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26.01.2013

Stomach reduction helps testosterone level but not erection

If extremely obese men lose weight after having a stomach reduction, their testosterone levels rise to levels found in healthy, slim men. But the erection problems that many obese men suffer from don't disappear, write Brazilian doctors working at the Hospital das Clinicas in Sao Paulo in Surgery for Obesity and Related Diseases.

Fat mass & testosterone
Fat men have less testosterone in their blood than slim men. Too much body fat disturbs the body's hormone balance and reduces testosterone production. Some studies have shown that overweight can reduce the concentration of testosterone by as much as a half.

Declining testosterone levels as men age are not entirely due to the process of aging. It's also a consequence of the growing belly they develop and the decline in health that accompanies this. [Urology. 2003 Mar;61(3): 629-33.] It's not surprising that obese men often have erection problems. [JAMA. 2004 Jun 23;291(24): 2978-84.]

The solution is simple. If overweight men lose weight their testosterone levels rise and their erections improve.

Study
But for some men losing weight is too difficult, so they resort to an operation. This is what the 23 men that the Brazilians studied had done. Now aged between 30 and 65, they had all had a Roux-en-Y gastric bypass six to fourteen years previously.

Surgeons perform their tricks on the stomach and small intestine, so food only passes through a small part of the stomach, going directly to the small intestine. The rest of the stomach is kept in place, and continues to produce enzymes and juices, which make their way to the small intestine where they help with the process of digestion.

The researchers compared the men who had been operated on with a dozen healthy, slim men, and a dozen obese men who had not undergone an operation. The results are shown in the table below.

The testosterone level in the men who had had the operation was the same as that of the healthy men. But the scores on the International Index of Erectile Function questionnaire [IIEF] were not the same. Despite the operation these men still had erection problems.

Conclusion
"The normalization of some, but not all, preoperative clinical aberrations could underlie the dichotomy between the obviously elevated testosterone levels and the incompletely restored sexual drive and performance", the Brazilians write. "General health benefitted from gastric bypass, as demonstrated by the robust weight loss and a healthier metabolic profile than comparable nonoperated obese participants."

"All these advantages notwithstanding, many participants were still affected by residual obesity, sleep apnea, arterial hypertension, and assorted aberrations of glucose and lipid homeostasis, which could interfere with erectile function."

Source:
Surg Obes Relat Dis. 2013 Sep-Oct;9(5):636-40.

More:
Overweight halves teenagers' testosterone levels 31.10.2012
Weight loss makes fat men more masculine 12.10.2011
Fat belly neutralises DHT 29.12.2010

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