The impact of type 1 diabetes mellitus on male sexual functions and sex hormone levels

Abstract

Little is known about type 1 diabetes mellitus (T1DM) impact on the male sexual and reproductive functions. We aim to evaluate the influence of T1DM on male sexual function, quality of sexual life, and sex hormone levels. A total of 57 male patients aged 18 to 50 years (mean = 33) with T1DM (duration mean = 15 years) had a medical examination and completed a set of questionnaires-International Index of Erectile Function-5 (IIEF-5), Beck Depression Inventory (BDI) and Sexual quality of life questionnaire male (SQoL-M). The prevalence of erectile dysfunction was 28.1% (IIEF-5 ≤21). Patients without diabetic nephropathy had better erectile function (p = 0.008). Subjects with better glycemic control (HbA 1c <65 mmol/ mol) had also better erectile function (p = 0.041). At least 8.8% patients had retrograde ejaculation. Blood serum levels of sex hormones were determined and compared to laboratory reference values of healthy men. Total testosterone level was not significantly changed, sex hormone binding globulin was higher (p < 0.001) and its level correlated with daily insulin dose adjusted to body weight (p = 0.008). Free androgen index and calculated free testosterone were lower (p = 0.013; p < 0.001), estradiol was not significantly changed, LH was higher (p < 0.001), FSH was unchanged, and prolactin was higher (p < 0.001). Prostate-specific antigen (PSA) negatively correlated with HbA 1c (p < 0.001). To conclude, we found significant changes in sexual functions and sex hormone blood concentrations that indicate impairment of sexual and reproductive functions in T1DM males.

Comparative Study of the Steroidogenic Effects of Human Chorionic Gonadotropin and Thieno[2,3-D]pyrimidine-Based Allosteric Agonist of Luteinizing Hormone Receptor in Young Adult, Aging and Diabetic Male Rats

“…In men, the prospects for their use are associated with the treatment of hypogonadotrophic hypogonadism, androgen deficiency and infertility. Production of androgens and the sperm count and quality in men are decreased in a number of metabolic and endocrine diseases, including T1DM [ 28 , 29 , 31 ], as well as in aging [ 32 , 33 , 34 , 62 ]. Despite the differences in etiology and pathogenesis of reproductive dysfunctions in T1DM and aging, the main causes of androgen deficiency and impaired spermatogenesis are the reduced T production by Leydig cells due to an increase in oxidative stress, inflammation and apoptosis in the testes, as well as the hormonal dysregulation due to an imbalance between signaling cascades regulated by gonadotropins, insulin, insulin-like growth factor-1 and adipokines in testicular cells [ 28 , 38 , 63 ].…”

“…The main cause for this is the impaired steroidogenic response of the testes to gonadotropins [ 30 ]. It is shown that the gonadotropin stimulating effect on androgen production in T1DM patients is reduced, especially in severe and moderate forms of this disease [ 28 , 29 , 31 ]. In turn, older men with increased LH levels often exhibit testicular resistance to gonadotropins and androgen deficiency [ 32 , 33 , 34 ].…”

Impact of diabetic hyperglycaemia and insulin therapy on autophagy and impairment in rat epididymis

“…Previous clinical and animal experimental data have proved that diabetic hyperglycaemia can disrupt male reproductive function, and male infertility and sexual dysfunction are considered to be common diabetic complications (Hylmarova et al., 2020; Maresch et al., 2018; Shi et al., 2017). Currently, there are few studies on the effects of diabetic hyperglycaemia on epididymis (Korejo et al., 2016; Singh et al., 2009).…”

Pengaruh Diabetes Mellitus Terhadap Kejadian Disfungsi Ereksi

“…19 Pasien yang menderita nefropati diabetik memiliki skor IIEF-5 yang lebih rendah daripada pasien tanpa komplikasi nefropati diabetik (p=0,008). 10 Laporan penelitian yang dilakukan pada 30 pasien yang dibawa ke unit hemodialisis di rumah sakit Charles Nicolle Tunis, Tunisia menyatakan prevalensi DE pada pasienpasien tersebut adalah 80%, termasuk 33,3% mengalami DE parah. 20 Pasien dengan DE memiliki kadar trigliserida (9,9 mU/ml) dan glukosa plasma (8.2 mU/ml) (p<0,05) yang lebih tinggi.…”