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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sexual dysfunction associated with diabetes mellitis has been reviewed. The prevalence of impotence among diabetic males ranges between 50 and 60 percent. Duration of diabetes does not correlate with the increasing incidence of impotence, but increasing age of the male is associated. The etiology of impotence is generally assumed to be autonomic neuropathy; the role of vascular pathology is moot. Retrograde ejaculation is present in one to two percent of the cases. Nocturnal penile tumescence monitoring during periods of rapid eye movement (REM) sleep will aid in the differential diagnosis of organic vs psychogenic etiology. Penile prostheses should be considered in the treatment of organic impotence, while sex counseling is indicated for psychogenic cases. The effect of diabetes on female sexual response is conflicting. Further research in needed.
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PMID:Sexual dysfunction associated with diabetes mellitus. 37 85

The etiology of impotence, which effects 50 per cent of the men with diabetes, is unknown. The neurotransmitter (norepinephrine) released from adrenergic neurons is thought to be the most direct regulator of vascular smooth muscle. We have measured the norepinephrine content of the erectile tissue of diabetic men. Our results indicate the presence of a dual neural regulator mechanism of the corpora that controls penile erection.
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PMID:The possible role of the catecholamines of the corpora in penile erection. 43 10

The arterial vascular bed of the penis has been studied histologically in postmortem material from 30 males in the age range 19 to 85 years, mean 57. Fifteen of these propositi had had diabetes mellitus of average duration of 13 years. In all males more than 38 years old, there was fibrous substitution of the longitudinal smooth muscle in the Ebner pads. Later this was complemented by fibrous proliferation of the intima, medial fibrosis, calcification, and narrowing of the lumen to obilteration from thrombi. The extent of the pathology was apparently related to both age and diabetes mellitus. The nature and extent of the changes indicate that they must necessarily lead to a limitation of the basic function of this arterial tree, i.e., to increase essentially the flow of blood to the cavernous bodies at the time of the erection. These changes can play a decisive role in explaining impotence that occurs with aging, particularly in diabetics.
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PMID:Morphologic changes in the arterial bed of the penis with aging. Relationship to the pathogenesis of impotence. 59 Dec 64

Transient organic causes of impotence include alcohol consumption, drug use or inflammatory genital disease. Many diagnoses of organic impotence, with diabetes, for example, have been premature and have resulted in iatrogenic, psychogenic impotence. After a stroke, heart attack or major surgery, depression may cause impotence. Anxiety and sexual ignorance are major etiologic factors. Thus, sex education and uncomplicated sex therapy can achieve a high percentage of cure. Penile plethysmography during sleep provides useful information. Penile prostheses are helpful for appropriately motivated couples when there is permanent impotence.
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PMID:Impotence--some causes and cures. 62 40

Simple bedside measurements of blood pressure and systolic pressure response to the Valsalva maneuver will confirm a clinical impression of orthostatic hypotension. Careful questioning of the patient usually elicits other symptoms of autonomic nervous system dysfunction, such as impotence, urinary and fecal incontinence, constipation or diarrhea, blurred vision, or sweating changes. Drugs are the most common cause of autonomic dysfunction, and their benefits should be weighed against the severity of the dysfunction. In addition, diabetes mellitus, uremia, amyloidosis, acute intermittent porphyria, myeloma, tabes dorsalis, and alcohol-nutritional problems may produce symptoms of autonomic dysfunction. Thus, patients who present with autonomic features but no history of dysfunction-producing drugs should undergo complete laboratory evaluation. A regimen of tyramine or L-dopa or a diet rich in cheese, processed meats, and wine (a monoamine), coupled with a monoamine oxidase inhibitor have beneficial effects in patients with orthostatic hypotension due to preganglionic autonomic dysfunction. Patients who do not respond to catecholamine precursors have stable, isolated orthostatic hypotension or a polyneuropathy such as that caused by diabetes.
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PMID:Evaluating dysfunction of the autonomic nervous system. 63 67

