Diabetes and Sexual Problems

Many of us know that diabetes can cause sexual complications in men, but women can suffer from sexual problems due to their diabetes too. If a frank discussion of human sexuality and anatomy make you uncomfortable then please don’t read further.

Both men and women with diabetes can develop sexual problems because of damage to nerves and small blood vessels. The nerves that control sexual stimuli are an involuntary, autonomic response that sends nerve signals to increase blood flow to the genitals. Damage to these nerves as a result of neuropathy can impact normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction.

  • Sexually transmitted diseases (STDs) can be transmitted easily because of the dry, cracked skin found in many people who have diabetes. This makes it important to practice safe sex.
  • Chronic high blood sugars can lead to abnormal nerve function, leading to pain with only light touch.
  • Heightened sense of pain associated with neuropathy can make sexual relations uncomfortable.
  • Because sex burns calories, people with diabetes should watch for signs of low blood sugar) after sex.

Who is at risk for developing sexual problems of diabetes?

Diabetic neuropathy and related sexual problems are more common in people who

  • Have poor blood glucose control
  • Have high levels of blood cholesterol
  • Have high blood pressure
  • Are overweight
  • Are older than 40
  • Smoke
  • Are physically inactive

Sexual Dysfunction in Men

The most common form of sexual dysfunction in men is a consistent inability to have or maintain an erection firm enough for sexual intercourse.

Erectile Dysfunction. The estimates of erectile dysfunction of men with diabetes vary widely, ranging from 35 – 75%. Above the age of 50, having difficulties with an erection occurs in approximately 50%-60% of men with diabetes. Above age 70, that rate climbs to 95%. Men who have diabetes are two to three times more likely to suffer from erectile dysfunction and may have symptoms 10 to 15 years earlier than men without diabetes. Research suggests that for men ages 45 years and younger erectile dysfunction may be an early marker of diabetes.

In addition to diabetes, sexual dysfunction may also occur because of the alcohol abuse, side effects of medications or psychological factors. Chronic high blood sugar levels can lead to reduced testosterone and may lead to decreased sexual interest.

Retrograde Ejaculation. Is is a little known condition in which part or all of a man’s semen goes into the bladder instead of out the tip of the penis during ejaculation. A man experiencing retrograde ejaculation may notice that small amounts of semen is discharged during ejaculation or may only become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen. Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.

What sexual problems can occur in women with diabetes?

Many women with diabetes experience sexual problems. Although research about sexual problems in women with diabetes is limited, studies show 18 – 27% of women with type 1 diabetes and 42% of women with type 2 diabetes experienced some sexual dysfunction.

Sexual problems may include:

  • Decreased vaginal lubrication that makes intercourse uncomfortable or even painful.
  • Nerve damage also can lead to loss of sensation in the genital area, making orgasm difficult or impossible to achieve.
  • Decreased or no desire for sex

Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, anxiety or depression, gynecologic infections, other diseases, and conditions relating to pregnancy or menopause.

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