Can Belly Fat Cause Erectile Dysfunction? Obesity & Sexual Health

Belly fat is related to decreased testosterone, insulin resistance, increased inflammation, and a risk for early atherosclerosis. It can also change body composition, strength, and the ability to achieve and prevent losing erection quickly.

In the following subsections, we will review these risk factors in greater detail.

Reduced Testosterone Levels

Belly fat can cause a decline in testosterone levels and lead to deficiency. In contrast, high testosterone levels reduce or prevent belly fat in men. This means that belly fat in men is regulated by testosterone. Men with belly fat are more likely to develop ED, which worsens as obesity severity increases. Belly fat contains a high amount of the enzyme aromatase, which converts testosterone into estrogen. Thus, reduced testosterone levels are followed by increased estrogen levels, which further causes hormonal imbalances leading to ED.

Poor Blood Circulation

Belly fat promotes plaque buildup in arteries, which negatively impacts erectile function. Erections are heavily reliant on proper blood flow to the penile tissues. Narrowing of the blood vessels disrupts endothelial function and impairs blood flow to the penis. ED precedes heart problems and may serve as an early warning sign of cardiovascular issues. In men aged 40 to 70 years, the incidence of ED was reported to be 52%. However, when men without signs of coronary artery disease were screened, the prevalence of ED was only 2% for men aged 40 to 49 years and 39% for men aged 70 years. The relationship between ED and heart disease is as strong as it is with other risk factors such as family history, smoking, and high cholesterol.

Insulin Resistance and Diabetes

ED affects at least 50% of men with diabetes mellitus, causing ED through various pathophysiological pathways, such as neuropathy, endothelial dysfunction, and hormonal changes. Reduced testosterone levels are commonly found in men with diabetes, which must be identified and managed to prevent progressive ED. In addition, ED and diabetes negatively affect male self-esteem and lead to depression and anxiety. ED is also a strong predictor of poor quality of life in men with diabetes. Concealed diabetes mellitus is often preceded by prolonged insulin resistance. Excessive belly fat triggers inflammation in the body and worsens insulin resistance. Insulin resistance affects 25% of adults in the United States, increasing to 60% among those who are overweight. It affects endothelial function and alters nitric oxide production, hindering proper blood vessel dilatation and resulting in sexual dysfunction.

Inflammation and Oxidative Stress

Oxidative stress plays a role as the critical factor linking obesity with its associated complications. Excess adipose tissue stimulates inflammatory cytokines and increases oxidative stress, leading to vascular dysfunction. Vascular dysfunction limits the body’s ability to produce nitric oxide, which hinders proper blood vessel dilatation and prevents proper sexual function. On the other hand, oxidative stress could trigger obesity by stimulating fat tissue deposition and altering food intake, creating a vicious cycle.