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Updated: Apr 24, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
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Longitudinal associations between changes in body mass index and erectile dysfunction.

Rafael Mathias Pitta1, Oskar Grau Kaufmann1, Eduardo Rossato de Victo1,2

  • 1Postgraduate Program in Health Sciences, Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.

The Journal of Sexual Medicine
|April 22, 2026
PubMed
Summary

Maintaining a healthy weight is crucial for men

Keywords:
body mass indexcardiovascular diseaseserectile dysfunctionobesity

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Area of Science:

  • Urology
  • Cardiovascular Health
  • Obesity Research

Background:

  • Erectile dysfunction (ED) is a significant indicator of systemic vascular dysfunction.
  • Obesity is a primary modifiable risk factor for ED, yet its long-term effects on ED risk are not well understood globally.

Purpose of the Study:

  • To investigate the longitudinal association between body mass index (BMI) trajectory patterns and the risk of erectile dysfunction (ED) in Brazilian men.
  • To analyze how different BMI changes over time impact ED development in adult men.

Main Methods:

  • A longitudinal cohort study involving 924 Brazilian men aged 40 years and above with baseline ED.
  • Data collection included BMI, ED assessment (IIEF-5), and clinical/lifestyle factors at baseline and follow-up (300-800 days apart).
  • Participants were classified into four BMI trajectories: remained healthy, became healthy, became obese, or remained obese. Hierarchical logistic regression was used for analysis.

Main Results:

  • Men who became or remained obese showed significantly higher odds of developing or having erectile dysfunction (OR: 2.46 and 1.73, respectively).
  • These associations remained significant even after adjusting for age, comorbidities, and lifestyle factors.
  • At follow-up, 44.3% of men no longer reported ED, indicating potential for improvement with weight management.

Conclusions:

  • Unfavorable BMI trajectories, particularly becoming or remaining obese, are independently linked to increased erectile dysfunction risk in men.
  • Sustained weight management and lifestyle interventions are vital for preventing ED and maintaining vascular and sexual health.
  • Proactive management of BMI trajectories should be integrated into men's health and sexual medicine care.