Diabetes and Sex Issues: Low Libido, Erectile Dysfunction, and More
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Diabetes and Sexual Dysfunction

Diabetes and Sexual Dysfunction
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Published on April 11, 2025
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It’s not often discussed, but diabetes can lead to sexual dysfunction in both men and women. Erectile dysfunction, decreased sex drive, a decline in fertility, and vaginal dryness may all result from damage to the small blood vessels and nerves caused by chronic hyperglycemia. The body’s sexual response depends on nerve signals that communicate with the brain and adequate blood flow, both of which can be compromised by high blood sugar.

If you have diabetes, one of the best ways to avoid or manage sexual dysfunction is to stay on top of your blood sugar levels as best as possible. Stable, healthy blood sugar can preserve nerve function and may stop symptoms from getting worse.

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Does Diabetes Affect Sex Drive?

Poorly managed diabetes can lower feelings of sexual desire in both men and women. This can happen both in the short term and over a longer period of time.

 In males, chronically high blood sugar can lower testosterone, a hormone that directly impacts libido, says Justin Houman, MD, a urologist in private practice and an assistant professor of urology at Cedars-Sinai Medical Center in Los Angeles.

 Experts say men with diabetes are twice as likely to have low testosterone as men who don’t have blood glucose issues.

Dr. Houman says high blood sugar can also cause hormonal imbalances in women, reducing levels of testosterone and estrogen, which also plays a role in sex drive. “Fatigue from uncontrolled diabetes may also reduce interest in sex,” he adds.

Diabetes and Erectile Dysfunction

Research suggests that men with type 2 diabetes are more than three times as likely to have erectile dysfunction (ED) as men without type 2 diabetes.

 ED, which is defined as the inability to get or maintain an erection during sex, is a common complication of diabetes.

“Erectile dysfunction (ED) is the most common sexual dysfunction in men, including those with diabetes,” says Sharon J. Parish, MD, a professor of medicine who specializes in sexual medicine at Weill Cornell Medical College in New York City.

 And, while ED becomes more likely in older age, men with diabetes tend to get ED 10 to 15 years earlier than men without diabetes.

Testosterone not only plays a role in libido but also in getting and maintaining an erection. When testosterone levels drop, men with and without diabetes often develop ED.

 But diabetes increases the risk of other complications that can contribute to ED.
For example, diabetes can accelerate the buildup of plaque in the arteries, a condition known as atherosclerosis.

 This causes the arteries to become narrower, which reduces blood flow to the penis and makes it more difficult to achieve and maintain an erection, says Houman.
In addition, some medications used by people with diabetes to treat related conditions can hinder erectile function, including beta-blockers, a class of high blood pressure drugs.

 Antidepressants, which are prescribed to many people with chronic conditions, also are linked to ED, says Houman.

Beyond those health and medication issues, other conditions may cause or contribute to erectile dysfunction, such as alcohol or drug abuse, smoking, and vascular disease.

 A healthcare provider can help you get to the root cause.

Treatments for ED

For men with diabetes, there’s a significant ED remedy at hand: better blood sugar control. If your ED is ultimately caused by hyperglycemia, your complications can be lessened or reversed if you can keep your blood sugar in a healthy range.

There are also many other treatments for erectile dysfunction. A doctor will likely first suggest a prescription oral medication known as a PDE5 inhibitor:

  • avanafil (Stendra)
  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil
If oral medication is ineffective or not tolerated, there are other options, including a medication called alprostadil that is either injected or inserted into the penis, as well as penis pumps or penile implants.

Other Male Sexual Dysfunction Issues

Beyond ED and low testosterone, there are other sexual complications in men with diabetes.

Retrograde Ejaculation

A complication in men whose diabetes has progressed, retrograde ejaculation occurs when some or all of a man’s semen goes into the bladder rather than exiting the tip of the penis.

 It’s not necessarily as uncomfortable as it sounds — you may not even realize you have it. Retrograde ejaculation is typically identified after a person notices how little semen is discharged during ejaculation. It can lead to fertility problems.

Like erectile dysfunction, retrograde ejaculation is caused by nerve damage from prolonged high blood sugar levels, says Houman. It can also be precipitated by prostate surgery and certain medications. If the condition is suspected, a urine sample is used to detect semen and diagnose retrograde ejaculation. There are both pharmaceutical and surgical treatments available.

Peyronie’s Disease

This condition, characterized by an extreme curvature of the penis, is common in men with poorly controlled diabetes.

 The hyperglycemia associated with diabetes appears to make Peyronie’s disease both more common and more severe.

 Peyronie’s disease often coexists with erectile dysfunction, and it can lead to physical pain and discomfort during sexual intercourse.

Sexual Dysfunction in Women With Diabetes

Women with diabetes also commonly experience sexual dysfunction, though the issues aren’t as well understood as men’s.

Research suggests that women with diabetes can experience the following sexual dysfunctions:

  • Reduction or loss of sexual interest or desire
  • Arousal difficulties or vaginal dryness
  • Loss of the ability to reach orgasm
Women with diabetes may also suffer from dyspareunia, which is discomfort or pain during intercourse, and recurrent yeast and urinary tract infections (UTIs), says Houman.

The causes of sexual dysfunction are essentially the same for women with diabetes as those for men, but sexual dysfunction in women may also be attributed to gynecologic infections, pregnancy-related issues, menopause, and other health problems, says Dr. Parish.

