Patients with diabetes, whether male or female sexual function, there may be obstacles. Men's sexual function including sexual desire, penile erection and ejaculation, in which dysfunction erectile function (in English referred to as ED) accounted for male sexual dysfunction in the majority, meaning that more than 25% of sexual intercourse, and can not achieve or maintain an erection sufficient time to to obtain a satisfactory sex life. According to statistics, the incidence of ED patients with diabetes is 35% ~ 75%, occurred earlier age than non-diabetic patients appear 10 to 15 years. For women with diabetes, although diabetic patients without a male sexual dysfunction obvious, frequent, but there are many patients showed orgasmic disorder, decreased sexual drive, vaginal secretions decrease menstrual abnormalities such as sexual dysfunction. Diabetic patients the reasons for sexual dysfunction and related performance Due to differences in sex, leading to its formation is also a cause of sexual dysfunction vary. Male Sexual Dysfunction Causes and clinical manifestations of With the extension of duration of diabetes, vascular endothelial cells in a wide range injury, nitric oxide functions to degrade, while smooth muscle structure, function, hemorheology and other changes can lead to a wide range of unique nerve, vascular diseases and smooth muscle lesions, especially small and medium blood vessels, peripheral neuropathy and autonomic neuropathy and different levels of endocrine changes, such as the decline in testosterone levels, elevated levels of plasma prolactin and androgen receptor in peripheral blood leukocytes decreased, the result of the biological effects of testosterone can not be fully expressed, resulting in the abnormal erectile function, there ED. The normal physiological penile erection requires adequate blood flow and nerve stimulation. Diabetic neuropathy often cause blood vessels, especially the medium and small blood vessels resulting from atherosclerosis, cavernous smooth muscle and blood vessels within the tension more nerve impulses and chemical substances subject to the impact of increased adrenergic nerve tension, autonomic nervous function barriers include not only the adrenergic nervous system, but also cholinergic nerve, acetylcholine synthesis has been damaged. Therefore, poor response to penile blood vessels, less blood flow into the penis, resulting in the occurrence and development of ED. As the duration of the extension of the deterioration of the central autonomic nervous system dysfunction, often add to the autonomic nervous system dysfunction in the penis, poor blood glucose control and diabetes complications in the presence of an aggravating the incidence of ED. Therefore, patients with diabetes vascular and neurological complications caused by ED seems to be a key issue, which is not surprising, because patients with a detailed analysis shows that: vascular and neurological disease in ED patients with diabetes accounted for 89%, 2 factors exist simultaneously accounted for 39%, vascular lesions may also be affected by other risk factors, such as, tobacco, alcohol consumption, high blood pressure. About 40% ~ 70% of diabetic patients with high blood pressure. At present six types of drugs in the treatment of hypertension, β-receptor blockers, calcium blockers, angiotensin-converting enzyme inhibitors, diuretics and angiotensin-receptor antagonist five will to a certain extent, produce the male patients with ED, only the α-receptor blockers in diabetic patients with less impact on erectile function, and may even have some beneficial effects. Another study found that more patients with diabetes exist neuropathy and psychological factors, and neuropathy and vascular disease is sometimes compared with ED caused by psychological disorder occurs less lesser extent, ED caused by psychological factors in diabetic patients is about 9% ~ 36%, while other patients may have mixed device quality, psychological factors exist. Further studies have shown that patients with type 2 diabetes, the incidence of ED caused by psychological factors, the rate of 28% in patients with type 1 diabetes accounts for 26%. In addition, many of the central nervous system drugs may directly affect the central nervous impulse, the release of inhibition of prolactin to inhibit sexual function. In addition to diabetes, there are 32% of diabetic patients with sexual dysfunction are male hormone, thyroid hormone, or prolactin exception. Female sexual dysfunction in patients with diabetes and clinical manifestations 70 early 20th century, some 18 to 42 of 125 cases of diabetes between the ages of female orgasm frequency of a 1-year study and compared with non-diabetic patients and found that diabetes, accounted for the lack of female orgasm 35%, non-diabetic were only 6%, and 44 cases of asexual orgasm 40 cases in the past who have had an orgasm, most patients suffering from diabetes in the emerging post-orgasmic disorder. For the following reasons: (1) orgasmic disorder and duration of diabetes have a close relationship with the patient's age, whether there are complications, no significant relationship; (2) women with diabetes psychological abnormalities: These patients may have loss of libido, painful intercourse and sexual wake-up power drops, vaginal fluid secretion accompanied by slow or insufficient, instinctive sexual desire, vaginal fluid secreted by the frequency and speed, genital excitement, orgasm and vaginal spasms, diabetes can occur in patients with vaginal fluid secretion in the two extremes, namely, inadequate secretion of or excessive, as compared with men, penile erection, women's physiological changes is the most direct vulvar and vaginal blood vessel congestion, which is vaginal secretion; (3) contrast with the other women with diabetes compared with autonomic neuropathy in the nature of genital excitement of life decline in the process of Central Africa, in the female patients with diabetes and her husband made a series of tests, such as sexual attraction, sexual awakening power, sex, control, sexual ability and general evaluation of the determination, these patients husband evaluation of their capabilities