Known as the andropause or late-onset hypogonadism, the male menopause is a term used to describe low or decreasing testosterone levels in men.

Menopause in women is well documented, but the male menopause is less known.

While low sex drive and difficulty maintaining muscle mass are well known symptoms of low testosterone, there are other, less documented effects of reduced levels of the male sex hormone.

Testosterone, which is mainly produced in the testicles, has a role to play in bone density, sperm production, fat distribution and facial and body hair.

Testosterone levels peak at around age 20 but reduce with age – studies have shown that low testosterone affects around 12% of men in their 50s, 19% of men in their 60s, 28% in their 70s, and 49% of men in their 80s.

What are the symptoms of the male menopause?

The most common signs of low testosterone include:

Low sex drive and erectile dysfunction

As the primary driver of libido, when testosterone levels drop, it can result in a lack of interest in sex.

In addition, it is more difficult to get an erection with low testosterone levels, as the erectile tissue can become less healthy in someone with reduced levels of the hormone. It can cause erectile dysfunction, and can also reduce the effectiveness of drugs like Viagra.

Depression

Although more research is needed to better understand the link between low testosterone and depression, it is known that androgen receptors are located within different parts of the brain, including amygdala, the area of the brain which processes fear.

Memory problems

In a similar way, if there is not enough testosterone to bind certain receptors in the brain, it could cause memory problems.

Fatigue

Energy and motivation levels are driven primarily by testosterone, which is also a type of steroid. As testosterone levels lower, it means men will feel more tired as the day goes on.

Decreased muscle mass 

Testosterone stimulates muscle growth so reduced levels mean that muscle mass starts to decline. However, it can be rebuilt through strength training.

Increased abdomen fat

More belly fat can be a sign of low testosterone. It occurs because fatty adipose tissue replaces muscle mass. Increasing amounts of fat tissue break down testosterone, resulting in low levels of the hormone.

Weak bones

Testosterone is converted into oestrogen in men. Oestrogen has a key role to play in bone health, so men with lower levels of testosterone will have reduced oestrogen. This can lead to osteoporosis, which is when someone has weak bones.

Type 2 diabetes

Insulin is dependent on testosterone, so for insulin to function well, you need testosterone. If insulin function is diminished, it can lead to high blood sugar and type 2 diabetes. One study found that testosterone therapy helped to combat insulin resistance in men with low levels of testosterone.

Heart disease

Some research has indicated that low testosterone could increase the risk of heart disease, cardiac arrest and stroke. One school of thought is that it could be due to testosterone’s role in opening up blood vessels to the heart.

However, experts are divided about the link between low testosterone and heart disease.

Is there a relationship between the male menopause and diabetes?

Low testosterone levels which is the cause of the male menopause is more common in men with type 2 diabetes.

Approximately 25-50% of men with type 2 diabetes have low testosterone levels.

Although the exact reason hasn’t been identified, it is thought that insulin resistance, a key component of type 2 diabetes, may play a role in disrupting hormone production.

Obesity is a significant risk factor for type 2 diabetes and can also lead to lower testosterone levels.

How do I treat the male menopause?

The male menopause is a natural process and just like the female menopause, people experience symptoms differently.

Treatment of the male menopause is made of several different therapies.

Lifestyle changes

A healthy, nutritious diet and regular exercise can help increase testosterone levels, promote hormone balance, and improve your mood. Maintaining a healthy weight is useful as excess fat can convert testosterone into estrogen.

Stress management

Stress can affect your hormone balance.

Activities like yoga, meditation and mindfulness can help reduce stress levels and balance your hormones.

Counselling

Speaking to a therapist about the changes you are going through can prove effective for some people.

Medication

Medication may be prescribed to manage particular symptoms, such as mood changes or erectile dysfunction.

Hormone Replacement Therapy (HRT)

HRT involves testosterone supplementation to help balance hormone levels however has many potential side effects including an increased risk of heart disease.

