People with diabetes have an increased risk of sexual dysfunction. Sexual problems that commonly affect diabetic men include:

• Erectile dysfunction. This is an inability to consistently achieve or sustain an erection firm enough for intercourse. Men with this condition, which is commonly called impotence, may occasionally be able to have or sustain an erection.
  
  Men with diabetes are three times more likely to experience erectile dysfunction than those without diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). In addition, men with diabetes and erectile dysfunction may experience the problem 10 to 15 years earlier in life than nondiabetics. It is not uncommon for a man seeking treatment for erectile dysfunction to learn that he has diabetes and that it may be the cause of his sexual difficulties.
  
  
• Male hypogonadism (low level of the hormone testosterone). Beginning in middle age, this condition is common in men. Researchers have found that obesity, diabetes, elevated blood pressure or unhealthy amounts of blood fats (cholesterol and triglycerides) are associated with hypogonadism. Insufficient production of testosterone has been linked to fatigue, diminished sexual desire, depression and the bone-thinning disease osteoporosis. Recent research suggests that hypogonadism may also be associated with insulin resistance, the progression of type 2 diabetes and possibly heart disease.
  
  

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• Retrograde ejaculation. This condition occurs when part or all of the semen travels into the bladder rather than out of the penis during ejaculation. Retrograde ejaculation is typically caused by irregular functioning of internal muscles called sphincters. Men experiencing this problem may notice that a small amount of semen is discharged during ejaculation. They may also experience fertility problems.
  
  
• Premature ejaculation. Factors that may contribute to this common condition include diabetes, cardiovascular disease, nerve damage or urethritis.
  
  
• Delayed (retarded) ejaculation. This is a difficulty in ejaculating even when there is an erection and sexual desire. Risk factors for delayed ejaculation include diabetes, high blood pressure, nerve disease and prostate problems.
  
  

Women with diabetes are prone to sexual dysfunction as well. They commonly experience:

• Vaginal dryness. Decreased lubrication of the vagina, caused in part by nerve damage to cells that line the vagina, may lead to pain or discomfort during intercourse (dyspareunia). Another common sexual problem that affects women with diabetes is decreased vaginal sensitivity, which often makes orgasm difficult to achieve.
  
  
• Decreased arousal. Up to 35 percent of women with diabetes may exhibit a decreased or absent sexual desire or response, according to the NIDDK. A major reason for this is that chronic hyperglycemia can damage blood vessels and restrict blood flow to the vagina and clitoris. In addition, many women, including those without diabetes, experience a decreased desire to engage in sexual activity before, during and immediately after menopause.
  
  
• Polycystic ovarian syndrome (PCOS). PCOS, a risk factor for diabetes, is a hormonal disorder that can cause menstrual problems and pelvic pain
  
  

Many people with diabetes also are overweight or obese, suffer from fatigue, are prone to yeast or urinary tract infections, experience bladder problems such as overactive bladder, or have depression or anxiety, any of which can contribute to sexual difficulties. And like nondiabetics, people with diabetes may also experience sexual dysfunction caused by other factors, such as physical or psychological trauma or prostate disorders.