Functional Sexual Disorders in diabetics is a medical concern which should be investigated-Shabeen Naz Masood

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 7th Int. Diabetes and Endocrine Conference at Faisalabad
Functional Sexual Disorders in diabetics
is a medical concern which should be
investigated-Shabeen Naz Masood
Doctors do not feel comfortable talking about
it hence patients go to Quacks
Prevalence of Erectile Dysfunction in diabetic
men is about 31-81% & is more common
under 40 years of age-Dr.Saif Ul Haque

FAISALABAD: Functional Sexual Disorders is a medical concern which needs to be investigated. This topic has been ignored for too long. Doctors do not feel comfortable talking about it with female patients hence most often the patients then go to quacks or suffer in silence. This was stated by Prof. Shabeen Naz Masood Prof. of Obstetrics & Gynaecology at Isra University Karachi. She was making a presentation on “ Female Health in Diabetics which has been ignored for too long” at the 7th International Diabetes and Endocrine Conference organized by Prof.Ahmad Bilal from Faisalabad Medical University here from 8-10th February 2019.

Whenever a female diabetic patients visits the doctor for consultation, doctors do not ask for their sexual health as if this does not exist though the problem could be acute in some patients. We need to learn to unlearn all this and change our attitude.  The illiterate of the 21st century she remarked are those who are not prepared to learn. Issues related to sexuality is a taboo in our society. She quoted Elliot Joslin who had stated that “no diabetic boy or girl should get married unless he or she is prepared to face diabetes mellitus and manage it”. She then discussed the issues related to sexual desire and arousal in women with diabetes. These are serious problems which needs treatment.

Continuing Prof. Shabeen Naz Masood said that in patients with Type-2 diabetes, the functional sexual disorders are diagnosed quite late. Male diabetics can suffer from impotency. Female diabetic patients are reluctant to discuss sexual disorders due to social and cultural issues. She laid emphasis that functional sexual disorders should be identified very early. Female sexual issues should be discussed and then one should refer these female patients to appropriate person who can take care of them, she remarked.

The next speaker in this session was Dr. Saif ul Haque from Baqai Institute of Diabetes and Endocrinology Karachi whose presentation was on “Men’s Health and Diabetes: Managing the forgotten yet important aspect of diabetes”. Dr. Saif pointed out that the prevalence of erectile dysfunction in men with diabetes was about 31-81%. It is much more common under forty years of age. It is a mix of organic, psychogenic, vascular & neurogenic causes. Some medications are also responsible for it, he added. He then discussed in detail the issues related to arousal, desire, depression, performance anxiety and relationship problems. Vasculogenic is the major cause, he remarked.

Continuing Dr. Saif ul Haque said that diagnosis of ED in diabetics is important because of quality of life. It affects sexual performance. It may lead to unsatisfactory sexual relationship. Detailed history both medical and drugs history is essential. Digital rectal examination of prostate is mandatory in ED patients. He suggested that the treating physicians must review the issues of ED with men suffering from diabetes. Since we do not discuss these issues with patients, they are willing to go to Hakeem’s and Quacks rather than consulting the doctors. He advised the physician colleagues to ask questions related to ED and sexual health from the patients suffering from diabetes when they come for consultation and ensure to maintain confidentiality. These patients can be offered PDE-5 inhibitors. It is important to know about the side effects of beta blockers while psychiatric assessment of young diabetics is essential. Sexual arousal must be initiated. Brain, Dr. Saif ul Haque opined was the most important sex organ. Life style changes are also very important. Studies have showed that weight loss will improve ED. Viagra can be used in a dose of 50mg. It takes thirty to sixty minutes to show its effects. Its effect lasts for twelve hours. Tadalafil was another drug which gives good results. Varadenafil was yet another effective drug. These are on demand drugs. One can take 100mg of Avanafil thirty minutes before intercourse. Almost 70-90% of diabetic patients prefer Tadalafil. Most reported side effects is headache. He however cautioned that these pill do not work for everyone. Life style changes may improve the situation. He then also referred to the penile prosthesis. He concluded his presentation by stating that ED in diabetics is a treatable condition. Patient and doctor relationship and communication is important. At present a variety of treatments exists for managing this disorder, he added.

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