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 Diabetes

October 2009
Diabetes and Sex
Dr Ramesh Goyal
 
Diabetes is a common problem among the world's population today, and particularly so in India, the world's diabetes capital. Along with diabetes, come other problems related to the body and the mind.
Since diabetes is a lifelong disease, it can only be kept under control by healthy lifestyle and proper medicines. However, the damage caused by the high levels of glucose in the blood cannot be altogether stopped. Whether one develops diabetes during childhood - juvenile diabetes - or it is acquired later on in life, it definitely seems to have some effect on a person's sexual life.

The Three Letter Word
In men, the most common problem is that of the function of erection. Eventually, most diabetics develop an inability to maintain an erection for long. This definitely has its effect on the length of sexual intercourse, which in turn can cause a lot of conflict between the partners. If the disease is not diagnosed at a proper time and adequate medication not taken, it can lead to severe stress and even lead to marital disharmony. How It Happens Over a long period of time, diabetes damages the small nerves of the penis, which are essential for erection. Diabetes also speeds up the process of atherosclerosis. As a result, the blood vessels get coated from within with fat, and the lumen of the blood vessels to the penis gets narrowed. This reduces blood flow to the penis.

The erectile problems in a person, can in turn affect a person's psychology so tremendously that he may get nervous and anxious resulting in no erection. Thus, it becomes a vicious cycle. Sometimes, other associated diseases like pneumonia, high blood pressure or kidney disease may put the blood sugar out of control, which can again give rise to erection issues.

The Test
First and foremost, it is necessary to find out the exact cause of the erectile problems. Even if a person is a confirmed diabetic, an NPT (Nocturnal Penile Tumescence) test should be done. This test measures the number and strength of erections a person has during his sleep.

Normally, a healthy man has erections lasting for 20 to 30 minutes. Erectile problems in diabetes can be due to physical problems caused by diabetes itself, as well as due to psychological stress. A person not having normal erections in sleep every one-and-a-half hour might assuredly be having some physical problem.

Diabetes and Women
In women, the sexual side effects caused by diabetes are comparatively less. Diabetes may affect the blood vessels and nerves of the vagina, thereby reducing vaginal lubrication in some women. However, diabetic women are prone to vaginal infections, fungal infections and secondary bacterial infections.

Controlling diabetes with proper medicines is essential. Regular monitoring of the blood sugar is also very important. Eating a low fat, low cholesterol diet with a lot of fibre, plenty of water and good exercise is mandatory for maintaining good health.  
Dr Ramesh Goyal is Consultant – Endocrinology at Apollo Hospitals, Ahmedabad

    
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