Erectile Dysfunction, Metabolic Syndrome, and Cardiovascular Risks

Facts and Controversies

Edward Sanchez; Alexander W. Pastuszak; Mohit Khera


Transl Androl Urol. 2017;6(1):28-36. 

In This Article


MetS, now considered an important public health threat, is a constellation of several cardiovascular risk factors associated with a 2-fold increase of a 5- to 10-year risk of CVD. MetS is characterized by the presence or treatment of any three of the following: abdominal obesity (waist >94 cm), triglycerides >150 mg/dL, blood pressure >130/85 mmHg, fasting glucose >100 mg/dL, and HDL <40 mg/dL.[60] Low levels of androgens are strongly associated with MetS and its components.[61] In a study of men with low serum testosterone, García-Cruz et al. found that MetS was associated with significantly lower IIEF scores. Incidence of moderate to severe ED was higher among subjects with MetS versus those without. Severity of ED was found to be associated with severity of MetS, with an increased mean number of MetS components seen as ED severity increased. Multivariate analysis revealed that moderate and severe ED were the variables associated with the highest odds of MetS.[62]

Yassin et al. followed 261 patients diagnosed with late onset hypogonadism and ED treated with testosterone undecanoate (TU). The mean duration of treatment was more than 4 years. The study assessed parameters affected by MetS, including body weight, waist circumference, BMI, total cholesterol, LDL, HDL, triglycerides, glucose, hemoglobin A1c, and blood pressure. Significant improvements in obesity parameters (BMI and waist circumference) were observed, along with a decrease in total cholesterol, LDL, triglycerides, fasting blood glucose, hemoglobin A1c, and blood pressure over the course of the study. Health related quality of life was significantly improved after testosterone therapy, with sustained improvement in erectile function and muscle and joint pain.[63]