Impact of diabetes on reproductive health

A change in the sexual function is one of the most common health problems as people age. Having diabetes can mean early onset and increased severity of these problems. Sexual and urologic complications of diabetes occur because of the damage diabetes can cause to blood vessels and nerves. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. Urinary tract infections and bladder problems occur more often in people with diabetes. People who keep their diabetes under control can lower their risk of the early onset of these sexual and urologic problems.

Both men and women with diabetes can develop sexual problems because of damage to nerves and small blood vessels. Nerve signals control internal organs like the heart and bladder, but people do not have the same kind of conscious control over them as they do over their arms and legs. The nerves that control internal organs are called autonomic nerves, which signal the body to digest food and circulate blood without a person having to think about it. The body’s response to sexual stimuli is also involuntary, governed by autonomic nerve signals that increase blood flow to the genitals and cause smooth muscle tissue to relax. Damage to these autonomic nerves can hinder normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction.

What sexual problems can occur in men with diabetes?
a. Erectile Dysfunction – Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection. Estimates of the prevalence of erectile dysfunction in men with diabetes vary widely, ranging from 20 to 75 percent. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Research suggests that erectile dysfunction may be an early marker of diabetes, particularly in men ages 45 and younger.
b. Retrograde Ejaculation- Retrograde ejaculation is a condition in which part or all of a man’s semen goes into the bladder instead of out the tip of the penis during ejaculation. Retrograde ejaculation occurs when internal muscles, called sphincters, do not function normally. A sphincter automatically opens or closes a passage in the body. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen. Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation.

Sexual problems in women with diabetes
Many women with diabetes experience sexual problems. Although research about sexual problems in women with diabetes is limited, one study found 27 percent of women with type 1 diabetes experienced sexual dysfunction. Another study found 18 percent of women with type 1 diabetes and 42 percent of women with type 2 diabetes experienced sexual dysfunction. Sexual problems may include
a. Decreased vaginal lubrication, resulting in vaginal dryness
b. Uncomfortable or painful sexual intercourse
c. Decreased or no desire for sexual activity
d. Decreased or absent sexual response
e. Decreased or absent sexual response can include the inability to become or remain aroused, reduced or no sensation in the genital area, and the constant or occasional inability to reach orgasm.

Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, psychological problems such as anxiety or depression, gynecologic infections, other diseases, and conditions relating to pregnancy or menopause.

How Ayurveda can help?
Ayurveda has two approaches to solve this problem. They are
a. Detoxification followed by Rejuvenation and aphrodisiac therapies
b. Addressing this problems directly by taking medicines, yoga and Diet

Detoxification and Rejuvenation, Aphrodisiac therapies
Ayurveda recommends purification therapies like vomiting, Purgation, bloodletting, medicated enema and Medicated nasal drops therapy for complete detoxifications. Any one of these therapies is carefully selected after considering the cause, age, disease condition, complication, season etc. These primary detoxification therapies are supported by the Preliminary and post therapy procedures for the complete care.
After these purification therapies, the patient is asked to undergo a series of diet and medicine regime, which helps in rejuvenation which in turn helps them to perform better. Ayurveda recommends virilification therapies for ED. This therapy claims to make the patient as ‘virile as a horse’ and makes use of various aphrodisiacs, tonics to be used internally and externally, and appropriate diet plans.
The remedy includes
1. Powder of Indian ginseng to be taken with milk
2. Velvet bean powder to be taken with milk
3. Flowers of Drum stick tree in the diet
4. Crab extract in the diet
5. Fig fruits in the diet
6. White pumpkin juice and Pumpkin seed oil
7. Indian Asparagus processed with milk (100 ml of milk + 200 ml of water + 10 gm of Indian Asparagus powder – Boiled and reduced to 100 ml) taken in empty stomach helps the women to come out of their Diabetic reproductive trouble.

Addressing with Medicines – Ayurveda recommends both internal and external medications for this problem.
Sukra Vallabha Ras
4. Amrita Prasa Ghee
5. Maha Kalyanaka Ghee
6. Bhallataka Lehyam
7. Linga Vardhana Thailam
8. Soubhakya Vardana Thailam
9. Shilajatu Parpam
10. Karisalai Parpam

There are more than 1000 Ayurvedic recipes for treatment and management of ED.

Yoga for Erectile Dysfunction

Apart from herbal remedies, some simple exercises can help improve ED. These exercises relieve physical and psychological stress which in turn helps improve cardio-vascular functions essential in treating ED.
Many Yoga experts advocate Kanda Asana which has been clinically proven effective for improving strength in legs, thighs, and muscles below the navel region. The asana also reduces stiffness in hips and joint pains. It also improves sexual vigor and is, thus, good for treating impotence including erectile dysfunction.

The primary objective of the Ayurveda therapies and medicines is to bring back normalcy in the functional elements of the human body which not only corrects the problems in the reproductive system but also helps in overcoming diabetes and its complications.

Source: Dr K Gowthaman, Medical Director, rVita (rVita Ayurveda Centers)
Image: Flickr creativecommons spaceodissey