Living with obesity increases the risk of experiencing erectile dysfunction (ED), a sexual health condition. According to the journal Andrologia, estimates show that between 30 percent and 40 percent of men with obesity or who have been diagnosed as overweight experience ED.

People with a high body mass index (BMI) are more susceptible to problems with circulation, and issues with blood flow can lead to erectile dysfunction. Fat-like particles can stick to the lining of arteries, obstructing the passage of blood through the penis, leading to effects like ED. BMI uses your height and weight to estimate body fat, but it’s important to note that it’s just one tool your doctor might use to assess your health.

This article will cover the weight-related causes of ED and how to manage and treat ED if you’re living with obesity.

What Is Erectile Dysfunction?

Erectile dysfunction, or ED for short, is the inability to get or keep an erection. Treatable medical conditions are often the cause of ED.

A 2021 survey estimated that about 24 percent of men had experienced ED, according to Statista. Although older men are more at risk, sexual health issues affect all ages.

Arousal, touch, or deep sleep triggers erections. Messages travel from the brain to the penis through the nervous system. Blood vessels open up, and blood flows into the penis. Valves trap the blood, leading to an erection. The erection ends when muscles squeeze and stop blood flow. The pressure drops as the blood flow reverses, and the penis becomes soft.

How Is Erectile Dysfunction Diagnosed?

If you suspect you may have ED, your healthcare provider will run several tests to uncover the cause of your symptoms, such as:

• Physical examination
• Blood work
• Urine sample
• Noninvasive imaging
• Mental health screening

What Causes Erectile Dysfunction?

Blood vessel and nerve issues related to diseases like diabetes can cause ED. Injuries to the penis and mental health issues can also play a role. At times, the treatment for another condition leads to erectile dysfunction. For example, heart medications for high blood pressure or diuretics (water pills) may contribute to ED.

Medications like those for high blood pressure or diuretics (water pills) may contribute to erectile dysfunction.

Medications Associated With Erectile Dysfunction

Different types of medications can lead to ED. Some of these include:

• Certain antidepressants like fluoxetine (Prozac) or anti-anxiety medications such as lorazepam (Ativan)
• Atenolol (Tenormin) and captopril, prescribed for high blood pressure
• Beta-blockers, especially older beta-blockers like propranolol, prescribed for heart and blood pressure conditions
• Statins, like atorvastatin (Lipitor), used for lowering lipid levels
• Methadone, fentanyl, and other opioids, prescribed for pain
• Famotidine (Pepcid), taken for acid reflux

If you experience ED as a drug side effect, changing the dose or medication may resolve the issue. Talk with your medical provider to discuss your options.

Can Low Testosterone Levels Cause Erectile Dysfunction?

Testosterone, a chemical messenger and sex hormone, plays an important role in sex drive. Low testosterone and high BMI levels often create a feedback loop. Hormonal imbalances prompt weight gain, but excess body fat can also cause low testosterone levels. This cycle makes it hard to know what came first. Low levels of this hormone can lead to ED, according to Cleveland Clinic. However, better health and testosterone replacement can improve your testosterone levels and associated erectile dysfunction.

Obesity and Erectile Dysfunction

Excess weight is one of several risk factors for ED. This means that having a higher weight or obesity may increase your risk of developing ED. Obesity, when severe, can make it more difficult for your blood to flow through blood vessels, and this can cause ED.

Excess weight is a risk factor for erectile dysfunction.

Some chronic health conditions linked to obesity can also damage blood vessels and nerves, contributing to ED. Because the blood vessels in the penis are small, they can become become blocked more easily.

Here are some chronic conditions linked to a high BMI, and how they may contribute to erectile dysfunction:

• High blood pressure weakens the lining of your arteries and veins.
• High glucose from diabetes mellitus thickens your blood and damages nerves.
• Inflammation from various causes can damage your blood vessels.
• Atherosclerosis causes deposits of fats and cholesterol in your arteries.
• Metabolic syndrome describes a combination of high blood pressure, increased glucose levels, high triglyceride levels, and weight around your waist, all of which can impact ED.

ED can also serve as an early sign of heart disease and other health conditions. Always tell your healthcare provider about symptoms like ED, since they may indicate other health problems.

Treating Erectile Dysfunction With Obesity

If you have ED, your healthcare provider may suggest lifestyle changes to treat the condition before trying medications or surgery. Losing weight may help improve symptoms of erectile dysfunction. Other lifestyle changes your healthcare provider might recommend to prevent and treat ED include:

• Eating a healthy diet
• Exercising
• Quitting smoking
• Limiting alcohol intake
• Avoiding marijuana and other substances

Other Treatment Options

If lifestyle changes don’t work, doctors may offer other treatment options, including:

• Medications that relax muscles and increase blood flow to the penis
• Self-injections that deliver medication to the base of the penis
• Urethral medications inserted into the tip of the penis
• Penile pumps that pull blood into the penis
• Penile implant devices that inflate or use bendable rods to produce an erection

Healthcare providers often include sex therapy or psychotherapy (also known as talk therapy) as another aspect of treatment, regardless of the other treatments used.

Talking With Healthcare Professionals

Topics like weight and sexual health may be difficult to approach with healthcare professionals. Members of MyObesityTeam have expressed a need for empathetic doctors, with one member saying, “It’s frustrating to have doctors blame most things on our weight without listening and considering other alternatives.” Finding a healthcare provider who will listen is crucial to your overall health.

Talking With Intimate Partners

Talking with intimate partners about your sexual health can be equally difficult. Feelings of depression, anxiety, and stress can impact sex drive and lead to relationship problems. Addressing sexual health topics with a trained therapist may help. It can also help to talk to others with similar issues, which can help you feel less alone.

Find Your Team

On MyObesityTeam, the social network for people with obesity and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Are you living with obesity or ED? Share your experience in the comments below, or start a conversation by posting on your Activities page.