Many of us are aware of the consequences of uncontrolled diabetes like kidney failure, damaged retina, dysfunctional heart, foot ulcers etc. However very few are aware of Sexual Dysfunctions. 
According to diabetologists, the population of diabetics in India will register a steep increase from 50 million in 2010 to 87 million in 2025. Indians seem to be developing diabetes at a much younger age (at least 10 to 15 years earlier) than the western population.
Many sexual problems can occur as a result of diabetic complications. Men may have problems like Erectile Dysfunction, Retrograded Ejaculation (semen travels back into the bladder instead of coming out through the penis), Dyspareunia (painful intercourse) and Premature Ejaculation. Women may experience problems like Orgasmic Dysfunction (inability to reach orgasm) and Dyspareunia.
However, it must be noted that it is not diabetes but rather its complications that cause sexual problems. The problems are caused due to damaged blood vessels and nerves due to the abnormal accumulation of Advanced Glycation End products (AGEs). AGEs adversely affect the functioning of Endothelium, the inner lining of blood vessels.
The endothelium is the seat of many chemical reactions which ultimately determine the amount of blood flowing through the arteries and thereby into the organs. When this endothelium is damaged it can not relax and allow sufficient blood to flow through it. Not only that, the damaged endothelium is more prone to develop plaques, clots, thus narrowing the lumen of the blood vessels. In effect the penis will not receive sufficient blood. The effect of this insufficient blood supply will be first felt in the penis before other organs start showing symptoms. This is because the diameter of the penile arteries is narrow (just 1-2mm) as compared to other arteries.
However, there is no need to panic as there are a few steps one can take to ward off the complications:
Have a healthy life style.
Avoid smoking and consuming high fat diet.
Do regular physical exercise.
Keep diabetes and blood pressure under control.
Don’t hesitate to discuss with your doctor if you have a sexual problem.
Dr D Narayana Reddy, MBBS, Ph.D, FACS is a well-known Sexologist from Chennai. He can be contacted at degainstitute@gmail.com or visit www.drnarayanreddy.com.
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