HOW DIABETES AFFECTS THE REPRODUCTIVE SYSTEM | Added: 12, August 2017



DIABETES, MENSTRUAL CYCLE, AND FEMALES

What are the female reproductive organs?

The organs of the female reproductive system include the ovaries, the uterine tubes, the uterus, the vagina, the external organs called the vulva, and the mammary glands. The paired ovaries are the female gonads. Each ovary is approximately 1 to 2 inches (2.5 to 5 centimeters) long, 0.6 to 1.2 inches (1.5 to 3.0 centimeters) wide, and 0.24 to 0.6 inches (0.6 to 1.5 centimeters) thick, similar in size and shape to an unshelled almond. They produce the female gametes, called ova, and secrete the female sex hormones.

What is the female reproductive cycle?

The female reproductive cycle is a general term to describe the ovarian cycle and the uterine cycle as well as the hormonal cycles that regulate them. The ovarian cycle is the monthly series of events that occur in the ovaries related to the maturation of an oocyte. The menstrual cycle is the monthly series of changes that occur in the uterus as it awaits a fertilized ovum. The reproductive cycle averages 28 days, but it may last from 24 to 35 days. A cycle of 20 to 45 days is still considered within normal range. The menstrual phase lasts five to seven days.

In what way does diabetes affect a woman’s menstrual cycle?

Diabetes’ effect on a woman’s menstrual cycle mainly involves the hormones that regulate the cycle-estrogen and progesterone. These hormones interact with the insulin hormone and may make a woman’s body more resistant to its own insulin or injected insulin (if the woman has type 1 diabetes). This causes a rise in blood glucose either before, after, or during menstruation and lasts for about three to five days. The actual number of days and times varies from month to month and person to person. The number of days can also change because of certain conditions, such as eating a food that makes the person’s blood glucose levels become unbalanced.

How are menstruation and diabetes linked?

Unusually long, extremely irregular, or infrequent menstrual cycles may be linked to insulin resistance and the development of type 2 (or adult-onset) diabetes. In addition, there are changes in a woman’s menstruation if she has type 1 diabetes, including starting menstruation a year later (on average) than women without diabetes and being more likely to have menstrual problems before age 30. Diabetes also increases a woman’s chances of having longer menstrual cycles and periods, heavier periods, and an earlier onset of menopause.

What is polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a disease of hormones. It affects between 5 and 20 percent of American and European women, depending on the study, and is the most common reproductive hormone disorder for women of childbearing age. It is also the number one cause of female infertility. Symptoms include ovaries with a large number of “cysts,” skin discoloration, depression, fatness around the waist, and painful periods.

PCOS is often thought of as a form of prediabetes, as some of the symptoms-especially the early ones-are similar. For example, PCOS, like prediabetes, often starts with insulin resistance, which causes the body to produce high levels of insulin. (In some women, the insulin stimulates the production of male sex hormones, such as testosterone.) There are also crossovers to both diseases, such as irregular or absent periods and a link to heart disease. As with diabetes, PCOS is thought to be caused by several factors, including genetics, exposure to certain environmental conditions, and/or eating refined carbohydrates.

DIABETES AND SEX

How does diabetes affect female and male sexual activity?

Diabetes can cause autonomic neuropathy, or damage to nerves that take care of everyday functions. Such nerve damage can also gradually decrease sexual response in men and women, although the sex drive may be the same. Such damage may also mean a man may be unable to have erections or may reach sexual climax without ejaculating normally. Women with such nerve damage may have difficulty with arousal, lubrication, or having an orgasm.

Do birth control pills affect a woman who has diabetes?

If a woman takes a birth control (contraceptive) pill, she may experience a difference in blood glucose levels from before she started taking the pill. But taking birth control pills is a highly debated subject, as many health care professionals believe they have a potentially harmful effect on women with diabetes. This is because many studies indicate that diabetic women who take contraceptives-or use other methods that contain estrogen-have higher blood glucose and cholesterol levels than women who are on the pill and do not have diabetes.

Contraceptive pills can affect blood glucose levels in women with diabetes.

