How to Deal with Men’s Sexual Dysfunctions Caused by Diabetes


Impotence

Many men are more afraid of the possibility of impotence than they are of the side effects of diabetes. Impotence, defined as the inability to achieve or sustain an erection sufficient for sexual function, is a problem not just of diabetics but of all men. When a diabetic man suffers from impotence, the cause may or may not be related to the physicality of diabetes. In fact, the major cause of impotence in all men is psychological: tension, fear of the failure to perform sexually (often called performance anxiety), guilt, de­pression, grief—almost anything that preys on the mind.

In terms of physical causes of impotence, some are directly related to diabetes and some are not. Most diabetic impotence does not appear until a man has had the disease for many years, and then it is more likely to occur when the diabetes has not been well-controlled for a long time. No one knows exactly why impo­tence is associated with diabetes, but many physicians believe it is a form of neuropathy. Nerves that control erection are damaged as a result of chronically high levels of blood glucose. These nerves control tiny valves in blood vessels leading to and from the penis. When the valves open as a result of sexual stimulation, blood fills the vessels of the penis. They then close and trap the blood there, stiffening the penis. If the nerves that control these valves are damaged, erection is impossible. A major nondiabetic cause of impotence is the hardening or occluding of the vessels that supply blood to the penis, thus preventing a sufficient amount of blood flow to stiffen it.

Mens Sexual Dysfunctions

Impotence is not a sudden occurrence. Most men notice that over time, their erection is not as hard as it used to be, or they can­not sustain it for long enough. Sexual desire is not diminished at all, which is what makes impotence so frustrating.

And because American men are so emotionally, socially, and culturally focused on sex and their ability to “perform,” many of them are ashamed, embarrassed, and reluctant to talk about impotence, even with their sexual partners. There are, how­ever, a number of ways that men can counteract or even solve the problem:

  • Discuss the problem with your physician, because you need to find out the cause before you can correct it.
  • Impotence may be a side effect of a medication, and discon­tinuing it or changing the brand or type of drug may solve the problem.
  • Couples counseling or individual therapy can help you deal with the problem and, in the process, increase your ability to sustain an erection.
  • A penile prosthesis, surgically inserted into the penis, can cre­ate the ability to have sexual intercourse. One type of prosthe­sis keeps the penis permanently erect, but it can be folded down during times other than sexual intercourse. The other type inflates when needed by means of a small pump located under a testicle. Both types of prosthesis have no effect on sperm production or the ejaculatory process; they have no re­productive repercussions.
  • Nonsurgical mechanical devices exist as well. There is a vac­uum device that fits over the penis and pulls blood into it. An­other technique involves self-injection of a substance that constricts blood vessels, trapping blood in the penis for a tem­porary erection.

In early 1998, the FDA approved the first drug to treat impotency. Viagra (sildenafil) is taken about an hour before inter­course, acts on the physiological system in the penis, and causes an erection in a man who is sexually excited. It has no effect if the man is not aroused. The drug’s manufacturer, Pfizer, claims that it will help 70 to 80 percent of impotent men. The most common side effect is headache; others include flushing, indigestion, and a stuffy nose.

Whether Viagra will work for diabetics depends on how badly the nerves of the penis have been damaged by elevated glu­cose over the years. The best course of action is to try it and see—but don’t get your hopes up.

More important than treating impotence, which may be only temporary, is preventing it in the first place. The number of dia­betics who eventually becomes impotent ranges from about 10 to 50 percent of men between age thirty and eighty. Because neuro­pathy is the main cause, maintaining tight blood glucose control can decrease the statistical risk of impotence.

Retrograde Ejaculation

Retrograde ejaculation, experienced by a few men with dia­betes, is the backward flow of semen into the bladder at ejacula­tion. It is thought to be caused by nerve damage. Retrograde ejaculation may diminish reproductive capacity if none of the semen enters the vagina, and some men are psychologically dis­turbed by the lack of “evidence” that they have ejaculated.

Men and Women

There are a number of sexual and related problems that af­fect both men and women.

Urinary Tract Infections

Urinary tract infections (UTI) are much more common in people with elevated blood glucose. Various bacteria thrive in an atmosphere of increased sugar content, and the immune system is less able to combat the infection. UTIs tend to be uncomfortable and painful, and you should not have sex while you are being treated, even in the unlikely event that you want to. The infectious organisms are often contagious.

Genital Infections

Genital infections also are more common in diabetics. Men can get yeast infections too; they are usually related to poor blood glucose control and are as easily treated with topical creams and lotions as those of women.

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About the Author: Andrew Reinert is a health care professional who loves to share different tips on health and personal care. He is a regular contributor to MegaHowTo and lives in Canada.

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