Everything men should know about sexuality and diabetes

As humans, we are sexual beings. We need and require loving close contact and intimacy with our partner in order to foster trust, caring, and acceptance allowing us to feel safe to share our innermost thoughts and feelings. And that’s why sexuality is a gift to be nurtured and enjoyed between couples. When everything is working just right, sex is exciting and something to look forward to. But for men with a chronic disease, such as diabetes, suddenly a thriving sex life may not be quite as robust as before the diagnosis. 

Most men, with or without diabetes, will have sexual problems at some point in their lives. Diabetes in men however, can amplify issues of sexual dysfunction, especially if their disease is not well-controlled. 

According to the CDC’s National Diabetes Statistics Report 2020, 14 percent of adult men in the U.S. have diabetes, which includes prediabetes and type 2 diabetes. This represents millions of men likely suffering from a poor quality sex life. Part of the reason is often years and years of uncontrolled high blood sugar levels. The younger a man is at the time of his diagnosis and if his diabetes is also poorly managed, within time his sex life may be underperforming.

Common sexual concerns men with diabetes may face

Just how does diabetes affect men sexually? For starters, it often depends on the length of time a man has had the disease and how well his diabetes has been controlled. Men who’ve had diabetes for years and have struggled to manage their high blood sugar levels, likely will have sexual issues associated with the disease. Here are examples of how diabetes may affect men sexually:

  • Erectile dysfunction

Erectile dysfunction (ED) is when a man is unable to achieve and maintain an erection firm enough for sexual intercourse. Men with diabetes can have complications associated with reduced blood flow and poor nerve conduction also known as neuropathy. Men, who are taking certain medications for high blood pressure, may also experience ED.

  • Low testosterone

Testosterone is the hormone associated with sexual arousal and sexual energy helping men to desire sexual encounters. Men with diabetes may be diagnosed with low testosterone resulting in a lack of interest in sex.

  • Delayed ejaculation or orgasm

This condition is when it takes an extended period of sexual stimulation for a man to reach sexual climax; for some men with delayed ejaculation, they are unable to ejaculate at all. Possible causes of delayed ejaculation are chronic health conditions like diabetes. Since poorly managed diabetes can lead to neuropathy, this sometimes can also lead to delayed ejaculation. 

  • Retrograde ejaculation

A man with retrograde ejaculation is when at orgasm the ejaculate or semen is forced back into the bladder rather than through the urethra and out of the penis. For men with diabetes, this condition may be associated with neuropathy but for men with a past traumatic event or psychological factors regarding sex may be the underlying cause too. 

  • Peyronies disease 

This condition causes a painful curvature of the penis caused by plaque buildup in an artery in the penis. Men with diabetes have a compromised immune system due to problems of carrying too much sugar in their blood. This is what leads to a buildup of plaque within their arteries and blood vessels. The worse the level of blood sugar control, the greater the chance men with diabetes will suffer from Peyronies disease. This can damage both the nerve tissues and blood vessels in the penis that eventually can cause a loss of sexual sensitivity as well as ability to achieve an erection. 

In addition to the above issues associated with diabetes in men, there may be other symptoms possibly related to their disease affecting a man’s sex life:

  • Reduced libido or sex drive 
  • Reduced sensation
  • Higher rate of infections such as urinary tract infections
  • Increased fatigue

Taking control of sexual issues

The best advice for men with diabetes in enjoying a healthy sex life is to first and foremost, take care of themselves. Diabetes is a disease that needs daily lifestyle management in order to achieve normal blood sugar ranges as much as possible. When blood sugar levels are within normal limits a majority of the time, this can mean the difference between good health or serious health complications eventually affecting a man’s sex life. 

The goal for men with diabetes is to learn and adopt good health habits for a lifetime. Fortunately, there are many ways to achieve this goal.  Here’s what men with diabetes can do:

  • Be mindful of food and beverage choices: Ask for a referral to a registered dietitian – many insurance plans cover this service. Dietitians can help men by discussing a variety of nutrition approaches on managing diabetes. This will learning how to choose nutritious foods, watch portion sizes by learning carbohydrate counting, creating individualized meal plans, and behavior strategies. Meeting with a dietitian also helps manage weight, improve cholesterol levels, reduce need for medications, and reduce risk for other diseases. 
  • Test regularly and take medications as prescribed: Regular self-glucose monitoring is a key factor in understanding and controlling blood sugar levels. A man’s doctor will let them how frequently testing should be done. Taking medications as prescribed for diabetes and any other health conditions is also an important tool for managing this disease.
  • Stay fit with regular exercise: Having an interest in sex and being able to engage in such a strenuous activity requires men and their heart to be in good shape. That’s why regular exercise throughout the week is crucial for an active sex life. It’s advised to incorporate both cardio and weight training in addition to stretching to maintain muscle mass for strength and endurance, flexibility, and heart health with activities such as brisk walking, jogging, swimming, or bicycling.
  • Lose weight if needed: Research has shown that men who are overweight to obese who lose just 5 percent of more of their body weight had better erections and more sexual desire in a matter of weeks. Why? Extra weight raises a man’s chance of problems like nerve damage since it makes the body less able to use insulin. It also raises a man’s chance of developing low testosterone. 
  • Keep sex fun and interesting: When couples tend to do the same thing over and over when it comes to meeting sexual needs, exploring new interests or ideas can add some freshness and interest in keeping sex playful. 
  • Talk to the doctor: Only about half of men with diabetes say they bring up sexual concerns with their doctor. Other health problems, like high blood pressure and kidney disease, may be to blame for ED. Or for men with little to no interest in sex, maybe it’s due to depression and not low testosterone. Openly discussing sexual concerns can help a doctor better pinpoint the problem with the intention of recommending the right treatment. 

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911. 

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