Bidirectional Relationship Between Metabolic Syndrome and Erectile Dysfunction

Metabolic syndrome is highly correlated with erectile dysfunction (ED) according to direct and indirect evidence. The results of individual studies have shown that the frequency of ED in patients with metabolic syndrome varies between 26.7–76.2% among ethnic groups. ED occurs earlier and remains longer in patients with metabolic syndrome compared with those with organic ED without metabolic syndrome. The prevalence of ED increases and the International Index of Erectile Function score decreases as the number of abnormal metabolic items of metabolic syndrome increases. The pathogenesis of ED in patients with metabolic syndrome is likely multifactorial in nature, but endothelial dysfunction is the most important mechanism. Lifestyle modifications, including weight control may, be one of the best strategies for treating ED patients with metabolic syndrome. When treating an ED patient, physicians should determine the status of cardiac risks and metabolic syndrome to decrease heart diseases and promote the patient's health.