Diabetics In The Sleeper Position

11. July 2017

Diabetics often have to fight not only with their blood sugar levels, but with problems in the bedroom as well. Sexual disorders are the most concomitant phenomenon which males and females with diabetes mellitus endure. And the group of sufferers is growing.

If things are not working properly in the bedroom, the supposedly most natural matter in the world quickly becomes an all-controlling theme. This is because it suddenly becomes a matter of more than just sex. It is about virility, self-esteem, the feeling of wanting to exist and also about the partnership itself. There are many causes for a stillstand under the sheets. Some produce only temporary problems. Stress at work, anger in the family or depressive moods are true passion killers. As soon as the job situation eases or disputes with the partner are sorted out, sexual matters often also run a better course. If the problems in the bedroom keep going, there are perhaps quite different triggers behind them, such as unwanted side effects of medicines or physical disorders.

Diabetes, for example, not only creates disorder in patients’ sugar metabolism, but often also does the same to their love life. “Sexual disorders are the most common complication with diabetes mellitus”, Thomas Haak, from the Diabetes Center Mergentheim (Germany), says. According to estimates, half of men who have diabetes and have had the disease for several years suffer from erectile dysfunction. “We’re dealing here with a virility disorder in which the penis does not become sufficiently stiff or the erection does not last long enough”, Haak explains.

Rising numbers

Yet a lack of ejaculation, a delayed or missing orgasm or balanitis can cause problems for diabetics. Somewhat less is known about how common sexual disorders are among women with diabetes. One reason for this could be that women with this problem seldom trust the doctor enough and do not want to address the alleged tabu subject. What is certain, however, is that they too suffer from it.

In a survey of women aged 40 to 80 years, American scientists established that diabetics are less satisfied with their sex life. With the ever-increasing numbers of metabolic disorders, the number of those suffering from sexual disorders is also growing. The longer the diabetes lasts, and the higher the age, the greater the negative effects on sexual excitability and the pleasure of the patients.

The increased blood sugar levels damage the nervous system over time. “The damage to the nerves, in turn, can cause the penis and clitoris to not react to sexual stimuli as is usual”, says Haak. With men, erection and ejaculation disorders develop, women complain of orgasm problems or diminished pleasure. With women, high sugar levels also affect the blood circulation in the mucous membrane. The vagina must be well-perfused, so that it becomes more moist during sexual intercourse. If moisture is absent here, sex can become unpleasant and painful for women. “In addition, poor blood glucose levels are accompanied by the increased risk of these women getting fungal or bacterial infections”, says Haak.

Risk of heart attack

With some men who seek medical attention because of erectile dysfunction, the occurrence of an erectile dysfunction is also the first indication of the presence of an initial vascular disease, from which later on arteriosclerosis develops. If the arteries begin to harden and calcify, not enough blood flows into the penis. An erection is often already impaired in a very early stage of disease. Furthermore, hypertension and increased blood fat levels, which are frequent companions of diabetes, also affect the blood vessels. Anyone who works at dealing with sex problems can therefore also under certain circumstances prevent heart attack in a timely manner.

The first contact person is the family doctor or the diabetologist. They can find out what is behind the problems in the bed, whether its nerves or blood vessels which are being attacked, or whether medications are to blame for the stillstand. Moreover he or she needs to also ensure that blood sugar is well adjusted and that the blood glucose fluctuations are kept as low as possible. Once the cause of the sexual problems is identified, the problem can be tackled in a targeted manner.

The doctor can help

The therapy options for men range from tablets to surgery. PDE5 inhibitors cause more blood to flow into the corpus cavernosum during sexual arousal. “They improve erection ability with a response rate of about 60 percent”, diabetic expert Haak says. Three active agents work according to this pattern: sildenafil, vardenafil and tadalafil, “People with poor cardiac functions in particular should nevertheless first check with their doctor before taking these medications”.

One mechanical aid is the vacuum pump, a hollow plastic cylinder which the man shoves over the penis before sex. “After pumping out the air, blood flows into the penis through the vacuum and it becomes stiff”, explains Thomas Haak. “In order to prevent the blood from draining again, the veins are clamped with a rubber ring for a maximum of 30 minutes”. The auto-injection technique (SKAT), in which a vasodilator is injected into the penis, is significantly more rarely used. The use of a tablet placed in the urethra, which increases the blood flow, is usually refered to by doctors as MUSE. In very rare cases it makes sense to improve the blood flow in the penis via surgery.

In women undergoing hormonal changes, hormone-containing ointments or suppositories can improve problems such as dry vaginal membranes or pain during sex”, Haak says. Lube creams moisturise the vagina, while pelvic floor training with gymnastics promotes the blood flow in the vaginal area and the sensations of desire. What’s more vaginal trainers and dilators for the vagina can help women to be able to enjoy sex again. Thomas Haak is certain: “In most cases, satisfaction in the sex life of patients can be significantly enhanced”.

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