Zemel P
Division of Endocrinology and Hypertension, Wayne State University, Detroit, Michigan.
Am J Cardiol. 1988 Jun 15;61(16):27H-33H. doi: 10.1016/0002-9149(88)91102-2.
The prevalence of diabetes mellitus and hypertension in the United States is increasing partly because of the incidence of these diseases in the growing geriatric population. Diabetes and hypertension have been associated with sexual dysfunction in both men and women. Neuropathy, vascular insufficiency and psychological problems have been implicated in impotence, impaired ejaculation and decreased libido in men and in decreased vaginal lubrication, orgasmic dysfunction and decreased libido in women. Several investigations of women with diabetes suggest fewer reports of sexual dysfunction than have been reported by diabetic men. However, there have been few evaluations of sexual dysfunction in women and no standard methods for assessment. Antihypertensive agents, especially diuretics, sympathetic inhibitors and beta-blocking agents have been associated with sexual dysfunction due to autonomic and hormonal effects. An estimated 40 to 80% of diabetic hypertensives have reported sexual dysfunction in several investigations. Clearly, the diabetic hypertensive patient should be evaluated for sexual dysfunction, and appropriate therapy, including changes in medication or referral for sex counseling, should become routine in clinical care.
在美国，糖尿病和高血压的患病率正在上升，部分原因是这些疾病在不断增长的老年人口中的发病率。糖尿病和高血压与男性和女性的性功能障碍都有关联。神经病变、血管功能不全和心理问题被认为与男性的阳痿、射精障碍和性欲减退以及女性的阴道润滑减少、性高潮功能障碍和性欲减退有关。几项针对糖尿病女性的调查显示，性功能障碍的报告比糖尿病男性少。然而，对女性性功能障碍的评估很少，也没有标准的评估方法。抗高血压药物，尤其是利尿剂、交感神经抑制剂和β受体阻滞剂，由于自主神经和激素作用，与性功能障碍有关。在几项调查中，估计40%至80%的糖尿病高血压患者报告有性功能障碍。显然，糖尿病高血压患者应接受性功能障碍评估，适当的治疗，包括改变药物治疗或转介进行性咨询，应成为临床护理的常规操作。
