Diabetes hits below the belt

He is only 48 but he was not in the mood for love.

His flagging libido had an impact.

"My wife was fine with it at the start but later she started asking questions. She was worried that I didn't find her attractive anymore," says the nightclub manager, who declined to give his name.

"She actually sent me an SMS one day, saying she felt insecure and asked why I don't want to have sex with her anymore," he adds.

Luckily, she did not suspect he was having an affair.

"Because I work in a nightclub, there is mutual trust. Otherwise, our relationship would not have lasted for so many years," he tells The New Paper on Sunday.

A medical check-up soon after revealed that diabetes was the root cause.

A link between diabetes and low testosterone - the male hormone - is well established but the exact nature of the link is unclear, says Dr Shum Cheuk Fan, Associate Consultant Urologist at Khoo Teck Puat Hospital (KTPH).

"As many as one in two men over 40 and suffering diabetes have low testosterone," he says.

Testosterone also helps the body use insulin so sugar can be absorbed easily from the blood.

"Men with low testosterone levels often have insulin resistance. This means they need to produce more insulin to keep their blood sugar levels in the healthy range," Dr Shum says.

He reveals that about two in three men treated for erectile dysfunction (ED) at KTPH's Urology Clinic have diabetes. Diabetes can also damage blood vessels and nerves involved in penile erection.

A recent report by the National Healthcare Group (NHG) showed that the number of diabetics treated at its hospitals and polyclinics shot up from 96,970 in 2010 to 110,554 in 2013 - a jump of 14 per cent.

If the number of patients seeking treatment at the NHG is any indication, diabetes is spiking.

"My mother and brothers have diabetes. So when I was diagnosed with borderline diabetes, I was not at all surprised," says the nightclub manager.

However, he was shocked when he was told that his testosterone level was 6.8 instead of normal 12.

The hospital is raising awareness of the link because men may not know that flagging sexual interest could have a medical reason.

And often, even the strongest marriages can be rocked when the husband loses interest in sex.


So treating the root cause is not enough, says Head of Psychiatry at KTPH, Dr Chan Keen Loong.

"It's important that couples talk to each other if they are facing sexual problems. A loving relationship and supportive family and friends... can make all the difference in self-management, helping people with diabetes manage their condition well and avoid complications," says Dr Chan.

Dr Shum says: "A very important yet frequently overlooked part of erectile dysfunction management is lifestyle modification. Good diabetic control, good blood pressure control, smoking cessation and correcting obesity are just as important as any other aspects of ED management."

Apart from using sexual enhancement drugs, patients with concurrent ED and testosterone deficiency syndrome may benefit from testosterone replacement therapy.

The nightclub manager, who is being treated with testosterone injections, says they have helped a lot.

"I am now able to have sex with my wife again. But I do need to go back for regular blood tests and an injection every three months," he says.


This article was first published on November 22, 2015.
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