Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men
Abstract
Introduction: Obesity and inactivity are associated with erectile dysfunction and hypogonadism. Aim: To compare the effects of low volume (LV) and high volume (HV) of moderate-intensity exercise on sexual function, testosterone, lower urinary tract symptoms (LUTS), endothelial function, and quality of life (QoL) in obese men. Main Outcome Measures: Weight, waist circumference (WC), body composition, International Index of Erectile Function 5-item (IIEF-5), International Prostate Symptom Scale (IPSS) (for LUTS), and 36-item Short Form Survey version 2 Instrument (SF-36) (for QoL) scores, plasma testosterone, sex-hormone binding globulin, glucose, insulin and lipids, and endothelial function (by Reactive Hyperaemia Index [RHI] using finger plethysmography) were measured at baseline and 24 weeks. Methods: Ninety abdominally obese (body mass index>27.5kg/m2, WC>90cm), sedentary (exercise ∼80 minutes/week) Asian men (mean age 43.6 years, range 30–60) were prescribed a diet to reduce daily intake by ∼400kcal below calculated requirement and randomized to perform moderate-intensity exercise of LV (<150 minutes/week) or HV (200–300 minutes/week) (n=45 each) for 24 weeks. Seventy-five men (83.3%) completed the study. Results: Weekly exercise volume was significantly greater in the HV (236±9 minutes) than the LV (105±9 minutes) group. The HV group had significantly greater increases in IIEF-5 score (2.6±0.5 points) and testosterone (2.06±0.46nmol/L) and reductions in weight (−5.9±0.7kg, −6.2%), WC (−4.9±0.8cm, −4.9%), and fat mass (−4.7±1.0kg, −14.5%) than the LV group (−2.9±0.7kg, −3.0%; −2.7±0.7cm, −2.5%; −1.1±0.8kg, −3.2%; 0.79±0.46nmol/L; and 1.8±0.5 points). Improvements in IPSS and SF-36 scores, and RHI, were similar. Conclusions: Moderate-intensity HV aerobic exercise>200 minutes/week produces greater improvements in sexual function, testosterone, weight, WC, and fat mass than smaller exercise volume.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Genetic heritability likely accounts for a significant portion of mean testosterone levels in a select population and of observed diurnal variations.
“Genetic heritability likely accounts for a significant portion of mean T levels in a select population as well as observed diurnal variations.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [57]
Adult male studies confirmed similar findings, with genetic contribution to testosterone variability of 42-65%.
“Results of adult males have confirmed similar findings, with genetic contribution towards T variability of 42–65%.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [57]
In obese men, exercise decreased body weight by 5.9 kg and improved erectile function (2.6 increase in IIEF-5 score).
“In obese men, exercise decreased body weight by 5.9 kg and improved erectile function (2.6 increase in IIEF-5 score) (31).”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [31]
Cites
(2004) · The Lancet · doi:10.1016/s0140-6736(03)15268-3 · Cited by 12,717 · see citing works
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824 · see citing works
DONNELLY, J. E., BLAIR, S. N., JAKICIC, J. M., MANORE, M. M., RANKIN, J. W., & SMITH, B. K. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181949333 · Cited by 2,658 · see citing works
Aytaç, Mckinlay, & Krane (1999) · BJU International · doi:10.1046/j.1464-410x.1999.00142.x · Cited by 1,329 · see citing works
A descriptive study of individuals successful at long-term maintenance of substantial weight loss
Klem, M., Wing, R., McGuire, M., Seagle, H., & Hill, J. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.2.239 · Cited by 1,060 · see citing works
Bonetti, P. O., Pumper, G. M., Higano, S. T., Holmes, D. R., Kuvin, J. T., & Lerman, A. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.08.062 · Cited by 974 · see citing works
Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men: A Randomized Controlled Trial
