Diabetes mellitus (DM) is one of the most common chronic metabolic disease worldwide involving male reproductive dysfunctions (RD). Male diabetics are more prone to varieties of sexual disorders such as impotence, retrograde ejaculation, sexual drive, decreased libido, delayed sexual maturation and erectile dysfunction (ED). The incidences of impotence in diabetics are 2-5 times higher than non-diabetics. The epidemiological data revealed that 20-30% of adult diabetic men have one RD and found to be increasing with advancing of age. The prevalence rate of ejaculatory disturbance and orgasmic dysfunction were estimated in the range of 9-31% and 7-8% respectively. DM associated male RD poses major risk with advancing of age, longer duration of DM, poor glycaemic control, several medications, psychological and high consumption of alcohol. The physical factors (hormonal, vascular, neurological, alcohol and drug addiction) as well as psychological factors (ignorance, negative attitude toward sex, poor self esteem marital disharmony and anxiety over sexual performance) are also involved. There are no specific diagnosis available for detection of DM associated male RD but patient history, physical assessment, psychological assessment, semen analysis which include mortality, viability and morphology of semen are useful as diagnostic purpose. Recent therapeutic strategies involve in correction of physical and psychological factors.
Kamaldeep Singh, Savita Devi and Pranay P Pankaj