[The pathogenesis of sexual disorders in men with diabetes mellitus]

The examination of 217 males suffering from diabetes mellitus revealed copulative dysfunction in 111 (51.1%) of them. The investigation of sex, gonadotropic hormones, testicular reserves, sexual constitution and sexual formula was carried out in 22-55-year-old males with sexual dysfunction and healthy controls. It was an erectile phase of the sexual cycle that suffered most frequently. Reduced libido was observed in 19% of the patients. All the diabetes examined showed constitutional predisposition to impaired potency. The patients had high serum concentrations of prolactin, lutropin and dihydroepiandrosterone in low testosterone and insignificantly elevated follitropin and estradiol. There was also low gonadal resistance to choriogonin stimulation. These findings and literature data lead to the conclusion that insulin insufficiency entailing hyperglycemia brings about a rise in prolactin and dihydroepiandrosterone levels which may reduce the sensitivity of the receptors and lutropin in the testes and inhibit testosterone secretion. This is confirmed by inactive gonadal response to stimulation of chorionic gonadotropin. Spermatogenic disorders observed in 25% of the patients were associated with sexual affections and local structural changes (hypotrophy) of the testes.