Esposito, K., Giugliano, F., Di Palo, C., Giugliano, G., Marfella, R., D'Andrea, F., D'Armiento, M., & Giugliano, D. (2004) · JAMA · doi:10.1001/jama.291.24.2978 · Cited by 841 · see citing works
Slentz, C. A., Duscha, B. D., Johnson, J. L., Ketchum, K., Aiken, L. B., Samsa, G. P., Houmard, J. A., Bales, C. W., & Kraus, W. E. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.1.31 · Cited by 656 · see citing works
Pitteloud, N., Hardin, M., Dwyer, A. A., Valassi, E., Yialamas, M., Elahi, D., & Hayes, F. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-2190 · Cited by 525 · see citing works
Coyne, K. S., Wein, A. J., Tubaro, A., Sexton, C., Thompson, C. L., Kopp, Z. S., & Aiyer, L. P. (2009) · British Journal of Urology · doi:10.1111/j.1464-410x.2009.08371.x · Cited by 491 · see citing works
Rosen, R. C., Allen, K. R., Ni, X., & Araujo, A. B. (2011) · European Urology · doi:10.1016/j.eururo.2011.07.053 · Cited by 460 · see citing works
Male Inclusion in Randomized Controlled Trials of Lifestyle Weight Loss Interventions
Pagoto, S., Schneider, K. L., Oleski, J. L., Luciani, J. M., Bodenlos, J. S., & Whited, M. C. (2011) · Obesity · doi:10.1038/oby.2011.140 · Cited by 388 · see citing works
Vermeulen, A. (1993) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.76.5.1140 · Cited by 346 · see citing works
Caprio, M., Fabbrini, E., Isidori, A. M., Aversa, A., & Fabbri, A. (2001) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(00)00352-0 · Cited by 308 · see citing works
Predictors and Prevalence of Erectile Dysfunction in a Racially Diverse Population
Saigal, C. S. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.2.207 · Cited by 307 · see citing works
Lower urinary tract symptoms and sexual dysfunction: epidemiology and pathophysiology
McVary, K. T. (2006) · British Journal of Urology · doi:10.1111/j.1464-410x.2006.06102.x · Cited by 276 · see citing works
Williamson, D. A. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.544 · Cited by 244 · see citing works
Corona, G., Mannucci, E., Forti, G., & Maggi, M. (2009) · International Journal of Andrology · doi:10.1111/j.1365-2605.2008.00951.x · Cited by 223 · see citing works
Kupelian, V. A., McVary, K. T., Kaplan, S. A., et al. (2009) · The Journal of Urology · doi:10.1016/j.juro.2009.04.025 · Cited by 198 · see citing works
Vignozzi, L., Morelli, A., Sarchielli, E., Comeglio, P., Filippi, S., Cellai, I., Maneschi, E., Serni, S., Gacci, M., Carini, M., et al. (2011) · Journal of Endocrinology · doi:10.1530/joe-11-0289 · Cited by 186 · see citing works
Wing, R. R., Rosen, R. C., Fava, J. L., Bahnson, J., Brancati, F., Gendrano, I. N. C., Kitabchi, A., Schneider, S. H., & Wadden, T. A. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01458.x · Cited by 180 · see citing works
Sexual Functioning and Obesity: A Review
Kolotkin, R. L., Zunker, C. L., & Østbye, T. (2012) · Obesity · doi:10.1038/oby.2012.104 · Cited by 171 · see citing works
Bischoff, S. C., Damms-Machado, A., Betz, C., Herpertz, S., Legenbauer, T., Löw, T., Wechsler, J. G., Bischoff, G., Austel, A., & Ellrott, T. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.107 · Cited by 168 · see citing works
Pierce, G. L., Beske, S. D., Lawson, B. R., Southall, K. L., Benay, F. J., Donato, A. J., & Seals, D. R. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.111427 · Cited by 167 · see citing works
Metabolic syndrome and lower urinary tract symptoms: the role of inflammation
Gacci, M., Vignozzi, L., Sebastianelli, A., et al. (2012) · Prostate Cancer and Prostatic Diseases · doi:10.1038/pcan.2012.44 · Cited by 160 · see citing works
Khoo, J. J. C., Piantadosi, C., Duncan, R. F., Worthley, S. G., Jenkins, A. J., Noakes, M., Worthley, M. I., Lange, K. M., & Wittert, G. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02417.x · Cited by 157 · see citing works
Self-citationAntiinflammatory effect of androgen receptor activation in human benign prostatic hyperplasia cells
