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Sexual and urological problems of diabetes facts*

*Sexual and urological problems of diabetes facts Medically Edited by: Melissa Conrad Stöppler, MD

  • Sexual and urologic complications of diabetes occur because of the damage diabetes can cause to blood vessels and nerves.
  • Both women and men can develop sexual problems from diabetes.
  • Sexual problems in men with diabetes include erectile dysfunction and retrograde ejaculation.
  • Sexual problems in women with diabetes include vaginal dryness, painful intercourse, decreased libido, and decreased or absent sexual response.
  • People with diabetes may experience bladder problems such as overactive bladder, poor control of sphincter muscles that surround the urethra, urine retention, and urinary tract infections.
  • Those people with diabetes who are at risk of sexual or urologic problems include people who have poor glucose and blood pressure control; have high levels of cholesterol; are overweight, are over the age of 40 years, those that smoke, and lack of physical activity.
  • Individuals with diabetes can lower their risk of sexual and urologic problems by controlling glucose, blood pressure, and cholesterol numbers; being physically active and maintaining a healthy weight; and smoking cessation.

Food to Improve Your Sex Drive

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Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Viewer Question: Is there anything I can eat to improve my sex drive?

Doctor''s response to sexual stimuli is also involuntary, governed by autonomic nerve signals that increase blood flow to the genitals and cause smooth muscle tissue to relax. Damage to these autonomic nerves can hinder normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction.

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SLIDESHOW

Type 2 Diabetes Diagnosis, Treatment, Medication See Slideshow

What sexual problems can occur in men with diabetes?

Erectile Dysfunction

Erectile dysfunction is a consistent inability to have an erection firm for 1 last update 04 Aug 2020 enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection. Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection.

Estimates of the prevalence of erectile dysfunction in men with diabetes vary widely, ranging from 20 to 75 percent. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Research suggests that erectile dysfunction may be an early marker of diabetes, particularly in men ages 45 and younger.

In addition to diabetes, other major causes of erectile dysfunction include high blood pressure, kidney disease, alcohol abuse, and blood vessel disease. Erectile dysfunction may also occur because of the side effects of medications, psychological factors, smoking, and hormonal deficiencies.

Men who experience erectile dysfunction should consider talking with a health care provider. The health care provider may ask about the patient''s semen goes into the bladder instead of out the tip of 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. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may for 1 last update 04 Aug 2020 notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen. Men who experience erectile dysfunction should consider talking with a health care provider. The health care provider may ask about the patient''s semen goes into the bladder instead of out the tip of 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. With retrograde ejaculation, semen enters the bladder, mixes with urine, 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. Analysis of a urine sample after ejaculation will reveal the presence of semen.

Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.

Retrograde ejaculation caused by diabetes or surgery may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. 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.

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Many women with diabetes experience sexual problems. Although research about sexual problems in women with diabetes is limited, one study found 27 percent of women with type 1 diabetes experienced sexual dysfunction. Another study found 18 percent of women with type 1 diabetes and 42 percent of women with type 2 diabetes experienced sexual dysfunction.

Sexual problems may include

  • decreased vaginal lubrication, resulting in vaginal dryness
  • uncomfortable or painful sexual intercourse
  • decreased or no desire for sexual activity
  • decreased or absent sexual response

Decreased or absent sexual response can include the inability to become or remain aroused, reduced or no sensation in the genital area, and the constant or occasional inability to reach orgasm.

Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, psychological problems such as anxiety or depression, gynecologic infections, other diseases, and conditions relating to pregnancy or menopause.

Women who experience sexual problems or notice a change in sexual response should consider talking with a health care provider. The health care provider will ask about the patient''s quality of life. Common bladder problems in men and women with diabetes include the following:

Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include

  • urinary frequency - urination eight or more times a day or two or more times a night
  • urinary urgency - the sudden, strong need to urinate immediately
  • urge incontinence - leakage of urine that follows a sudden, strong urge to urinate

Poor control of sphincter muscles. Sphincter muscles surround the urethra - the tube that carries urine from the bladder to the outside of the body - and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when a person is trying to release urine.

