Sexual Disorders: Diabetes is an increasingly common disease. It can cause sexual difficulties in both men and women. Which and by what mechanisms?
Before discussing the difficulties of diabetes, let’s begin by clarifying that diabetes is not necessarily a risk factor in sexual life. Being diabetic does not necessarily imply sexual problems. Thus, Joel, 69, diabetic and suffering from prostate adenoma, an increase in prostate volume, has no sexual difficulty. Yet, he has been diabetic for 20 years! To give a figure, according to studies, 20 to 71% of men with diabetes also suffer from sexual disorders.
We see that the range is vast, and the figures correspond to different realities depending on the importance of the disorders, the age of diabetes, the quality of its follow-up, etc. In women with diabetes, 27% have sexual dysfunction, compared to 14% in non-diabetic women. But sexual dysfunctions have been much less studied in women.
A diabetic man is two to three times more likely to suffer from an erection problem than a man without diabetes. This phenomenon is since diabetes damages the large as well as the small arteries over time and that it is a source of neuropathy, poor conduction of the nerve impulse, which also concerns the nerves of the erection. To reduce the risk of erectile dysfunction, a man with diabetes must seek to best balance his diabetes. This decreases the risk of erectile dysfunction.
Erection treatments are also effective in men with diabetes, such as Viagra® (or Sildenafil generic), Cialis®, or Levitra®. But, it is likely that if a man with diabetes takes one of these drugs, he will need it consistently to compensate for the impairment of his erectile device by diabetes. Intracavernous injections (injection of an active ingredient into the penis) to trigger an erection are also widely used in diabetic men when tablets are not enough.
Diabetes can cause retrograde ejaculation in men. At the moment of ejaculation, the sperm, instead of going out through the urethra, rises in the bladder. Some men talk about “dry” ejaculation, but this is a short term, since sperm is present, even if it does not follow the usual trajectory. This phenomenon of retrograde ejaculation is due to the fact that the lock closing the bottom of the bladder loses its effectiveness.
Ejaculation causing a powerful spray of sperm succeeded in forcing this lock and sperm rises in the bladder. Subsequently, when this man is going to urinate, sperm is mixed with urine. This can lead to infertility problems. Poor control of diabetes and neuropathy (nerve damage) can be the cause of this ejaculation disorder. In some cases, a drug that strengthens the tone of the bladder lock can be effective.
Note that the sensation of pleasure linked to ejaculation does not change in a man suffering from retrograde ejaculation. However, it is often embarrassed psychologically by the absence of visible sperm.
If a diabetic man can suffer from an erection problem, a diabetic woman may suffer from the corresponding challenge: a dysfunction of her vaginal lubrication at the time of sexual arousal. Diabetic macroangiopathy, damage to the arteries and nerves, and also to those in the genital area and neuropathy due to diabetes will cause in women a decrease in the swelling of the sexual tissues around the vagina and the clitoris and a drop in lubrication.
The diabetic woman may thus experience pain at penetration due to vaginal dryness due to a lack of reaction of the sexual areas leads to excitement. To limit these problems, we must, of course, start by balancing diabetes as well as possible. On the other hand, using lubricants can compensate for the lack of lubrication. And then muscle building the muscles of the perineum can help to keep or restore better vaginal lubrication.
In women with diabetes, it is more common to observe problems to keep sexual arousal and to achieve orgasm. Similarly, problems of desire are also more frequent.
In men with diabetes, there may also be decreases in sexual desire. It is very difficult to know whether desire disorders are related to diabetes or other sexual difficulties. It is well understood that a man who is afraid of losing his erection or fears not to see ejaculation may have less desire for a sexual relationship likely to confront him with these difficulties.
Similarly, a woman with diabetes who anticipates pain at penetration may see her desire diminishes. It is, therefore, vital to begin by tackling concrete problems so that desire can last and flourish.
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