Obesity Is Associated With Low Testosterone and Sexual Dysfunction

Obesity Is Associated With Low Testosterone and Sexual Dysfunction

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.


Obesity has long been linked to diabetes, hypertension and cardiovascular disease; additionally it may contribute to erectile dysfunction (ED).

Testosterone levels peak during puberty and continue to remain relatively steady through middle age before gradually declining with obesity being an aggravating factor in this decline.


Testosterone is an essential sex hormone that affects mood, muscle mass, penis size and more. Over time it becomes naturally lower with age while certain medical conditions, medications and injuries may reduce testosterone. Being overweight also reduces your testosterone level; to raise it again if this is your issue consider weight loss to boost it further.


Body mass index (BMI) is calculated by dividing an individual's weight in kilograms by their height in meters squared to estimate body fatness and is the primary measure used in population studies to correlate weight with health issues.

Unfortunately, BMI cannot take into account body composition (muscle vs fat), age-related distribution changes of fat distribution patterns or ethnic and gender variance; nevertheless it remains an effective way of identifying individuals at risk of obesity-related diseases as it's easy to use and interpret

Obesity reduces testosterone levels due to how excess body fat is processed in the body.

Excess fat cells convert to estrogen, suppressing the hypothalamic pituitary-gonadotropin (HPG) axis that normally promotes genital development for both genders.

Its effectiveness can also be hindered by factors like increased pro-inflammatory cytokine secretion and insulin resistance caused by obesity; additional issues associated with obesity such as diabetes or sleep apnea further inhibiting its effectiveness.

University of Buffalo researchers recently conducted a study that revealed obese males aged 14-20 have up to 50% less total testosterone compared to normal-weight counterparts, increasing their chances of becoming impotent or infertile as adults.

Obesity not only decreases testosterone, but can also hinder fertility, as evidence suggests by low sperm counts and reduced motility of their sperm count. Furthermore, obesity increases risk for erectile dysfunction and kidney stones among men.

If you are overweight and struggling with low testosterone levels, one effective strategy to increase those levels would be weight loss.

As more weight is shed off, so will testosterone levels. If this has already happened and they remain low even after losing weight, there are supplements which may help boost T levels and enhance sexual drive.

Consult with your physician on which one would best meet your needs and keep weight off long term. Additionally ENDO 2019 research revealed that treatment could even prevent your testosterone from rebounding after having lost all desired pounds.

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Estrogen is an essential hormone in sexual function and reproductive health for people assigned male at birth (cisgender men, transgender women and nonbinary men).

Estrogen can affect sexual drive, the ability to get and maintain an erection and sperm production; fertility; as well as gynecomastia (enlarged breasts). Furthermore, estrogen has links with bone health, hair growth and skin.

Erections occur as the result of blood being pumped from the heart to the penis, dilatant vessels in that area dilate and expand, prompting increased flow to reach the penis.

Unfortunately, obesity-related health conditions such as diabetes, atherosclerosis, and hypertension may reduce this dilating effect and make increased amounts of blood difficult or impossible to reach the penis.

Such conditions include diabetes, atherosclerosis, and hypertension.

Obesity can also increase circulating levels of proinflammatory markers like tumor necrosis factor (TNF). This increases inflammatory activity that damages Leydig cells and interrupts LH signaling pathways, both which decrease testosterone production resulting in reduced sperm motility and count.

Excess adipose tissue can raise temperatures in the scrotal area, altering sertoli cell functions that support spermatogenesis. This may reduce motility, count and lead to infertility for men with obesity.

Eating healthy and losing weight are effective methods of helping those who are obese to enjoy normal levels of testosterone, thereby decreasing symptoms associated with obesity, such as impotence and erectile dysfunction.

When this happens, symptoms associated with obesity such as impotence can become significantly less apparent or completely disappear altogether.

Due to this reason, individuals who are obese must collaborate with a physician or nutritionist in order to meet their weight loss goals and overcome medical complications associated with obesity.

Diet, exercise and medication may all play a part. Many find that losing weight and improving their health is the way back to restoring normal testosterone and sex drive levels; in turn leading to improved relationships and quality of life for those affected by obesity.

