Today, let’s discuss the dangers of obesity and diabetes on the sexual function of patients.
We all know that obesity and diabetes are closely related – it is estimated that about 90% of type 2 diabetes is caused by excessive obesity. Obesity and diabetes can influence and interact with each other, with obesity leading to insulin resistance and insulin deficiency, exacerbating the patient’s diabetes and thus exacerbating
The symptoms and chronic complications of type 2 diabetes are doubly harmful to the patient.
As Joslin’s Diabetes Handbook says: “Diabetes is caused by obesity, and diabetes is caused by obesity”! Today, we will focus on the dangers of obesity and diabetes on the sexual function of patients.
Obesity and diabetes can both affect sexual function
The clinical reality is that, on the one hand, the incidence of ED in men with diabetes is three times higher than normal, and the incidence increases with age; on the other hand, there are many people with diabetes combined with obesity, obesity, especially the larger the waistline the higher the chance of erectile dysfunction (ED) in men. The two evils together, it can be said that obesity makes male diabetic patient’s unspeakable “worse”.
1, obesity and sexual dysfunction
According to the survey shows that in obese men have sexual dysfunction or similar sexual life problems accounted for about 60%, manifested as sexual desire, penile erection, ejaculation during sex and sexual feelings on the low.
Obese people generally have dyslipidemia and hypercholesterolemia and hypertriglyceridemia, and these diseases themselves cause metabolic disorders in the body. A small amount of estrogen exists in normal men, and most of these estrogens are transformed from androgens, with a very small amount being secreted directly from the seminal vesicles.
Although the blood estrogen is very small, it has an important regulatory role in the secretion of gonadotropin by the pituitary gland and testosterone by the testes. In obese people, the increase of body fat makes androgens transform into estrogen more often, and the concentration in blood can increase about 1 times, androgens will be reduced relatively or absolutely, which will manifest as the decrease of sexual desire, the weakening or loss of erectile and sexual intercourse function, and also the ejaculatory dysfunction.
Although obesity in general does not have a significant effect on sexual function, but if the weight is too heavy, sexual intercourse is difficult and problems can occur from the image and self-confidence. Therefore, mental factors are also a cause of impotence caused by obesity.
2.Diabetes and sexual dysfunction
Sexual dysfunction is one of the common complications of diabetes, because the blood sugar in the patient’s body is at a high level for a long time, which will lead to a number of lesions in the peripheral nerves, autonomic nerves and peripheral arterial vessels. When the lesions accumulate to the peripheral nerves near the penis, it can cause the penis to be less sensitive to stimulation, which can easily lead to impotence in the long run. Higher blood sugar levels are the main cause of peripheral nerve and autonomic nerve lesions.
Obesity leads to insulin resistance and insulin deficiency, increasing the difficulty of glucose-lowering treatment, which inevitably makes the symptoms of sexual dysfunction more serious.
What should be done in the face of “unspeakable problems”?
In view of this, for the treatment of obese type 2 diabetic patients ED, we should pay attention to the close relationship between sexual dysfunction and obesity and diabetes, and pay more attention to the weight control of type 2 diabetic patients based on the control of patients’ blood glucose, blood pressure, blood lipids and other clinical goals, specifically in the following aspects: 1.
1, diet control: control the total energy, develop a balanced dietary habits, reasonable distribution of protein, fat, carbohydrate ratio.
2, exercise exercise: aerobic exercise is the main, pay attention to the intensity of exercise, time and other elements, and pay attention to prevent the occurrence of hypoglycemia.
3, psychological intervention: for patients to strengthen psychological intervention, through professional psychologists or diabetes specialist psychological guidance, to help patients gradually improve their lifestyles, from weight loss and exercise to gain self-confidence, eliminate anxiety, do not produce inferiority complex thoughts, the wife should give more comfort, improve sexual satisfaction, to help them get through this difficult time.
4, the choice of glucose-lowering drugs: pay attention to the impact of glucose-lowering drugs on weight, it is recommended that the preferred drugs with lower weight or less impact on weight (commonly used drugs see the table below).
(The effect of glucose-lowering drugs on body weight)
5, strengthen monitoring: blood glucose monitoring, generally every 3-6 months to measure HbA1c; weight monitoring, measured once a month, weight loss of at least > 3%;
6, patients should pay attention to the impact of drugs on weight and sexual function when using other drugs in combination: such as beta-blockers increase weight and affect sexual function; statins increase blood sugar and affect sexual function; certain antidepressants and anxiety drugs increase weight and affect sexual function. Thiazide diuretics, some antihypertensive drugs such as reserpine, guanethidine affect sexual function; cardiac glycosides, amiodarone can also cause sexual dysfunction.
7, some patients through strict blood glucose and weight control, with psychological intervention: ED symptoms can gradually improve, for the more severe symptoms can be based on the mastery of the indications, the application of sildenafil treatment or Chinese medicine conditioning.