Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: Dr Esposito and colleagues1 report that caloric restriction and increased physical
activity led to weight loss, a decrease in markers of inflammation, and improvement
in erectile function in obese men with erectile dysfunction. The authors suggest
that this improvement may relate to changes in endothelial function, an idea
that is also addressed in the accompanying editorial by Dr Saigal.2 In the same issue of JAMA,
Dr Morgentaler3 discusses the important interactions
between testosterone and erectile function. Obesity is also associated with
decreased levels of testosterone and free testosterone, and increased peripheral
conversion of androgens to estrogen.4,5 Given
this, it would be helpful to know if Esposito et al measured testosterone
levels, and, if so, whether there was a change related to weight loss.
Sarne DH. Erectile Dysfunction in Obese Men. JAMA. 2004;292(20):2466-2467. doi:10.1001/jama.292.20.2467-a