Diabetes, sexual dysfunction and therapeutic exercise: a 20 year review

Most trials on the effect of exercise on patients with diabetes mellitus focused on their glycaemic control, only a few focused on sexual dysfunction. A comprehensive two-decade literature review (1989-2009) from peer-reviewed journals was undertaken to examine the roles if any, of therapeutic exercise as an intervention for sexual dysfunction in patients with diabetes. Because of the paucity of studies on this subject, meta-analyses, small and non-randomized trials cited on Medline, Pedro, Embase, Scirus, Highwire and the Cochrane Library of systematic reviews were examined. Sexual dysfunction in general, links between diabetes and sexual dysfunction and management options for sexual dysfunction including therapeutic exercises were reviewed. In women, diabetes is reported to slightly increase he risk of decreased sexual arousal, inadequate lubrication and pain on sexual intercourse, while erectile dysfunction is the most common presentation of sexual dysfunction in men. The literature is scanty but shows some effectiveness of therapeutic exercise in managing sexual dysfunction in patients with diabetes. However, this review shows that i) pelvic floor exercises ii) biofeedback techniques iii) electrical stimulation and iv) vaginal dilators are effective in managing sexual dysfunction secondary to other disease factors in the non-diabetic populations. More research is recommended to further establish the efficacy of therapeutic exercise in managing sexual dysfunction in patients with diabetes.