Sexual dysfunction in diabetes

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

We aimed to summarize the etiology, clinical characteristics, diagnosis, and possible treatment options of sexual dysfunction in diabetic patients of both sexes. Details of dysfunction in diabetic women are less conclusive than in men due to the lack of standardized evaluation of sexual function in women. Male sexual dysfunction is a common complication of diabetes, including abnormalities of orgasmic/ejaculatory function and desire/libido in addition to penile erection. The prevalence of erectile dysfunction (ED) among diabetic men varies from 35% to 75%. Diabetes-induced ED has a multifactorial etiology including metabolic, neurologic, vascular, hormonal, and psychological components. ED should be regarded as the first sign of cardiovascular disease because it can be present before development of symptomatic coronary artery disease, as larger coronary vessels better tolerate the same amount of plaque compared to smaller penile arteries. The diagnosis of ED is based on validated questionnaires and determination of functional and organic abnormalities. First-, second- and third-line therapy may be applied. Phosphodiesterase-5 (PDE-5) inhibitor treatment from the first-line options leads to smooth muscle relaxation in the corpus cavernosum and enhancement in blood flow, resulting in erection during sexual stimulus. The use of PDE-5 inhibitors in the presence of oral nitrates is strictly contraindicated in diabetic men, as in nondiabetic subjects. All PDE-5 inhibitors have been evaluated for ED in diabetic patients with convincing efficacy data. Second-line therapy includes intracavernosal, trans- or intraurethral administration of vasoactive drugs or application of a vacuum device. Third-line therapies are the implantation of penile prosthesis and penile revascularization.

Original languageEnglish
Pages (from-to)223-232
Number of pages10
JournalHandbook of Clinical Neurology
Volume126
DOIs
Publication statusPublished - 2014

Fingerprint

Erectile Dysfunction
Phosphodiesterase 5 Inhibitors
Penile Implantation
Penile Erection
Therapeutics
Libido
Muscle Relaxation
Diabetes Complications
Vacuum
Nitrates
Nervous System
Smooth Muscle
Blood Vessels
Coronary Artery Disease
Coronary Vessels
Cardiovascular Diseases
Arteries
Psychology
Equipment and Supplies
Pharmaceutical Preparations

Keywords

  • Artery size hypothesis
  • Erectile dysfunction
  • Phosphodiesterase-5 inhibitors
  • Princeton guidelines
  • Sexual dysfunction

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Sexual dysfunction in diabetes. / Várkonyi, T.; Kempler, P.

In: Handbook of Clinical Neurology, Vol. 126, 2014, p. 223-232.

Research output: Contribution to journalArticle

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