Diabetes can have a profound impact on a man’s reproductive health. Understanding the challenges and finding suitable treatments can greatly enhance the chances of conception. This blog explores the relationship between diabetes and male fertility, outlines treatment options, and offers advice for improving fertility outcomes.
How Diabetes Affects Male Fertility :
Over years, diabetes adversely affects the nerves and blood vessels supplying the penis, especially if the diabetes is uncontrolled. The nerves that control sexual stimulation and response get damaged and can cause problems with erection. By narrowing the blood vessels that supply the penis, the blood flow to the penis is decreased which hampers erection. . Also, the endothelium i.e the lining of the blood vessels gets damaged, which in turn leads to a decrease in the production of nitric oxide. This furthers decreases the blood flow to the penis.
Thus, diabetes can cause fertility issues in males by causing erectile dysfunction, retrograde ejaculation ( dry orgasm), delayed ejaculation, reduced libido, poor sperm quality, and decreased testosterone levels.
Of these, erectile dysfunction in addition to infertility, can interfere with a person’s sexual life leading to stress anxiety and emotional problems eventually leading to depression.
● Erectile dysfunction( ED): It is the inability to achieve and erection and this can interfere with a person’s sexual life leading to stress anxiety and emotional problems eventually leading to depression. Diagnosed early, it can be reversed to an extent. But when the nerve and blood vessel damage is severe, ED may reach a stage where reversal cannot be achieved. Controlling blood sugar levels is the best way to put a halt to the progression of the disease. If one is a smoker and having alcohol regularly, then quitting alcohol and smoking will help in arresting the progression of ED.
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● Retrograde ejaculation: A condition where semen flows backward into the bladder instead of being expelled from the body. So in these cases, the semen is found in the urine and the person complains of having a dry orgasm and passing cloudy or whitish urine.
● Delayed ejaculation: Persistent difficulty in ejaculating, often caused by nerve damage, stress, or certain medications.
● Decreased testosterone levels: Impaired production and function of testosterone due to diabetes can affect sperm production and quality.
Treatment
Mental health care is an integral part of fertility treatment for diabetic men, as emotional well-being influences overall health. Various treatments are available to address fertility issues associated with diabetes.
Strict Diabetes Control: The mainstay of the treatment of diabetes related infertility is strict control of diabetes and bringing the HBA1C levels below six. By doing this, nerve damage and blood vessel damage will reduce, thus improving the chance of reversal of the problem. This can be achieved by regular blood work to check the diabetic status and to ensure that the anti-diabetic medications and/or insulin that one is taking is adequate. If not, under control, the dose of anti-diabetic medications and/or insulin may need to be increased.
Cardiovascular exercises should be started which may include brisk walking, jogging, swimming, cycling.
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Metabolic surgery: If blood sugar is not at all getting under control, then Metabolic surgery, which is a keyhole surgery will definitely get the sugar levels under control and even bring about remission of diabetes.
Problem specific treatment
Counselling is very important in the management of ED. Only after meeting the infertility specialist and only with a proper prescription, medications like Sildenafil ,Vardenafil and Tadalafil can help in achieving an erection.
A blood work to check for vitamin deficiencies is important. Supplement of vitamins and arginine can help. A balanced diet rich in antioxidants can reduce oxidative stress, improving sperm quality.
Hormone therapies may also be recommended to boost testosterone levels.
Assisted Reproductive Technologies (ART) like IVF or intracytoplasmic sperm injection (ICSI) may be recommended in cases where natural conception is challenging,. These techniques help increase the chances of conception by directly involving medical assistance in fertilizing the egg. ART is especially beneficial for men experiencing significant sperm quality issues or conditions like retrograde ejaculation.
Professional counseling services also offer personalized guidance for managing the psychological impact of infertility. Combining emotional support with medical treatments can enhance both mental and physical health, increasing the chances of a positive fertility outcome.