Metabolic syndrome (MetS) is a diagnostic category, based on a cluster of risk factors (
hyperglycemia/diabetes,
abdominal obesity, hypertriglyceridaemia, low
HDL cholesterol and
hypertension), which identifies subjects at high risk for forthcoming
type 2 diabetes mellitus and cardiovascular (CV) diseases. Recently, a close association between MetS,
erectile dysfunction (ED) and male
hypogonadism has been reported. In patients with MetS,
hypogonadism can exacerbate sexual dysfunction and arteriogenic ED because of its typical symptoms, such as decreased sexual desire and mood disturbances. On the other hand,
hypogonadism per se has been associated with an increased risk of CV and overall mortality.
Obesity and in particular
central obesity is nowadays considered the most important determinant of MetS-induced
hypogonadism whereas
hypertension and diabetes play a major role in ED associated with MetS. This review analyses the current literature regarding the relationship between ED, MetS and
hypogonadism emphasising the epidemiological and psychopathological aspects and stressing the concept that ED subjects are 'lucky', because ED offers a unique chance to undergo medical examination and therefore to improve not only their sexual but, most importantly, their overall health.