At the Heart of Men's Sexual Problems

Metabolic syndrome occurred more often in men with erectile dysfunction and low testosterone

/ Author:  / Reviewed by: Chris Galloway, M.D. Beth Bolt, RPh

(RxWiki News) For men who decide to see their doctor for sexual issues, it may be a good idea to get the heart checked out at the same time. 

A recent study found that metabolic syndrome occurred more often among men with low levels of testosterone, which is the male sex hormone. Signs of the syndrome could mean type 2 diabetes, stroke and other heart problems in the future.

According to the authors of this study, their findings show that heart and cardiovascular health ought to be assessed in patients seeking medical care for sexual dysfunction, which includes sexual desire disorders, arousal issues, orgasm disorders and pain.

"Get your heart checked while visiting the doctor for sexual problems."

Eduardo García-Cruz, MD, from the Department of Urology at the Hospital Clinic de Barcelona in Spain, led this investigation that aimed to identify any cardiovascular risk factors and illnesses that were related to metabolic syndrome among middle-aged men with low levels of testosterone.

Metabolic syndrome is a group of factors that can increase the risk for coronary artery disease, type 2 diabetes and stroke when the factors occur together.

In total, 1,094 participants were recruited for this study during health care office visits in Spain between October 2009 and December 2010. These participants were at least 45 years of age and about 61 years old on average.

Each of the participants was required to have total testosterone levels of less than 8 nanomoles per liter and a confirmed diagnosis of testosterone deficiency.

The participants reported whether they used tobacco products and consumed more than two glasses of wine or beer each day or more than four hard alcohol drinks each week.

The researchers also measured participants’ waist size. Those who had a waist circumference of more than 102 centimeters and a body mass index (BMI) of more than 30 kilograms per square meter were considered obese. BMI is a measure of height and weight that shows if someone is overweight, obese or at a healthy weight.

The researchers tracked any cardiovascular illnesses related to metabolic syndrome and whether patients were diagnosed with erectile dysfunction (ED) as defined on a scale of 25 through the International Index of Erectile Function questionnaire.

In this study, metabolic syndrome was diagnosed as having at least three out of five signs for the condition, which include abdominal obesity, fatty acid levels of more than 150 milligrams per deciliter, high blood pressure, high fasting blood sugar and reduced levels of HDL cholesterol (the "good" cholesterol).

The researchers found that 97.6 percent of the participants had erectile dysfunction and 69 percent had metabolic syndrome.

About a third of all participants had three signs of metabolic syndrome. About 27 percent of all participants had four signs and about 21 percent had only two signs. High blood pressure was found in 85 percent of participants and abdominal obesity was found in a little more than 81 percent.

The researchers found three main factors that led to metabolic syndrome. These factors included having moderate or severe erectile dysfunction, having peripheral artery disease (the narrowing of arteries in the legs and pelvis) and being obese.

Those who were obese or had peripheral artery disease were more than two and a half times more likely to have metabolic syndrome compared to those who were not obese or did not have peripheral artery disease.

Patients with low testosterone who also drank large amounts of alcohol were about 91 percent more likely to develop metabolic syndrome than those who did not drink.

Factors that were not tied to metabolic syndrome included tobacco use, age and severity of testosterone deficiency.

The researchers also found that combined with a low level of testosterone, higher levels of fat and “good” cholesterol also became risk factors for metabolic syndrome.

“Coexistence of metabolic syndrome, ED, and testosterone deficiency can lead to increased cardiovascular risk,” the researchers wrote in their report. “Identification of patients at a greater risk allows the implementation of intensive measures to reduce the risk.”

The researchers noted that the participants selected for the study were chosen based on a single measurement of testosterone. Testosterone levels could have changed throughout the course of the study.

In addition, the researchers were unable to measure the extent that men with deficient levels of testosterone were affected by metabolic syndrome since the study did not compare metabolic syndrome conditions in men without low testosterone.

This study was published July 30 in The Journal of Sexual Medicine. No conflicts of interest were reported.

The study was funded using an unrestricted grant from Bayer Hispania SL.

Review Date: 
August 11, 2013
Last Updated:
December 30, 2013