Diabetes and Sexual Malfunction: A Closer Look at Their Connection
Sexual dysfunction is a common issue faced by individuals with Type 2 diabetes, and it's essential to understand the factors contributing to this problem.
Sexual dysfunction arises from a combination of vascular, neurological, hormonal, metabolic, psychological, and lifestyle factors. High blood sugar damages the endothelial lining of blood vessels, leading to atherosclerosis and reducing blood flow essential for sexual function. Diabetes can also cause neuropathy that impairs nerves transmitting signals necessary for sexual arousal and function.
Hormonal imbalances, such as lowered testosterone levels, are common in men with diabetes and can reduce libido and worsen sexual dysfunction. Women with diabetes may also experience hormonal effects that disrupt libido. Insulin resistance and metabolic syndrome further raise the risk of sexual dysfunction, as they lead to reduced nitric oxide production, worsening endothelial function and erectile dysfunction.
Psychological factors, such as anxiety about hypoglycemia during sexual activity, depression, decreased self-confidence, and body image concerns, are common and can exacerbate sexual dysfunction. Sleep apnea, common in those with obesity and Type 2 diabetes, can reduce oxygenation at night, causing inflammation, vascular damage, and lower testosterone, all contributing to ED.
Lifestyle factors, such as physical inactivity, obesity, and poor blood sugar control, worsen insulin resistance, circulation, and nerve health, increasing the risk of sexual dysfunction. However, exercise improves insulin sensitivity, circulation, and nerve function and can help reduce sexual dysfunction symptoms.
Sexual dysfunction can include problems such as reduced libido, inability to achieve arousal, decreased sensation, intercourse-related pain, and infections. High levels of glucose can damage nerves, leading to decreased sexual sensation or painful intercourse.
Some medications used to manage depression or anxiety can inhibit arousal or sexual interest. High blood pressure medications can also impact the ability to achieve or maintain an erection. Obesity, high blood pressure, sleep apnea, and depression are common conditions associated with diabetes and can contribute to sexual dysfunction.
Endocrinologist Shirisha Avadhanula, MD, states that sexual dysfunction can occur in individuals with diabetes, affecting various aspects of the sexual response cycle. She encourages discussing any concerns with your provider, as sex is an important component of a high-quality life. Approximately 80% of patients prefer if a doctor asks about sexual function.
There are treatment options for both men and women experiencing sexual dysfunction. Keeping open communication with your care team can help move towards finding effective treatment options. By managing blood sugar, improving metabolic health, addressing psychological issues, and making lifestyle changes, individuals with Type 2 diabetes can improve their sexual health.
[1] American Diabetes Association. Diabetes Care 2018;41(Suppl 1):S13-S80. [2] American Association of Clinical Endocrinologists. AACE Clinical Practice Recommendations for Diabetes Management and Strategies to Prevent Complications 2018. Endocrine Practice. 2018;24(Suppl 1):1-106. [3] Mayo Clinic. Diabetes and sexual dysfunction. 2021. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/sexual-dysfunction/art-20047318 [4] National Institute of Diabetes and Digestive and Kidney Diseases. Sexual Dysfunction and Diabetes. 2021. https://www.niddk.nih.gov/health-information/diabetes/sexual-health-diabetes [5] National Women's Health Network. Diabetes and Sexual Health. 2021. https://www.nwhn.org/diabetes-and-sexual-health/
- Chronic diseases like Type 2 diabetes can lead to health issues beyond blood sugar management, such as sexual dysfunction, which may stem from factors like hormonal imbalances, neuropathy, and psychological conditions.
- Management of mental health, particularly anxiety and depression, plays a crucial role in managing sexual dysfunction in individuals with Type 2 diabetes, as these conditions can exacerbate the issue.
- Lifestyle changes, such as regular exercise and maintaining a balanced diet, can help improve metabolic health and nerve function, reducing the risk of sexual dysfunction in individuals with Type 2 diabetes.
- In addition to medical treatments for Type 2 diabetes, addressing sexual health concerns requires open communication with healthcare providers, along with counseling for psychological factors and education on sexual health and wellness.
