Open Access Peer-reviewed

Sexual Dysfunctions as Self-Reported by Diabetic- Type-2 Men: An Andrology Clinic-Based Study in Alexandria, Egypt

Nader Salama
Department of Urology, Alexandria Faculty of Medicine, Alexandria, Egypt
American Journal of Medical and Biological Research. 2013, 1(3), 50-57. DOI: 10.12691/ajmbr-1-3-1
Published online: August 25, 2017

Abstract

Objectives: To document the prevalence of self-reported sexual dysfunctions (SDs) in diabetic type 2 (DM2) men attending the andrology clinic in the Alexandria University hospital. Methods: A retrospective analysis of clinical case records of 276 consecutive DM2 and 100 consecutive non-diabetic (controls) men who reported SDs directly to the andrology clinic was done. Results: The majority of the patients and controls had light manual occupation, low education level and no history of smoking. No patient reported history of alcohol intake. Erectile dysfunction (ED) was frequent in the DM2 patients and the only complaint in 54.7%. The remaining patients had more than one (compound) complaint. ED (42.7%), premature ejaculation (22.1%) and low libido (11.7%) were the most frequent SDs in these compound complaints. They often joined together in the patients. Less frequently reported SDs were anejaculation (7.2%), penile curvature (4.4%), small-sized penis (2.5%) and penile plaques (0.7%). Penile pain and delayed and painful ejaculations were the rarest reported SDs. Conclusion: DM2 men consulting the andrology clinic may present with several different sexual complaints although ED is the most frequent among these. All diabetic men, therefore, should be asked carefully about the probable existence of any variety of SDs during their medical evaluation.

Keywords:

diabetes, sexual dysfunction, self-reported complaints
[1]  Arafa, N., Amin, G. “Epidemiology of diabetes mellitus in Egypt: results of a national survey”. Egypt. J. Comm. Med. 28. 29-43. 2010.
 
[2]  Diabetes Atlas. Third edition, International Diabetes Federation. 2006.
 
[3]  Malavige, L.S., Jayaratne, S.D., Kathriarachchi, S.T., Sivayogan, S., Fernando, D.J., Levy, J.C. “Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido”. J. Sex. Med. 5. 2125-2134. 2008. PubMed
 
[4]  Isidro, M.L. “Sexual dysfunction in men with type 2 diabetes”. Postgrad. Med J. 88,152-159. 2012.View Article  PubMed
 
[5]  Malavige, L.S., Wijesekara, P., Seneviratne Epa, D., Ranasinghe, P., Levy. J.C. “Ethnic Differences in Sexual Dysfunction among Diabetic and Nondiabetic Males: The Oxford Sexual Dysfunction Study”. J. Sex. Med. 2012. Aug 27. 2012.
 
[6]  Yamada, T., Hara, K., Umematsu, H., Suzuki, R., Kadowaki, T. “Erectile dysfunction and cardiovascular events in diabetic men: a meta-analysis of observational studies.” PLoS One [Accessed Sep 4, 2012].
 
[7]  Barrett-Connor, E., Khaw, K.T., Yen, S.S. “Endogenous sex hormone levels in older adult men with diabetes mellitus”. Am. J. Epidemiol. 132. 895-901. 1990. PubMed
 
[8]  Minhas, S., Eardley, I. “Diabetic impotence”. In: Carson CK, Kirby R, Goldstein I, eds. Textbook of Erectile Dysfunction. Isis Medical Media, Oxford, 541-550. 1999.
 