Translumbar aortographies performed in 91 patients for limiting leg ischemia were reviewed, and stenosis was graded by points from one (normal vessel) to five (complete occlusion) for each vessel. Of 62 nondiabetic patients, 18 (29 per cent) were impotent, while of 29 diabetics, 17 (58.6 per cent) were impotent (p less than 0.01). Significantly greater stenosis (p less than 0.005) was found in the internal pudendal arteries of impotent patients when compared statistically with potent patients. This was true for the group as a whole, for diabetics and nondiabetics, and for patients over 50 years old both with and without diabetes. There was no significant difference in the extent of stenosis of the iliac arteries (common and internal) between potent and impotent patients. There was also no significant difference in the pattern of stenosis between diabetic and nondiabetic patients in the group as a whole and also in the potent and impotent subgroups analyzed separately. Neither diminished femoral pulses nor aortographic evidence of external iliac and common femoral arterial stenosis correlated significantly with impotence. These observations indicate that vascular lesions are as important in diabetics as in nondiabetics in the genesis of impotence. Clinical implications regarding diagnostic investigations and treatment are discussed.
Diabetes 1978 Oct
PMID:Vascular lesions associated with impotence in diabetic and nondiabetic arterial occlusive disease. 70 Feb 61

Assessment of pituitary-gonadal function was made in impotent diabetic males using luteinizing hormone-release hormone tests. Serum testosterone, sex-hormone-binding globulin capacity, and basal and incremental gonadotrophin concentrations in the impotent diabetics were similar to those in control diabetics, suggesting a primary neurologic rather than an endocrine defect as the cause of the impotence.
Diabetes 1976 Oct
PMID:Luteinizing release hormone tests in impotent diabetic males. 78 59

In ten previously undiagnosed patients, we have found erstwhile-"primary" nonhereditary amyloidosis as an overlooked cause of a predominately sensory, painful, and hyperesthetic distal neuropathy occurring in middle-age and older patients. These symptoms, associated with orthostatic hypotension, diarrhea or constipation, cardiac abnormality, and male impotence are virtually diagnostic (in the absence of diabetes mellitus). Tissue diagnosis is quickly made by crystal-violet metachromasia of amyloid in fresh-frozen sections of a muscle biopsy specimen. Immunoglobulin and bone marrow evidence of plasma cell dyscrasia in eight of the ten patients suggests that the neuropathy in this form of amyloidosis is actually secondary to a plasma-cell-originating dysproteinemia. Therapy with melphalan and prednisone was not of benefit.
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PMID:Amyloidosis with plasma cell dyscrasia. An overlooked caused of adult onset sensorimotor neuropathy. 84 55

The various aspects of the sexual life of 100 female patients aged 40-60 with acute myocardial infarction were compared with those of a control group of 100 female patients of the same age, hospitalized for other diseases. Sexual frigidity and dissatisfaction were found among 65% of the coronary patients as compared with 24% of the controls. The commonest cause for sexual dissatisfaction was premature ejaculation or impotence in the husband. The incidence of premarital sexual relations was greater among the frigid patients when compared with those who achieved orgasm. The coronary patients had an earlier menopausal age than the controls. The number of coronary patients who underwent artificial abortions in the past was lower than in the control group. All these findings were statistically significant at a level of P less than 0.05. No connection was found between extramarital relations and sexual frigidity. There was no relation found between sexual frigidity and diabetes, essential hypertension, marital status, pathological gynecological findings, or localization of the infarction. Until now, sexual frigidity and dissatisfaction appear to have been a neglected aspect in the female coronary patient.
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PMID:Sexual life and sexual frigidity among women developing acute myocardial infarction. 100 33

The authors present the results of clinico-sexological study in 57 patients suffering from diabetes and in 12 apparently healthy men in whom blood plasma testosterone content was studied. The patients with diabetes displayed a significant reduction in the testosterone concentration with the advance of the patients' age, increased duration and severity of diabetes, and also its inadequate compensation during the disease in the presence of microangiopathy and peripheral neuropathy. The role of diabetic metabolic, vascular and innervational disturbances in reduction of the androgenic function of the testes in diabetics was demonstrated. In patients with the late stages of progressive impotence the level of testosterone was sharply decreased. This fall was less pronounced in the patients at the stage of the initial disturbances. It was revealed that the androgenic insufficiency of the testes was of great significance in the complicated pathogenesis of impotence in diabetes. Recommendations are presented on the prophylaxis of androgenic insufficiency of the testes in diabetes, and on the use of the testosterone preparations in the general complex therapy of impotence of men suffering from diabetes.
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PMID:[Plasma testosterone levels of diabetic men]. 122 46


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