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Diabetes and sexual health: What you need to know

Diabetes, a chronic condition that affects millions of people worldwide, can have a profound impact on sexual health beyond blood glucose levels. Understanding the relationship between diabetes and sexual health is essential to managing these issues, improving overall wellbeing and enhancing intimate relationships.

Diabetes and sexual health

Diabetes is a common chronic disease that impacts millions of people worldwide. While much is known about its effects on blood glucose levels, weight management and cardiovascular health, the effects of diabetes on sexual health are often less discussed. However, these effects are significant and can influence both men and women in different ways. Both men and women with diabetes may face challenges such as reduced libido, erectile dysfunction or vaginal dryness, frequently due to the disease's effects on blood flow, nerve function and hormonal balance. Understanding this relationship is crucial to managing the challenges that diabetes can pose to sexual health, thereby improving overall quality of life and intimate relationships.

Any stage at which we divide the sexual response can lead to sexual dysfunction. Let's go back to the division established by Masters and Johnson[1], which has survived to the present day with some modifications, and which defines three stages in the physiological sexual response: arousal, orgasm and resolution, using a simple and linear division. If we add the phase of desire, which can occur at any time and which in some way favours the sexual impulse, we have all the aspects that can be modified by diabetes from a physiological perspective.

Medical conditions can alter sexual desire in ways apart from the purely physical. When a person is diagnosed with a medical condition, their body image can be altered depending on their personality and pre-existing beliefs about the condition and the idea of 'being sick'. Because low self-esteem can lead to feelings of fear of rejection, people tend to avoid circumstances that require physical or sensual contact out of sheer caution. Lack of desire is a result of these feelings and unconscious avoidance for both the patient and their partner, who don't always know how to behave appropriately in sexual situations.

Before receiving a medical diagnosis, you should discuss any concerns you have about your sexuality with your doctor. This will give you the opportunity to learn more about the potential impact of the condition on your sexuality and help you avoid irrational fears. It also allows you to put an issue on the table that needs to be discussed as a couple.

How diabetes affects sexual health

Diabetes can affect sexual health through several mechanisms, mainly related to blood flow, nerve function and hormone levels.

  • Blood flow: Diabetes can damage blood vessels throughout the body, a condition known as vascular disease. In men, this damage can lead to reduced blood flow to the penis, making it difficult to achieve or maintain an erection, a condition known as erectile dysfunction. In women, poor blood flow can cause vaginal dryness and reduced sensation, leading to discomfort or pain during sex.
  • Nerve damage: Over time, high blood glucose levels can lead to neuropathy, or nerve damage. In terms of sexual health, this can reduce sensation and sexual response in both men and women. For men, this can make it harder to achieve an erection or ejaculate, while women may experience a decrease in arousal, lubrication, or the ability to reach orgasm.
  • Hormonal imbalances: Diabetes can also affect the balance of sex hormones. In men, it can lead to lower levels of testosterone, which is important for sexual desire and function. This can lead to reduced libido and other related problems. Women with diabetes may experience fluctuations in oestrogen, which can contribute to vaginal dryness, reduced sexual desire and discomfort during intercourse.

Another factor influencing sexual desire that is not purely physical is the change in the rhythm of a person's life that can be caused by illness. This is often the case when chronic conditions are first diagnosed before any changes are made, or when obstacles arise that take attention away from more significant things. An ongoing chronic process such as diabetes may require couples to take a more specialised sexual approach to provide resources for adjustment and prevention.

Low desire might be caused by arousal difficulties. In people with diabetes, especially those with poorly controlled disease or complications, the physiological processes for sexual stimulation are more impaired than in healthy people. In men, the focus is on erection, while in women the main problem is loss of lubrication in response to sexual stimulation.

In response to arousing nerve stimuli, the vascular tissue of the penis dilates and fills with blood, resulting in an erection. The stimulus, the neurotransmission, the health, and function of the blood vessels must all be sufficient for this to work properly. However, once blood sugar levels are under control, issues usually disappear if there are no other contributing factors (such as high blood pressure, smoking, being over 45–50 years old or taking medication at the same time, etc.).

Managing sexual health issues with diabetes

Despite these challenges, there are many strategies to help manage sexual health difficulties associated with diabetes. These strategies often involve a combination of medical treatment, lifestyle changes and open communication.

  1. Blood glucose control: The most important step in managing the sexual health effects of diabetes is to keep blood glucose levels under control. Proper management can help prevent or reduce blood vessel and nerve damage, thereby minimising the risk of sexual health problems. This involves a combination of medication, a healthy diet, regular exercise and monitoring of blood glucose levels.
  2. Medications: For men with erectile dysfunction, drugs such as phosphodiesterase type 5 inhibitors (e.g. Sildenafil, Tadalafil or Vardenafil) can be effective. However, it is essential to consult a healthcare professional as these drugs may interact with other medications commonly used by people with diabetes. Women may benefit from lubricants or estrogen therapy to combat vaginal dryness, but these should also be discussed with a healthcare professional.
  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet and maintaining a healthy weight can improve overall blood flow and nerve function, which are important for sexual health. Quitting smoking and limiting alcohol intake can also help, as both can exacerbate sexual health issues.
  4. Counselling and communication: Psychological factors such as stress, anxiety, or depression can have a significant impact on sexual health. People with diabetes may experience these feelings as they manage their condition. Talking to a counsellor or therapist can help address these issues. Open communication with a partner is also indispensable. Discussing concerns and exploring ways to maintain intimacy can strengthen the relationship and reduce the stress associated with sexual health problems.
  5. Regular medical check-ups: Regular visits to a healthcare professional are essential for people with diabetes. These check-ups allow early detection and management of any complications, including those related to sexual health. Don't hesitate to discuss any sexual health concerns with your doctor, it's an important part of your overall wellbeing.

When it comes to diabetes-related erectile dysfunction, generic erectile dysfunction drugs such as Kamagra can often be used to treat the condition quickly and effectively. Ajanta Pharma's Kamagra has been the world's most popular erectile dysfunction medication since its introduction in 2003.

How to have a good sex life with diabetes

Diabetes can have a significant impact on sexual health, but understanding the relationship between the two can help people manage these challenges effectively. By maintaining good blood glucose control, adopting a healthy lifestyle, seeking appropriate medical treatment and maintaining open communication, people with diabetes can have a fulfilling and satisfying sexual life. Remember that sexual health is a significant aspect of overall wellbeing, and addressing these issues is essential for a healthy, happy life.

Treating these problems can be more challenging if diabetes is long-standing and/or has neurological or vascular consequences, in addition to other problems, such as difficulty achieving orgasm in either sex. Always remember that the best way for people with diabetes to maintain a full and enjoyable sexual life is to have adequate metabolic control and to take action/preventive measures in the event of difficulties.

Always seek the advice of a healthcare professional if you have any questions about erectile dysfunction and diabetes.

References

  1. William H. Masters, Virginia E. Johnson (1966), "Human Sexual Response", wikipedia.org