Sexual Dysfunction in Men and Women – Part 2

Continued from prior blog.

Issues for both sexes:

• Urinary infections are more common in people with poorly controlled diabetes and can cause discomfort for women during intercourse and for men during urination and ejaculation. These generally are temporary complications, but they can recur. Sexual activity should be stopped during treatment of urinary tract and yeast infections, which also are relatively common in people with diabetes.
• 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 glucose levels can lead to reduced testosterone and may contribute to decreased sexual interest (libido).
• Chronic high blood glucose 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 intercourse is exercise, people with diabetes should watch for signs of hypoglycemia (low blood glucose) after sex.

Other factors:

• People with diabetes (particularly men whose disease is poorly controlled) may have too little or too much of certain hormones, such as prolactin, testosterone, or thyroid hormone. Generally these conditions can be treated with pills.
• Certain drugs for heart problems, high blood pressure, anxiety, depression, pain, allergies, and weight control sometimes cause impotence. Switching medications may solve the problem.
• Stress and other mental health problems can cause or worsen sexual dysfunction, as can smoking and alcohol use.
• Physical problems not caused by diabetes, such as accidents that injure nerves, prostate surgery, and spinal cord injuries, can cause impotence.

See your doctor: Make an appointment to see your doctor if you are experiencing sexual dysfunction. Your doctor should perform a physical exam, which includes:

• Medical history, including questions about morning erections (a sign that the impotence probably is not due to a physical problem); how long the problem has occurred; and whether you are experiencing anxiety or stress
• A physical exam and review of diabetes complications
• Lab tests to check hormone levels
• Review of medicines taken
• Occasionally additional testing, including measurements of erections, an ultrasound, and/or neurological and other tests done at the doctor's office or by you at home.

People with diabetes can lower their risk of sexual and urologic problems by keeping their blood glucose, blood pressure, and cholesterol levels close to the target numbers their doctor recommends. Being physically active and maintaining a healthy weight can also help prevent the long-term complications of diabetes. For those who smoke, quitting will lower the risk of developing sexual and urologic problems due to nerve damage and also lower the risk for other health problems related to diabetes, including heart attack, stroke, and kidney disease.

For information from another source, please read this article.