Sexual dysfunction associated with diabetes mellitus.

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.