Nonalcoholic Fatty Liver Disease, Male Sexual Dysfunction, and Infertility: Common Links, Common Problems.

Introduction: Nonalcoholic fatty liver disease (NAFLD) is considered a hallmark of metabolic syndrome (MetS) and a significant contributor to cardiovascular disease (CVD). With the alarming rates of obesity in the United States and worldwide, efforts at understanding, preventing, and treating MetS and its components are being increasingly undertaken by scientists and clinicians. A strong association between MetS and male sexual problems is already well established. More recent animal and human studies have further evaluated the relationship of NAFLD with male sexual problems and infertility. The molecular and physiological mechanisms correlating these conditions are incompletely established at this time, however.

Aim: To review and analyze current literature associating NAFLD with andrologic disorders, including erectile dysfunction (ED), infertility, and hypogonadism.

Methods: The PubMed database was searched using terms "erectile dysfunction," "hypogonadism," "male infertility," and "nonalcoholic fatty liver disease" for articles published between January 1980 and June 2018.

Main Outcome Measures: We present a summary of the recent clinical and experimental evidence and discuss the possible pathophysiological mechanisms relating NAFLD development and progression to ED, a hypogonadal state, and infertility.

Results: A total of 132 articles were reviewed. These included human observational and clinical studies and animal and basic science research relating NAFLD to the development and progression of ED, hypogonadism, and infertility in men.

Conclusion: There is growing evidence linking NAFLD to male sexual and reproductive dysfunction. A complex interplay of pathophysiological processes underlying these entities and further relating them to the MetS components may ultimately aid the identification and development of novel diagnostic and therapeutic approaches. Hawksworth DJ, Burnett AL. Nonalcoholic Fatty Liver Disease, Male Sexual Dysfunction, and Infertility: Common Links, Common Problems Sex Med Rev 2020;8:274-285.