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No loving or shoving: Diabetes can dent men’s performance
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No loving or shoving: Diabetes can dent men’s performance

Vascular and neurological complications of diabetes trigger sexual dysfunctions in males
Sexual dysfunction in men with diabetes gets further supplemented with its co-morbidities mainly obesity.
Reduced sexual desire, low testosterone, and erectile dysfunction are common issues associated with diabetes.

Diabetes could play spoilsport in your bedroom as unmanaged blood glucose levels could let you down, literally during your most intimate moments. Diabetes is rated among the main factors that trigger sexual dysfunction in men, especially erectile dysfunction. It is also known to affect sexual wellness and health of women as well and extensive research is underway to unravel the impact of diabetes on male sexual health.

Dr Sonali Kagne, Deputy Consultant, Department of Endocrinology, Sir HN Reliance Foundation Hospital, Mumbai, explains, normal sexual function relies on a balanced relationship of psychological, hormonal, vascular, and neurological factors. Diabetes can affect each of these components that potentially leads to sexual health problems.

Dr Kagne highlights that high blood sugar can cause several sexual problems in men. Reduced sexual desire, low testosterone, and erectile dysfunction are common issues associated with diabetes.

Complications caused by diabetes

1. Erectile dysfunction

She says,“ Healthy neurological functions and adequate blood flow to the penis are the main factors responsible for achieving an erection.” High blood glucose levels impair nerves along with blood vessels that supply to genital areas leading to erectile dysfunction. Dr Poosha Darbha, a sexologist based in Hyderabad, Telangana, reiterates that erectile dysfunction is the most common sexual dysfunction among men with diabetes.

According to experts, diabetes-related erectile dysfunction may also indicate a higher risk of cardiovascular complications due to reduced blood flow. Obesity which is also closely linked with type 2 diabetes is another factor which increases the risk of erectile dysfunction.

2. Low testosterone

Dr Kagne points out that sexual dysfunction in men with diabetes gets further supplemented with its co-morbidities mainly obesity. These two conditions often result in decreasing testosterone level in men. She adds that the testosterone deficiency happens as fat tissue contains enzymes that convert testosterone to estrogen, leading to an increase in estrogen and dip in testosterone levels.  Moreover, obesity can decrease the production of sex hormone-binding globulin (SHBG), a protein that binds to testosterone, resulting in lower levels of bound testosterone.  

She continues, “Pituitary gland’s production of luteinizing hormone (LH), can subsequently affect testosterone production. This phenomenon is known as secondary hypogonadism, where decreased LH secretion results in reduced testosterone levels.”

3. Low Sexual Desire

While it can be difficult to attribute low sexual desire solely to diabetes, studies suggest decreased testosterone levels in individuals with diabetes, leading to a decrease in sexual desire.

Dr Sandeep Reddy, Senior Endocrinologist, Kamineni Hospitals, Hyderabad, explains, diabetes is often accompanied by other conditions like hypertension, hyperlipidemia, or obesity. These comorbidities, as well as the medications used to treat them, can impact sexual desire and function.

He adds, the psychological effects of diabetes, including low self-esteem, difficulty accepting the diagnosis, and lifestyle limitations, can further contribute to reduced sexual desire.

4. Pain and Infections

Diabetes can also lead to sexual pain and infections. Dr Reddy says, for men, penile infections such as Candida (yeast infection) can cause discomfort, including cracking, redness, itching, and pain during intercourse. Similarly, women with diabetes may be prone to thrush or urinary tract infections, which can also impact sexual activity, he adds.

Dr Poosha says, “diabetes also puts both men and women at a higher risk of urinary tract infections”. Excess glucose is expelled in the urine when blood sugar levels reach a particular threshold, resulting in increased urine production that further encourages bacterial growth and increases the risk of UTIs.

5. Retrograde ejaculation

According to Dr Darbha, about a third of men with Diabetes do experience retrograde ejaculation (when semen goes backward into the bladder). Some men do experience other ejaculatory disturbances as well, such as anejaculation (no ejaculation), delayed ejaculation, painful ejaculation, and decreased semen volume – all of which are factors in decreased fertility as well, he adds.

Precautions and Management

Since sex is a form of physical activity, it can lead to fluctuations in blood sugar level. During sexual activity, individuals with diabetes should take precautions to avoid fluctuations in blood sugar levels, says Dr Poosha.

He adds, regular blood sugar monitoring is important, especially to prevent hypoglycemia during physical exertion. Also, both males and females with diabetes are at an increased risk of UTIs, making the need for proper hygiene and sugar control more significant.

Managing Diabetes-Induced Sexual Problems

Managing the negative effects of diabetes on male sexual health requires a holistic approach. Dr Poosha emphasizes that psychological stress must be considered alongside medical and lifestyle interventions. Lifestyle changes, including weight management, a healthy diet, and regular exercise, are crucial in controlling diabetes and improving sexual health. He adds, medications may be prescribed to address specific aspects such as low testosterone levels or high blood pressure.

Takeaway

Diabetes can significantly impact sexual health, affecting desire, arousal, orgasm, and causing pain or infections. While diabetes itself contributes to these challenges, various accompanying factors and comorbidities can further complicate the sexual function.  

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