[9]  Tan, R.S., Pu, S.J. “Impact of obesity on hypogonadism in the andropause”. Int. J. Androl. 25. 195-201. 2002.View Article  PubMed
 
[10]  Malavige, L.S., Levy, J.C. “Erectile dysfunction in diabetes mellitus”. J. Sex. Med. 6. 1232–1247. 2009.View Article  PubMed
 
[11]  El-Sakka, A.I. “Premature ejaculation in non-insulin-dependent diabetic patients”. Int. J. Androl. 26. 329-334. 2003.View Article  PubMed
 
[12]  Basile Fasolo, C., Mirone, V., Gentile, V., Parazzini, F., Ricci, E. “Premature ejaculation: Prevalence and associated conditions in a sample of 12,558 men attending the andrology prevention week 2001-A study of the Italian Society of Andrology (SIA)”. J. Sex. Med. 2. 376-382. 2005.View Article  PubMed
 
[13]  Corona, G., Mannucci, E., Mansani, R., Petrone, L., Bartolini, M., Giommi, R., et al. “Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus”. Eur. Urol. 46. 222–228. 2004.View Article  PubMed
 
[14]  Nakanishi, S., Yamane, K., Kamei, N., Okubo, M., Kohno, N. “Erectile dysfunction is strongly linked with decreased libido in diabetic men”. Aging Male, 7. 113-119. 2004.View Article  PubMed
 
[15]  Sexton, W.J., Jarow, J.P. “Effect of diabetes mellitus upon male reproductive function”. Urology. 49. 508-513. 1997.View Article
 
[16]  Symonds, T., Roblin, D., Hart, K., Althof, S. “How Does Premature Ejaculation Impact a Man’s Life?” J. Sex Mar. Ther. 29. 361-370. 2003.View Article  PubMed
 
[17]  Mallis, D., Moisidis, K., Kirana, P.S., Papaharitou, S., Simos, G., Hatzichristou, D. “Moderate and severe erectile dysfunction equally affects life satisfaction”. J. Sex. Med. 3.442-449.2006.
 
[18]  Rosen, R.C., Cappelleri, J.C., Smith, M.D., Lipsky, J., Pena, BM. “Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction”. Int.J. Impotence Res. 11. 319-26. 1999.View Article  PubMed
 
[19]  Shamloul, R., Ghanem, H., Abou-zeid, A. “Validity of the Arabic version of the sexual health inventory for men among Egyptians”. Int. J. Impotence Res. 16. 452-455. 2004.View Article  PubMed
 
[20]  Montague, D.K., Jarow, J., Broderick, G.A., Dmochowski, R.R., Heaton, J.P., Lue, T.F., et al. “AUA guideline on the pharmacologic management of premature ejaculation”. J. Urol.172. 290-294. 2004.View Article  PubMed
 
[21]  American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders”. 4th ed, text revision. American Psychiatric Association,Washington, DC. 2000.
 
[22]  Papaharitou, S., Athanasiadis, L., Nakopoulou, E., Kirana, P., Portseli, A., Iraklidou, M., et al. “Erectile dysfunction and premature ejaculation are the most frequently self-reported sexual concerns: profiles of 9,536 men calling a helpline”. Eur. Urol. 49, 557-63. 2006.View Article  PubMed
 
[23]  Son, H., Song, S.H., Kim, S.W., Paick, J.S. “Self-reported premature ejaculation prevalence and characteristics in Korean young males: community-based data from an internet survey”. J. Androl. 31. 540-546. 2010.View Article  PubMed
 
[24]  El-Sakka, A.I., Tayeb, K.A. “Peyronie's disease in diabetic patients being screened for erectile dysfunction”. J. Urol. 174. 1026-1030. 2005.View Article  PubMed
 
[25]  Feldman, H.A., Goldstein, I., Hatzichristou, D.G., Krane, R.J., McKinlay, J.B. “Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study”. J. Urol. 151. 54-61. 1994. PubMed
 
[26]  Lu,C., Jiann, B.,Sun C., Lam H., Chih-Hsun Chu, C.,Lee, J. ”Association of Glycemic Control with Risk of Erectile Dysfunction in Men with Type 2 Diabetes. ” J. Sex. Med. 6.1719-1728. 2009.
 
[27]  Yaman O, Akand M, Gursoy A, Erdogan MF, Anafarta K. ”The effect of diabetes mellitus treatment and good glycemic control on the erectile function in men with diabetes mellitus-induced erectile dysfunction: A pilot study”. J. Sex. Med. 3.344-348. 2006.
 
