People living with diabetes are aware of the various health complications their condition can bring. However, one often overlooked aspect is the impact of diabetes on sexual health. Both men and women with diabetes can experience sexual dysfunction, but it often goes unspoken due to its sensitive nature and cultural and social taboos.
Sexual dysfunction is relatively common worldwide and more common in men and women with diabetes compared to those without the condition. The frequency in people with diabetes varies depending on gender, type of diabetes and location.
A 2023 study, Global prevalence of sexual dysfunction among diabetic patients from 2008 to 2022, found that globally, 61% of people with diabetes experienced sexual dysfunction, with a higher prevalence of 71% in people with type 2 diabetes. These results only reinforce the case for including regular screening and providing appropriate treatment for sexual complications in diabetes care.
Sexual dysfunction in diabetes stems from different physical and psychological causes and factors. In both men and women, chronic high glucose levels can damage nerves and blood vessels, including those involved in sexual function. Further causes can be a hormone imbalance or even treatment to lower blood pressure.
In both men and women, chronic high glucose levels can damage nerves and blood vessels, including those involved in sexual function.
In men, nerve damage can lead to erectile dysfunction, while other symptoms may include decreased sexual desire and delayed ejaculation. Erectile dysfunction (ED) is the inability to achieve or maintain an erection suitable for sexual intercourse. Men with diabetes have a threefold risk of ED than men without the condition. In fact, ED is the most reported sexual health issue among men with diabetes, with approximately 50% of men with type 1 diabetes experiencing the complication.
Meanwhile, about 35-70% of women with type 1 and type 2 diabetes also experience a range of sexual concerns. Women may experience reduced sexual desire or libido, decreased lubrication, and diminished sexual response due to nerve damage.
Unsurprisingly, there is less research available on sexual complications in women with diabetes, the focus being mainly on erectile dysfunction in men. Furthermore, healthcare professionals often do not ask women with diabetes about their sexual health.
Additionally, depression, anxiety and stress, all frequent in people with diabetes, as well as common problems that arise in relationships, can significantly impact sexual desire.
If you experience any issues related to sexual health, it is vital to discuss them with your healthcare provider. These issues can indicate a diabetes complication, such as neuropathy or CVD, or that your current treatment is not working.
Fortunately, treatment options are available for sexual dysfunction in diabetes. These include lifestyle changes, medication and counselling.
Maintaining a healthy lifestyle is key to diabetes management and can help mitigate sexual complications. A healthy lifestyle includes monitoring glucose levels, eating healthy foods, exercising regularly and reducing stress.
Maintaining a healthy lifestyle is key to diabetes management and can help mitigate sexual complications. A healthy lifestyle includes monitoring glucose levels, eating healthy foods, exercising regularly and reducing stress.
Medications available to treat sexual dysfunction in diabetes include phosphodiesterase type 5 (PDE5) inhibitors, which prove effective in treating erectile dysfunction having a physical cause, such as poor circulation. Furthermore, metformin, when used with inhibitors, can reduce vasculogenic erectile dysfunction, a condition due mainly to blockages or narrowing of the blood vessels.
Another treatment that has been successful in men with hypogonadism — caused by hormone deficiencies — is transdermal gels. Hormonal replacement therapy (HRT) can also help both men and women with issues such as erectile dysfunction and decreased libido.
Seeking guidance from your healthcare provider is important. You can be open and honest with them about any sexual health concerns you may have. Likewise, mental health professionals can help address any emotional or relationship issues that may be affecting your sex life.
Sometimes, lack of communication can harm the sexual and intimate side of a relationship, even resulting in separation or divorce. So, keep an open line of communication with your partner about any sexual issues. Often, counselling can help you articulate issues and be more open with your partner.
Remember, you are not alone, and resources and treatments are available. Your sexual health matters and deserves the same care and attention as any other aspect of your well-being. By breaking the silence on this sensitive and often unspoken issue, people with diabetes can access treatment and enjoy a fulfilling and healthy sex life.
