Metabolic and cardiovascular outcomes of fatherhood: results from a cohort of study in subjects with sexual dysfunction

J Sex Med. 2012 Nov;9(11):2785-94. doi: 10.1111/j.1743-6109.2012.02865.x. Epub 2012 Aug 15.

Abstract

Introduction: Previous cross-sectional and longitudinal studies reported a negative correlation between fatherhood and testosterone (T) levels, likely due to a centrally mediated downregulation of the hypothalamic-pituitary-gonadal axis. Moreover, epidemiological data indicate that fatherhood might affect metabolic and cardiovascular outcomes, although different results have been reported. Up to now, no studies have evaluated these associations in a population of men seeking treatment for sexual dysfunction (SD).

Aim: To explore biological and clinical correlates of number of children (NoC) and its possible associations with forthcoming major cardiovascular events (MACE) in a sample of men with SD.

Methods: A consecutive series of 4,045 subjects (mean age 52 ± 13.1 years old) attending the Outpatient Clinic for SD was retrospectively studied. A subset of the previous sample (N = 1,687) was enrolled in a longitudinal study.

Main outcome measures: Information on MACE was obtained through the City of Florence Registry Office.

Results: Among patients studied, 31.6% had no children, while 26.3% reported having one child, 33.4% two, and 8.8% three or more children. Although fatherhood was negatively related with follicle-stimulating hormone levels and positively with testis volume, we found a NoC-dependent, stepwise decrease in T plasma levels, not compensated by a concomitant increase in luteinizing hormone. NoC was associated with a worse metabolic and cardiovascular profile, as well as worse penile blood flows and a higher prevalence of metabolic syndrome (MetS). In the longitudinal study, after adjusting for confounders, NoC was independently associated with a higher incidence of MACE. However, when the presence of MetS was introduced as a further covariate, the association was no longer significant.

Conclusions: This study supports the hypothesis that bond maintenance contexts and fatherhood are associated with an adaptive downregulation of the gonadotropin-gonadal axis, even in a sample of men with SD. Moreover, our data suggest that NoC predicts MACE, most likely because of an unfavorable, lifestyle-dependent, parenthood-associated behavior.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / physiopathology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology*
  • Cardiovascular Diseases / psychology
  • Cohort Studies
  • Cross-Sectional Studies
  • Family Characteristics
  • Family Conflict / psychology
  • Fathers / psychology*
  • Humans
  • Hypogonadism / epidemiology
  • Hypogonadism / physiopathology*
  • Hypogonadism / psychology
  • Impotence, Vasculogenic / epidemiology
  • Impotence, Vasculogenic / physiopathology*
  • Impotence, Vasculogenic / psychology
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / physiopathology*
  • Metabolic Syndrome / psychology
  • Middle Aged
  • Prolactin / blood
  • Proportional Hazards Models
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / physiopathology*
  • Sexual Dysfunction, Physiological / psychology
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / physiopathology*
  • Sexual Dysfunctions, Psychological / psychology
  • Smoking / adverse effects
  • Smoking / physiopathology
  • Testosterone / blood*

Substances

  • Testosterone
  • Prolactin