It is crucial to speak to your doctor or healthcare team before making any changes to your lifestyle and to ensure treatment is individualised for you.

As a woman who has type 1 or

type
2 diabetes, there should be no reason why you cannot take birth control pills in
safety.

You should always consult with your doctor before taking the pill.

Birth control pills

Birth control
pills generally fall into two types, although there at present 23 different
brands of contraceptive pill on the UK market.

Oestrogen and progestin

The first contains the hormones
oestrogen and progestin, and the second contains progestin alone.

Combination
pills, those that contain oestrogen and progestin, very rarely cause shifts
in blood glucose levels
and the ways in which the body controls them.

Progesterone

Pills
which contain only progesterone don’t cause changes in blood glucose
control.

Further contraceptive methods such as injections and implants
are also considered fairly safe for diabetics to use.

Loss of control

Many women experience a slight loss of control in blood sugars initially
when they start taking the pill, but this can usually be rectified by a
slight change in treatment regime.

Contraceptive pill

The contraceptive pill may indirectly complicate diabetes,
however. Some of the side-effects of the pill may lead to increased risk
of diabetes complications.

High blood pressure, for instance, could increase
your chance of contracting eye or kidney problems for diabetes.

Diabetics
who also smoke
are advised to seek alternative forms of contraception.

Some
medical thinking implies that the oestrogen present in birth control pills
can increase glucose levels whilst simultaneously decreasing bodily

insulin
response.

Progestin present in birth control pills could also possibly
lead to insulin overproduction.

Some medical practitioners advise that
taking the birth control pill should be limited only to those women who
are younger than 35, who do not smoke, who are generally healthy and without
diabetes-related complications.

Concerns about the pill

Anyone concerned about how the contraceptive pill will
affect their diabetes should seek medical assistance before proceeding
any further.

The FPA (Family
Planning Association) is a comprehensive resource about the different methods
of contraception available.

The FPA can be contacted at:

• 27-35 Mortimer Street,
  London W1N 7RQ
• Telephone: 0207 1636 7866.

Recording your blood glucose results can be helpful in finding patterns in your levels and helping you to better control your diabetes.

How will my period affect my sugar levels?

There is not a definite answer to this as periods affect each one of us differently.

However, many women report having higher blood sugar levels a few days prior to their period starting.

During your period, you may
experience high blood sugar levels but some women notice a sharp drop in sugar levels so it’s best to be prepared for unexpected changes to happen.

Why does blood sugar rise before or during periods?

Before and during your period, changes in the level of the hormones oestrogen and progesterone can induce
temporary resistance to insulin which can last for up to a few days and then drop off.

Some girls and women have consistent effects as to how their period affects blood sugar whereas other women may find that the effect on blood sugar varies from one month to another.

Coping with periods

The effect on blood sugar as a result of periods can change from one month to another so keeping a diary of your blood glucose numbers can help you to see if there are any patterns in your results across different months.

If you are finding your blood glucose levels go very high before or during your period, you may need to either inject more insulin (if insulin dependent) or reduce your carbohydrate intake.

If you increase your insulin, be careful to
avoid hypoglycemia as your insulin sensitivity can sometimes return quickly.

Speak to your health team if you need advice on how to manage your insulin doses or carbohydrate intake.

Increased appetite

You may also experience an increase in appetite before your period. It is best to avoid refined carbohydrates (such as white bread and sugary foods) in response to cravings as these foods raise blood glucose levels which then causes further hunger.

It is better to stick to your normal balanced meals as best as you can.

Contraceptive pill and effect on blood glucose levels

If you take a contraceptive pill, you may experience a different effect on your blood glucose levels than when you weren’t taking the pill.

It is advisable to review your sugar levels through the first few cycles to see if a pattern emerges in your results.

• Read more on the
  contraceptive pill and its effects on blood sugar levels

The best way to remain in control is by knowing what to expect so that you can prepare yourself for the unique challenges that may lie ahead.

What is menopause?

