Chapter 16 - Sexual dysfunction in diabetes
Introduction
Impaired sexual function is a frequent complication in diabetes in both women and men. Studies in diabetes focus primarily on erectile dysfunction (ED) in men but there are also detrimental manifestations of sexual dysfunction in women and both have a relationship with depression and impaired quality of life. Moreover mostly in men, sexual dysfunction is associated with an increased cardiovascular risk and a poor life expectancy (Banks et al., 2013). This warrants a detailed analysis of sexual dysfunction in both sexes.
Section snippets
Sexual dysfunction in diabetic women
Studies in diabetic women are less conclusive than in men owing to several factors, including the lack of standardized definitions of sexual function in women, the low number of well-validated research methods, and social taboos regarding female sexuality (Althof et al., 2005). A loss of libido, problems with orgasm, lubrication and arousal, dyspareunia, and lower overall sexual satisfaction have all been reported with a significantly higher frequency in both type 1 and type 2 diabetic women (
Sexual dysfunction in diabetic men
Male sexual dysfunction is a common complication of diabetes. Studies on sexual function in diabetic and nondiabetic patients tend to focus primarily on ED. Besides the highly prevalent ED, the full spectrum of male sexual dysfunction consists of a multidimensional construct comprising abnormalities of orgasmic/ejaculatory function and desire/libido in addition to penile erection (Penson et al., 2009). In the UroEDIC study 55% of type 1 diabetic men had decreased libido, 34% suffered from ED
Definition
ED is defined as the persistant inability to achieve or maintain an erection sufficient to permit satisfactory sexual intercourse. Normal penile erection is a hemodynamic process that is dependent upon corporal smooth muscle relaxation mediated by parasympathetic neurotransmission, nitric oxide, electrophysiologic events and possibly other regulatory factors (Andersson, 2011).
Prevalence of erectile dysfunction in diabetes
The prevalence of ED among diabetic men varies from 35% to 75% in different publications. These differences can be
Treatment of erectile dysfunction in diabetic patients
Considering that diabetes is associated with several organic disturbances which can lead to ED, diabetic individuals are more likely to seek treatment for ED for nonpsychogenic causes and at presentation may have a greater severity of disease than nondiabetic subjects (Corona et al., 2004).
As ED is strongly associated with cardiovascular risk factors in diabetic men, the patients must be categorized by their cardiovascular status before planning their treatment. Two international consensus
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Cited by (47)
Autonomic neuropathy and urologic complications in diabetes
2020, Autonomic Neuroscience: Basic and ClinicalA Small Group Randomized Double-Blind Placebo-Controlled Study to Evaluate the Efficacy of Daily Pentoxifylline in the Management of Patients With Erectile Dysfunction with Suboptimal Treatment Response to Sildenafil
2020, Sexual MedicineCitation Excerpt :The randomization list was computer generated, with equal allocation to the 2 treatment arms. ED in patients with diabetes mellitus can be contributed by the neurogenic component, which may result in poor response to PDE-5 inhibitor,15 as such, stratified randomization according to the presence of diabetes mellitus was fully implemented. The intervention group (S+P) were given pentoxifylline (400 mg) thrice daily orally for 8 weeks and the control group (S only) were given placebo capsules thrice times daily orally for 8 weeks.
Does Chronic Hyperglycemia Affect Female Rat Sexual Behavior? Differences in Paced and Non-Paced Mating
2019, Journal of Sexual MedicineCitation Excerpt :DM2 has been associated with different disorders, such as cardiovascular dysfunction, neuropathy, nephropathy,7 and, importantly, sexual dysfunction in men8–12 and women.13–15 The effect of DM on human female sexuality varies, may affect all aspects of sexual function, and is mostly reported in patients with diabetes mellitus type 1 (DM1).12,16–18 In women with DM2, the results are controversial; the main problems described are a decrease in vaginal lubrication19–23 and orgasmic dysfunction.24–28
Sexuality Perceptions and Sexual Care Needs of Patients with Type 1 Diabetes Mellitus: A Mixed Methods Study
2023, Sexuality and DisabilityDetecting and treating the protean manifestations of diabetic autonomic neuropathy
2023, Diabetes, Obesity and Metabolism