Although sexual problems are common as men grow old, diabetes can worsen them, causing erectile dysfunction, difficulty ejaculating or low level of testosterone, said Dr. Elizabeth Salsavilca, head of the Endocrinology Service of the Sabogal Hospital of EsSalud.
According to the specialist, nerve damage caused by poorly controlled diabetes, also known as diabetic neuropathy, can injure genital organs or urinary tract due to high blood glucose concentrations.
“Sexual problems in diabetic patients depend largely on the late complications of the disease.In this case, the person presents peripheral neuropathy and peripheral circulatory insufficiency, in addition to constant hyperglycemia, ”he told the Andean agency.
For that reason, he said that bad glycemic control can negatively affect the sexual life of diabetic people, especially in men, who are more likely to develop erectile dysfunction or problems with ejaculation compared to the rest of the population.
"The erection of the male organ is a reflex arc circuit, where desire begins in the brain as an order, which travels to the marrow and then to the nervous plexus of the cranial area," he explained.
The endocrinologist added that, being a nerve circuit with a very fine circulation, it is altered when diabetes is uncontrolled and hyperglycemia appears, causing the arteries to be reduced.
As a consequence, the nerve does not receive a good nutrition from the blood and begins to irrit.
retrograde ejaculation
Another of the sexual complications that diabetes can cause is retrograde ejaculation, a rare and rare consequence that causes semen to enter the bladder instead of going out through the penis.
“This happens when the patient, because of the same neuropathy, at the time of ejaculating, the semen does not go out with the shot, but returns to the bladder.Although this change does not damage health, it affects the relationship and generates discomfort when performing the sexual act, ”said Dr. Salsavilca.
penis curvature
Men with diabetes are more likely to have Peyronie's disease, also known as the penis curvature, than men who do not have diabetes, the health expert warned.
"This disease occurs when the erection of the penis is not straight, but has a significant curve that can make painful or difficult sexual relations for him and his partner," he added.
low level of testosterone
Although testosterone, male hormone in charge of the development of sexual characters, decreases naturally with age, diabetes can enhance this reduction.
In some men, a low concentration of testosterone can be the cause of erectile dysfunction or can explain why they feel tired, depressed or with little sexual desire.
neurogenic bladder
In addition to problems in the genital organ, nerve damage caused by diabetes also affects urinary tract, such as having the need to frequently urinary, urinary infection or urine leaks.
“Hyperglycemia can cause an alteration of the bladder, becoming neurogenic and losing its ability to expel the entire urine normally, leaving waste at the time of urging.When a bladder does not have that strength, it can have urine escapes, even during intercourse, ”he said.
prevention
Dr. Salsavilca said that moreof 50 % of patients with hyperglycemia suffer from sexual problems and bladder at some point in their life.Therefore, he recommended a blood test for type 2 diabetes and prediabetes.
"Patients should maintain a good glycosylated hemoglobin that is a parameter that measures the average blood glucose level during the last three months," he said.
He also stressed that if a diabetic patient has a glycosylated hemoglobin above 7 %, it means that diabetes is not well controlled and has a greater risk of developing problems with sexual intercourse or bladder.
To prevent these complications, it is essential to maintain stable glucose levels, which leads to a healthy lifestyle, which includes a balanced diet and physical activity under supervision.
Finally, he stressed that changes in sexual function or bladder habits can also be diabetes symptoms.
“There are patients who arrive at the office with a very irritable bladder, they urinate more at night or have no strength at the time of urging.Therefore, the first thing the urologist asks, in this situation, is a glucose test to rule out diabetes. ”
