When people think about what it means to have diabetes, “great sex” may not come to mind, but sexual problems may.
“People with diabetes should be able to have sex just as often as people without diabetes.” said David G. Marrero, PhD, president of the American Diabetes Association’s Department of Health Care and Education. “If you want a long-lasting, full sex life, you just need to use your brain and learn more about what you can do to improve the quality of your sex life.”
Don’t believe it? After all, diabetes can cause low sex drive and erectile difficulties in men with the condition. But experts say controlling diabetes can prevent sexual problems or improve existing ones, making them easier to treat. In men with diabetes, most treatments are effective.
Here are some of the most common sexual problems and how they can be prevented and treated.
Erectile dysfunction
Erectile dysfunction (ED) – the inability to get an erection – is the leading sexual problem among men with diabetes. Of course, all men are at risk for ED, and it is especially likely to occur as they age. But if you are diabetic, you are 1 times more likely to develop ED at a younger age.
Erectile dysfunction is ED if it occurs 1 out of 4 times. nerve and artery damage from poorly controlled diabetes can block blood flow to the penis, which is one of the triggers for ED. Such damage also slows the flow of blood to the heart, making patients more likely to develop heart disease.
ED can be emotionally draining and can hurt self-esteem, causing frustration and anxiety during sex and stress for the partner.
Low sex drive
If there is just not much desire for sex, then you may be suffering from hypogonadism. As with ED, men are more likely to develop hypogonadism as they get older. But having diabetes, especially type 2 diabetes or being overweight (or both), increases the chance of developing the condition by a factor of 1.
The effects of hypogonadism are multifaceted and may include low physical strength, muscle strength, mood and libido, and potentially fewer erections and less hard erections.
Combating sexual problems: where to start
Getting your diabetes, blood pressure and cholesterol under control is the best way to prevent and reduce sexual dysfunction. The approach is a win-win, with improvements in both health and quality of sexual life. “Even if there’s already nerve damage, this approach helps minimize sexual problems.” David noted.
The following recommendations can be incorporated into a course of action.
Lose weight
Lose weight if you need to. A small study in 2011 showed that obese men with type 2 diabetes who lost 5% or more of their body weight had improved erections and sex drive after a few weeks. What’s the reason? The extra weight reduces the body’s use of insulin and therefore increases the chance of problems such as nerve damage, and also increases the chance of developing hypogonadism. “Even a small weight loss such as 5 or 7 percent can have a big impact,” David said.
Get moving
Sitting on the couch watching TV all day is more likely to lead to erectile dysfunction. Regular exercise can help improve blood circulation and prevent ED.
Consult your doctor
Don’t be shy. About half of men with diabetes say they talk to their doctors about their sexual problems. Other health problems such as high blood pressure and kidney disease may be triggers for ED, and there may be a loss of interest in sex because of depression, not because of low testosterone levels. Your doctor will be able to point out the problem and guide you to the right treatment.
Know your medications
This is another issue to discuss with your doctor. A certain medication that you take may have side effects on sexual function. For example, some antihypertensive medications can cause erectile dysfunction, and some antidepressants can decrease sexual desire. If there is a medication that is affecting your sex life, you can reduce the dosage or switch to another medication.
Treating erectile dysfunction
“There’s necessarily a treatment for everyone.” said Janis Roszler, a diabetes educator, marriage therapist, and author of Sex and Diabetes: For Him and For Her. Which treatment is best for you depends on the nature of your sexual and other health problems.
Oral medications
Sildenafil, tadalafil, and vardenafil encourage blood flow to the penis when stimulated, and the most common side effects are headaches and nasal congestion, but they are usually mild and short-lived. Side effects such as erections lasting up to several hours are relatively rare. Oral medications are the most common treatment, with up to 60% of people with diabetes doing well on them.
Injections
A dose of prostilbestrol, which dilates blood vessels and helps improve blood flow in up to 90% of people with diabetes, can be injected into the root of the penis up to 3 times a week, with the main drawback being a burning sensation in the testicles and a long-lasting erection.
Suppositories
Prostil also comes in small, rice-sized pellets that can be put into the tip of the penis to help relax the muscles and dilate blood vessels. It can be used up to 2 times a day. 35% of men who use it are effective.
Devices
A vacuum pump available over the counter at a drugstore can draw blood into the penis to help it get hard. If you can’t get a lasting erection, you can put a strap on the root of the penis during erection to keep the blood in the penis. A support sleeve maintains the penis in position during intercourse and is another option for those with erectile dysfunction.
Penile implants
This may be the best option when there is advanced diabetes and severe ED and other treatments have not worked. The most natural implant is an inflatable device with a fluid-filled cylinder that needs to be placed in the erectile cavity of the penis, and an erection is created by controlling the implant pump to allow fluid to flow into the cylinder.
Treatment of hypogonadism
“Hypogonadism has a big impact on life, and the good news is that it’s easy to treat.” Janis said. Testosterone gels, patches, injections or pills can be used.
Testosterone replacement therapy can help boost stamina, libido, and improve erectile status, muscle mass, and mood. In a 2013 study, this therapy improved all aspects of sexuality and overall quality of life in obese patients with type 2 diabetes. However, men who were overly obese or suffered from depression had relatively poor results with the therapy, another good reason to lose weight or treat depression.