»  Education Center
EDUCATION CENTER: Clinical Overview


Clinical Overview

Sexual Problems and Diabetes

Clinical Overview
Reviewed by Michael Fuller, MD

Sexual Problems in Men With Diabetes

Erectile Dysfunction

Estimates of the prevalence of erectile dysfunction in men with diabetes range from 20 percent to 85 percent. Erectile dysfunction is defined as a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection, the inability to sustain an erection, or the occasional inability to have or sustain an erection. A recent study of a clinic population revealed that five percent of the men with erectile dysfunction also had undiagnosed diabetes.*

Men who have diabetes are three times more likely to have erectile dysfunction as men who do not have diabetes. Among men with erectile dysfunction, those with diabetes are likely to have experienced the problem as many as 10 to 15 years earlier than men without diabetes.

In addition to diabetes, other major causes of erectile dysfunction include high blood pressure, kidney disease, alcoholism, and blood vessel disease. Erectile dysfunction may also occur because of the side effects of medications, psychological factors, smoking, and hormonal deficiencies. Some of these factors may be related to diabetes; others may occur independently.

If you experience erectile dysfunction, talking to your doctor is the first step toward getting help. Your doctor may ask about your medical history, the type and frequency of your sexual problems, your medications, your smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may help pinpoint causes. Your blood glucose control and hormone levels will be checked. The doctor may also ask you whether you are depressed or have recently experienced upsetting changes in your life. In addition, you may be asked to do a test at home that checks for erections that occur while you sleep.

Treatments for erectile dysfunction caused by nerve damage, also called neuropathy, vary widely and include oral pills, a vacuum pump, pellets placed in the urethra, injections directly into the penis, and surgery. All these methods have benefits and drawbacks. Psychotherapy to reduce anxiety, depression or address other issues may be helpful. Surgery to implant a device to aid in erection or to repair arteries is another option.

* Sairam K, Kulinskaya E, Boustead GB, Hanbury DC, McNicholas TA. Prevalence of undiagnosed diabetes mellitus in male erectile dysfunction. BJU International. 2001;88(1):68–71.

Retrograde Ejaculation

Retrograde ejaculation is a condition in which part or all of a man's semen goes into the bladder instead of out the penis during ejaculation. Retrograde ejaculation occurs when internal muscles, called sphincters, do not function normally. A sphincter automatically opens or closes a passage in the body. The semen mixes with urine in the bladder and leaves the body during urination, without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. His urine may appear cloudy; analysis of a urine sample after ejaculation will reveal the presence of semen.

Poor blood glucose control and the resulting nerve damage are associated with the lack of sphincter control that causes retrograde ejaculation. Other causes include prostate surgery or some blood pressure medicines.

Retrograde ejaculation caused by diabetes or surgery may be improved with a medication that improves the muscle tone of the bladder neck. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination.

More Information on Erectile Dysfunction

For additional information, see the fact sheet Erectile Dysfunction, available from the National Kidney and Urologic Diseases Information Clearinghouse at 1–800–891–5390. This fact sheet is also available online.

Sexual Problems in Women With Diabetes

Decreased Vaginal Lubrication

Nerve damage to cells that line the vagina can result in dryness, which in turn may lead to discomfort during sexual intercourse. Discomfort is likely to decrease sexual response or desire.

Decreased or Absent Sexual Response

Diabetes or other diseases, blood pressure medications, certain prescription and over-the-counter drugs, alcohol abuse, smoking, and psychological factors such as anxiety or depression can all cause sexual problems in women. Gynecologic infections or conditions relating to pregnancy or menopause can also contribute to decreased or absent sexual response.

As many as 35 percent of women with diabetes may experience decreased or absent sexual response. Decreased desire for sex, inability to become or remain aroused, lack of sensation, or inability to reach orgasm can result.

Symptoms include:

  • Decreased or total lack of interest in sexual relations

  • Decreased or no sensation in the genital area

  • Constant or occasional inability to reach orgasm

  • Dryness in the vaginal area, leading to pain or discomfort during sexual relations

    If you experience sexual problems or notice a change in your sexual response, talking to your doctor about it is the first step toward improvement. Your doctor will ask you about your medical history, any gynecologic conditions or infections, the type and frequency of your sexual problems, your medications, your smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may also help pinpoint causes. Your blood glucose control will be discussed. The doctor may ask whether you might be pregnant or have reached menopause and whether you are depressed or have recently experienced upsetting changes in your life.

    Prescription or over-the-counter vaginal lubricant creams may be useful for women experiencing dryness. Techniques to treat decreased sexual response include changes in position and stimulation during sexual relations. Psychological counseling, as well as Kegel exercises to strengthen the muscles that hold urine in the bladder, may be helpful. Studies of drug treatments are currently under way.

    Last updated: Dec-20-07

  • Lifestyle Change Emotion Part7
    Relaxation Techniques- Lifestyle Changes and Emotions
    Some suggestions for relaxation techniques...
    more more Featured Videos
    Cost Savings Tool
    Do you know the annual cost of managing your diabetes? Would you like to find ways to reduce your costs? Calculate your total budget and identify ways to save money. You can do this in just a few minutes by entering facts about the products you use. This quick analysis will provide you with a comprehensive overview of both spending and potential savings.

    Cost Savings Tool
    Monitor Comparison Tools
    Blood glucose monitors offer an easy way to test your blood sugar at home or on the go. Use this comparison tool as a guide to learn more about the features and benefits of your current monitor or to find a new one.
    Handheld Monitor Comparison
    Continuous Glucose Monitor Comparison
    Advanced BMI Calculator
    Ever wonder if you are at a healthy weight? Then enter your height and weight in our advanced Body Mass Index (BMI) calculator. This tool provides you with two important numbers reflecting the estimated impact of your present body weight and shape upon your overall health.
    Advanced BMI Calculator
    more Care Tools
    Home | About Us | Press | Make a Suggestion | Content Syndication | Terms of Service | Editorial Policy | Privacy Policy
    Last updated: Nov 29, 2020  © 2020 Body1 All rights reserved.