Treatment of Obesity-Related ED (Erectile Dysfunction) in Men

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation please contact us or call/text: 1-646-663-5211.

New York Urology Specialists offer the most effective treatment options for men with ED caused by obesity, diabetes, and hypertension.

Causes of Obesity in Men

Obesity and EDWith the advancement of technology, men are becoming less physically active, and are spending more and more time in front of computers, cell phones, and televisions.

 While we see a lot of men physically active when they are in their 20’s, the stress of life leads to less physical activity for many men as they age.

Diet high in fat, carbohydrates and fried foods contribute to the obesity epidemic  Obesity is a medical term used to describe people with a BMI (body-mass-index) over 30.

What are the Dangers of Obesity?

Many urological diseases are associated with obesity including hypogonadism (low testosterone), erectile dysfunction, kidney stones, and prostate cancerHeart disease, diabetes mellitus type II, high blood pressure, metabolic disorders, many other diseases all owe a debt of gratitude to obesity.

Erectile Dysfunction and Obesity

Erectile dysfunction has long been associated with obesity.

Obesity generally causes insulin insensitivity in the body which in turn leads to high blood glucose levels, a pre-diabetic state. Over time, high glucose levels (diabetes) causes damage to blood vessels that carry blood to the penis.  Diabetes also causes damage to nerves that innervate the penis and facilitate erections.

Another important mechanism that plays a role is the hyperlipidemia or increased blood cholesterol levels associated with weight gain. Elevated cholesterol is responsible for the deposition of lipids in the walls of vessels, leading to their blockade. This reduces blood supply to vital organs of the body.  In the case of erectile dysfunction, the penile artery or one of the arteries that bring blood to the penile artery get affected. Blood flow is crucial for erections to occur.

Obesity can also lead to low testosterone levels or abnormal testosterone/estrogen balance which can also affect erection quality.

As important, obesity can be a cause of high blood pressure in men, which damages blood vessels, including penile blood vessels.

How Obesity Leads to Problem with Getting and Keeping Erections (erectile dysfunction)?

Erections in a normal male result from sexual stimulation or visual stimulation.  Erections are controlled directly by the brain. The brain receives a stimulus that can be in the form of visual, auditory or tactile sexual stimulation. These are then processed in the brain, with subsequent impulses sent to the penis where it leads to an erection. So for an erection to take place, the nervous system, blood vessels, and smooth muscles, should all be healthy.

Damage to blood vessels and nerves can lead to erectile dysfunction. Both blood vessels and nerves are involved in getting and maintaining good erections in males.  Obesity can damage blood vessels directly by causing atherosclerosis (high cholesterol), high blood pressure.  It can damage the nerves by increasing the risk of diabetes which damages nerves and blood vessels.

Symptoms of Obesity-Related Erectile Dysfunction

Symptoms of erectile dysfunction or impotence usually start appearing slowly over time. It starts initially as partial dysfunction such as occasional difficulty obtaining or maintaining a sufficiently hard erection. Over time, men can completely lose the ability to obtain an erection.

Treatment Options for Overweight Men with Erection Problems

Obesity-related erectile dysfunction is treated by focusing initially on obesity itself. Research has shown that losing weight can reverse erectile dysfunction during the initial stages.

Obese men with ED often have low testosterone levels. Testosterone replacement therapy can often help with weight loss and can help men get better erections with or without medications such as Viagra or Cialis.  Estradiol levels need to be addressed as well as high estradiol levels are common in obese men with ED who are getting testosterone replacement therapy.

At New York Urology Specialists, we advise simultaneous treatment for ED with medications to help men get adequate erections fast and stay motivated and non-medical approaches such as weight loss and dietary changes, which can take time to work.

Weight loss can be achieved reasonably fast by lifestyle and dietary modification. Regular exercise is important for good health. Similarly, diet modification is also essential. Foods rich in refined sugars, carbohydrates and fats should be avoided. A consultation with a dietician is often beneficial.  Fruits, vegetables, proteins and omega 3 are good dietary options.  Medications that can help men lose weight are also available by prescription.  Few people truly realize what they eat and how many calories different foods in their diet contribute.


To work-off one BigMac meal, you need to run NON-STOP about 1-1.5 hours (1 mile in 10 minutes). You need to run 10 miles to run off a Big Meal.  You burn about 130-150 calories an hour running 1 mile in 10 minutes.

Total Meal calories:  BigMac Meal: 1180 calories   Double Quarter Pounder Meal: 1420 calories

BigMac 540 calories
Double Quarter Pounder® with Cheese 780 calories
Coca-Cola Large 300 Calories
World Famous Fries medium 340 Calories

Recommended Daily Intake Calories:  Around 2,000 calories.

Losing weight is not easy. It takes a lot of motivation and consistency. It usually takes more than 6 months to achieve a target weight. If erectile dysfunction persists after weight loss, then other treatment options can be employed.  If ED is severe, these options can be tried earlier. Physical exercise can help maintain better erections.

Treatment of Testosterone Deficiency in Overweight and Obese Men

Correction of testosterone deficiency, when present, can also help with weight loss.  Studies show that in men with low testosterone and obesity, treatment of low testosterone levels can help with weight loss.  In addition, testosterone replacement therapy can help with improving erection quality.

Help with Getting and Keeping Erections Hard in Men Who are Overweight or Obese

Medications used for treating ED: Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) are effective for men who are obese.  Medications should be used in combination with treatment focused on weight loss, diet modification and control of high blood pressure and diabetes when these diseases are present.

If oral pills such as Viagra or Cialis do not work well, medications may be directly injected into the penis with a tiny needle and minimal discomfort. Prostaglandins such as alprostadil (prostaglandin E) are effective in bringing about smooth muscle relaxation and hence, an erection. It is effective in 70-80% of patients.

Shockwave therapy for ED is another treatment option that is often helpful for men who are overweight.

A Vacuum Erection Device or VED may be useful for some men but the success rate is not high and it may be difficult to use in obese men who often have buried penis.

Effective Surgical Treatment for Erectile Dysfunction

For men who cannot tolerate medications or other non-surgical treatment options, a penile implant is a very effective treatment option.  An inflatable penile prosthesis is another good option for men who cannot take medications.  It has a high success rate and can be done with a small scrotal incision.  Men who are morbidly obese may not be good candidates for an inflatable penile implant as they may have difficulty reaching the scrotum to inflate and deflate the implant.

Weight loss prior to penile implant surgery is helpful to get the penis to appear larger when erect.  Some men may require abdominoplasty to remove excess skin and fat.

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If you have any questions, to schedule a consultation please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners. 

ED is Treatable in Nearly Every Man

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction.  We understand the challenges that ED creates for our patients, their relationships and their self-esteem.  We help you find a treatment for erectile dysfunction that fits your needs, your lifestyle and your preferences.

Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED.  We offer medical and surgical treatment for erectile dysfunction.

We Treat Some of the Most Complex ED Problems Including:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods.  We offer inflatable penile implant, shockwave therapy for ED and treatment for Peyronie’s disease.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.

If you have any questions, to schedule a consultation please contact us or call/text: 1-646-663-5211.

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