Male sexual dysfunction in obesity

The role of sex hormones and small fibre neuropathy

Jan Hoong Ho, Safwaan Adam, Shazli Azmi, Maryam Ferdousi, Yifen Liu, Alise Kalteniece, Shaishav S. Dhage, Brian G. Keevil, Akheel A. Syed, Basil J. Ammori, Tomás Ahern, Rachelle Donn, Rayaz Malik, Handrean Soran

Research output: Contribution to journalArticle

Abstract

Context Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established. Objective We aimed to investigate the relationship between sexual function, sex hormone levels and small nerve fibre morphology in men with severe obesity. Materials and methods A prospective study of 29 men with severe obesity was undertaken. Sexual function was assessed using the European Male Ageing Study Sexual Function Questionnaire. Small nerve fibre morphology was quantified using corneal confocal microscopy. Sex hormone levels were measured by mass spectrophotometry. Results Erectile dysfunction was present in 72% of the cohort with a higher prevalence of diabetes among the symptomatic group (88% vs 38%, p = 0.006). Corneal nerve fibre length (CNFL) and corneal nerve fibre density (CNFD) were both significantly lower in participants with erectile dysfunction compared to those without (p = 0.039 and p = 0.048 respectively). The erectile function score correlated with CNFL (r = -0.418, p = 0.034) and CNFD (r = -0.411, p = 0.037). Total testosterone and calculated free testosterone levels did not differ significantly between men with or without erectile dysfunction (median 8.8 nmol/L vs 9.0 nmol/L, p = 0.914; and median 176 pmol/L vs 179 pmol/L, p = 0.351 respectively), infrequent sexual thoughts (median 8.1 nmol/L vs 9.2 nmol/L, p = 0.650; and median 184 pmol/L, vs 176 pmol/ L, p = 0.619 respectively) and decreased morning erections (median 9.0 nmol/L vs 8.8 nmol/L, p = 0.655; and median 170 pmol/L vs 193 pmol/L, p = 0.278 respectively). Conclusion Sexual dysfunction is highly prevalent in men with severe obesity. We found an association between small fibre neuropathy with erectile dysfunction with presence of diabetes a likely a significant contributing factor. We found no associations between testosterone levels with sexual symptoms (including frequency of sexual thoughts). The influence of small nerve fibre neuropathy on response to therapeutic interventions and whether interventions that improve small fibre neuropathy can improve erectile function in this population merits further study.

Original languageEnglish
Article numbere0221992
JournalPloS one
Volume14
Issue number9
DOIs
Publication statusPublished - 1 Jan 2019

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peripheral nervous system diseases
sex hormones
Gonadal Steroid Hormones
nerve fibers
Nerve Fibers
obesity
Obesity
Erectile Dysfunction
Morbid Obesity
Fibers
Testosterone
testosterone
diabetes
Medical problems
Spectrophotometry
Confocal Microscopy
Small Fiber Neuropathy
prospective studies
Prospective Studies
Confocal microscopy

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Ho, J. H., Adam, S., Azmi, S., Ferdousi, M., Liu, Y., Kalteniece, A., ... Soran, H. (2019). Male sexual dysfunction in obesity: The role of sex hormones and small fibre neuropathy. PloS one, 14(9), [e0221992]. https://doi.org/10.1371/journal.pone.0221992

Male sexual dysfunction in obesity : The role of sex hormones and small fibre neuropathy. / Ho, Jan Hoong; Adam, Safwaan; Azmi, Shazli; Ferdousi, Maryam; Liu, Yifen; Kalteniece, Alise; Dhage, Shaishav S.; Keevil, Brian G.; Syed, Akheel A.; Ammori, Basil J.; Ahern, Tomás; Donn, Rachelle; Malik, Rayaz; Soran, Handrean.

In: PloS one, Vol. 14, No. 9, e0221992, 01.01.2019.

