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
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.
Conclusion: 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.