Diabetes and sexual disorders

Abstract

Sexual dysfunctions are common in diabetes mellitus, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction is less conclusive, as female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. The main mechanisms by which diabetes may lead to sexual dysfunctions include vasculopathy, neuropathy, endothelial dysfunction, visceral adiposity, endocrinological disorders, and psychological issues. An adequate comprehensive sexual and medical history investigation is of paramount importance for the evaluation of sexual dysfunctions in diabetes. Moreover, standardized questionnaires are frequently used to confirm the diagnosis and to measure its severity. Two of the most practical and easily administered ones are the International Index of Erectile Function (IIEF) and its short version, the IIEF-5, and the Female Sexual Function Index (FSFI) and its short version, the FSFI-6. Therapeutic possibilities for sexual dysfunctions in diabetes refer to lifestyle changes, optimal diabetic control, psychotherapy, and selected medications when appropriated.