Obesity and Erectile Dysfunction: From Bench to Clinical Implication
- Author:
Ki Hak MOON
1
;
So Young PARK
;
Yong Woon KIM
Author Information
- Publication Type:Review
- Keywords: Erectile dysfunction; Metformin; Obesity; Phosphodiesterase 5 inhibitors
- MeSH: Animals; Body Weight; Comorbidity; Erectile Dysfunction; Humans; Inflammation; Insulin; Leptin; Male; Metformin; Obesity; Oxidative Stress; Phosphodiesterase 5 Inhibitors; Public Health; Sildenafil Citrate; Soil; Vasodilator Agents
- From:The World Journal of Men's Health 2019;37(2):138-147
- CountryRepublic of Korea
- Language:English
- Abstract: Obesity is a major public health issue worldwide and is frequently associated with erectile dysfunction (ED). Both conditions may share an internal pathologic environment, also known as common soil. Their main pathophysiologic processes are oxidative stress, inflammation, and resultant insulin and leptin resistance. Moreover, the severity of ED is correlated with comorbid medical conditions, including obesity. Therefore, amelioration of these comorbidities may increase the efficacy of ED treatment with phosphodiesterase 5 inhibitors, the first-line medication for patients with ED. Although metformin was originally developed as an insulin sensitizer six decades ago, it has also been shown to improve leptin resistance. In addition, metformin has been reported to reduce oxidative stress, inflammatory response, and body weight, as well as improve ED, in animal and human studies. Moreover, administration of a combination of metformin and phosphodiesterase 5 inhibitors improves erectile function in patients with ED who have a poor response to sildenafil and are insulin resistant. Thus, concomitant treatment of metabolic derangements associated with obesity in patients with ED who are obese would improve the efficacy and reduce the refractory response to penile vasodilators. In this review, we discuss the connecting factors between obesity and ED and the possible combined treatment modalities.
