Men and women with diabetes can develop sexual health issues because of damage to small blood vessels and nerves. People who keep their blood sugars under control can reduce the chance of developing sexual and urologic problems. Find out more about the links between sexual health and diabetes.
- Men with diabetes may experience erectile dysfunction. This is a consistent inability to develop a firm erection for sexual intercourse. Men who have diabetes are up to three times more likely to experience erectile dysfunction than men who do not have diabetes. Additional causes of erectile dysfunction include blood vessel disease, kidney disease, high blood pressure and alcohol abuse. Neuropathy, or nerve damage which is often associated with diabetes, can be a cause of erectile dysfunction. Potential treatments include a vacuum erection device, oral medications, shots directly into the penis, pellets in the urethra and psychological counseling.
- Another sexual health issue for men with diabetes is retrograde ejaculation. All or part of the man’s semen goes into the bladder rather than out of the penis when ejaculating. This happens when internal muscles, referred to as sphincters, do not function properly. Poor blood glucose control and nerve damage can lead to retrograde ejaculation. Other causes include certain medications and prostate surgery. It is important to maintain healthy blood sugar levels and consult with your doctor about ongoing highs or lows. A medication that strengthens the muscle tone of the sphincter may help men with retrograde ejaculation. When it comes to fertility, an urologist who specializes in infertility treatments can help promote fertility through methods such as collecting the sperm for artificial insemination.
- More than 40 percent of women with type 2 diabetes experience sexual dysfunction. These symptoms may include vaginal dryness, painful sexual intercourse, decreased or absent sexual response and a lower desire for sexual activity. Women might find it difficult to become aroused, experience reduced sensation and may be unable to reach orgasm. Causes include reduced blood flow to the vaginal tissues, nerve damage, certain medications, alcohol and hormonal changes. Sexual issues can also be linked with smoking, gynecologic infections, menopause, pregnancy and psychological problems such as depression or anxiety. Treatments may include vaginal lubricants for vaginal dryness; psychological counseling for emotional issues and Kegel exercises to strengthen the pelvic muscles and help improve sexual response. Researchers are currently studying potential drug treatments.
- Urologic problems linked with diabetes may also cause sexual health issues. Bladder problems can be caused by damage to the nerves that control the bladder functions. Men and women may experience an overactive bladder. A person may have a sudden, strong urge to urinate and have leakage of urine, referred to as incontinence.
- Other bladder problems include poor control of the sphincter muscles that leads to leakage. Urine retention may occur when nerve damage keeps the bladder muscles from getting the message that it is time to urinate. The muscles might be too weak to fully empty the bladder. The bladder could back up and become too full, leading to an infection in the bladder or kidneys. To detect if a person has bladder problems, tests such as a cystoscopy, urodynamic testing and x-rays may be done. Medications could be prescribed for urine retention. A catheter might need to be used to help drain the urine. Other potential treatments include surgery, timed voiding, medications and Kegel exercises.
- Urinary tract infections occur when bacteria reach the urinary tract. Bacteria growing in the urethra are called urethritis. If this bacteria travels up the urinary tract, it can lead to a bladder infection called cystitis. An untreated infection can lead to a kidney infection and related sexual health issues. Symptoms of a urinary tract infection include cloudy urine, an urge to urinate frequently and burning during urination. Men may feel fullness in the rectum and women could have a feeling of pressure over the pubic bone. If a person feels pain in the back or side, gets a fever and becomes nauseous, this could indicate a kidney infection. The doctor will take a urine sample to analyze. Other tests that might be done include an ultrasound exam, cystoscopy and an intravenous pyelogram. It is important to detect a urinary tract infection early to avoid more serious health issues. Often an antibiotic treatment is prescribed and the patient is advised to drink plenty of water.
- People with diabetes can help prevent sexual and urologic problems by keeping their blood sugar, blood pressure and cholesterol levels close to the target number. Smokers should quit immediately due to increased nerve damage. It helps to maintain a healthy weight and be physically active.
It is important for people with diabetes to have an effective self-management plan to reduce the possibility of developing sexual health problems. If you do have sexual health issues, communicate your problems with your physician immediately to get the treatment you need.