While patients hardly ever learn from their doctors how diabetes affects sexual health, chronic high blood sugar lies behind many sexual problems both sexes face. Studies show that 54% of men and 12% of women have sexual concerns to a degree.
Diabetes and sexual problems can indicate nerve damage, hormone imbalances, blocked arteries and impaired blood circulation, all of which can lead to weak or delayed erections, inadequate lubrication, decreased genital sensation and diminished orgasm.
Sex involves more than just genitals, though. Certain diabetic complications can cause pain, and pain in its turn, can make it hard to relax and enjoy sexual activity. Fatigue associated with diabetes can also affect a person’s energy level, mood and hence result in lack of sexual desire.
Then there are psychological effects of living with diabetes. Some people may start feeling that having the disease or its complications makes them unattractive to others. They feel bad about themselves, withdraw socially and even develop mental health problems.
Major sexual problems that occur in men with diabetes are:
Erectile dysfunction. Epidemiological studies suggest that both types of diabetes are associated with an increased risk of ED, which occurs in over 50% of men with diabetes worldwide. Damage to the vascular system, hypertension and heart disease can impair circulation of blood to the genitals, making it difficult to get an erection.
Nerve damage also plays a significant role in developing ED. When the brain cannot properly communicate with the nerves in the sexual organs, the body isn’t able to send and hold blood there, contributing to the difficulty with getting an erection and ability to keep it.
Fortunately, there are many drugs for erectile dysfunction. PDE5 inhibitors, such as Sildenafil citrate is known to improve blood flow. It is the medical treatment that works for most men with impaired blood circulation. Treatments for ED caused by nerve damage vary from oral pills to surgery. Psychological counseling may also help.
Retrograde ejaculation. Nerve damage resulting from poor blood control can cause semen go back into the bladder due to sphincters not functioning properly. This doesn’t harm the bladder or other organs, but can raise fertility problems. The condition can be helped with medications that strengthen the muscle tone of the bladder sphincter.
Premature ejaculation. High triglyceride levels associated with diabetes and metabolic syndrome can reduce ejaculation time or make men unable to control it, precluding both partners from enjoying sex. The condition can be managed with drug therapy and behavioral treatment.
Female sexual problems associated with diabetes include:
- Decreased desire for sexual activity
- Poor lubrication and vaginal dryness
- Low or absent sexual response
- Pain during intercourse
Causes of these problems in women with diabetes are the same as in men – nerve damage, reduced blood flow to vaginal tissues and hormonal changes.
Unfortunately, there are not so many treatment options for managing sexual problems in women. While drug treatment studies are underway, vaginal lubricants, psychological counseling, Kegel exercise and various techniques to treat low sexual response may be helpful.
Anyway, it’s better to prevent diabetes-related sexual problems by keeping blood sugar under control than to treat impotence and other sexual issues separately.