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How Does Diabetes Affect a Man Sexually?

Vicky Davis

Reviewed by Vicky Davis, FNP

Written by Rachel Sacks

Published 05/16/2023

Your sex life and sexual function can be affected by several factors, from foods that boost testosterone to sleep habits and physical activity. So it shouldn’t be surprising that health conditions like diabetes can also impact sexual activity. But like many guys, you might wonder, How does diabetes affect a man sexually?

Are men with diabetes more susceptible to experiencing erectile dysfunction (ED)? Do people with diabetes have a higher or lower sex drive? If so, how does diabetes affect a man sexually? 

We’re here to answer all these questions and more about sexual dysfunction in diabetes.

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To answer “How does diabetes affect a man sexually?” we’ll take a quick look at the details of this particular health condition and how it affects sexual function.

  • Also called diabetes mellitus, diabetes is a chronic disease that affects how your body turns food into energy, resulting in high blood sugar levels (too much sugar in the blood).

  • People with diabetes mellitus have insulin resistance, meaning they don’t produce enough insulin to use blood sugar (or blood glucose) for energy.

  • There are three types of diabetes mellitus: type 1, type 2 (a common type, with about 90 percent of people with diabetes having type 2) and gestational diabetes.

  • Diabetes can cause several health issues, such as heart disease, loss of vision and other problems — including sexual issues.

High blood glucose levels can damage blood vessels and nerves — also called diabetic neuropathy — and lead to impaired sexual health and sexual dysfunction. Some people may learn they have diabetes as a result of sexual dysfunction caused by diabetic neuropathy.

Below, we’ve listed how diabetes can affect men and cause sexual dysfunction.

Erectile Dysfunction

For a man to achieve an erection, there must be significant blood flow to the penis. However, diabetes can cause blood vessel damage, which can affect blood flow to the genitals.

Diabetic neuropathy can also make it difficult to maintain an erection firm enough for sexual intercourse — otherwise known as erectile dysfunction.

Men with diabetes are three times more likely to experience erectile dysfunction than those without diabetes. Additionally, those with diabetes may develop ED 10 to 15 years earlier than those without the chronic condition, and they’re less responsive to oral medical treatment for ED.

Those with prediabetes — a condition where blood glucose levels are high but not high enough to be diagnosed as Type 2 diabetes — are also more likely to experience ED. A review of nine studies found that men with prediabetes experienced erectile dysfunction more frequently than those with normal blood sugar levels.

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Retrograde Ejaculation

Another sexual issue people with diabetes may experience is retrograde ejaculation.

Retrograde ejaculation is a condition where semen is ejaculated into the bladder instead of out of the penis due to diabetic neuropathy, the nerve damage caused by diabetes.

Men with diabetes mellitus are also more likely to experience premature ejaculation, a common male sexual function issue in which you may reach orgasm and ejaculate early during sexual encounters.

Testosterone Levels

Diabetes has been associated with reduced testosterone levels in men, which can affect sex drive. A meta-analysis of thirteen different studies suggests that men with diabetes often have reduced testosterone levels.

According to the American Diabetes Association (ADA), you’re twice as likely to have low testosterone if you have diabetes than people who don’t have diabetes.

Testosterone is a sex hormone that regulates a number of processes, including fertility, sex drive, fat distribution and muscle mass. People with low testosterone levels can experience various symptoms and may undergo testosterone replacement therapy.

Psychological Impact

People with diabetes may often feel tired as a result of devoting significant time and energy to managing this health condition. This may decrease their sex drive, affect their emotional health and lead to other psychological factors, such as self-esteem issues, anxiety or depression.

When you feel anxious or stressed about your diabetes, your body activates its sympathetic nervous system. This results in — among other things — constriction of blood vessels while increasing the production of stress hormones such as epinephrine, norepinephrine and cortisol. These effects can lead to an increase in blood pressure levels and a subsequent reduction in blood flow to parts of your body — such as your penis.

Put simply, the psychological effects of performance anxiety lead to a physical response from your body that makes sex more difficult.

