There are about 40 million people with Diabetes (fasting blood sugar >126 mg per dl) in our country, it is twice the number than in China and 3 times from USA. In another 15 years, it is going to be double. There are another 77 million with pre diabetes (fasting blood sugar 126-140 mg per dl). Our country has the dubious distinction of being the diabetic capital of the world.
About 35-65% of people with diabetes suffer from Sexual Dysfunctions. It is due to narrowed blood vessels, obesity, Neuropathy and weakening of muscles.
Effect on blood vessels – About 70 % diabetics will have complications involving blood vessels causing narrowing of lumen, loss of stretchibility of vessel wall and hypertension. Blood supply to the genital organs is reduced, especially on arousal, causing poor erection or failure to maintain the erection due to poor veno – occlusive mechanism in males and loss of lubrication in females.
Neuropathy – There is a lot of discussion on effects of neuropathy on body parts like foot but its effects on sexual health are not given the importance it deserves. Effect on somatic nerve supply from genitalia impairs the arousal response by manipulation of genital organs causing poor erection / lubrication and poor orgasmic response. Its effect on Parasympathetic Neurons causes reduced impulses reaching corpora cavernosa from the L3–S1 centre in spinal cord, loss of production of Nitric Oxide gas and reduced erection again.
Diabetes is associated with obesity – So exercise tolerance is reduced, poor muscle tone, poor rigidity and pre mature ejaculation.
It lowers the immunity and more prone to have genital infections and catch STD – It may cause pain on having sex and emit foul smell from genitals, causing aversion to sex, and loss of desire.
Cardiac Problems are associated in up to 70% of patients – It leads to poorer blood supply, easy fatiguability and fear of further cardiac problem due to sex, resulting in ED and Loss of lubrication 6- Hormonal Imbalance – Diabetics have lower serum testosterone level due to altered metabolism, causing reduced desire and ED.
Psychogenic Issues – Stress of controlling blood sugar, fear of another failure to satisfy the partner, side effects of medicines to control hypertension, cardiac problem, high cholesterol, psychiatric problem worsen the situation, causing poorer control of diabetes and more sexual dysfunction.
Curvature of Penis – Repeated microvascular injury in penile blood vessels causes bleeding and formation of fibrous tissue. Slowly it leads to bigger and palpable plaques, resulting in painful erection and bending of penis from shaft. It is called Peyronie’s Disease. It is a dangerous complication.