Menopause is the general term that describes the end of a woman’s menstrual cycle – in other words, the cessation of monthly periods – that

usually occurs around the age of 50

Periods usually come to a gradual halt, becoming less frequent and with longer intervals between each one before stopping altogether. But for some women, the end of menstruation can be sudden.

It is this period that is referred to when a woman is said to be ‘going through menopause’.

For many women, the end of menstruation can lead to a number of physical and emotional symptoms, which can be detrimental to health.

Levels of the female sex hormone oestrogen decrease, causing the ovaries to stop producing an egg each month (ovulation). Reduced oestrogen can result in women experiencing hot flushes, night sweats, mood swings and vaginal dryness.

However,

changing hormone levels can also trigger spikes and falls in blood sugar levels, which for women with diabetes can lead to a number of problems and may pose a number of health risks.

I have both diabetes and menopause – what should I expect?

Menopause will not affect every woman in the same way, however, there are a number of common effects.

Fluctuating blood sugar levels

As mentioned above, changes in the levels of

oestrogen
and progesterone – hormones that affect

how your cells respond to insulin
– can lead to unexpected fluctuations in your blood sugars, making it harder to keep diabetes well controlled.

Weight gain

Putting on weight is a common issue for some women who go through menopause and after menopause, and can increase the need for insulin or

oral diabetes medication

Infections

Diabetes raises the risk of urinary and vaginal infections, and this risk increases further during and after menopause as less oestrogen in the body makes for even more ideal conditions in the urinary tract/vagina for bacteria and yeast to thrive in.

Sleep problems

Hot flushes and night sweats after menopause can cause sleepless nights. This, in turn, can have a negative impact on blood glucose control.

Sexual dysfunction

Over time,

high blood sugar levels can damage the nerves
of in the vagina and cause thinning and inflammation of the vaginal walls, making it more difficult for women to become aroused or achieve orgasm. This problem is often exacerbated by vaginal dryness, a common symptom of menopause, which can cause

pain during sex

How can I better manage menopause and diabetes?

While menopause can make it harder for you to keep your blood sugars levels in check, the good news is that there are a number of simple steps you can take to improve menopause management and reduce the

impact it has on your diabetes control

These include:

Healthy lifestyle changes

Eating a

healthy, balanced diet, avoiding smoking, reducing alcohol intake and keeping physically active are all

healthy lifestyle factors
that can help you feel your best after menopause, as well as helping to keep your diabetes well controlled.

Test your blood glucose regularly

Testing blood sugar levels
more often than usual during the day, and occasionally during the night, will help you to see how your blood sugars respond to menopausal symptoms such as hot flushes and changes in mood (

anxiety, tiredness, etc).

Note down your blood sugar readings and symptoms and provide this information to your doctor as they may use it to adjust your diabetes treatment plan as needed. For example, if your

blood glucose continues to rise, a higher dosage of your

diabetes medication, or new medication may be needed.

Regular HbA1c testing
may also be advised by your doctor to get an idea of what your average blood sugar level has been over the previous 8-12 weeks.

Seek help for menopausal symptoms

If you’re struggling to cope with vaginal dryness and pain,

sleeping problems, hot flushes or other menopausal symptoms, remember that support is available. For example, to restore vaginal moisture your doctor may recommend a vaginal lubricant, or if weight gain is a problem, expert advice from a dietician may help.

Hormone replacement therapy (HRT) is also an option for some women. This form of treatment is used to relieve symptoms of menopause by replacing the female hormones (oestrogen and progesterone) no longer produced after menopause.

Get assessed for heart disease risk

Menopause triggers metabolic changes that can cause your weight to increase. For women with diabetes, weight gain can

elevate their risk of heart disease
even more, as well as complicating management of blood sugar levels.

As your doctor about regular blood pressure and

cholesterol screening
as both health factors are important for controlling diabetes and heart disease risk, but can be affected by menopause.

