Diabetes and Midlife Sexuality

 
How are diabetes and sexual dysfunction related?

Diabetes may affect the sexual function of both men and women. .

Some men who have diabetes have a problem with impotence (the ability to have and maintain an erection). In fact, impotence, along with the need to urinate often, may be an early sign of diabetes. Impotence occurs in men with type 1 diabetes as well those with type 2 diabetes.

Changes may more be subtle in women with diabetes. It may become harder for them to have an orgasm.

How much diabetes affects sexual function may depend on how severe the disease is and how old you are when the disease begins.

Diet and medication to regulate blood sugar levels are very important in controlling diabetes.

How does diabetes affect sexual function?

Diabetes in men can lead to hardening and narrowing of the blood vessels that supply the erectile tissue of the penis. This spongy tissue swells and stiffens the penis during an erection. Decreased blood flow to the penis may cause erectile problems. For example, the penis may be less rigid during erection. Diabetes may also affect nerve function.

In women, diabetes can lead to hardening of the blood vessels of the vaginal wall. Decreased blood flow due to diabetes may cause the vagina to be too dry, both normally and during arousal. It also may cause a woman to be at much greater risk of getting recurring yeast infections.

In women, the combination of diabetes and menopause may cause:

  • a 50% decrease in vaginal blood supply due to low estrogen levels
  • vaginal secretions that are less acidic and less protective, which lowers the resistance to bacteria in the vagina and increases the risk of yeast infection
  • levels of glucose in vaginal mucus that may help cause yeast infections

Women may notice that they are not as easily aroused. They may be less sensitive to touching and stroking, which can result in decreased interest in sex.

How is the sexual dysfunction treated?

Treatment for the menopausal, diabetic woman includes medication.

If a woman is having pain with intercourse, treatment, together with possible medication, includes:

  • early diagnosis of the diabetes and a pelvic exam, including a Pap smear and maturation index (shows the level of estrogen in your body)
  • treatment for any vaginal infections
  • use of lubricants
  • control of the diabetes with diet, if possible, in addition to medication .

Treatment for the older, diabetic man may include:

  • having intercourse only when well rested (early morning hours may be better because testosterone levels are higher then)
  • having certain tests such as a Doppler study to check for adequate blood flow in the penis or sleeping in the hospital to see if erections occur during sleep
  • injecting medication into the erectile tissue of the penis to produce erections that can result in intercourse
  • considering implanted penile devices that improve the function of the penis if blocked blood vessels leading to the penis continue to cause problems
  • using a vacuum device to draw the blood to the erectile tissues. A temporary device (band) to constrict blood flow can then be used to maintain the erection for long enough to have sex one time. This can be repeated as needed. The device should not be left on for longer than 20 to 30 minutes at a time. The penis will become soft again when the device is removed. Ejaculation response varies.
  • Medication

Written by James P. Semmens, M.D.
Published by iMcKesson Clinical Reference Products.
Copyright 1991-2000 iMcKesson LLC. All rights reserved.

Adapted from content provided by iMcKesson, LLC
Review Date: 7/29/2001