Tuesday, 12 November 2013

Obesity and Impotence

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. Impotence is classified as a condition of erectile dysfunction of male with characteristic of inability maintain an erection of the penis during sexual intercourse.

C. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

D. How Obesity associates with Impotence
1. In a study of "Obesity and sexual dysfunction, male and female" by Esposito K, Giugliano F, Ciotola M, De Sio M, D'Armiento M, Giugliano D" ( from Source Division of Metabolic Diseases, Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy. katherine.esposito@unina2.it, Int J Impot Res. 2008 Jul-Aug;20(4):358-65. Epub 2008 Apr 10), posted in PubMed, researchers stated that
a. Overweight and obesity may increase the risk of erectile dysfunction (ED) by 30-90% as compared with normal weight subjects. On the other hand, subjects with ED tend to be heavier and with a greater waist than subjects without ED, and also are more likely to be hypertensive and hypercholesterolemic.
b. The metabolic syndrome, characterized by a clustering of risk factors associated with insulin resistance and abdominal obesity, associates with ED.

2. According to the abstract of study of "Mechanisms of obesity and related pathologies: androgen deficiency and endothelial dysfunction may be the link between obesity and erectile dysfunction" by Traish AM, Feeley RJ, Guay A. (Source from Department of Biochemistry and Urology, Boston University School of Medicine, MA 02118, USA. atraish@bu.edu, FEBS J. 2009 Oct;276(20):5755-67. Epub 2009 Sep 15), posted in PubMed, researchers found that visceral obesity, a component of the metabolic syndrome, adversely affects endothelial function and testosterone levels, contributing to hypogandism and erectile dysfunction. Thus, clinical screening for the risk of erectile dysfunction in obese patients should include the assessment of waist circumference, testosterone levels, body mass index and physical inactivity.

3. According to the study of "Androgen deficiency and abnormal penile duplex parameters in obese men with erectile dysfunction" by Zohdy W, Kamal EE, Ibrahim Y. (Source from University of Cairo, Department of Andrology, Cairo, Egypt. wzohdy62@hotmail.com, J Sex Med. 2007 May;4(3):797-808), posted in PubMed, researchers indicated that Obesity is associated with lower TT and disturbances of penile hemodynamics. It is an independent clinical factor for vasculogenic ED.

4. In a study of "Obesity, low testosterone levels and erectile dysfunction" by Diaz-Arjonilla M, Schwarcz M, Swerdloff RS, Wang C. (Source from Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90803, USA.Int J Impot Res. 2009 Mar-Apr;21(2):89-98. Epub 2008 Oct 9), researchers found that the relationships between low serum testosterone concentrations and ED in obese patients and those with metabolic syndrome and type 2 diabetes mellitus.

5. According to the abstract of study of "Complications of a buried penis in an extremely obese patient" by Mattsson B, Vollmer C, Schwab C, Padevit C, Horton K, John H, Horstmann M. (Source from Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.© 2011 Blackwell Verlag GmbH), posted in PubMed, researchers concluded that Whereas acute complications of a buried penis in obese patients include local infection and urinary retention, chronic problems are undirected voiding, disturbed vaginal penetration and erectile dysfunction. Even though several surgical techniques are described, weight reduction should be primarily preferred.

6. In a study of "Body mass index regulates hypogonadism-associated CV risk: results from a cohort of subjects with erectile dysfunction" by Corona G, Rastrelli G, Monami M, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, Maggi M. (Source from Sexual Medicine and Andrology Unit, University of Florence, Florence, Italy, © 2011 International Society for Sexual Medicine.), posted in PubMed, researchers found that Hypogonadism-associated CV risk depends on the characteristics of subjects, being more evident in normal weight than in obese patients. Further studies are advisable to clarify if low T in obese patients is a (positive) consequence of a comorbid condition (i.e., to save energy) or if it represents a pathogenetic issue of the same illness. Hence, possible misuse/abuse of T treatment in obese subjects must be avoided.

7. Etc.

E.Treatments of Obesity and Impotence
1. According to the study of "The importance of risk factor reduction in erectile dysfunction" by
Jackson G. (Source from Cardiothoracic Centre, 6th floor, East Wing, St. Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, United Kingdom. gjcardiol@talk21.com, Curr Urol Rep. 2007 Nov;8(6):463-6.), posted in PubMed, researchers Intensive intervention with lifestyle advice focusing on a healthy diet, weight loss, and increased physical activity benefits men with ED, reducing the markers of inflammation and improving endothelial function. Though phosphodiesterase type 5 inhibitors are highly effective in treating ED, lifestyle advice and aggressive risk reduction remain fundamental to the overall vascular good health of the individual.

2. In a study of "Beneficial impact of exercise and obesity interventions on erectile function and its risk factors" by Hannan JL, Maio MT, Komolova M, Adams MA. (Source fromDepartment of Pharmacology and Toxicology, Queen's University, Kingston, Ontario, Canada,J Sex Med. 2009 Mar;6 Suppl 3:254-61), posted in PubMed, the result showed that Physical inactivity negatively impacts on erectile function, and experimental and clinical exercise interventions have been shown to improve sexual responses and overall cardiovascular health. Mediterranean-style diets and a reduction in caloric intake have been found to improve erectile function in men with the aspects of the metabolic syndrome. In addition, both clinical and experimental studies have confirmed that combining the two interventions provides additional benefit to erectile function, likely via reduced metabolic disturbances (e.g., inflammatory markers, insulin resistance), decreased visceral adipose tissue, and improvement in vascular function (e.g., increased endothelial function), researchers concluded that Lifestyle modifications provide significant benefits to vascular health and erectile function in a population that is increasingly aged and more obese.

3. In an abstract of the study of "Physical activity and erectile dysfunction in middle-aged men : a brief review" by La Vignera S, Condorelli R, Vicari E, D'Agata R, Calogero A. (J Androl. 2011 May 19. [Epub ahead of print]), posted in PubMed researchers found that Conflicting data regarding the effects of exercise on the androgen status. In clinical practice would be recommended to add regular physical activity to balanced diet and drugs to achieve better therapeutic results.

4. Etc.
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