The sexual side effects of diabetes
J. Ward Godsall, MD, credits the media – Viagra® commercials in particular – for making sexual health "much less taboo" when patients see him at Allina Medical Clinic – Edina. Since he is an endocrinologist, many patients who bring up the subject also have diabetes.
"If your diabetes is out of control, you may develop problems that affect your sex life," says Godsall.
What sexual problems affect both men and women with diabetes?
Anyone with diabetes can have sexual problems when high blood glucose levels damage nerve tissue and blood circulation.
Diabetic neuropathy is a common complication of diabetes. It can lead to autonomic neuropathy.
"Autonomic nerves control your heartbeat, food digestion, blood circulation – stuff you don't think about," says Godsall.
Autonomic nerves also control the body's response to sexual stimuli, sending extra blood flow to the genitals. In men, this causes erections. In women, it causes smooth muscle tissue to relax and aids lubrication.
"Sometimes you find no vascular or nerve problems, but then you find out that a patient is mad at his wife or they're sleeping in separate rooms," says Godsall. "Relational and emotional difficulties affect sex drive."
In cases like these, Godsall encourages his patients to get counseling and be evaluated for depression.
What sexual problems affect men with diabetes?
Men with diabetes are two to three times more likely to have erectile dysfunction (erection problems) than men who don't have diabetes.
"You need good blood flow in order to have an erection," says Godsall. "That can be a problem when your blood glucose is out of control and affects your circulation."
Poor blood glucose control can also lead to retrograde ejaculation, when some or all of a man's semen goes into the bladder instead of out the tip of the penis during ejaculation.
What sexual problems affect women with diabetes?
Women with diabetes may have low or no sexual desire because of depression or hormone levels that make them always feel tired or moody. Some women have problems controlling their blood glucose before and during their monthly periods. Out-of-control blood glucose can also lead to vaginal yeast infection and painful sex.
How can I avoid the sexual side effects of diabetes?
Diabetes may increase the likelihood of sexual problems, but it doesn't have to.
- Keep your blood glucose in check.
- Control your diabetes through diet, exercise and medicine.
- Find someone on your diabetes care team you can talk to about sexual health.
"You can control the diabetes or it can control you," says Godsall. "If you admit you have diabetes and choose to manage it, we can help."
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Source: J Ward Godsall, MD, Allina Medical Clinic – Edina; American Diabetes Association; National Diabetes Information Clearinghouse, Sexual and Urologic Problems of Diabetes
First published: 05/10/2010
Last updated: 05/10/2010
Reviewed by: Mary Frederick, RN, MS, CDE, diabetes program manager, Allina Medical Clinic - Diabetes Education; Dawn McCarter, RN, BSN, CDE, diabetes program coordinator, Allina Medical Clinic - Diabetes Education