Being overweight or obese has many clearly documented effects on health, including increased risk of diabetes, heart disease, and other chronic health conditions. It also affects sexual and reproductive health in both men and women.
Many overweight people report sexual dysfunction (e.g. low sexual desire, difficulty getting an orgasm e.t.c) and reduced sexual activity.
In this post, we focus specifically on how being overweight or obese affects male sexual health, including male fertility. This is a follow up to our first post on how alcohol consumption causes a deterioration in male sexual and reproductive health.
Male Sexual Problems Caused by Obesity and Weight Gain
Many men who are overweight experience some kind of problem with their sexual functioning. Here are the three main ones.
Erectile Dysfunction
One of the most common ones is erectile dysfunction. Also called impotence, erectile dysfunction (ED) refers to a condition where a man has difficulty getting and maintaining an erection. In overweight men, ED can be caused by physical or psychological problems, which we are going to discuss shortly.
Obesity-related ED is especially prevalent in older men. That’s because older men are already at a risk of erectile dysfunction because of lower testosterone. In one study involving Slovakian men 40 years and older and with abdominal obesity, 73% of them had various degrees of erectile dysfunction.
To further demonstrate the link between weight gain and ED, another study found that 79% of men diagnosed with ED had a BMI of25 or higher. A 25+ BMI is considered overweight. Furthermore, obese men tend to get more severe erectile dysfunction compared to those with a healthy weight.
Sexual Dysfunction
A majority of overweight men also report some sort of sexual dysfunction. This refers to an inability to get pleasure from sex, or not wanting to have sex at all.
Examples of sexual dysfunction include low or no desire for sex, lack of arousal even when you desire sex and difficulty reaching climax.
As with ED, sexual dysfunction can be caused by physical problems, psychological issues, or a combination of both.
Male Fertility
Multiple studies have found that obesity in men can also lead to reduced fertility primarily because of low sperm count.
Researchers think that lower testosterone levels and increased scrotal temperature could be some of the factors that affect sperm production as well as sperm quality. So obese and overweight men might find it harder to conceive.
How Obesity and Weight Gain Affects Male Sexual Health
Obesity can cause sexual dysfunction, erectile dysfunction and low fertility in men. But how exactly does being overweight lead to these problems? Researchers have proposed three main mechanisms.
1. Obesity Lowers Testosterone & SHBG Levels
Obesity lowers T levels primarily through a process called aromatization. This is where testosterone is converted into estrogen.
An increase in adipose tissue (body fat) causes a proportional increase in aromatase, an enzyme that converts androgens like testosterone into estrogens. So the more weight you put on, the lower your T levels get.
Low testosterone levels lead to erectile dysfunction, sexual dysfunction and reduced fertility. That’s because testosterone is crucial in things like getting an erection, having sexual desire (libido) and sperm production and quality.
Researchers have also found that obesity lowers the level of SHBG or sex hormone-binding globulin. SBHG is a protein that binds sex hormones in blood including testosterone.
SBHG controls the amount of testosterone available to tissues throughout your body. So when you have low levels of it, it affects processes like sperm production and erection.
2. Obesity Affects Ability to Have Sex
Being overweight physically makes it harder to engage in sexual activities. The discomfort and sometimes even pain can lead to less desire to have sex.
It’s also psychological. Obese men are more likely to have body image issues and may not want to undress in the presence of a sexual partner. They are also more likely to suffer from anxiety, chronic stress and depression, all of which can lead to sexual dysfunction.
3. Obesity Causes a Myriad of Health Problems
Obesity can also affect male sexual health indirectly via the many health problems it causes.
For instance, a lot of men who are overweight also suffer from hypertension or high blood pressure. Hypertension damages the lining (endothelium) of blood vessels, which leads to erectile dysfunction.
Damage to the endothelium leads to lower production of nitric oxide (NO). NO is crucial in getting an erection. It relaxes smooth muscles, which allows arteries leading to the penis to dilate and fill up with blood and cause an erection.
Diabetes, another obesity-related health problem, can also damage the endothelium, increasing risk of ED.
Another type of damage to blood vessels caused by hypertension is atherosclerosis. This is the thickening of arteries as fatty materials (plaque) build up in the inner walls. But the initial damage to blood vessels is caused by hypertension, diabetes and other health issues caused by weight gain.
This then leads to the deposit of plaque on the walls of blood vessels, which obstructs blood flow and leads to erectile dysfunction as well as other health problems like stroke and heart disease.
Here are other ways obesity-related health conditions affect male sexual health.
Being overweight increases the amount of bad cholesterol in your blood. Bad cholesterol, also called LDL, increases the risk of clogged blood vessels, which in turn reduces blood flow to the penis.
Obesity causes increased inflammation in the body. Inflammation involves an excessive and chronic immune response. It’s been linked to a wide range of health problems including diabetes, heart disease and cancer. Inflammation is a major factor behind atherosclerosis, which we’ve seen can lead to ED. It can also affect sperm count and cause fertility problems.
Medications used to treat obesity-related health conditions like depression and high blood pressure can lead to lower sex drive, erectile dysfunction and other sexual health issues.
Final Thoughts
A lot of men who lose weight also experience a positive impact on their sexual health. Weight loss can improve testosterone levels, help with erectile dysfunction and increase libido.
Talk to your doctor on the healthiest way you can start losing weight.
For most men, making lifestyle changes such as eating healthier and being more active is enough for them to start losing weight. But some extremely obese men or those with serious health conditions like diabetes may need additional interventions like bariatric surgery or medication.
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