Protect your bones

Over time, diabetes can cause a number of bone and joint problems, particularly in women. Problems such

as bone thinning can escalate
during and after menopause, so it’s important to build up strength in the bones. This can be done by adding calcium and

vitamin D supplements
to your diet and getting your bone density assessed.

Sexual problems can be disheartening but they needn’t take all the pleasure out of your sex life.

This article looks at how to work around sexual difficulties if treatment is either not possible or not desired.

Direct treatments are covered within our guides on

erectile dysfunction,

female sexual dysfunction
and

low libido

Loss of sensation

Diabetes can affect our nerves, in the form of

neuropathy, and loss of sensation in the penis, clitoris and vagina is possible as well.

Trying out different positions may help to find positions which enhance sensation and therefore make reaching orgasm easier.

Oral sex

Oral sex can be pleasurable to give or receive whether climax is involved or not. Oral sex can be a good option if you’re having unexpected difficulties and can also keep your sex life alive and kicking when sexual dysfunction is a longer term issue.

When climax is unobtainable

Climax may not always be possible for one reason or another. Reasons for having difficulty reaching climax include having loss of sensitivity, psychological issues and having

low blood sugar
As we age, we may find it harder to reach climax.

If an orgasm seems unobtainable, switch the focus of your love making either onto pleasuring your partner or in building an intimate sensual bond.

If you can have penetrative sex but cannot orgasm, positions which maximise body to body contact, eye contact and kissing can be sensual and fulfilling without necessarily requiring climax.

Communicate with your partner

If you are having difficulties, it’s important to let your partner know. If you’re not having as much sex as you used to, chances are that your partner will have recognised even if it hasn’t been mentioned. If you address the issue, it’ll save your partner from being anxious and having to guess to why you’re not having sex so often.

The communication can help to ease any tension that may be present and may allow you and your partner to re-ignite your sex life in alternative ways.

Loss of sex drive

Many of us will experience periods of lower sex drive. Sometimes it’s temporary, sometimes a longer term issue. There are a number of reasons why sex drive may be lost which can range from psychological issues, including depression, to side effects of medication and long term illnesses. Diabetes itself can sometimes be a factor involved in a reduced sex drive.

Understanding the possible causes may help you to address

low libido
and your health team may be able to advise you to help you rediscover your sex drive.

Pain during sexual intercourse (dyspareunia) is more commonly reported by women but can also affect men. High blood sugar levels as a result of diabetes may increase the risk of certain causes of pain.

Lack of lubrication

Vaginal dryness will most likely lead to pain during intercourse. Insufficient lubrication may be caused by a number of factors.

Arousal can be inhibited either by a lack of foreplay, psychological reasons or as a side effect of certain medications including some blood pressure medications and antidepressants.

Autonomic neuropathy
may prevent arousal and lubrication. High blood glucose levels at the time of sex may further lead to vaginal dryness.

Use of a lubricant may help to relieve the pain. If the problem is psychological, you may be offered sexual and relationship therapy.

Genital thrush (yeast infections)

Genital thrush can affect both men and women and is more likely to occur when blood glucose levels are higher than normal.

Yeast infections
can cause soreness of the genitals which may cause sex to be painful.

Thrush is not a sexually transmitted infection but it is possible to pass on a yeast infection to your partner whilst having sex.

For this reason, it is advisable to allow the infection to clear up before having sex.

Thrush may be treated with oral medication or with anti-thrush creams. Maintaining good control of blood sugar levels can also help thrush to clear up.

Vaginismus

Vaginismus is the name for involuntary contraction of the muscles around the vagina in response to an attempt at penetration.

Vaginismus may occur if previous attempts at sex have been painful but may be a

psychological response
for other reasons. If the cause is psychological, sexual therapy may help you to gain control of the muscles.

Tight foreskin – phimosis

Phimosis describes having tight foreskin that prevents a man from being able to retract the foreskin over the glans (head of the penis). Phimosis may cause pain during sex.

