Diabetes and sexuality in men and women

Before we talk about the difficulties caused by diabetes, let's start by saying that diabetes is only a risk factor for sexual difficulties. Being diabetic does not necessarily mean having sexual problems. For example, Joel, 69 years old, diabetic and suffering from prostate adenoma (= enlargement of the prostate) has no sexual difficulties. Yet he has been diabetic for 20 years! To give a figure, according to the studies, 20 to 71% of diabetic men also suffer from sexual problems. We can see that the range is very wide and the figures correspond to different realities depending on the extent of the problems, the length of time the diabetes has been present, the quality of the follow-up, etc.

Among diabetic women, 27% suffer from sexual dysfunction compared to 14% among non-diabetic women.

But sexual dysfunction has been much less studied in women

Erectile problems in diabetic men

A diabetic man is two to three times more likely to suffer from erectile dysfunction than a man without diabetes. This is because diabetes damages both large and small arteries over time and causes neuropathy, a poor conduction of nerve impulses that also affects the erectile nerves.

Ejaculation problems in diabetic men

Diabetes can lead to retrograde ejaculation in men. During ejaculation, the semen does not exit through the urethra, but instead goes up into the bladder. Some men refer to this as "dry" ejaculation, but this is a misnomer, as the semen is present, even if it does not follow the usual trajectory. This phenomenon of retrograde ejaculation is due to the fact that the lock closing the lower bladder loses its effectiveness. The ejaculation, resulting in a strong jet of semen, succeeds in forcing this lock and the semen moves up into the bladder. Subsequently, when the man goes to urinate, semen is mixed with the urine. This can lead to infertility problems. Poor control of diabetes and neuropathy (nerve damage) can cause this ejaculation disorder. In some cases, medication to strengthen the tone of the bladder lock may be effective.

Vaginal lubrication problems in diabetic women

If a diabetic man can suffer from erectile dysfunction, a diabetic woman can suffer from the corresponding problem: a dysfunction of her vaginal lubrication at the time of sexual arousal. Diabetic macroangiopathy (= damage to the arteries and nerves, and also those in the genital area) and neuropathy due to diabetes will then cause the woman to have less swelling of the sexual tissues around the vagina and clitoris and less lubrication.