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Diabetes mellitus and male sexual function: a controlled study
R C Schiavi1, B B Stimmel, J Mandeli
1Department of Psychiatry, Biomathematical Sciences and Medicine, Mount Sinai School of Medicine, New York City, New York.
Diabetologia
|August 1, 1993
Summary
Diabetic men experience significant sexual dysfunction, including reduced desire and erectile capacity, compared to healthy men. Even diabetic men without overt sexual issues show abnormalities in nocturnal penile tumescence, suggesting subclinical erectile impairment.
Area of Science:
- Urology
- Endocrinology
- Sleep Medicine
Background:
- Erectile dysfunction is common in diabetic men, but controlled studies considering confounding factors are scarce.
- Previous research often overlooks the impact of age, comorbidities, and medications on sexual function in diabetes.
Purpose of the Study:
- To investigate sexual function and nocturnal penile tumescence in diabetic men compared to age-matched controls, while excluding other influencing factors.
- To explore the relationship between metabolic control, diabetic complications, and erectile function in diabetic individuals.
Main Methods:
- A controlled study involving 40 diabetic men (free of confounding illnesses/medications) and 40 age-matched healthy controls.
- Utilized semistructured interviews with subjects and partners, comprehensive medical evaluations, and three nights of polysomnography with nocturnal penile tumescence monitoring.
Main Results:
- Diabetic patients reported significantly lower sexual desire, arousal, erectile capacity, coital frequency, and sexual satisfaction.
- Significant decrements in REM sleep duration and nocturnal penile tumescent episodes were observed in the diabetic group.
- No differences in sexual problems or nocturnal tumescence were found between Type 1 and Type 2 diabetes.
- Impaired nocturnal tumescence correlated with poor metabolic control and diabetic complications.
- Sexually non-dysfunctional diabetic men exhibited nocturnal penile tumescence abnormalities, indicating subclinical erectile dysfunction.
Conclusions:
- Diabetic men, even those without reported sexual dysfunction, often have subclinical erectile impairment detectable by nocturnal penile tumescence testing.
- The findings suggest caution is needed when interpreting nocturnal penile tumescence tests for diagnosing erectile impotence in diabetic men.
- Metabolic control and diabetic complications are linked to impaired erectile function and nocturnal penile tumescence in diabetic individuals.