Sexual dysfunction can place a significant burden on both mental well-being and relationships. Therefore, it should not be considered a taboo subject. Talk to your doctor about it.
The following questions and examinations can be expected during a medical consultation:
(Possibly including the partner)
* Duration of diabetes
* Quality of diabetes control
* Presence of diabetes-related complications, particularly neuropathy (nerve damage)
* Signs of circulatory problems
* Coronary artery disease
* History of stroke
* Circulatory disorders affecting the legs
* Quality of diabetes control
* Presence of complications, particularly neuropathy
* Signs of circulatory problems
* Coronary artery disease
* History of stroke
* Circulatory disorders affecting the legs
* Current medications, particularly in relation to erectile dysfunction
* How long has the problem existed?
* Are you in a stable relationship?
* Is sexual intercourse possible, and how often does it occur?
* How frequently did intercourse occur previously?
* Does ejaculation occur?
* Is ejaculation premature?
* Do spontaneous morning erections occur?
* Assessment of blood circulation in the groin and feet
* Evaluation of nerve function using a reflex hammer and tuning fork
* Examination of the genital organs, if necessary
Hormonal abnormalities can contribute significantly to reduced libido, erectile dysfunction, difficulty achieving orgasm, fatigue, and reduced overall well-being. Blood tests are therefore often performed to identify potentially treatable endocrine causes of sexual dysfunction.
Testosterone
Testosterone is the principal male sex hormone and plays a key role in:
Low testosterone levels (hypogonadism) are more common in men with Type 2 diabetes and obesity. A deficiency may contribute to reduced sexual desire, erectile dysfunction, fatigue, depression, and loss of muscle mass.
Pituitary Hormones (LH and FSH)
The pituitary gland controls testosterone production by releasing:
Measuring LH and FSH helps determine whether low testosterone is caused by:
Prolactin
Prolactin is a hormone produced by the pituitary gland.
Elevated prolactin levels can:
Markedly elevated prolactin levels may indicate a pituitary disorder and may require further investigation.
Additional Hormonal Tests (if indicated)
Depending on symptoms and medical history, additional hormones may be evaluated, including:
(Performed only when necessary)
These tests are usually reserved for patients in whom the cause of erectile dysfunction remains unclear after the initial assessment or when a vascular cause is suspected.
Intracavernosal Injection and Stimulation Test (ICI Test)
The ICI test ( intracavernosal injection test) evaluates the ability of the penile blood vessels and erectile tissue to produce an erection.
A small amount of a vasoactive medication (usually alprostadil) is injected directly into one of the erectile bodies (corpora cavernosa) of the penis using a very fine needle. The injection is generally well tolerated and causes little discomfort.
The physician then observes:
Interpretation of the Results
Rapid, Firm Erection
Delayed or Weak Erection
No Meaningful Erection
Advantages of the ICI Test
The test can help distinguish between:
It can also help determine whether treatments such as oral medications, injection therapy, vacuum devices, or surgery are likely to be effective.
Potential Risks
Although generally safe, possible side effects include:
Doppler Ultrasound of the Penile Arteries
A penile Doppler ultrasound is often performed together with the ICI test.
After administration of the erection-inducing medication, an ultrasound probe is used to assess blood flow within the penile arteries.
What the Examination Measures
What the Results Can Show
The examination can identify:
Because erectile dysfunction may be an early sign of generalized vascular disease, abnormal Doppler findings can also indicate an increased risk of cardiovascular disease elsewhere in the body.
Why These Tests Matter
For many men, erectile dysfunction is the first noticeable symptom of diabetes-related nerve or blood vessel damage. A comprehensive evaluation helps determine whether the problem is primarily:
It can also help determine whether treatments such as oral medications, injection therapy, vacuum devices, or surgery are likely to be effective.