Vignozzi, L., Cellai, I., Santi, R., Lombardelli, L., Morelli, A., Comeglio, P., Filippi, S., Logiodice, F., Carini, M., Nesi, G., et al. (2012) · Journal of Endocrinology · doi:10.1530/joe-12-0142 · Cited by 139 · see citing works
Obesity, low testosterone levels and erectile dysfunction
Diaz‐Arjonilla, M., Schwarcz, M. G., Swerdloff, R. S., & Wang, C. (2008) · International Journal of Impotence Research · doi:10.1038/ijir.2008.42 · Cited by 131 · see citing works
Lee, R. K., Chung, D. E., Chughtai, B. I., Te, A. E., & Kaplan, S. A. (2012) · British Journal of Urology · doi:10.1111/j.1464-410x.2011.10819.x · Cited by 127 · see citing works
Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men
Khoo, J. J. C., Piantadosi, C., Worthley, S. G., & Wittert, G. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.76 · Cited by 121 · see citing works
Self-citationTraish, A. M., Feeley, R. J., & Guay, A. T. (2009) · FEBS Journal · doi:10.1111/j.1742-4658.2009.07305.x · Cited by 110 · see citing works
Beneficial Impact of Exercise and Obesity Interventions on Erectile Function and its Risk Factors
Hannan, J. L., Maio, M. T., Komolova, M., & Adams, M. A. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.01143.x · Cited by 110 · see citing works
Han, T. S., Tajar, A., O’Neill, T. W., Jiang, M., Bártfai, G., Boonen, S., Casanueva, F. F., Finn, J. D., Forti, G., Giwercman, A., et al. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-1129 · Cited by 110 · see citing works
Exercise Dose and Insulin Sensitivity
Dubé, J. J., Allison, K. F., Rousson, V., Goodpaster, B. H., & Amati, F. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31823f679f · Cited by 107 · see citing works
Maio, G. D., Saraeb, S., & Marchiori, A. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01783.x · Cited by 101 · see citing works
Androgens and Adipose Tissue in Males: A Complex and Reciprocal Interplay
Mammi, C., Calanchini, M., Antelmi, A., Cinti, F., Rosano, G. M. C., Lenzi, A., Caprio, M., & Fabbri, A. (2012) · International Journal of Endocrinology · doi:10.1155/2012/789653 · Cited by 95 · see citing works
The Link Between Erectile and Cardiovascular Health: The Canary in the Coal Mine
Meldrum, D. R., Gambone, J. C., Morris, M. A., Meldrum, D. A. N., Esposito, K., & Ignarro, L. J. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.03.093 · Cited by 95 · see citing works
Lamina, S., Okoye, C. G., & Dagogo, T. T. (2009) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00086.x · Cited by 91 · see citing works
Maserejian, N. N., Kupelian, V. A., Miyasato, G., McVary, K. T., & McKinlay, J. B. (2012) · The Journal of Urology · doi:10.1016/j.juro.2012.03.128 · Cited by 89 · see citing works
Effect of Exercise on Serum Sex Hormones in Men
Hawkins, V. N., Foster‐Schubert, K. E., Chubak, J., Sorensen, B. E., Ulrich, C. M., Stancyzk, F. Z., Plymate, S. R., Stanford, J. L., White, E., Potter, J. D., et al. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31815bbba9 · Cited by 87 · see citing works
Sex Steroid Receptors in Male Human Bladder: Expression and Biological Function
Chavalmane, A. K., Comeglio, P., Morelli, A., Filippi, S., Fibbi, B., Vignozzi, L., Sarchielli, E., Marchetta, M., Failli, P., Sandner, P., et al. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01811.x · Cited by 84 · see citing works
Regular exercise attenuates the metabolic drive to regain weight after long-term weight loss
MacLean, P. S., HIGGINS, J. A., Wyatt, H. R., Melanson, E. L., Johnson, G. C., Jackman, M. R., Giles, E. D., Brown, I. E., & Hill, J. O. (2009) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00192.2009 · Cited by 78 · see citing works
Janiszewski, P. M., Janssen, I., & Ross, R. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01302.x · Cited by 75 · see citing works
Wee, H. L., Wu, Y., Thumboo, J., Lee, J., & Tai, E. S. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.24 · Cited by 58 · see citing works
Musicki, B., Liu, T., Strong, T., Jin, L., Laughlin, M. H., Turk, J. R., & Burnett, A. L. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2007.00731.x · Cited by 58 · see citing works
