Organic Diet and Intermittent Fasting are Associated With Improved Erectile Function.

OBJECTIVE: To explore associations between dietary habits and erectile dysfunction (ED) in a cohort of patients presenting to a high-volume men's health clinic. MATERIALS AND METHODS: All patients presenting to a high-volume men's health clinic between July 2018 and May 2019 were evaluated for their dietary habits and screened with the International Index of Erectile Function-5 (IIEF-5) and Androgen Deficiency in Aging Males (ADAM). The primary outcome measure was the impact of dietary habits on ED, defined as IIEF-5 <22. Stepwise logistic regressions were used to control for patient characteristics and relevant comorbidities. RESULTS: Two hundred seventy-one patients were included. Primary reasons for visit were ED (110, 40.6%), hypogonadism (39, 14.4%), benign prostatic hyperplasia/lower urinary tract symptoms (80, 29.5%), and Peyronie's Disease (30, 11.1%). 176 (64.9%) followed no diet, while 11 (4.1%), 11 (4.1%), 8 (2.9%), and 11 (4.1%) were whole food only, low-carb/keto, vegetarian/pescatarian, and low-fat, respectively. Additionally, 105 (38.7%) reported organic foods consumption, while 51 (18.8%) had no processed food consumption, and 77 (28.4%) performed intermittent fasting. Patients reporting ED were more likely to be over the age of 65, had higher body mass index, more comorbidities, and less likely to report an organic diet or intermittent fasting. There were no correlations between diet and ADAM score. In adjusted analysis, patients reporting organic diet or intermittent fasting were significantly less likely to have ED. CONCLUSION: This is the first study suggesting organic diet and intermittent fasting to be protective against ED. These results are hypothesis-generating and warrant further exploration.

Diet and Men's Sexual Health.

INTRODUCTION: Male sexual dysfunctions are more prevalent with aging. With increasing evidence about the impact of various diets on chronic diseases, there is a growing interest in establishing an association between various diets and men's health and sexual dysfunction. AIM: To review the current literature examining diet and dietary patterns and male sexual health. METHODS: A thorough literature search of peer-reviewed publications on the association between diet and dietary patterns and male sexual health (erectile dysfunction, hypogonadism, and infertility) was carried using the online PubMed database from 1977 through 2017 with the keywords diet, dietary patterns, erectile dysfunction, male hypogonadism, low testosterone, and male infertility. MAIN OUTCOME MEASURES: Summary of significant findings on erectile function, androgen levels, and semen analysis parameters in relation to diets or dietary patterns. RESULTS: Thirteen studies on diet and erectile dysfunction and 15 studies on diet and testosterone levels were reviewed, including observational studies and randomized controlled trials. Thirteen studies analyzing the relation between diet and semen analysis parameters were reviewed but consisted of only cross-sectional and case-control studies. CONCLUSION: Evidence exists demonstrating the association between various diets and men's sexual health. Erectile dysfunction appears to lessen in men adhering to the Mediterranean diet. Obese and overweight men who lose weight through low-fat, low-calorie diets seem to have improvements in their erectile function and testosterone levels. Furthermore, a Western diet is associated with lower semen quality. Future prospective and randomized controlled trials are necessary to establish the benefit of diet and dietary patterns on men's sexual health. La J, Roberts NH, Yafi FA. Diet and Men's Sexual Health. Sex Med Rev 2018;6:54-68.

Testosterone Replacement Therapy and Components of the Metabolic Syndrome.

INTRODUCTION: The prevalence of metabolic syndrome (MetS) is rapidly increasing in the United States and, because of its strong association with male hypogonadism, has become a significant topic of interest in the sexual medicine community. At the center of this conversation is the efficacy and safety of testosterone replacement therapy (TRT) as a therapeutic option for HG and MetS. AIM: To provide a review of the current literature pertaining to TRT and MetS. METHODS: A thorough literature review was performed to review the relation between TRT and MetS using the PubMed online database from 1976 through 2016 with the keywords testosterone, hypogonadism, metabolic syndrome, and testosterone therapy. MAIN OUTCOME MEASURES: Outcomes pertaining to MetS including weight, waist circumference, body mass index, blood glucose control, cholesterol parameters, blood pressure, and quality of life. RESULTS: From the plethora of contrasting literature on the efficacy and safety of TRT, it is increasingly clear that more well-designed studies are needed to clarify the efficacy and safety of TRT. Although most of the current literature shows that TRT has the potential to significantly lower the studied outcome variables associated with MetS, several studies provide more mixed results. CONCLUSION: TRT has the potential to alleviate some of the morbidity associated with hypogonadism and MetS. Larger multicenter well-designed studies are needed to better describe and quantify the relation between MetS and TRT. Anaissie J, Roberts NH, Wang P, et al. Testosterone Replacement Therapy and Components of the Metabolic Syndrome. Sex Med Rev 2017;5:200-210.