Treatment for Issues in Women With Diabetes

Hormone therapy, including vaginal estrogen, may relieve vaginal dryness and painful intercourse, and drugs like flibanserin (Addyi) and bremelanotide (Vyleesi) are approved by the U.S. Food and Drug Administration (FDA) to treat low sexual desire in premenopausal women. Other treatments and therapies that may help include:

  • Vaginal lubricants and moisturizers, which are available both over-the-counter and in prescription strength, can help with dryness
  • Learned techniques such as certain positions or stimulation during sexual interactions
  • Kegel exercises for stronger pelvic muscles to help with sexual response
  • Counseling to help manage any underlying anxiety, depression, or sexual performance worries
Researchers have suggested that sexual dysfunction in women may be more likely caused by social and psychological factors than the side effects of diabetes.

 As a result, women experiencing dissatisfaction in the bedroom may want to address distress, depression, or other mental health issues to improve their sex life.

Psychological and Emotional Aspects

Sexual issues related to diabetes can strain intimate relationships, so it’s important to communicate well with your partner.

“Open and honest discussions about sexual concerns can reduce stress and help find alternative ways to maintain intimacy,” Houman says.

He adds that mental health therapy or couples’ counseling can help facilitate these conversations and address anxiety, depression, or relationship stress that can make problems in the bedroom even worse.

It’s also helpful to remember that sexual dysfunction in diabetes is common and treatable. This may encourage you to seek solutions rather than withdraw from intimacy, Houman says.

The Takeaway

  • Diabetes is a common cause of sexual dysfunction in both men and women due to poor blood flow, nerve damage, and hormonal imbalances.
  • For men, diabetes increases the risk of erectile dysfunction, retrograde ejaculation, and low testosterone. Women may experience low libido, painful intercourse, and difficulties with arousal and orgasm.
  • These conditions are treatable with blood sugar management, medical advice, prescription medications, and lifestyle adjustments that can restore sexual health and improve intimacy.
  • Improving communication with your partner can also help you deal with sexual dysfunction and strengthen your relationship.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Sex and Diabetes. American Diabetes Association.
  2. Elabbady A et al. Studying the Effect of Type 2 Diabetes Mellitus on Prostate-Related Parameters: A Prospective Single Institutional Study. Prostate International. August 2016.
  3. Low Testosterone. American Diabetes Association.
  4. Defeudis G et al. Erectile Dysfunction and Diabetes: A Melting Pot of Circumstances and Treatments. Diabetes/Metabolism Research and Reviews. September 2021.
  5. Definition & Facts for Erectile Dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. October 2024.
  6. Chu NV et al. Diabetes and Erectile Dysfunction. Clinical Diabetes. January 2001.
  7. Rajfer J. Relationship Between Testosterone and Erectile Dysfunction. Reviews in Urology. 2000.
  8. Ye J et al. Diabetes Mellitus Promotes the Development of Atherosclerosis: The Role of NLRP3. Frontiers in Immunology. June 28, 2022.
  9. Blood Pressure Drugs and ED: What You Need to Know. Harvard Health Publishing.
  10. Antidepressants: Which Cause the Fewest Sexual Side Effects? Mayo Clinic. August 24, 2024.
  11. Erectile Dysfunction: Viagra and Other Oral Medications. Mayo Clinic. June 24, 2023.
  12. Erectile Dysfunction. Cleveland Clinic. August 28, 2023.
  13. Mao YS et al. Retrograde Ejaculation as an Initial Presenting Symptom of Type 2 Diabetes Mellitus: A Case Report and Literature Review. Journal of Men’s Health. February 2022.
  14. Retrograde Ejaculation. Cleveland Clinic. September 28, 2021.
  15. Habous M et al. Peyronie’s Disease is Common in Poorly Controlled Diabetics But is Not Associated With the Metabolic Syndrome. Urology Annals. July-September 2019.
  16. Gianazza S et al. Peyronie’s Disease Development and Management in Diabetic Men. Andrology. June 2022.
  17. Shindel AW et al. Sexual Dysfunction in Diabetes. Endotext. June 8, 2021.
  18. Massud N et al. Frequency of Sexual Dysfunction in Women With Diabetes Mellitus: A Cross=Sectional Multicenter Study. Journal of Diabetology. July-September 2021.
  19. Paudel S et al. Systematic Review of Literature Examining Bacterial Urinary Tract Infections in Diabetes. Journal of Diabetes Research. May 17, 2022.
  20. Female Sexual Dysfunction. Mayo Clinic. October 20, 2024.
  21. Maiorino MI et al. Diabetes and Sexual Dysfunction: Current Perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. March 6, 2014.
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Sandy Bassin, MD

Medical Reviewer
Member of American College of Lifestyle Medicine

Sandy Bassin, MD, is an endocrinology fellow at Mount Sinai in New York City. She is passionate about incorporating lifestyle medicine and plant-based nutrition into endocrinology, particularly for diabetes and obesity management.

She trained at the Geisel School of Medicine at Dartmouth, where she taught culinary medicine classes to patients and medical trainees. She continued her training at the Robert Wood Johnson Medical School.

Dr. Bassin has published reviews of nutrition education in medical training and physical activity in type 2 diabetes in Nutrition Reviews, Endocrine Practice, and the American Journal of Lifestyle Medicine. She has been featured on the Physician to Physician Plant-Based Nutrition podcast and given many presentations on lifestyle interventions in endocrine disorders.

She stays active through yoga and gardening, and loves to cook and be outdoors.

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Lauren Bedosky

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Lauren Bedosky is an experienced health and fitness writer. She regularly contributes to top websites and publications like Men's Health, Women's Health, MyFitnessPal, SilverSneakers, Runner's World, Experience Life, Prevention, AARP, Blue Cross and Blue Shield, UnitedHealthcare, Livestrong, Fitness, Shape, Family Circle, Healthline, Self, Redbook, and Women's Running.

When she's not writing about health and fitness — her favorite topics being anything related to running and strength training — she's reading up on the latest and greatest news in the field and working on her own health goals.
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