Poor control of blood sugars can affect your reproductive health, regardless of your age. High blood sugars over time can increase the risk of sexual difficulties such as impotence and retrograde ejaculation.

When a man is unable to attain and/or maintain an erection to have sex, he may have impotence or ER. Impotence can be caused by diabetes, by drugs or psychological factors. Poor glucose control, hormonal problems, and/or nerve damage are some reasons why men with diabetes develop impotence. It is important to remember that men who are impotent because of diabetes still have the desire to have sex.

Diabetes causes impotence by damaging the nerves that supply the penis. The correct signals no longer get to the penis, and it is unable to expand and an erection is not produced. Impotence caused by diabetes usually occurs gradually, with the firmness of the penis decreasing over a long period of time.

If you experience impotence, it is important that you tell your health-care provider. It is possible that something other than diabetes is causing your impotence. If diabetes is causing your impotence, improving your blood glucose control may improve your sexual function. In addition, there are drugs, medical devices, and surgery that can help you regain your sexual function.

Retrograde ejaculation occurs during an orgasm when sperm is ejaculated into the male bladder, rather than through the penis. Men who have retrograde ejaculation have a normal desire for sex, are able to attain and maintain an erection and have an orgasm. They may notice cloudy urine upon urination after intercourse. They may also experience infertility.

Diabetes causes retrograde ejaculation by damaging the nerves that open and close the bladder and penile openings during ejaculation. If you are concerned that you may be having retrograde ejaculations, please contact your health-care provider. Medication and counseling may assist you in overcoming this condition.

Poorly controlled diabetes can affect your reproductive health by:

• increasing the risk of vaginal and urinary tract infections
  
  
• decreasing your libido (desire for sex)
  
  
• putting you and your unborn baby at risk during pregnancy

Urinary Infections

If your blood sugar is elevated, then there is glucose in your urine. This glucose will provide a perfect growing place for bacteria in your bladder and/or kidneys. This is called cystitis, referring to an infection of the bladder; or Pyelonephritis (infection of the kidneys). You should contact your health-care provider immediately if you think you have a urinary infection.

Vaginal Infections

If your blood sugar is elevated, then there is glucose in your body tissues, including the dark, moist tissues of your vagina. This will provide the perfect growing place for yeast, and you could get a vaginal yeast infection. Antibiotics taken for bacterial infections create a higher risk of a vaginal yeast infection. Call your health care provider if you think you have a vaginal infection.

If your blood sugars are elevated, you may have a decreased desire for sex. High blood sugars can also make you feel very tired and decrease your desire to have sex. Urinary or vaginal infections may make sex uncomfortable, thus decreasing your desire for sex.

Regaining control of glucose may help regain your desire for sex. Some women with diabetes may have decreased vaginal lubrication. This may lead to painful sex. Over-the-counter lubricants (Astroglide, KY) are available that will eliminate the problem of painful intercourse.

Unless you have entered menopause or have had permanent sterilization, diabetes will not prevent you from becoming pregnant. Women with diabetes can get pregnant with little risk to themselves, and have a healthy baby. It is important that pregnancy is planned, and your glucose are controlled (Hemoglobin A1C less than 6%) for at least three months prior to attempting to conceive. It is also very important that you take a daily vitamin that contains .8 mg of folic acid for at least three months prior to attempting pregnancy, and continue taking it throughout your pregnancy. Before trying to conceive you should also have a thorough medical evaluation to make certain that you are entering pregnancy in the best physical state possible.

In order to increase the likelihood of a healthy pregnancy, pregnancies must be planned. There is an increased risk of birth defects if a pregnancy is conceived while blood sugars are elevated (Hemoglobin A1C higher than 6%). Therefore, you must be using a reliable method of birth control if you are having sex, or are anticipating having sex. Ask your health-care provider about appropriate birth control methods.