Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: a prospective randomized controlled trial

The effects of weight loss on erectile function and hormones have not been well studied. The aim of this study was to measure the degree to which sexual function and in particular erectile function and hormonal environment change after substantial weight loss, surgically and non-surgically induced i...

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Published in:	International journal of andrology Vol. 33; no. 5; pp. 736 - 744
Main Authors:	Reis, L.O, Favaro, W.J, Barreiro, G.C, de Oliveira, L.C, Chaim, E.A, Fregonesi, A, Ferreira, U
Format:	Journal Article
Language:	English
Published:	Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01-10-2010 Blackwell Publishing Ltd Blackwell
Subjects:	Adult Biological and medical sciences erectile dysfunction Erectile Dysfunction - surgery Estradiol - blood Follicle Stimulating Hormone - blood Fundamental and applied biological sciences. Psychology gastric bypass Gastric Bypass - statistics & numerical data Gynecology. Andrology. Obstetrics Humans impotence Life Style lifestyle modifications Luteinizing Hormone - blood Male Male genital diseases Mammalian male genital system Medical sciences Metabolic diseases Middle Aged morbidly obese Non tumoral diseases Obesity Obesity, Morbid - physiopathology Obesity, Morbid - surgery Penile Erection Prolactin - blood prospectively randomized controlled trial sexual function sexual hormones Vertebrates: reproduction Weight Loss Hormone Stomach Obesity Erection disorders Digestive system Impotence prospectively randomized controlled trial Nutrition disorder Male morbidly obese Male genital system erectile dysfunction lifestyle modifications Reproduction Treatment sexual function Bypass Surgery Clinical trial Male genital diseases sexual hormones Nutritional status gastric bypass
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Summary:	The effects of weight loss on erectile function and hormones have not been well studied. The aim of this study was to measure the degree to which sexual function and in particular erectile function and hormonal environment change after substantial weight loss, surgically and non-surgically induced in the morbidly obese male in a prospective randomized long-term controlled trial. Furthermore, how surgery makes a difference when treating morbidly obese men was envisaged in this context. We prospectively studied 20 morbidly obese men for 24 months, divided into two groups: group A included 10 patients who underwent life style modifications (exercise and diet) for 4 months and subsequently gastric bypass, and another 10 patients in group B were kept on weekly follow-up. None of the men were taking phosphodiesterase type-5 inhibitors. All patients underwent International Index of Erectile Function (IIEF)-5 questionnaire, serum oestradiol, prolactin (PRL), luteinizing (LH) and follicle-stimulating (FSH) hormones, free and total testosterone (FT and TT) at baseline (time 0), surgery - 4 months latter baseline (time 1) and final evaluation - 24 months (time 2). From times 0 to 1, group A presented a mean body mass index (BMI) reduction of 12.6 (p < 0.0001), whereas group B, 2.1 (p > 0.05). The BMI reductions between times 0 and 2 were 24.7 (p < 0.0001) and 0.7 (p > 0.05) for groups A and B respectively. BMI average between the two groups was similar at time 0 (p = 0.2142), and different at times 1 (p = 0.0033) and 2 (p < 0.0006). Increase in IIEF-5 score (p = 0.0469), TT (p = 0.0349) and FSH levels (p = 0.0025), and reduction in PRL level (p < 0.0001) were observed in group A from times 0 to 2 and 1 to 2. There were no changes from times 0 to 1. Comparing groups A and B at time 2, IIEF-5, TT and FT increased significantly in group A (p = 0.0224, 0.0043 and 0.0149 respectively). Surgery-induced weight loss increased erectile function quality measured by IIEF-5 questionnaire, increased TT, FT and FSH and reduced PRL levels. The hormonal impact verified could justify the improvement in erectile function. Lifestyle modifications impacted BMI without hormonal or sexual impact in morbidly obese. New studies are warranted in the field to support our data.
Bibliography:	http://dx.doi.org/10.1111/j.1365-2605.2009.01017.x istex:200263EA281D1DC263A5096B0E4FE88D9B5503F7 ark:/67375/WNG-XMQC8JC9-Z ArticleID:IJAN1017 Leonardo Oliverira Reis presented this work at the American Urological Association Annual Meeting Podium (Chicago, IL, USA) on 30 April 2009. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0105-6263 1365-2605
DOI:	10.1111/j.1365-2605.2009.01017.x