Research output: Contribution to journalArticle

Ho, JH, Adam, S, Azmi, S, Ferdousi, M, Liu, Y, Kalteniece, A, Dhage, SS, Keevil, BG, Syed, AA, Ammori, BJ, Ahern, T, Donn, R, Malik, R & Soran, H 2019, 'Male sexual dysfunction in obesity: The role of sex hormones and small fibre neuropathy', PloS one, vol. 14, no. 9, e0221992. https://doi.org/10.1371/journal.pone.0221992
Ho JH, Adam S, Azmi S, Ferdousi M, Liu Y, Kalteniece A et al. Male sexual dysfunction in obesity: The role of sex hormones and small fibre neuropathy. PloS one. 2019 Jan 1;14(9). e0221992. https://doi.org/10.1371/journal.pone.0221992
Ho, Jan Hoong ; Adam, Safwaan ; Azmi, Shazli ; Ferdousi, Maryam ; Liu, Yifen ; Kalteniece, Alise ; Dhage, Shaishav S. ; Keevil, Brian G. ; Syed, Akheel A. ; Ammori, Basil J. ; Ahern, Tomás ; Donn, Rachelle ; Malik, Rayaz ; Soran, Handrean. / Male sexual dysfunction in obesity : The role of sex hormones and small fibre neuropathy. In: PloS one. 2019 ; Vol. 14, No. 9.
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abstract = "Context Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established. Objective We aimed to investigate the relationship between sexual function, sex hormone levels and small nerve fibre morphology in men with severe obesity. Materials and methods A prospective study of 29 men with severe obesity was undertaken. Sexual function was assessed using the European Male Ageing Study Sexual Function Questionnaire. Small nerve fibre morphology was quantified using corneal confocal microscopy. Sex hormone levels were measured by mass spectrophotometry. Results Erectile dysfunction was present in 72{\%} of the cohort with a higher prevalence of diabetes among the symptomatic group (88{\%} vs 38{\%}, p = 0.006). Corneal nerve fibre length (CNFL) and corneal nerve fibre density (CNFD) were both significantly lower in participants with erectile dysfunction compared to those without (p = 0.039 and p = 0.048 respectively). The erectile function score correlated with CNFL (r = -0.418, p = 0.034) and CNFD (r = -0.411, p = 0.037). Total testosterone and calculated free testosterone levels did not differ significantly between men with or without erectile dysfunction (median 8.8 nmol/L vs 9.0 nmol/L, p = 0.914; and median 176 pmol/L vs 179 pmol/L, p = 0.351 respectively), infrequent sexual thoughts (median 8.1 nmol/L vs 9.2 nmol/L, p = 0.650; and median 184 pmol/L, vs 176 pmol/ L, p = 0.619 respectively) and decreased morning erections (median 9.0 nmol/L vs 8.8 nmol/L, p = 0.655; and median 170 pmol/L vs 193 pmol/L, p = 0.278 respectively). Conclusion Sexual dysfunction is highly prevalent in men with severe obesity. We found an association between small fibre neuropathy with erectile dysfunction with presence of diabetes a likely a significant contributing factor. We found no associations between testosterone levels with sexual symptoms (including frequency of sexual thoughts). The influence of small nerve fibre neuropathy on response to therapeutic interventions and whether interventions that improve small fibre neuropathy can improve erectile function in this population merits further study.",
author = "Ho, {Jan Hoong} and Safwaan Adam and Shazli Azmi and Maryam Ferdousi and Yifen Liu and Alise Kalteniece and Dhage, {Shaishav S.} and Keevil, {Brian G.} and Syed, {Akheel A.} and Ammori, {Basil J.} and Tom{\'a}s Ahern and Rachelle Donn and Rayaz Malik and Handrean Soran",
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T1 - Male sexual dysfunction in obesity

T2 - The role of sex hormones and small fibre neuropathy

AU - Ho, Jan Hoong

AU - Adam, Safwaan

AU - Azmi, Shazli

AU - Ferdousi, Maryam

AU - Liu, Yifen

AU - Kalteniece, Alise

AU - Dhage, Shaishav S.

AU - Keevil, Brian G.

AU - Syed, Akheel A.

AU - Ammori, Basil J.