Penile Cancer

Obesity has numerous adverse health repercussions, including increased genital cancer risk. Obese men also appear more at risk for erectile dysfunction; yet the mechanisms linking both phenomena remain unknown.

Visceral obesity is marked by increased inflammation responses that lead to endothelial dysfunction and lower testosterone levels, contributing to hypogonadism which in turn contributes to erectile dysfunction.

At the present study, children and adolescents were evaluated for their genital development and BMI using growth charts.

Children who fell within normal and obese weight categories were then matched up with controls by age and calendar year to minimize any confounding factors that may exist in these samples.

A conditional logistic regression was then employed to investigate any correlations between BMI and invasive penile cancer cases.

Results revealed a strong, statistically significant relationship between BMI and invasive penile cancer, both positively in childhood and negatively as an adult.

Higher BMI was linked with higher odds of developing invasive penile cancer; the effect was even stronger among obese participants.

Therefore, this suggests that BMI can act as an accurate predictor of risk when applied to adults; greater emphasis should be put on encouraging weight loss for those at high risk and encouraging regular self-examinations to detect early signs of cancer. 

Penile Length

Men with extreme cases of obesity may notice their penises become significantly smaller than they actually are due to fat pads in the pubic area engulfing its entire shaft, giving an illusion of shorterness.

While this phenomenon tends to affect obese men more, it could happen with men of any weight or body shape--even those who have excess abdominal fat or pelvic surgery may experience it as well.

Researchers investigating male genital growth conducted an in-depth investigation, discovering that obese boys' penis length was generally shorter than normal-weight peers throughout puberty.

This is likely due to their fat covering the penis interferes with testosterone production and causes it to decline, while their foreskin may pull tight, decreasing length and diameter of their glans.

Researchers noted that flaccid penis length measurements do not correlate with body mass index, unlike erect penis lengths, due to foreskin of the glans providing some extra length that's ignored during measurements of penis length.

Instead, according to these authors, correlating an erect penis length with BMI would be more suitable.

Another factor contributing to decreased penis length is decreased blood flow to the glans due to obesity. Lowering this flow may result in smaller glands as well as potential erectile dysfunction issues.

Obesity can damage the inner lining of blood vessels that supply the penis, and this may prevent it from expanding further.

Though its exact cause remains unknown, one theory suggests it could be tied to obesity's increased likelihood for high blood pressure and atherosclerosis; both conditions have been shown to reduce diameter in arteries that supply penises.

While not directly correlating with BMI, obese adolescents' overall trend toward shorter penis length is notable and could have serious repercussions for sexual function and confidence in both men and women.

This research represents the first assessment of genital development among obese children and adolescents, testing whether their BMI influences genitalia growth and testosterone levels during adolescence.

Results revealed that boys with elevated BMIs experienced reduced penile length growth as well as lower testosterone levels across their pubertal period.


Sexual dysfunction is an immensely troubling issue for men and can have profound repercussions for their quality of life, including sexual satisfaction and confidence.

Although obesity is associated with several diseases - diabetes, high blood pressure/cardiovascular disease, sleep apnea or high cholesterol among them - less people understand that obesity can also result in sexual problems.

One reason is because obesity reduces blood flow to the penis, making it hard for it to get and remain hard enough for a satisfying erection. Another contributing factor is plaque build-up in arteries which cuts off oxygen supply to blood vessels supplying the penis, restricting them and forcing their vessels to contract further.

Furthermore, obesity may affect penis length amongst obesity males around puberty.

Researchers conducted a case-control study, comparing 58 non-obese children and 86 obese prepubescent boys.

Each child was matched according to basic characteristics such as their Body Mass Index (BMI), height and testosterone/estradiol levels. Then the research team explored correlations among BMI, height, estradiol and the stretch of the penis length (SPL).

Researchers discovered that during puberty, obese boys' SPL was significantly lower than that of non-obese boys, as evidenced by significant negative correlations between BMI and penis length.

There was also an exponentially positive relationship between testosterone and SPL for both groups. Using multiple variable regression analysis, they concluded both height and testosterone were linked with size of penis during prepubertal phase and taken as potential risk factors for micropenis in obese boys.

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