Phimosis is caused by an infection and high blood sugar levels as a result of diabetes may provide a breeding ground for infection. Treatment for phimosis will typically involve a topical steroid cream which can help to reduce the tightness.

Inflamed head of the penis – balanitis

Balanitis is swelling of the glans (head of the penis). Balanitis may occur as a result of phimosis if tight foreskin causes irritation of the glans or difficulty in cleaning the glans. Balanitis may also be caused by allergic reactions to soaps or detergents or prolonged contact of the glans with urine.

As with phimosis, balanitis may be treated by use of a topical steroid cream. Depending on the cause of balanitis, it may be treated with antibiotics. Traditionally circumcision was a common treatment for balanitis but these days this will usually only be considered for serious or recurrent cases.

Loss of sex drive and libido can affect people of all ages and both genders. Loss of libido tends to become more likely the older we get and this has been found to be more pronounced in women.

Complications of diabetes, including depression and nerve damage, can also have an impact on libido.

Which factors affect libido?

The NHS lists the following factors which can play a role towards a lower sex drive:

• If your
  
  relationship is having problems
• If you have certain
  
  diabetic complications
• Low sex hormone levels
• If you are approaching the menopause
• 
  Stress
• 
  Exhaustion
• 
  Depression
• Over consumption of
  
  alcohol
• An underactive thyroid (hypothyroidism)
• If you are on certain medications

Relationship issues

The NHS notes relationship issues as one of the most common factors in a loss of sex drive.

Talking about your feelings with your partner can be beneficial. You can also get help by talking with Relate, a charity that offers relationship counselling – contact Relate on 0300 100 1234

Your GP can also be able to refer you to speak with a psychosexual therapist.

Diabetic complications

The presence of certain diabetic complications, such as

nerve damage (neuropathy)
or circulation difficulties, can lead to difficulties in arousal, which can also affect libido.

Achieving good control of blood sugar levels is generally recommended for men and women.

• Read more on
  
  female sexual dysfunction
• Read more on
  
  male sexual dysfunction

Low sex hormone levels

Low testosterone levels in men and women can lead to a lower sex drive. Women produce testosterone albeit in much smaller quantities than males.

If you have low testosterone levels, your GP may be able to prescribe treatments to help.

Approaching the menopause

Women approaching the menopause will typically experience a reduction of oestrogen in their blood which can lead to a loss of libido.

Hormone replacement therapy (HRT) can help but does have side effects. You can discuss with your GP whether hormone replacement is appropriate.

Stress, exhaustion and depression

Stress, exhaustion and depression can each lead to reduced interest towards sex. Certain medications for depression, such as SSRIs (selective serotonin reuptake inhibitors) can lower libido as a possible side effect.

If stress, exhaustion or depression is having a negative effect on your sex life, speak to your health team.

Alcohol

Drinking excess amounts of alcohol is linked with lower sex drives.

The recommended maximum limits for alcohol intakes for men and women are:

• 
  Men:
  
  three to four units a day
• 
  Women:
  
  two to three units a day

Underactive thyroid

The thyroid gland is responsible for producing the hormone thyroxine.

An underactive thyroid gland can lead to symptoms such as tiredness, depression and weight gain, which can have a knock on effect of reducing libido.

Medications and loss of libido

A number of medications may also lead to a lower sex drive, notably including the antidepressants SSRIs, as mentioned above, and medications for high blood pressure.

Diabetes and impotence are strongly associated with each other. Amongst men, impotence refers to the inability to gain an erection in order to perform sexual intercourse.

Men commonly face this problem, and it is more likely to happen amongst diabetic men.

The problem is thought to affect about one in ten men on a long-term basis.

• For more on this topic also see
  
  diabetes and sex

What are the causes of impotence?

Impotence can be caused by stress, anxiety, relationship problems, drinking too much alcohol and medication, as well as low testosterone levels.

What is the link between diabetes and impotence?

Men with diabetes are more prone to suffer from impotence problems, but it is not clearly understood what the exact association is. Diabetics can suffer from hardened arteries, and this could influence blood flow.

