title: Hypogonadism as a possible link between metabolic diseases and erectile dysfunction in aging men.
abstract: There is evidence demonstrating that sexual complaints represent the most specific symptoms associated with late onset hypogonadism, while central obesity is the most specific sign. In obese men, hypogonadism can further worsen the metabolic profile and increase abdominal fat. In addition, although hypogonadism can exacerbate obesity-associated erectile dysfunction (ED), recent data suggest that a direct contribution of fat-derived factors could be hypothesized. In particular, an animal model recently documented that fat accumulation induces several hepatic pro-inflammatory genes closely linked to corpora cavernosa endothelial dysfunction. Lifestyle modifications and weight loss are the first steps in the treatment of ED patients with obesity or metabolic diseases. In symptomatic hypogonadal men with metabolic impairment and obesity, combining the effect of testosterone substitution with lifestyle modifications could result in better outcomes.
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Medical Department, Azienda-Usl Bologna, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Medical Department, Azienda-Usl Bologna, Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bianchini
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Medical Department, Azienda-Usl Bologna, Bologna, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sforza
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence; Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Vignozzi
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence; Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology; D050154:Adiposity; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D010410:Penile Erection; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013739:Testosterone / Q000172:deficiency / Q000627:therapeutic use; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D013739:Testosterone