When I was starting my career as a doctor, Thursdays were dedicated to my diabetes patients. On that day, my patients would come very early in the morning to take part in different wellness activities: group exercises, support group meetings, lectures, and blood sugar monitoring. Among them, only around a tenth were men.
The reasons for this disproportion in gender could be varied. It could be because women are more likely to visit a doctor, a notion captured in the adage that a woman is often behind every man visiting a doctor. Or maybe the men have less time to spare. Regardless of the reason, this experience highlights one undeniable thing—that diabetes affects men and women in different ways.
Hitting men hard
In a bold generalization, you can say that diabetes hits men harder than women. First of all, diabetes adds on to the cardiovascular risk of men—who are already at an increased risk in the first place, simply for being men. In a paper published in Diabetes Spectrum, men reported poorer health due to diabetes across a broad range of indicators. The study attributed this to poor adaptation to the stress of illness; less likelihood that men will seek medical help; and the impact of illness on “male invincibility.” According to the book “The Diabetic Man” by Lodewick, Biermann, and Toohey, “Diabetes is a bear in every sense of the word. Deny its existence, pretend it isn't there, walk right through it, and you can wind up mauled and destroyed. Unrealistic though this approach may be, it's exactly the approach a number of men take toward diabetes.” The maladaptive behaviors and reactions taken by many men eventually lead to poorer health. Unlike women, men are less likely to study more about their disease; follow regular blood sugar monitoring and exercise recommendations; and reach out for social support.
Notice that most of the factors that put males in the disadvantage are due to behavioral factors that are completely within one’s control. Instead of allowing diabetes to trample your manhood, take it like a man and beat it to the ground. Be a trooper: Take time to study the enemy and strategize. Take your medications and follow your doctor’s advices like a good soldier. And sweat it out with regular exercise to keep yourself fit.
Stand at attention
Another reason why men should pay attention when it comes to diabetes is that poorly controlled diabetes can affect their sexual performance. Up to 75 percent of men with diabetes can suffer from erectile dysfunction (ED), or the inability to have or sustain an erection. This can deliver a strong sucker punch to a man’s ego. Unfortunately, many men don’t even realize that their ED can be due to their diabetes.
How does diabetes cause ED? The first factor is the elevated blood sugar. Chronically high blood sugar levels damage nerves. Most people experience nerve damage in the form of numbness in the extremities. However, nerves that control blood flow to the penis can also be affected. When these nerves are damaged, you get ED. The second factor is anxiety and depression, which can accompany the diabetes-beaten man. These psychological problems reduce libido and your ability to enjoy sex, as well as distract you or exert undue pressure on you, making you have difficulty getting an erection.
Furthermore, some men suffer from retrograde ejaculation. This is when, during ejaculation, semen doesn’t exit the penis, but instead flows back to the urinary bladder. When this happens, conceiving a baby may be a problem.
The good news is that both conditions can be prevented by tight blood sugar control and medications. If you feel that your diabetes is affecting your sex life, visit your friendly urologist.
It’s the women’s turn
Men aren’t the only ones who can get sexual problems secondary to diabetes. One study showed that up to 42 percent of women with diabetes experience sexual dysfunction. These problems include decreased vaginal lubrication and dryness; uncomfortable or painful sexual intercourse; decreased or no desire for sexual activity; or decreased or absent sexual response—such as inability to become or remain aroused, reduced or no sensation in the genital area, and the constant or occasional inability to reach orgasm. These problems may be due to nerve damage, reduced blood flow to the sexual organs; and hormonal changes. Some studies suggest that poorly controlled diabetes can lower estrogen levels. Conversely, a woman’s hormonal cycles can cause fluctuations in blood sugar levels.
The effects of hormones on blood sugar should also be brought to mind. The strong association between hormones, blood sugar control, and a woman’s sexual health makes it very important for women with diabetes to check their blood sugar more often, especially on different times in their monthly cycle. In addition, diabetes medications should be taken religiously, as some of them have been shown to also improve hormonal dysfunction associated with diabetes.
Experts also recommend the use of over-the-counter water-based vaginal lubricants for women who suffer from vaginal dryness. Kegel exercises that help strengthen the pelvic muscles may also improve sexual response. Other techniques that may help include changes in position, manual stimulation, and even psychological counseling. These latter techniques may require the assistance of a professional counselor.