significantly. Some studies reported that 18 to 40-year-old woman with type 1 diabetes compared with non-diabetic women with vaginal plethysmograph testing when the television camera appears pornography and pornographic images of non-congestion of the vaginal capillaries showed that subject's own assessment of sexual awakening similar to the situation between the two groups, but by physiological measurements, vaginal pulse amplitude was significantly lower in the diabetic group; the other a study of 23 patients with type 2 diabetes, women's observations find that their sexual desire, orgasmic capacity, vaginal secretion and sexual activity are reduced , compared with the control group, found that good relationship with their spouse. Many studies have confirmed that the emergence of these problems had no significant relationship with diabetes complications, but duration of diabetes related. In addition, research from the psychology point of view, men with diabetes showed a noticeable compared to sexual dysfunction in this area less impact on women, its causes may be different from the role of sexual relations. Clinically, most women complain about lack of enjoyment, very few women complain about difficulties in vaginal secretion and sexual orgasm. However, diabetes associated with depression, sexual dysfunction seems to be rather common, clothing β-blockers, such as metoprolol, Concord, propranolol, after women with diabetes can be significantly inhibited sexual arousal. In general, diabetes mellitus on the impact of menstruation in female patients is not clear. However, there have been reports before the age of 10 diabetic patients whose disease may be delayed menarche, menstrual cycle disorders, women with diabetes with complications than those without complications, menstrual disorders more common. Menstrual disorders in adolescence with type 1 diabetes, the most common, and in poor blood glucose control and body mass index higher, see more obese patients, women of childbearing age with type 1 diabetes, reproductive disorders are more common. In addition, insulin requirements before and after menstruation may also be subject to change. Another reason for interfering with women's sex life is infected. Many factors make women with diabetes are vulnerable to infectious diseases, the most common vaginal Candida albicans infection, high blood sugar to a large extent contributed to the growth of Candida albicans. Therefore, many women with diabetes often genital itching chief complaint to seek treatment, because the persistence of this infection will naturally affect the sex life, research shows that women with diabetes, 77% in the vaginal secretions can be cultured from Candida albicans, and the the difficulties of those who treat women with diabetes is more prevalent, they place vaginal fungal infection were also far more than non-diabetic patients. Moreover, urinary tract infections are also common, particularly in poor glycemic control or the existence of autonomic neuropathy in patients with urinary tract infections can also affect the quality of sexual life. Diabetic sexual dysfunction risks Diabetic patients, especially younger men with diabetes, erectile dysfunction in patients, in large measure to reduce their self-confidence, an increase of depression, depression and even suicide may, for themselves, their family, social responsibility is obviously inadequate . A means of escape are often taken to deal with: either to concentrate on the cause of, or concentrate on playing to escape his wife to escape sex life. In this way, his wife's discontent with Japan will therefore increase, over time, will inevitably cause feelings of strange husband and wife, husband and wife relationship breakdown. Pairs of elderly men with diabetes families are the obstacles because of their sexual function can not meet the requirements of the wife arising from disharmony of family life. Due to gender differences, accompanied by sexual dysfunction in women with diabetes for themselves, their spouses, the impact on society than men, less significant, but also to a certain extent, affected their quality of life and family harmony and stability. Diabetes mellitus treatment of sexual dysfunction in patients 1. For sexual dysfunction in patients with diabetes, whether it is doctors, nurses, or patients themselves or their spouses, all should pay sufficient attention to overcome the traditional concept of shyness brought a sense of calm to face this disease exists, seek spouses the active support and cooperation with the medical staff work together to jointly overcome the disease. 2. To correct the cause can be corrected. Male diabetic patients with ED first thing to consider is to control blood sugar and avoid hypoglycemia, these measures help to improve the nervous system disease; early diagnosis and treatment of diabetic hypertensive patients to avoid the use of antihypertensive drugs may cause ED, etc.; another should quit alcohol limit. 3. Sex therapy: Sex therapist targeted through the guidance, a simple behavioral therapy can obtain good results. At the same time when the lifting of sexual anxiety, improve relationships with their sexual partners. 4. Hormone therapy: the existence of that had been detected significantly in patients with low levels of male hormones, it is necessary to supplement androgen; right associated with elevated plasma prolactin levels in patients may be bromocriptine treatment; for secondary hypogonadism patients can switch to clomiphene citrate to stimulate the hub to improve sexual function in patients. 5. Symptomatic treatment: In the above-mentioned treatment, based on the rational use of a certain amount of "Viagra" (Viagra), for improving the quality of sexual life in patients with definite help. 6. For women with diabetes because of their sexual sensitivity, sexual, psychological and other differences, and often the existence of the vagina, urinary tract infections, so that patients with impaired sexual function. Therefore, in addition to caring for his or her spouse, the need for psychological treatment, enhanced blood glucose control, cure urinary genital tract inflammation, will contribute to the improvement of sexual life.
