Diabetes can have a profound impact on the sex life of people living with diabetes, particularly since it affects the nerves in the form of neuropathy and can lead to a loss of sensation in the penis, clitoris and vagina.
Until recently, erectile dysfunction was one of the most neglected complications of diabetes. Erectile dysfunction is common in men who have diabetes, especially those with type 2 diabetes. It is estimated that up to 75% will experience some degree of erectile dysfunction over the course of their lifetime and it seems to occur earlier in men with diabetes than in men without the disease.
Erectile dysfunction is the inability to get or maintain an erection firm enough for sex. In order to obtain an erection, men need to have healthy blood vessels, nerves, male hormones and a desire to have sex. Causes of erectile dysfunction are complex and based around changes that occur to the body over time, affecting nerve, muscle, and blood vessel functions, often due to poor long-term blood sugar control. Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease.
Luckily, awareness of this significant and common complication of diabetes has increased in recent years, mainly due to better understanding of male sexual function and the rapidly expanding array of novel treatments.
Having erectile dysfunction can be a challenge and many men hesitate to discuss it with their doctors. But seeking advice can make a big difference. A healthcare provider will consider underlying causes of the dysfunction and provide advice about oral medicine, such as Viagra, Cialis and Levitra, and other treatments, including intracavernous injection therapy, vacuum constriction devices, intraurethral therapy and sex therapy. Recent preclinical and clinical trials have demonstrated that gene therapy strategies may also be feasible as the penis is a convenient tissue target for gene therapy with its external location and accessibility, the ubiquity of endothelial-lined spaces, and low level of blood flow, especially in the flaccid state. Good lifestyle choices can also have a profound impact. Losing excess weight, stopping smoking, limiting alcohol use and increasing physical activity are all important factors to prevent erectile dysfunction.
But it´s not only about the men. Diabetes and female sexual dysfunction tend to get less coverage than male sexual dysfunction but studies have found that the prevalence in women could be as much an issue as for men. Indeed, nerve damage can reduce sensitivity and vascular damage can affect blood supply to the vagina and clitoris, which can cause problems with dryness and arousal.
Sexual problems are an under-recognized, under-discussed, and commonly untreated complication of diabetes. They´re also one of the most treatable diabetic complications. Knowledge of sexual dysfunction is rapidly expanding, and effective new treatments are available or being introduced. It is therefore important for both people living with diabetes and healthcare professionals to be well informed and aware of the causes and treatments of sexual dysfunction due to diabetes.