Diabetes and Its Impact on Sexual Functioning
People living with type 2 diabetes may face challenges with sexual function due to the damage caused to blood vessels and nerves essential for sexual response. High glucose levels lead to endothelial damage and atherosclerosis, restricting blood flow to the penis, making it difficult to achieve and maintain an erection. Diabetic neuropathy also impairs the transmission of signals required for erections.
Moreover, type 2 diabetes and obesity are often associated with lowered testosterone levels, contributing to reduced sexual desire and worsening ED symptoms. Even slightly elevated blood sugar levels below the diabetic range can correlate with declined sperm movement and erectile function.
Fortunately, there are treatment options available for both men and women to resume an active, enjoyable sex life.
Managing Diabetes-Related Sexual Dysfunction
Improving glycemic control through diet, exercise, and weight management is fundamental in treating diabetes-related sexual dysfunction. By reducing vascular and nerve damage and stabilising testosterone levels, lifestyle changes can significantly improve sexual function.
Anti-obesity medications like semaglutide, dulaglutide, or tirzepatide can aid weight loss and have been shown to increase testosterone levels in men with obesity and type 2 diabetes, potentially improving sexual function.
Testosterone therapy may be considered when low testosterone significantly contributes to symptoms, though testosterone alone does not directly improve erections. Phosphodiesterase type 5 inhibitors (e.g., sildenafil), commonly used drugs to treat ED by enhancing blood flow, are also an option, though their effectiveness depends on the extent of vascular and nerve damage.
Psychological Support
Managing stress and mental health can also support sexual function. Depression and anxiety are common conditions that occur alongside diabetes and can negatively impact the libido or lead to the use of medication that affects sexual interest or function.
Open Communication with Healthcare Providers
Sex is an important component of a high-quality life, and it's important to bring up any concerns about sexual dysfunction with your provider. Approximately 80% of patients prefer if a doctor asks about sexual function, so they don't have to bring it up.
Obesity, high blood pressure, sleep apnea, depression, and anxiety are common conditions that occur alongside diabetes and can increase the risk of sexual dysfunction. Lessened or nonexistent libido, arousal inability, decreased sensation, intercourse-related pain, and infections in individuals with diabetes may be connected.
Continued Communication with Your Care Team
Changes in testosterone or estrogen due to diabetes, menopause, or co-occurring conditions can impact libido, lubrication, and the ability to become sexually aroused. If you don't see instant success with the initial treatment options, keep talking with your care team to move to the next option.
Diabetes affects both men and women, and the longer one has diabetes, the more likely they are to experience sexual dysfunction. Endocrinologist Shirisha Avadhanula, MD, explains that diabetes can cause sexual dysfunction, including problems in attaining an erection, reduced libido, arousal inability, decreased sensation, intercourse-related pain, and infections.
- People with type 2 diabetes might face challenges in their sexual function due to damage caused to blood vessels and nerves, which are essential for sexual response.
- Improving glycemic control through diet, exercise, and weight management can help treat diabetes-related sexual dysfunction by reducing vascular and nerve damage, and stabilizing testosterone levels.
- Managing stress and mental health conditions, like depression and anxiety, can also support sexual function, as they are common conditions that occur alongside diabetes and can negatively impact the libido.
- If initial treatment options for diabetes-related sexual dysfunction don't yield instant results, it's important to continue communicating with your care team to explore other options.
