Diabetes and Sexual Health

Sexual problems are among the commonest complications of diabetes and among the least discussed. They are also, in many cases, treatable.

In men

More than half of men with diabetes will develop erectile dysfunction, and men with diabetes are more than three times more likely to develop it than men without — typically 10 to 15 years earlier. The cause is the same nerve and blood vessel damage that affects the rest of the body, which is why ED is sometimes the first sign that something needs attention elsewhere too.

Other recognised problems include retrograde ejaculation, Peyronie's disease, low testosterone and fertility difficulties. All have specific treatments.

In women

Less often discussed and no less common: reduced desire and arousal, insufficient lubrication, reduced sensation, difficulty reaching orgasm, and painful intercourse caused by nerve damage affecting lubrication. Recurrent yeast infections are also more likely, because higher glucose lets the organism grow.

What to do about it

• Raise it. Your doctor will not usually ask. "I want to ask about something that is not blood sugar" is enough to start.
• Do not assume it is age or stress. In diabetes it often has a physical cause with a treatment.
• Managing glucose, blood pressure and cholesterol helps, as does stopping smoking.
• Ask about your medicines. Some blood pressure and antidepressant medicines contribute, and alternatives usually exist.

This is a medical problem, not an embarrassing one — and treating it well is part of treating diabetes well.