Obesity contributes to a myriad of conditions- right from heart disease to joint disorders, but another, often undiscussed yet extremely important issue related to obesity is - sexual problems. Sex life is usually affected in morbidly obese individuals. Research tells us that obese people have 25 times more chances of having sex related problems when compared to people with normal BMI.
Obesity and male sexual dysfunction
Obesity or excess body weight in men can lead to erectile dysfunction. Obese people usually have hypercholesterolemia; excess cholesterol in blood gets deposited on the inner walls of the blood vessels and causes narrowing of the blood vessels. Erection occurs when there is adequate blood flow to the penis. In obese men, atherosclerotic deposits in the penile blood vessels may cause reduced blood flow to the penis, leading to erectile dysfunction. People with abdominal obesity are at greater risk of developing erectile dysfunction.
Obesity and female sexual dysfunction
Obese people gradually develop insulin resistance. Insulin resistance alters the regulation of sex hormones in the body. This causes increased production of androgens (male sex hormones), and reduced production of estrogen (female sex hormones) in women, which is responsible for female sexual dysfunction. Women with metabolic syndrome are at greater risk of sexual dysfunction.
Obesity and infertility
Infertility is defined as the inability to conceive after one year of unprotected intercourse. Various studies show that being obese not only affect one’s sexual life but also causes infertility (male/ female).
Obesity and female infertility:
W H O tells us that nearly 50-80 million women world-over have infertility. The risk of infertility is three times more in obese women than non-obese women. Obesity increases the risk of PCOD which is a major risk factor for infertility.
Infertility in women is primarily driven by two mechanisms- hyperinsulinemia and hyperandrogenemia. Increased adipokines (chemicals released by the fatty tissue) levels lead to hyperinsulinemia. Derangement of hypothalamic- pituitary pathway leads to hyperandrogenemia. Obesity can eventually lead to impaired development of the ovarian follicles (which contain the egg), impaired qualitative and quantitative development of the female eggs, decreased chances of fertilization, embryo development, and implantation.
Obese women also find it difficult to conceive by assisted reproductive technologies. Advanced treatments, such as in vitro fertilization (IVF), also does not show good success rates in obese women. IVF procedures makes the egg retrieval and embryo transfer more difficult in obese women.
Obesity and male infertility:
Studies show an association between high body mass index and low testicular volume, and impaired sperm production. Increased weight is also associated with low testosterone levels. Obesity in males may cause alterations in the sperm parameters like sperm count, total motile sperm count, sperm structure and sperm DNA changes.
Studies tells us this:
- High BMI is associated with reduced levels of sex hormone binding globulin (SHBG) and testosterone and high levels of plasma concentration of estrogen. This affects sperm quality and quantity.
- Hyper-insulinemia contribute to low testosterone levels
- Sleep apnea which is common in obese people is associated with decreased pituitary gonadal function and decreased morning testosterone concentrations.
- High temperatures in the scrotum due to excess fats could damage sperms.
- Metabolic syndrome is associated with hypogonadism and erectile dysfunction.
- Obesity increases the risk of oxidative stress induced damage of sperm DNA
Treatment of obesity related sexual dysfunction and infertility
Weight loss is the ultimate step to treat sexual or reproductive problems in the obese people. A reduction in calories of 500 to 1,000 kcal/day will help achieve a weight loss of 1 to 2 pounds per week. It can be achieved by the following steps:
- Follow a strict diet by reducing high calorie foods and increase in fiber-rich foods, such as green vegetables, fruits, fish oil, nuts, etc.
- Maintain the daily step count of minimum 10,000 steps/day, which can be measured using pedometer.
- Involve in the physical activity or exercise for 30 minutes for at least three to four days per week.
- Reduce the levels of high blood pressure, high blood sugar if present.
- Avoid consuming alcohol and stop smoking.
A person with PCOS should reduce the weight and take the prescribed medications to prevent the risk of fertility problems. Regularly monitor the cholesterol levels, not only to reduce the risk of sexual dysfunction and infertility problems, but also to prevent other obesity-related disorders.
Keep a check on your health
Sexual dysfunction and infertility in obesity are mainly caused by hormonal imbalances. Weight loss is an important step to reduce obesity-related sexual problems. Even 5-10% of weight loss can help reduce the ovulation problems and improve pregnancy rates. Undergo regular check-up of the cholesterol levels and follow the healthy life-style changes to reduce the obesity and its associated sexual problems. Indulge in the counselling programs, which not only improve the psychological state but also reduces obesity and prevent the risk of sexual dysfunction and fertility.