Damage to the nerves,

diabetic neuropathy, can also cause impotence.

How do I find out the cause of diabetes-related impotence?

How impotence is treated depends entirely on the cause, and in order to establish this the problem usually needs to be brought into the open and discussed with a doctor.

Impotence can be physical or psychological.

How can impotence be treated?

A variety of treatment alternatives are possible for diabetes-related impotence. A doctor will be able to discuss and decide on an appropriate treatment.

Treatment for impotence will depend entirely on whether the impotence has a physical or psychological cause.

• See also
  
  diabetes and erectile dysfunction

Low testosterone levels in men may also be referred to as male hypogonadism or testosterone deficiency syndrome.

A number of the symptoms of low testosterone are similar to some of the symptoms of type 2 diabetes and health statistics indicate that the two conditions may be associated with eachother.

How common is low testosterone in males?

The natural reduction in testosterone levels in men usually begins around the age of 40 and the decrease will usually be by about 1 to 2% each year.

Low testosterone levels are more commonly found in men with

type 2 diabetes

NHS Diabetes reports that 16% of males with type 2 diabetes have lower than normal levels of testosterone and an additional 24% have testosterone levels close to the border of low levels.

Symptoms of low testosterone

The symptoms of low testosterone levels may include:

• Low libido
• 
  Erectile dysfunction
• Reduced frequency of having a morning erection
• Increased body fat -particularly around the waist
• Reduced muscle mass and physical strength
• Fatigue
• Low motivation and self-confidence
• Increased sweating

What can cause low testosterone?

Factors which can lower testosterone levels or decrease the body’s ability to respond to testosterone include:

• Aging
• Radiation therapy or chemotherapy
• 
  Stress
• Use of
  
  corticosteroids

The NHS states that a lack of regular exercise and smoking may also contribute to the symptoms of hypogonadism in men.

Diagnosis

Hypogonadism can be diagnosed if you have a number of the symptoms in addition to evidence of low testosterone in the morning.

Your GP may ask you to have a blood test to confirm whether your testosterone levels are low.

Treatments

Where the symptoms are brought on by stress, the condition may benefit from exercise, talking therapies such as cognitive behavioural therapy, or through

mindfulness

If hypogonadism is confirmed, you may be offered testosterone replacement therapy to help restore normal levels of the hormone and relieve the symptoms.

Are low levels of testosterone a sign of the male menopause?

The terms male menopause or andropause have been used to describe reduced testosterone levels in men.

However, the

NHS
notes that drawing parallels between decreases in sex hormones in males and females is less helpful as whilst women naturally experience a significant reduction in sex hormones during and after the menopause, the natural reduction in testosterone levels in men should be gradual, as stated above.

Diabetes and female sexual dysfunction (FSD) tends to get less coverage than male sexual dysfunction but studies have found that the prevalence in women could be as much an issue for women as men.

Sexual dysfunction in women can affect sexual desire and arousal and can also lead to

pain during sex

How diabetes can affect sex for women

Sex can affect women in the following ways:

• Vaginitis (inflammation of the vagina) often caused by
  
  yeast infections
• Cystitis (inflammation of the bladder) often a result of a
  
  urinary tract infection
• Trouble with vaginal lubrication
• Difficulty with arousal of the clitoris
• 
  Pain during sex
• Difficulty achieving orgasm
• Psychological effects

Causes of female sexual dysfunction

Vascular damage (damage to blood vessels) can affect blood supply to the vagina and clitoris which can cause problems with dryness and arousal.

Neuropathy (nerve damage)
can have a similar effect in that it can reduce sensitivity.

Diabetes can also lead to

low oestrogen levels
which can also affect lubrication of the vagina.

However, it does not affect your ability to become

pregnant

Psychological reasons can be a common cause of sexual dysfunction in women and can

affect relationships

Diabetes no doubt makes life harder and this can affect one’s sex life in a number of ways including stress, self-image and through to

depression

Treatments for female sexual dysfunction

If the issues are related to psychological issues then you may benefit from sexual and relationship therapy.