Steig, A. J., Jackman, M. R., Giles, E. D., Higgins, J. A., Johnson, G. C., Mahan, C., Melanson, E. L., Wyatt, H. R., Eckel, R. H., Hill, J. O., et al. (2011) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00212.2011 · Cited by 52 · see citing works
Hsiao, W., Shrewsberry, A. B., Moses, K. A., Johnson, T. V., Cai, A. W., Stuhldreher, P. P., Dusseault, B. N., & Ritenour, C. W. M. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02560.x · Cited by 50 · see citing works
Kratzik, C., Lackner, J. E., Märk, I., Rücklinger, E., Schmidbauer, J., Lunglmayr, G., & Schatzl, G. (2008) · European Urology · doi:10.1016/j.eururo.2008.02.020 · Cited by 49 · see citing works
Sauver, J. L. S., Jacobson, D. J., McGree, M. E., Girman, C. J., Klee, G. G., Lieber, M. M., & Jacobsen, S. J. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwq438 · Cited by 33 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Grossmann, M., & Matsumoto, A. M. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-3580 · Cited by 246 · see citing works
Hypogonadism and male obesity: Focus on unresolved questions
Grossmann, M. (2018) · Clinical Endocrinology · doi:10.1111/cen.13723 · Cited by 164 · see citing works
Ng Tang Fui, M., Prendergast, L. A., Dupuis, P., Raval, M., Strauss, B. J., Zajac, J. D., & Grossmann, M. (2016) · BMC Medicine · doi:10.1186/s12916-016-0700-9 · Cited by 124 · see citing works
Physical activity to improve erectile function: a systematic review of intervention studies
Gerbild, H., Larsen, C. M., Graugaard, C., & Areskoug Josefsson, K. (2018) · Sexual Medicine · doi:10.1016/j.esxm.2018.02.001 · Cited by 121 · see citing works
Khoo, J., Hsiang, J., Taneja, R., Law, N., & Ang, T. (2017) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13007 · Cited by 99 · see citing works
Self-citationTrost, L. W., & Mulhall, J. P. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.04.068 · Cited by 98 · see citing works
Treatment of Functional Hypogonadism Besides Pharmacological Substitution
Corona, G., Rastrelli, G., Morelli, A., Sarchielli, E., Cipriani, S., Vignozzi, L., & Maggi, M. (2020) · The World Journal of Men's Health · doi:10.5534/wjmh.190061 · Cited by 87 · see citing works
Morelli, A., Filippi, S., Comeglio, P., Sarchielli, E., Cellai, I., Pallecchi, M., Bartolucci, G., Danza, G., Rastrelli, G., Corno, C., et al. (2019) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00377.2018 · Cited by 59 · see citing works
Leitão, A. E., Vieira, M. C. D. S., Pelegrini, A., da Silva, E. L., & Guimarães, A. C. D. A. (2021) · Maturitas · doi:10.1016/j.maturitas.2020.12.002 · Cited by 30 · see citing works
- Authors
- Khoo, J., Tian, H.-H., Tan, B., Chew, K., Ng, C.-S., Leong, D., Teo, R. C.-C., & Chen, R. Y.-T.
- Affiliations
- Changi General Hospital (SG)
- Corresponding author
- Khoo, Joan
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-07-01
- Volume
- 10
- Issue
- 7
- Pages
- 1823-1832
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W1664663910
- Cited by
- 101
- References
- 49
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 10 · 2020: 10 · 2019: 9 · 2018: 10 · 2017: 7 · 2016: 8 · 2015: 10 · 2014: 9 · 2013: 5
- FWCI
- 7.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- SingHealth Foundation
- Singapore, and Changi General Hospital, Singapore
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- moderate-intensity exercise, exercise volume, obesity, erectile dysfunction, testosterone, hypogonadism, lower urinary tract symptoms, endothelial function, quality of life, abdominal obesity, sedentary men, sex hormone-binding globulin, weight loss, waist circumference, fat mass, IIEF-5, IPSS, reactive hyperaemia index, hypocaloric diet, Asian men
- MeSH terms
- Adult, Aged, Body Composition, Body Weight, Humans, Erectile Dysfunction, Male, Obesity, Prostate, Quality of Life, Sex Hormone-Binding Globulin, Testosterone, Exercise, Body Mass Index, Waist Circumference
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
