-0.91). The LH levels don’t change significantly for the 3 groups, ranging from 3.38±0.77 to 2.6±0.46 U/l. The estradiol levels increased linearly with the decreasing of testosterone levels, from the average value o f 45.1±1.8 pg/ml in group 1 to 46.6±1.6 and 52.5±2.6 pg/ml in men from group 2 and 3, respectively. The prevalence of clinical manifestations of sexual dysfunction in men from group 1 was 36.4%, in men from group 2 and 3 was 61.5% and 88.8%, respectively. The most common clinical manifestations are decreased libido (9.1-27.8%) and erectile dysfunction (18.2-44.4%). Conclusions: The prevalence of androgen deficiency increases with the obesity’s degree from 45.5% to 100%. In the same time, there is not a compensatory secretion of LH. The androgen deficiency is associated with the linearly increasing of estradiol levels, from the average value of 45.1±1.8 pg/ml in first degree of obesity to 52.5±2.6 pg/ml in third degree of obesity (p<0.05, r=- 0.92). Sexual dysfunctions are more frequent in men with severe obesity 88.8%. The most common clinical manifestations are decreased libido (9-22%) and erectile dysfunction (18-44%).