A funny thing happened to Jim Turner years ago when he was hiking with a girlfriend. It was evening, and the two were lying on a blanket under a full moon. The conditions were perfect for romance. "And I just had zero interest in sex," says Turner, an actor and dLife television host, who has type 1 diabetes. "I was lying there staring at the moon. My girlfriend looked at me and said, 'Why are you sweating so much?'"
These were the days before he tested his blood sugar levels often, and Turner didn't know his levels were so low. But even now, with testing, he says, it's hard to have spur-of-the-moment sex when you have diabetes.
Diabetes is a leading cause of sexual issues in men. Some issues are a chronic nuisance. Some, such as erectile dysfunction (ED) -- not being able to get or keep an erection -- are easy to notice. Others, such as less desire for sex or low testosterone, can creep up on you.
"Decreased libido moves slowly, like a glacier," says R. Keith Campbell, distinguished professor in diabetes care and pharmacotherapy at Washington State University, who has type 1 diabetes. "You may not even notice it until your partner says, 'You haven't tried to have sex with me for 6 weeks.'"
Whatever the problem, there are ways to handle it. Read on to learn about them.
Diabetes and Men: What Causes Sexual Problems?
If you have poor blood sugar control, you're more likely to have sexual issues. High blood sugar levels over a long time can damage nerves and blood vessels, including those in the penis. This disrupts blood flow and makes it hard to get an erection. You can also have sexual issues if you have good diabetes control, but they may be milder and easier to treat.
About half of men who've had diabetes for more than 10 years have trouble with erections. And men with diabetes tend to develop this trouble 10 to 15 years before other men. If you can't get or keep an erection more than half the time, you may have ED.
Depression or emotional problems and some drugs can also cause ED. None of the diabetes drugs used to lower blood sugars are known to cause sexual problems in men or women, says Vivian Fonseca, MD. "However, high blood pressure is common in people with diabetes, and some blood pressure medications -- such as beta blockers, clonidine, and diuretics -- are more likely to cause ED than others," he says. Fonseca is chief of endocrinology at Tulane University School of Medicine in New Orleans and president of medicine and science for the American Diabetes Association.
Erectile Dysfunction and Heart Disease
Men with erectile dysfunction are also more likely to have heart disease, another condition linked to diabetes, because the same problems that block blood flow in your penis block it in your heart. So any practice that is bad for your heart -- such as smoking, not being active, and being overweight -- is also bad for erections.
"For men with type 2 diabetes, erection problems are usually just the tip of the iceberg," says Irwin Goldstein, MD, director of San Diego Sexual Medicine at Alvarado Hospital.