Some problems with vaginal lubrication may be a result of psychological issues, however, for those that aren’t standard lubricants can be used or a long lasting vaginal moisturiser, which can alleviate dryness for a number of days.

Erectile dysfunction (ED) is a common problem amongst men who have diabetes affecting 35-75% of male diabetics.

Up to

75%

of men suffering from diabetes will experience some degree of
erectile dysfunction (erection problems) over the course of their lifetime.

Men who have diabetes are thought to develop erectile dysfunction between
10 and 15 years earlier than men who do not suffer from the disease.

Over
the age of 70, there is a 95% likelihood of facing difficulties
with erectile function.

What
causes erectile dysfunction amongst diabetics?

Causes of ED are extremely complex, and are based around
changes that occur to the body over time affecting nerve, muscle and blood
vessel functions.

In order to obtain an erection, men need to have healthy
blood vessels, nerves, male hormones and a desire to have

sex

Without
blood vessels and nerves that control erection, ED can still occur despite
a desire to have sex and normal male hormones.

Factors amongst men

Many other factors bear on erectile dysfunction amongst diabetic men.

These
include:

• 
  Being overweight
• 
  Smoking
• Taking too little exercise and other
  lifestyle factors.

Surgery can

damage nerves
and arteries linked to the
penis, as can some injuries.

Many common medications (including antidepressants
and

blood pressure
drugs) can produce ED.

Psychological factors also have an enormous influence.

Anxiety, guilt, depression, low self-esteem and paranoia about sexual failure
are estimated to cause between 10% and 20% of ED cases.

How
is ED diagnosed?

Erectile dysfunction is diagnosed using several different methods.
Patient history often informs the degree and nature of the ED.

Medical
and sexual past often has an influence, as does prescription or illegal
drug use. ED patients may be physically examined, and bodily features can
give clues to the cause. Laboratory tests can also be key for diagnosing
ED.

Further tests such as monitoring nocturnal erection
(nocturnal penile tumescence) can help to cancel some causes out.

Furthermore,
psychological examination can reveal psychological factors.

Are
there treatments for men with diabetes and erectile dysfunction?

Men who have diabetes and are having trouble achieving
or maintaining an erection can take

oral medicine
The NHS can provide the following medications on prescription for men with diabetes:

Brand names include:

• Viagra
• Cialis
• Levitra

However, these medicines can all affect the
heart rate, and detailed consultation with your doctor is necessary to
determine the best course of action.

Additional treatments include intracavernous
injection therapy, vacuum constriction devices, intraurethral therapy and
sex therapy.

Psychotherapy can have an enormous influence on erectile
dysfunction. Further treatment such as surgery and vacuum devices may also
have a role to play in some specific cases.

Non-oral treatments for erectile dysfunction

Additional treatments include vacuum constriction devices, intraurethral alprostadil suppository or intracavernous injection therapy and sex therapy.

Vacuum pumps consist of a plastic tube, in which you place your penis. The pump, which may be battery or hand pump operated, creates a vacuum that will draw blood into the penis making it erect. A rubber ring will need to placed around the bottom of the penis to keep it erect. A vacuum pump is not for use if you have a bleeding disorder or take anticoagulants.

Alprostadil is a form of hormone medication that stimulates blood flow to penis, and may be given by two different methods:

• Intracavernosal injection – whereby alprostadil is given by injection into the penis
• Intraurethral application – whereby a pellet (1.6mm diameter and 6mm length) of alprostadil is inserted into the urethra via a urethral stick

Alprostadil may be prescribed if you do not respond to other treatments, or you are unwilling to try oral medications or vacuum pump therapy. Your health team may provide training on how to inject or insert alprostadil.

Which
treatment is the best for diabetes and ED?

