Sex: What’s weight got to do with it?

“About 30 per cent of obese men and women have sexual dysfunctions,” says Kenyan sexologist Joachim Osur. This has been confirmed by a study published in the National Centre for Biotechnology Information, which found that weight extremes have a negative effect on sexual function through metabolic, hormonal and psychological parameters.

This, however, does not mean that your sexual function will automatically suffer when you are overweight or underweight.

Sexual functioning is an intrinsic component of overall well-being. For many of us, how we feel about our bodies is a vital depiction of our sexual function. Whether your body weight makes you feel insecure or quite confident, it reflects on your desire and even ability to engage sexually. Without a doubt, maintaining a healthy body weight is one of the most effective preventive measures against lifestyle diseases. Also carrying extra weight or not carrying adequate mass can profoundly bring along a host of issues affecting your sexual function. Body weight status is determined by the Body Mass Index (BMI). You calculate your BMI by dividing your weight in kilogrammes by the square of your height in metres. A BMI less than 18.5 indicates one is underweight, ranging between 18.5 to 24 falls in the normal range, 25.0 to 30 falls under overweight, while 30 or higher is in the obese range.

Weight and sexual function in men

 Age alone is associated with the natural decrease in spontaneous erections. With additional conditions, the risk of erectile dysfunction (ED) is increased. Research is clear that obesity is a contributing factor to ED.

What being obese causes

? Lowered testosterone. One study showed that for men over 45 and obese, testosterone was 2.4 times lower than that of a normal weight man.

? Increased likelihood of getting diseases that affect sexual function.

? Deactivated nitric oxide. Generally, for erection to occur, blood vessels in the male genitalia dilate, causing them to fill up with blood. The entire process depends on the endothelium or lining of the blood vessel producing nitric oxide. The purpose of the nitric oxide is to enable the relaxation of smooth muscles that allow the penis to erect. This is why most medications used to treat ED are designed to increase the levels of nitric acid in the endothelium.

So what does this mean for your sexual health?

Generally, anything that impairs blood vessels - including obesity due to associated inflammation, diabetes, high cholesterol and hypertension- can potentially clog and disrupt function of the blood vessels involved in obtaining an erection and stimulating the clitoris for the women. Cardiologist and professor of medicine Robert Kloner describes an erection as a cardiovascular event. He emphasizes that if blood vessels fail to dilate normally, erectile function will decrease.

 Why testosterone matters for both genders

It is the primary male sex hormone, and is crucial for maintaining a man’s healthy sex drive. Adequate amounts of it are needed for erections to occur in men.

What many do not know is that it plays a crucial role in maintaining women’s healthy libido. Testosterone in women aids arousal and sexual enjoyment.  Reduced levels of the hormone leads to decreased sensitivity of the vagina and clitoris. This then affects libido.  Excess belly fat in both men and women has been linked to hormonal imbalance - when more oestrogen is released than testosterone. Other studies also show that obesity leads to increased amounts of the sex hormone binding protein (SHBG) that sucks up free circulating testosterone leading to lessened sex stimulation.

 Weight and sexual function in women

A woman’s body confidence is related to her sex drive. The more she loves the way she looks, the higher the chances she will want to have sex more.

Additionally, in 2007, sexology experts published a study that investigated the distribution of body fat and sexual function in women. The study revealed that obesity actually negatively affects several aspects of sexual function. These include:

·         Arousal

·         Lubrication

·         Satisfaction

·         Orgasm

Sexual desire and pain, however, did not correlate with BMI. Up to 83 per cent of the overweight and obese participants had sexual dysfunction.

These findings underscore the speculation that the factors involving the fat cell are important in the manifestation of female sexual dysfunction (FSD).

Data indicates that 20.5 per cent of women in Kenya are overweight and 9.1 per cent are obese. Additionally, a majority of them use hormonal contraceptives with increasing rates of discontinuation due to weight loss/gain and loss of libido. This is according to a published study that was conducted at The Aga Khan University Hospital in 2019.

Being underweight isn’t any better

A survey carried out in Denmark showed that being underweight affected men’s sexual function more than women. It carried the same effects as being overweight; sexual dysfunction and lower sex drive.

Also, does anyone want to break a bone during sex? When your body fat is too low, your bones may become too brittle due to lowered oestrogen levels. Oestrogen is needed for maintenance of healthy bones. Your bones end up becoming too fragile due to lack of calcium deposition in your bones. And since sex is like exercise, depending on the amount of energy you put into it, you do not want to come out with an injury.

Low body weight also brings fertility problems to women. Lowered estrogen levels interferes with menstruation and you may even end up having irregular cycles. Women may also have trouble conceiving or carry a pregnancy to term due to the inability of the uterine lining to support a growing fetus. And since estrogen is also essential for spermatogenesis - sperm production - unhealthy levels directly affect sexual function in men.