AU - Ahern, Tomás

AU - Donn, Rachelle

AU - Malik, Rayaz

AU - Soran, Handrean

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Context Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established. Objective We aimed to investigate the relationship between sexual function, sex hormone levels and small nerve fibre morphology in men with severe obesity. Materials and methods A prospective study of 29 men with severe obesity was undertaken. Sexual function was assessed using the European Male Ageing Study Sexual Function Questionnaire. Small nerve fibre morphology was quantified using corneal confocal microscopy. Sex hormone levels were measured by mass spectrophotometry. Results Erectile dysfunction was present in 72% of the cohort with a higher prevalence of diabetes among the symptomatic group (88% vs 38%, p = 0.006). Corneal nerve fibre length (CNFL) and corneal nerve fibre density (CNFD) were both significantly lower in participants with erectile dysfunction compared to those without (p = 0.039 and p = 0.048 respectively). The erectile function score correlated with CNFL (r = -0.418, p = 0.034) and CNFD (r = -0.411, p = 0.037). Total testosterone and calculated free testosterone levels did not differ significantly between men with or without erectile dysfunction (median 8.8 nmol/L vs 9.0 nmol/L, p = 0.914; and median 176 pmol/L vs 179 pmol/L, p = 0.351 respectively), infrequent sexual thoughts (median 8.1 nmol/L vs 9.2 nmol/L, p = 0.650; and median 184 pmol/L, vs 176 pmol/ L, p = 0.619 respectively) and decreased morning erections (median 9.0 nmol/L vs 8.8 nmol/L, p = 0.655; and median 170 pmol/L vs 193 pmol/L, p = 0.278 respectively). Conclusion Sexual dysfunction is highly prevalent in men with severe obesity. We found an association between small fibre neuropathy with erectile dysfunction with presence of diabetes a likely a significant contributing factor. We found no associations between testosterone levels with sexual symptoms (including frequency of sexual thoughts). The influence of small nerve fibre neuropathy on response to therapeutic interventions and whether interventions that improve small fibre neuropathy can improve erectile function in this population merits further study.

AB - Context Multiple factors contribute to sexual dysfunction in men with obesity. Sex hormone levels are commonly abnormal in men with obesity and this abnormality is often the focus of management in clinical practice. The role of small fibre neuropathy in obesity-related sexual dysfunction is not well established. Objective We aimed to investigate the relationship between sexual function, sex hormone levels and small nerve fibre morphology in men with severe obesity. Materials and methods A prospective study of 29 men with severe obesity was undertaken. Sexual function was assessed using the European Male Ageing Study Sexual Function Questionnaire. Small nerve fibre morphology was quantified using corneal confocal microscopy. Sex hormone levels were measured by mass spectrophotometry. Results Erectile dysfunction was present in 72% of the cohort with a higher prevalence of diabetes among the symptomatic group (88% vs 38%, p = 0.006). Corneal nerve fibre length (CNFL) and corneal nerve fibre density (CNFD) were both significantly lower in participants with erectile dysfunction compared to those without (p = 0.039 and p = 0.048 respectively). The erectile function score correlated with CNFL (r = -0.418, p = 0.034) and CNFD (r = -0.411, p = 0.037). Total testosterone and calculated free testosterone levels did not differ significantly between men with or without erectile dysfunction (median 8.8 nmol/L vs 9.0 nmol/L, p = 0.914; and median 176 pmol/L vs 179 pmol/L, p = 0.351 respectively), infrequent sexual thoughts (median 8.1 nmol/L vs 9.2 nmol/L, p = 0.650; and median 184 pmol/L, vs 176 pmol/ L, p = 0.619 respectively) and decreased morning erections (median 9.0 nmol/L vs 8.8 nmol/L, p = 0.655; and median 170 pmol/L vs 193 pmol/L, p = 0.278 respectively). Conclusion Sexual dysfunction is highly prevalent in men with severe obesity. We found an association between small fibre neuropathy with erectile dysfunction with presence of diabetes a likely a significant contributing factor. We found no associations between testosterone levels with sexual symptoms (including frequency of sexual thoughts). The influence of small nerve fibre neuropathy on response to therapeutic interventions and whether interventions that improve small fibre neuropathy can improve erectile function in this population merits further study.

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