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ASK DR.K: I Can't See My Toes

Dear Dr. K, How does being overweight affect ED?



Most men, unless they are “genetically blessed” or are committed fitness junkies, tend to put on weight as they age, especially around the waist. That “spare tire” causes a multi-pronged attack on a guy’s erection as well as his general health.


Being overweight is usually associated with other medical problems, among which are high blood pressure, elevated cholesterol, and diabetes - hallmarks of metabolic syndrome.


What specifically is going on in fat cells that causes problems?


First, fall cell metabolism tends to produce toxic “free radicals.” These molecules cause inflammatory damage to the cells lining your blood vessels. These microinflammatory injuries are “repaired” by cholesterol molecules which leads to the formation of cholesterol plaques in the walls of the arteries, i.e. “hardening of the arteries.” The blood vessels eventually are so thickened that they cannot dilate adequately enough to allow increased bloodflow when needed. This may lead to heart attack, stroke, or ED. In fact, the latter may be the first warning sign of a possible heart attack or stroke. This inflammatory damage also results in a decreased ability of the cells to release nitric oxide which causes the blood vessels to dilate.


The second problem with being overweight is that fat cells reduce testosterone blood levels. How does this happen? Fat cells, especially those in the abdomen (“spare tire”) contain an enzyme called aromatase. This little mischief-maker converts testosterone to estradiol-the major female hormone. A guy needs a little estradiol. It helps with his libido among other things. But too much estradiol causes more fat to be deposited in the belly with more aromatase to convert more testosterone to estradiol which leads to more belly fat, and so on. You get the picture and you get “man boobs.”

There are other significant risks to being overweight-high blood pressure, diabetes, wear and tear on joints, especially knees and hips, sleep apnea. Each of these is detrimental to anyone’s well-being and in combination pose considerable risks to a person’s health and life.


Any program for the treatment of ED should incorporate information on nutrition and physical activity. The staff and physician of Renewal Medical Centers of North Texas are available to discuss these and other issues with you.

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