In people with diabetes, sexual dysfunction is particularly common and is closely linked to complications of the disease. In order to maintain a fulfilling sexual life, it is important to talk to your doctor, who will suggest solutions to treat and prevent them. Explanations with Dr. Dominique Huet, diabetologist endocrinologist.
Both men and women with type 1 or type 2 diabetes are at increased risk of sexual dysfunction. Studies have shown that they occur in one-third of women and one in two men with type 11 diabetes, and in one in two people with type 2 diabetes2.
The main sexual disorders in diabetes
It is estimated that men with diabetes are three to four times more affected by erectile dysfunction than men without diabetes3. 3 Risk factors include the patient’s age, the length of time the diabetes has been present, and the presence of complications related to the disease.
Advanced diabetes leads to complications at the :
Vascular: hyperglycemia chronic promotes fat deposits (atherosclerosis), responsible for artery obstruction. Blood circulation will be impeded in the penis, making it more difficult to achieve or maintain an erection;
Neurological: In cases of unbalanced diabetes, the disease can affect the nerves (diabetic neuropathy), including those involved in erection and ejaculation. This can not only cause erectile dysfunction, but in addition to ejaculation disorders, including retrograde ejaculation ;
Hormonal: the drop in testosterone levels seen in people with diabetes can lead to a decrease in libido. This decrease in testosterone levels can be linked to both obesity and diabetes3.
Added to this is the psychological impact of the chronic disease, which will influence desire: “When you are told that you are diabetic, that you will never get better and that you have a risk of complications that may occur in 15-20 years, this is not always a source of good morale,” stresses Dr Dominique Huet, a diabetic endocrinologist.
FOR THE WOMAN’S
As for diabetic women, “sexual disorders have been much less well explored,” laments the endocrinologist. In an American study published in 20175, researchers explain that “our knowledge of the medical and physiological aspects of the sexual function of women [with diabetes] is poor compared to that of men. Nevertheless, “it is recognized that diabetes can affect women’s sexuality in many ways, including both psychological and physiological dimensions.
Thus, diabetes in women exposes them to :
- More urinary tract infections and fungal infections, as the disease impairs the functioning of the immune system, making the patient more vulnerable to infection;
- Vaginal dryness, related to damage to the blood vessels in the vagina.
The pain caused by these disorders as well as the psychological consequences of the disease can again cause a decrease in libido and have a negative impact on the sexual life of patients.
How to maintain a fulfilled sexuality?
However, the sexual consequences of diabetes are not inevitable. First of all, because sexual problems are closely linked to the complications of the disease, the balance of diabetes can often be sufficient to treat and prevent them.
TREATMENT OF SEXUAL DISORDERS
In the case of erectile dysfunction, certain medications such as Viagra®, Cialis® or Levitra® (phosphodiesterase inhibitors) may also help. “When the forms are much larger, prostaglandin injections into the corpus cavernosum may be offered, or even penile prostheses,” explains Dr. Huet. These are palliative means”.
In women, an antibiotic or antifungal treatment will cure urinary tract infection or fungus. For a better vaginal lubrication, a lubricating product can be proposed.
To alleviate libido disorders linked to anxiety and thus improve her quality of life, a psychological follow-up, for example by a sex doctor, is useful and necessary.
PREVENTION OF SEXUAL DISORDERS
The most important element of prevention remains the control of blood sugar levels. In addition, prevention is based on limiting certain risk factors common to the general population, namely :
- High blood pressure;
Diabetic patients should not hesitate to talk about their sexuality to their treating physician, diabetologist, gynecologist for women, or andrologist or urologist for men, to know the impact of the disease. A study conducted in 2016 concluded that “more emphasis should be placed on improving patient knowledge, early detection and multidisciplinary approaches to manage the aspects of diabetes that affect the quality of life of patients “6. 6 Finally, erectile dysfunction in men can be a sign of a very high cardiovascular risk, including heart attacks, which is all the more reason to talk to your doctor about it.