How to Gain Support for Sexual Dysfunction

Male difficulties prompted by physical and emotional causes

sexual dysfunctionBy Jen Nash, DClinPsych, Director of

June is Men's Health Month,, which aims to heighten the awareness of preventable health problems and encourage early detection and treatment of medical issues among males. It is with this in mind that this month's article turns to an often overlooked aspect of men's health in diabetes — sexual dysfunction.

Encountering problems with sexual response is a common experience for both men and women with diabetes. Not only can diabetes affect your physical functioning, there can also be psychological factors that interfere with a full and rewarding sex life. Problems with sexual function can be very distressing, and affect the quality of your life as well as your relationships. Although help is available, many people (both with and without diabetes) find sexual dysfunction an embarrassing topic to talk about in the context of a health appointment, and therefore refrain from being open with their doctor or nurse about their difficulties. This article will help you to become more familiar with the different ways your sexual responses may be affected, give you strategies to help you tackle the psychological difficulties that might be getting in your way, and empower you to talk to your doctor or nurse about how they can help you.

Male sexual problems

Erectile dysfunction (also known as impotence) means that you are not able to obtain or keep an erection long enough for sexual intercourse. An erection is caused by the flow of blood into the penis and the blocking of the small blood vessels, making the penis hard. In one study more than 50% of males with diabetes admitted difficulties with sexual function, rising to more than 75% for men over the age of 70. To put this into context, about 1 in 10 men over 40 years old have erectile dysfunction whether they have diabetes or not. Many factors along with diabetes can contribute to difficulties with sexual response. These include:

•    Drinking alcohol
•    Smoking
•    Taking illegal drugs
•    Medications such as certain antidepressants
•    Injury to the penis
•    Damage to the spinal cord
•    Nerve damage caused by operations to the bladder, bowel or prostate gland
•    Poor blood supply to the penis due to blockage of the artery caused by peripheral arterial disease
•    Producing less testosterone than your body needs
•    High blood pressure.

In addition to physical explanations for sexual difficulties, there are also emotional reasons why you may be encountering problems relating sexually to your partner. These affect both men and women. Some of these are:

•    Stress
•    Depression and low mood
•    Anxiety and worry
•    Conflict with your partner
•    Issues regarding how sex is viewed in your religion or culture
•    Homosexuality
•    Bereavement
•    Illness or ill health
•    Being in an accident
•    Previous abuse
•    Infertility
•    Disabilities

Gain support for the physical side of sex

The first step is to have a physical examination by a healthcare professional and take advantage of medical treatments or aids that they recommend to you. For men with diabetes, Viagra and similar prescription medications can be incredibly helpful and they have no adverse impact on diabetes control. Do not buy any medicines over the Internet to treat erectile dysfunction. It may seem appealing as you can get help anonymously without having to approach a potentially embarrassing topic at your doctor's visit, but there is no guarantee that what you are buying is genuine. It is also important that your healthcare team is aware of all the medications you are taking.

Other general guidelines for improving sexual response for both men and women are:

•    Weight loss, smoking cessation, and cutting down on alcohol intake;
•    Improving glucose control or changing some of your medicines. If the sexual difficulty coincided with a sudden worsening of your glucose control or with starting a different drug, it is important to look at these factors.

It is natural to feel embarrassment about discussing sexual problems with healthcare professionals. Remember they have heard similar problems before and will not be fazed by them. Indeed, they will respect that you are able to be open about it and seek help. Remember the first word on this topic will be the most challenging; once that is done the clinician will steer the conversation for you. Some ideas for conversation starters are in the box below.

Conversation Starters for Discussing Sexual Problems

  • I'm having problems in bed.
  • I'm struggling with sex/my sex life.
  • My [penis, 'equipment', etc.] isn't working as it should.
  • I've got something I'm a bit embarrassed to mention... (The clinician may pre-empt what you are about to say.)
  • I was hoping that you might be able to help me with this problem I am having.
  • I think I've got ED/erectile dysfunction.
  • I can't get a hard-on.


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Last Modified Date: June 25, 2014

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by Brenda Bell
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