Diabetes and Bladder & Sexual Problems

Diabetes and Bladder & Sexual Problems

Diabetes can cause microvascular complications that disturb the normal functioning of blood vessels, nerves, and the body’s response to neurohormonal stimuli.1 Such disruptions can result in bladder and sexual dysfunctions, which are common in both men and women with diabetes. 

Bladder Dysfunction

Although the incidence of bladder dysfunctions increases with age, diabetes can also be a significantly contributor.1,2 Epidemiological studies have shown that men and women with diabetes are more likely to experience bladder dysfunctions than those without.3

Lower urinary tract symptoms in men are commonly associated with benign prostatic hyperplasia (BPH), the benign enlargement of the prostate gland.2,3 Studies have proposed several pathophysiological mechanisms, citing increased insulin levels that potentially promote prostate growth through inflammatory, hormonal, and sympathetic nerve pathways. Bladder dysfunctions in women and non-BPH-related dysfunctions in men are proposed to be caused by neuronal and smooth muscle dysfunctions from neuropathy and diabetes-related microvascular damages.

Here are some common forms of male bladder dysfunction in diabetes:

  • Urinary urgency
  • Urinary hesitancy
  • Frequent urination
  • Nocturia
  • Incontinence
  • Weak urinary stream
  • Sensation of incomplete emptying 

Here are some common forms of female bladder dysfunction in diabetes:

  • Urinary urgency
  • Frequent urination
  • Nocturia
  • Overactive bladder syndrome
  • Incontinence
  • Urinary tract infections

Sexual Dysfunction

Diabetes-related neurovascular damage can also cause sexual dysfunctions.2,3 Erectile dysfunction is the most widely studied sexual dysfunction in men, and diabetes-related causes include impaired nitric oxide release, smooth muscle dysfunction, impaired sensory neurons, and associated comorbid conditions (atherosclerosis, hypertension, obesity, etc.). In women, diabetes-related neurovascular damage has been proposed to impair blood flow and sensory neurons in the pelvic area. Depression and the use of antidepressants have also been associated with sexual dysfunction in women with diabetes.

Here are some common forms of male sexual dysfunction in diabetes:

  • Erectile dysfunction
  • Reduced libido
  • Orgasmic dysfunction
  • Retrograde ejaculation

Here are some common forms of female sexual dysfunction in diabetes:

  • Reduced desire
  • Decreased arousal
  • Painful intercourse



1. Brown JS, Wessells H, Chancellor MB, et al. Urologic Complications of Diabetes. Diabetes Care. 2005;28(1):177-185. doi:10.2337/diacare.28.1.177
2. Sarma AV, Townsend MK, Grodstein F, Breyer BN, Brown JS. Urologic Diseases and Sexual Dysfunction in Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds. Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. Accessed April 11, 2023. http://www.ncbi.nlm.nih.gov/books/NBK567969/
3. Blair Y, Wessells H, Pop-Busui R, Ang L, Sarma AV. Urologic Complications in Diabetes. J Diabetes Complications. 2022;36(10):108288. doi:10.1016/j.jdiacomp.2022.108288



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