[28]  Hidalgo-Tamola, J., Chitaley, K. “Type 2 Diabetes Mellitus and Erectile Dysfunction”. J. Sex. Med. 4. 916-926. 2009.View Article  PubMed
 
[29]  Jannini, E.A., Lombardo, F., Lenzi, A. “Correlation between ejaculatory and erectile dysfunction”. Int. J. Androl. 28(Suppl. 2). 40-45. 2005.View Article  PubMed
 
[30]  Mikailiūkštienė A, Juozulynas A, Narkauskaitė L, Zagminas K, Sąlyga J, Stukas R. “Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania”. Med. Sci. Monit. [Accessed Mar 6, 2013].
 
[31]  Vinik, A.I., Maser, R.E., Mitchell, B.D., et al. “Diabetic autonomic neuropathy”. Diabetes Care 26. 1553-1579. 2003.View Article  PubMed
 
[32]  Andersson, B., Marin, P., Lissner, L., Vermeulen, A., Bjorntorp, P. “Testosterone concentrations in women and men with NIDDM”. Diabetes Care, 17. 405-411. 1994.View Article  PubMed
 
[33]  Laumann, E. O., Paik, A. & Rosen, R. C. ” Sexual dysfunction in the United States: prevalence and predictors”. JAMA. 10, 281. 537-544.1999.
 
[34]  Masumori, N., Tsukamoto, T., Kumamoto, Y., Panser, L.A., Rhodes, T., Girman, C.J., et al. “Decline of sexual function with age in Japanese men compared with American men – results of two community-based studies”. Urology 54. 335-345. 1999.View Article
 
[35]  Travison, T.G., Araujo, A.B., Morley, J.E., O’Donnell, A.B., McKinlay, J.B. “The relationship between libido and testosterone in aging men: Results from the Massachussetts Male Aging Study”. J. Clin. Endocrinol. Metab. 91. 2509-2513. 2006.View Article  PubMed
 
[36]  Segraves, R.T. “Management of hypoactive sexual desire disorder”. Adv. Psychosom. Med. 29. 23-32. 2008.View Article  PubMed
 
[37]  Ellenberg, M., Weber, H. “Retrograde ejaculation in diabetic neuropathy”. Ann. Int. Med. 65. 1237-1246. 1966.View Article  PubMed
 
[38]  Tefekli, A., Kandirali, E., Erol, B., Tunc, M., Kadioglu, A. “Peyronie's disease: a silent consequence of diabetes mellitus”. Asian J. Androl. 8. 75-79. 2006.View Article  PubMed
 
[39]  Arafa, M., Eid, H., El-Badry, A., Ezz-Eldine, K., Shamloul, R. “The prevalence of Peyronie's disease in diabetic patients with erectile dysfunction”. Int. J. Impotence Res. 19. 213-217. 2007.View Article  PubMed
 
[40]  El-Sakka, A. I., Selph, C. A., Yen, T. S. B., Dahiya, R. and Lue, T. F. “The effect of surgical trauma on rat tunica albuginea”. J. Urol.159. 1700-1707. 1998.View Article  PubMed
 
[41]  Mondiani, N., Ponchietti, R., Gontera, ., Muir, G.H., Natali, A., Caldarera, E., Biscioni, S., Rizzo, M. ” Penile length is normal in most men seeking penile lengthening procedures”. Int. J. Impot. Res. 14. 283-286. 2002.View Article  PubMed
 
[42]  Corona, G., Mannucci, E., Petrone, L., Fisher, A.D., Balercia, G., De Scisciolo, G., et al. “Psychobiological correlates of delayed ejaculation in male patients with sexual dysfunctions”. J. Androl. 27. 453-458. 2006.View Article  PubMed
 
[43]  Rowland, D.L., Keeney, C., Slob, A.K. “Sexual response in men with inhibited or retarded ejaculation”. Int. J. Impotence Res. 16. 270-274. 2004.View Article  PubMed
 
[44]  Althof, S., Rosen, R., Symonds, T., Mundayat, R., May, K., Abraham, L. “Development and validation of a new questionnaire to assess sexual satisfaction, control, and distress associated with premature ejaculation”. J. Sex. Med. 3. 465-475. 2006.View Article  PubMed