Sexual Dysfunction - Causes and Symptoms

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Sexual Dysfunction - Causes and Symptoms

Out-of-control blood sugar levels can lead to blood vessel and nerve damage that hamper sexual performance and enjoyment. This can cause diabetes-related sexual dysfunction in men as well as in women. Men and women with diabetes also should be aware of sexual function issues that affect both sexes.

Other factors can cause or exacerbate sexual dysfunction, including psychological issues, self-consciousness and fear of failure. If you are experiencing impotence or sexual dysfunction, it's important to see your doctor for an accurate diagnosis of your condition.
Sexual dysfunction in men

* Diabetes can cause nerve and artery damage in the genital area, disrupting the blood flow necessary for an erection. This is more common in older men who have had diabetes for a long time. High cholesterol, high blood pressure and obesity - all common among men with diabetes - as well as smoking, can contribute to the problem.
* Some men with diabetes experience retrograde ejaculation, which means that the ejaculate goes backward into the bladder instead of being discharged during climax. This condition does not affect orgasm, but it can make it difficult to father a child.


Sexual dysfunction in women

* Diabetes-related nerve damage can cause vaginal dryness that makes intercourse uncomfortable.
* Nerve damage also can lead to loss of sensation in the genital area, making orgasm difficult or impossible to achieve.


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 sugar levels can lead to reduced testosterone and may contribute to decreased sexual interest (libido).
* 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 intercourse is exercise, people with diabetes should watch for signs of hypoglycemia (low blood sugar) 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.

The Sexual Function Clinic at Joslin Clinic in Boston is designed to help men with and without diabetes who experience erectile dysfunction or decreased sexual function. Click here for more information about the Sexual Function Clinic.

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