The most suitable treatment will depend on the health
of the patient and their own ability to tolerate the treatment. Specialists
such as urologists can work with individual cases and determine the best
treatment.

What
is the future of diabetes and erectile dysfunction?

There are frequent advances in this field. Better medications,
implants, vacuum devices and suppositories have all increased options for
diabetic men with ED.

Gene therapy is not being tested, and at some point
may offer a permanent therapeutic approach to tackling diabetes and erectile
dysfunction.

Both type 1 and

type 2 diabetes
can lead to complications.
In some cases, sexual performance can be affected by diabetes.

Up to 50% of men and 25% of women may experience some kind
of sexual problems or a loss of sexual desire as a result of diabetes.

I am a diabetic man, what kind of problems could
diabetes cause to my sex life?

For men, diabetes can cause damage to the nervous system
over a sustained period of time, also known as

diabetic neuropathy
One aspect
of this is the potential for diabetes to damage the erectile tissue leaving
it impossible for a man to achieve or maintain an erection.

Almost

1 in 3 men

with diabetes suffer from erectile dysfunction.

Diabetes and Sex Guides:

Diabetes and Anger

Impotence and Sexual Dysfunction

Low Testosterone and Diabetes

Erectile dysfunction can be the way in which men discover that they have
diabetes.

However, through strict management if the disease through diet,

exercise, pills and insulin injections, minor sexual problems usually recede
and it is possible for the man to achieve and erection.

I am a diabetic woman, what kind of problems
could diabetes cause to my sex life?

For some women with diabetes, vaginitis (inflammation of the vagina) can be recurrent.

Vaginitis can be brought on by a number of different ways including bacterial inbalance of the vagina (bacterial vaginitis)

yeast
infections (thrush)
or from chemical irritatio, such as from soaps or fabric conditioners.

This can make sex
painful, and is heralded by itching or burning sensations.

Cystitis can
also be a recurrent problem for women with diabetes.

Furthermore, some evidence indicates that, in a similar way to men being
unable to maintain an erection, the woman’s clitoris may fail to
respond to stimulation.

Diabetes and Sex Guides:

Sexual Dysfunction

Contraceptive Pill

Periods (Menstruation)

Hypoglycemia and sex

Hypoglycemia
can occur during sex. You may also suffer from a

night time hypo
as the physical exertions of sex mean that in some ways it makes sense to treat intercourse in a similar way to exercise.

However, testing before and after ‘getting it on’ may not help in setting the right mood(!). How you handle

blood sugars
around sex will come down to personal preference. If you have an understanding partner it certainly helps, but how you handle things yourself is also key.

If you’re in a new relationship, it may be tempting not to tell your partner about your diabetes and you may find yourself taking great pains to hide your diabetes. However, your diabetes will emerge sooner or later so it’s best to be open where possible.

If your partner is reassuring, you may have found yourself a great life partner.

Could my blood sugar level affect my performance?

Having

high or low blood glucose levels
may lead to you feeling more tired or lethargic and therefore less up for sexual intercourse.

In men, high and low blood sugars can affect your ability to maintain erection and achieve ejaculation. In the case of

hypoglycemia, this is usually easy to remedy, although it may spoil the mood.

I am worried about my diabetes’ effects
on my sex life, what should I do?

The initial action one should take it to contact your
doctor and discuss it with him. Often, these issues can only be addressed
by seeking

professional
help.

Most doctors are used to discussing these
types of issues, and will aim to assess whether your problems are physical
or psychological in nature.

Many cases can be helped through psychological
methods.

Many men are choosing to use drugs to help their arousal, and some successful
cases have been reported of diabetes erectile dysfunction being aided by Viagra, Cialis
and Levitra.

I’m not sure if the sexual problems are
due to diabetes or not, what should I do?

The best thing to do is see your

doctor
Tests
can be conducted to discover whether the damage done to your nervous system
by diabetes is affecting your sex life.

If not, the problem may be psychological, and there is no reason why your sex life cannot recover.