title: The Role of Diabetes Mellitus in Sexual and Reproductive Health: An Overview of Pathogenesis, Evaluation, and Management.
abstract: BACKGROUND
  Uncontrolled or long-term diabetes mellitus is conducive to vascular and oxidative stress disturbances that impede several physiological systems, which may in turn elicit psychological symptoms.
  
  
  OBJECTIVE
  We assess the sexual and hormonal complications of diabetes mellitus that impair reproductive function in males and females.
  
  
  METHODS
  A comprehensive MEDLINE® search was guided using key words relevant to diabetes mellitus and reproductive health.
  
  
  RESULTS
  We reviewed the pathogenesis, clinical manifestations, imaging modalities, pharmacological treatment, and intervention options for each diabetic reproductive complication in males and females. Erectile dysfunction secondary to angiopathic, neuropathic, and myopathic damage is a leading complication of diabetes in males. Other reproductive complications include ejaculatory dysfunction, hypogonadism, modified semen parameters, and delayed puberty. Specifics of reproductive dysfunction in diabetic women are less definite than in men due to the lack of standardized evaluation of sexual function in women as well as the increased role of psychological morbidity. Despite this, it is known to manifest as hypogonadism, hypoactive sexual desire disorder, dyspareunia, menstrual dysfunction, and polycystic ovarian syndrome.
  
  
  CONCLUSIONS
  Longitudinal studies with larger sample sizes are necessary to better comprehend the connection between diabetes and sexual dysfunction, chiefly in females. Understanding and dividing the role of fertility and sexual issues in reproductive dysfunction can help guide evaluation and management.
authors.affiliation: Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY. United States.
authors.forename: Jason
authors.initials: J
authors.lastname: Gandhi
authors.affiliation: Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY. United States.
authors.forename: Gautam
authors.initials: G
authors.lastname: Dagur
authors.affiliation: Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY. United States.
authors.forename: Kelly
authors.initials: K
authors.lastname: Warren
authors.affiliation: Foley Plaza Medical, New York, NY. United States.
authors.forename: Noel L
authors.initials: NL
authors.lastname: Smith
authors.affiliation: Department of Urology, Stony Brook University, School of Medicine, Stony Brook, NY. United States.
authors.forename: Yefim R
authors.initials: YR
authors.lastname: Sheynkin
authors.affiliation: University of Messina School of Medicine, Messina. Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Zumbo
authors.affiliation: Department of Urology, Stony Brook University School of Medicine, Health Sciences Center T9- 040, 101 Nicolls Road, Stony Brook, NY 11794. United States.
authors.forename: Sardar A
authors.initials: SA
authors.lastname: Khan
mesh_terms: D048909:Diabetes Complications / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology; D004414:Dyspareunia / Q000209:etiology; D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D008297:Male; D060728:Reproductive Health; D000074384:Sexual Health
keywords: Diabetes mellitus; diabetic angiopathies; diabetic neuropathies; dyspareunia; ejaculatory dysfunction; erectile dysfunction; hypoactive sexual desire disorder; hypogonadism; infertility; polycystic ovarian syndrome; sexual dysfunction