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While diabetes can affect what happens in the bedroom, there are ways to prevent this health condition from interfering with your sex life too much.

Keeping your blood sugar levels in check is important for preventing nerve damage that can cause sexual dysfunction.

A healthcare provider may recommend taking medication, using insulin and checking your blood sugar levels regularly to make sure you have healthy blood glucose levels.

Living a healthful lifestyle is also crucial for those with diabetes to boost their overall sense of well-being and sexual health. Eating a healthy diet, exercising regularly, checking your blood pressure and quitting smoking are a few ways to help manage diabetes.

Likewise, there are plenty of treatment options for erectile dysfunction, including PDE5 inhibitors, such as sildenafil (Viagra®), avanafil (Stendra®) and tadalafil (Cialis®), which improve blood flow.

However, these medications may not be suitable for every man, particularly those with high blood pressure or heart conditions.

Consult with a healthcare provider to discuss any health concerns or questions before starting a new medication. You can also check out this guide to the safest drug for erectile dysfunction for more information.

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How does diabetes affect a man sexually? It turns out this condition can prevent you from having a healthy sex life in a few ways.

This chronic disease affects the way your body turns food into energy and your blood glucose levels. It also results in lower blood sugar levels as well as blood vessel and nerve damage.

This nerve damage — referred to as diabetic neuropathy — can result in a number of sexual issues, such as erectile dysfunction. Diabetes may also cause retrograde or premature ejaculation and performance anxiety and might even be connected to reduced testosterone levels.

While there’s no cure for diabetes, there are ways to manage blood sugar glucose levels as well as medications for erectile dysfunction.

Maintaining healthy blood glucose levels is important not only for reducing sexual dysfunction such as ED or premature ejaculation but also for overall sexual health and improved quality of life.

Explore erectile dysfunction treatment options from Hims today.

13 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. What is diabetes? | CDC. (n.d.). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html
  2. Diabetes, Sexual, & Bladder Problems | NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-bladder-problems
  3. Maiorino, M. I., Bellastella, G., & Esposito, K. (2013). Diabetes and sexual dysfunction: Current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 7, 95-105. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949699/
  4. Prediabetes - Your Chance to Prevent Type 2 Diabetes. (n.d.). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/diabetes/basics/prediabetes.html
  5. Jin, M., Yuan, S., Wang, B., Yi, L., & Wang, C. (2020). Association Between Prediabetes and Erectile Dysfunction: A Meta-Analysis. Frontiers in Endocrinology, 12. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784376/
  6. Mostafa, T., & Abdel-Hamid, I. A. (2021). Ejaculatory dysfunction in men with diabetes mellitus. World Journal of Diabetes, 12(7), 954-974. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311479/
  7. Retrograde Ejaculation. (n.d.). Harvard Health. Retrieved from https://www.health.harvard.edu/a_to_z/retrograde-ejaculation-a-to-z
  8. Wang, B., & Ding, L. (2018). Testosterone level and risk of type 2 diabetes in men: A systematic review and meta-analysis. Endocrine Connections, 7(1), 220-231. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793809/
  9. Low Testosterone | ADA. (n.d.). American Diabetes Association. Retrieved from https://diabetes.org/healthy-living/sexual-health/low-testosterone
  10. Low Testosterone: Symptoms, Diagnosis & Treatment. (n.d.). Urology Care Foundation. Retrieved from https://www.urologyhealth.org/urology-a-z/l/low-testosterone
  11. Ayada, C., Toru, Ü., & Korkut, Y. (2015). The relationship of stress and blood pressure effectors. Hippokratia, 19(2), 99-108. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938117/
  12. Managing Diabetes | NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes
  13. Are erectile dysfunction pills safe for men with heart disease? (n.d.). Harvard Health. Retrieved from https://www.health.harvard.edu/mens-health/are-erectile-dysfunction-pills-safe-for-men-with-heart-disease
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Vicky Davis, FNP

Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education. 

Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families. 

She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing

She is also an active member of the American Academy of Nurse Practitioners.

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