Diabetes and libido

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    ARTICLES from Mayo, Harvard, Stanford, and other reputable medical centers recently revisited and highlighted the effect of diabetes on libido and sexual performance among men and women.

    Does diabetes impact sexual performance?

    Yes. In men, diabetes mellitus can cause a varying degree of erectile dysfunction (ED), the inability to attain or sustain erection satisfactory for intercourse, as the diabetes progresses. Most of the time, however, the exaggerated and unfair condemnation, of diabetes as causing severe erectile dysfunction leads to a psychological deterrent and a self-fulfilling prophecy in most men. Many well-adjusted and well-treated diabetics enjoy sex without problems. In women, loss of vaginal lubrication is a major sexual effect of diabetes. It is also theorized that there could be some erectile dysfunction of the clitoris (female anatomical counterpart of penis) among women with diabetes. Viagra (Sildenafil), which has been found to be effective for male erectile dysfunction, has now been shown in some preliminary studies to be of help also among females, lending further support to the medical contention that perhaps diabetes also impairs female (clitoral) erectile function.

    Is ED the same as impotence?

    No, this was a scientific “error,” a harsh diagnosis overkill in the past. Erectile dysfunction has since then been considered a distinct and remediable medical entity and has replaced the term impotence, in this particular context. Impotence is now relegated to its proper “domain” where the male (himself) is unable to cause pregnancy. This clearer definition is more medically accurate and has given more hope and psychological relief to the millions afflicted by erectile dysfunction, which today has great treatment success rate.

    How prevalent is erectile dysfunction?

    It is very common. While impotence (accurately diagnosed) affects very few men, erectile dysfunction affects an estimated 10 to 20 million men aged 19 and older in the United States. The prevalence is 52% in men aged 40 to 70 and increases with age. However, today, men—and women—can enjoy sexual activity throughout life, with proper care and strategy. Erectile dysfunction is not inevitable with aging, even into the 70s and 80s. With proper medical counseling and aids like Viagra, etc., most males and females can enjoy sex at any age.

    What other damages does diabetes cause?

    Diabetes has a lot of potential complications. Among them are the effects on the small arteries and big arteries in the body, causing blockages in the circulation, leading to damages (poor supply of blood, oxygen and nutrition) to the various organs of the body: the eyes (retinopathy that results in blindness), kidneys (nephropathy resulting in kidney failure), legs (resulting in leg an feet ulcers, gangrene and amputation), nerves (neuropathy that causes numbness and pains in the feet), and cellular immunity (weakens the immune system leading to infections). This is the reason why all diabetic patients must be under the care of a physician and why the blood sugar must be well-controlled at all times.

    What causes erectile dysfunction?

    Erectile dysfunction is rare in diabetic men until their mid-30s. Erectile dysfunction is very common in the general male population, especially in these modern times. Contributing to this condition are psychological factors (severe anxiety, fear of intimacy, fear of unwanted pregnancy, sexual guilt, depression), drugs (most medications for high blood pressure and coronary heart disease, psychotropic drugs, CNS depressants-tranquilizers, etc. do affect erection), arteriosclerosis/vascular (blocking arteries that supply blood to the male organ), and, rarely, biogenic (associated with low testosterone levels and reflecting disorders of the hyphothalamic-pituitary-gonadal axis). Alcohol negatively affects erection. As Shakespeare wrote “Alcohol increases the desire but diminishes the performance.”

    What is the treatment for ED?

    Making the correct diagnosis is very important, since the treatment depends on the cause. Once the diagnosis of erectile dysfunction is clinically confirmed, medications called PDE (phosphodiesterase inhibitors) like Viagra, Cialis, Levitra, etc., are prescribed. This class of medications increases the blood flow to the penis to effect an erection. Persons on nitroglycerine (medications for coronary heart disease) are strictly warned against taking ED pills, the combination of which could cause intractable shock and death. It is essential that the diabetes is well-controlled at all times for this to work. Quitting smoking, exercising at least 3 times a day, and a conducive environment will help tremendously in improving sexual performance.

    How about in diabetic women?

    Among diabetic women, the major sexual side-effect is loss of the natural vaginal lubrication, which makes sexual encounters most uncomfortable and even painful. Master and Johnson, pioneering sex researchers in the 1960s, stressed the importance of vaginal lubrication during the initial sexual arousal in women and throughout the sex act. With proper vaginal lubrication, proper “ambiance,” and well-controlled blood sugar (and other medical conditions, if any), diabetic women can enjoy pleasurable sex at any age.

    What are the other causes of vaginal dryness?

    Other causes of loss in vaginal lubrication are: stress or psychological factors, undesired partner, drugs (Tricyclic Antidepressants, like Elavil, Anafranil, Tofranil, Sinequan, birthcontrol pills, antihistamines, cold formulas, etc), alcohol, cigarettes and marijuana. Other conditions include jet lag from travel across time zones, excessively prolonged foreplay or lovemaking, pregnancy and childbirth.

    What is the treatment for loss of vaginal lubrication?

    There is practically no excuse why women should not enjoy sex as men do. Loss of vaginal lubrication happens to majority of women past 40 years old, some even as young as in their 20s and 30s. The cause among menopausal women is hormonal, but stress, as stated above, could play a great role also, especially in the younger women. Diabetic women do not have to be ashamed of this, since this affects non-diabetics also, and at any age. There are now a lot of commercially available (no prescription needed) vaginal lubricants. This simple and inexpensive strategy has tremendously (to the surprise of many partners) improved the pleasure of sex, the sexual relations of husbands and wives, and lovers in general, and has enhanced many a marriage and personal relationship to a significant extent.

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    Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites:  philipSchua.com  and FUN8888.com  Email: [email protected]

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