Urine retention. For some people, nerve damage keeps their bladder muscles from getting the message that it is time to urinate or makes the muscles too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. If urine remains in the body too long, an infection can develop in the kidneys or bladder. Urine retention may also lead to overflow incontinence - leakage of urine when the bladder is full and does not empty properly.

Diagnosis of bladder problems

Diagnosis of bladder problems may involve checking both bladder function and the appearance of the bladder''s Diabetes Newsletter

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Who is at risk for developing sexual and urologic problems of diabetes?

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  • have poor blood glucose control
  • have high levels of blood cholesterol
  • have high blood pressure
  • are overweight
  • are older than 40
  • smoke
  • are physically inactive

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reverses diabetes type 2 dinner recipes (πŸ”₯ lifestyle changes) | reverses diabetes type 2 treatment optionshow to reverses diabetes type 2 for People with diabetes can lower their risk of sexual and urologic problems by keeping their blood glucose, blood pressure, and cholesterol levels close to the target numbers their health care provider recommends. Being physically active and maintaining a healthy weight can also help prevent the long-term complications of diabetes. For those who smoke, quitting will lower the risk of developing sexual and urologic problems due to nerve damage and also lower the risk for other health problems related to diabetes, including heart attack, stroke, and kidney disease.

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The nerve damage of diabetes may cause sexual or urologic problems.

  • Sexual problems for men with diabetes include
    • erectile dysfunction
    • retrograde ejaculation
  • Sexual problems for women with diabetes include
    • decreased vaginal lubrication and uncomfortable or painful intercourse
    • decreased or no sexual desire
    • decreased or absent sexual response
  • Urologic problems for men and women with diabetes include
    • bladder problems related to nerve damage, such as overactive bladder, poor control of sphincter muscles, and urine retention
    • urinary tract infections
  • Controlling diabetes through diet and exercise can help prevent sexual and urologic problems.
  • Treatment is available for sexual and urologic problems.

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Hope through research

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) was established by Congress in 1950 as one of the National Institutes of Health of the U.S. Department of Health and Human Services. The NIDDK conducts and supports research on diabetes, glucose metabolism, and related conditions. NIDDK-supported research on the sexual and urologic complications of diabetes includes research conducted as part of the Epidemiology of Diabetes Interventions and Complications (EDIC) study. The EDIC is an observational follow-up study of people who originally participated in the Diabetes Control and Complications Trial (DCCT). The DCCT showed that intensive blood glucose control can reduce the risk of complications of type 1 diabetes. EDIC study results suggest that tight glucose control can delay the onset of erectile dysfunction in men with type 1 diabetes.

A recent study focused on urinary incontinence in women at high risk for developing type 2 diabetes who participated in the NIDDK-sponsored Diabetes Prevention Program (DPP). The women had pre-diabetes, a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Women who were in the DPP group that used a lifestyle change approach to diabetes prevention and lost 5 to 7 percent of their weight through dietary changes and increased physical activity were compared with those in other DPP groups who received standard education and maintained a stable weight. The women in the lifestyle intervention group had fewer problems with urinary incontinence than women in the other groups. This finding adds to for 1 last update 04 Aug 2020 other results of the DPP study that indicate the value of lifestyle changes for preventing or delaying the development of type 2 diabetes. A recent study focused on urinary incontinence in women at high risk for developing type 2 diabetes who participated in the NIDDK-sponsored Diabetes Prevention Program (DPP). The women had pre-diabetes, a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Women who were in the DPP group that used a lifestyle change approach to diabetes prevention and lost 5 to 7 percent of their weight through dietary changes and increased physical activity were compared with those in other DPP groups who received standard education and maintained a stable weight. The women in the lifestyle intervention group had fewer problems with urinary incontinence than women in the other groups. This finding adds to other results of the DPP study that indicate the value of lifestyle changes for preventing or delaying the development of type 2 diabetes.

Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.

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References
SOURCE: National Diabetes Information Clearinghouse. Sexual and Urologic Problems of Diabetes.
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