Why do some pregnant women experience gestational diabetes?

This type of diabetes occurs in about 4 percent of pregnant women and usually disappears after the baby is born. But some studies show that if a mother has gestational diabetes, both she and her child may have a higher risk of type 2 diabetes later in life. (For more details about gestational diabetes, see the chapter “Other Types of Diabetes.”)

What is the main function of the male penis?

The penis is an external organ of the male reproductive system. It consists of three parts: the root, which is where the penis is attached to the wall of the abdomen; the shaft or body; and the glans, also known as the tip of the penis. The main body of the penis has a tubular, cylindrical shape and surrounds the urethra, which transports urine to the outside of the body. Spongy tissue that can expand and contract fills the body of the penis. There is also a slit opening at the tip of the glans through which urine is excreted and semen is ejaculated.

What is retrograde ejaculation and its connection to diabetes?

Although it is frequently, but not always, caused by diabetes, some men experience retrograde ejaculation. This is when the man’s semen is not ejected through the penis but goes backward into the bladder. It is not harmful, but it can cause male infertility (in other words, the man may need help in order to father a child).

What is erectile tissue?

The penis contains three main cylindrical bodies of erectile tissues, called the corpus cavernosa (which are two lateral bodies) and corpus spongiosum (which also contains the urethra). The three bodies are bound by a stocking of the more vascular, dense, and sensitive tissue called deep perineal fascia (tissue). Upon stimulation, blood flow to the erectile tissue is increased, resulting in an erection.

What are sperm?

It is estimated that during the lifetime of a normal male, he will produce 1012 sperm, or one trillion sperm, equivalent to about 300 million sperm per day. Sperm are some of the smallest cells in the human body and are about 0.002 inches (0.05 millimeters) long from the head to the tip of the tail. Each sperm cell has three distinct regions: the head, the middle piece, and the tail.

Can diabetes affect a man’s sperm?

Yes, in some cases, if a male has diabetes, he will have a lower sperm count. One study found that 25 percent of men with type 2 diabetes were infertile mainly because high blood glucose had damaged the sperm. Another study indicated that men with diabetes had less sperm mobility, or the ability of the sperm to move.

Is erectile dysfunction connected to diabetes?

Yes, it is estimated that as many as half of men with diabetes may develop erectile dysfunction (impotence), especially if they have had diabetes for many years. This is thought to be mainly because of a type of nerve damage called autonomic neuropathy (for more about autonomic neuropathy, see the chapter “How Diabetes Affects the Nervous System”). For men with diabetes who experience this problem, such drugs as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra) are often prescribed. Other solutions include injecting medications directly into the penis, the use of certain devices to help with an erection, and surgical implants.

Is there a connection between testosterone and diabetes?

Low testosterone is known to trigger erectile dysfunction, reduce physical strength, cause mood changes, and lower a man’s sex drive. There are several connections between low testosterone and diabetes. For example, one recent study showed that obesity (based on body mass index, or BMI) was strongly associated with low testosterone levels in men, a problem that often accompanies type 2 diabetes. It also showed that erectile dysfunction in men with type 2 diabetes could be caused by impaired circulation from blood vessel damage and neuropathy, or nerve damage. According to another study conducted at the University of Buffalo, men with type 2 diabetes and low levels of testosterone may benefit from TRT, or testosterone-replacement therapy. The study showed that TRT helped by improving insulin sensitivity in men, alleviating many problems associated with low testosterone.

What are some causes of erectile dysfunction?

E rectile dysfunction (ED, or impotence) is the inability to achieve or sustain an erection. It is often the result of disease, injury, or a side effect of certain drugs, including blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug). Damage to nerves, arteries, smooth muscles, and fibrous tissues of the penis are the most common physical causes of erectile dysfunction. In addition, it is estimated that about 70 percent of ED cases are caused by some of the major diseases, including diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular and neurological diseases. Treatment may include lifestyle changes, adjusting medications to alleviate side effects, medications to induce erection, surgery, and testosterone-replacement therapy (see below).