Sexual Dysfunction & Blood Sugar Control

Normally, I focus most of my articles on helping people lose weight safely, but this month I wanted to bring awareness to the guys on Diabeteens.com about the consequences of poor diabetes management and their sexual health.

Sexual Dysfunction refers to the difficulty for someone to engage in normal sexual activity including desire, arousal and orgasm. This is something that many diabetic men suffer from at some point in their lives. The two most common problems include erectile dysfunction as well as retrograde ejaculation.

Erectile Dysfunction is the consistent inability to have a strong enough erection for sexual intercourse. This includes both the ability to have an erection as well as the ability to sustain an erection to completion. The estimates for the prevalence of men with both diabetes and erectile dysfunction vary greatly ranging from 20 to 75% and men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes.

Additionally, men with erectile dysfunction and diabetes may experience erectile dysfunction symptoms as early as 10 to 15 years earlier than those that don’t have diabetes. Current

research suggests that erectile dysfunction may be an early indicator of diabetes, especially in men ages 45 and younger.

When men get an erection, several body processes come into play. The brain is turned on, the nerves send and receive pleasurable feelings and the arteries carry extra blood to the penis.

Diabetes can upset these processes.  When blood sugar stays too high for too long, both arteries and nerves that feed into the penis can become damaged. Arousal can still happen, but the physical effects might not work. This doesn’t happen overnight. Many men have diabetes for many years before they notice a problem with erections. Years of improper blood sugar management as well as a lack of exercise lead to this condition.

Another concern for men with diabetes is retrograde ejaculation. Retrograde Ejaculation is a condition where part or all of the man’s semen goes into the bladder instead of out through the tip of the penis during sexual ejaculation. Retrograde Ejaculation occurs when sphincter muscles do not function normally. These sphincter muscles normally open or close a passage to the body and in this case they don’t open a passage for semen to exit the body.  Rather, the semen enters the bladder, mixes with urine and is excreted from the body during urination.

While this is completely harmless physically, and is still a pleasurable sensation for the man during orgasm, it can cause emotional strain because it can lead to fertility problems.

Retrograde Ejaculation is caused from nerve damage resulting from poor blood glucose control. Other causes include prostate surgery and antidepressant and antipsychotic medications. Treatment includes the discontinuation of these medications as well as better blood glucose management. Patients are instructed to start exercising, adopting a healthier eating plan and checking their blood sugar more often. For patients that don’t see improvement, a qualified urologist can help by prescribing pseudoephedrine or imipramine to strengthen the muscle tone of the sphincter muscles involved. If this doesn’t remedy the problem, then semen can be extracted from the urine and used to artificially inseminate a female partner.