Evaluation of Sexual Dysfunction in Males with Diabetes

Health Literacy and Quality of Life in Patients With Type 1 Diabetes Mellitus

Aim The aim of this study was to investigate the relationship between health literacy (HL) and quality of life (QoL) in type 1 diabetes mellitus (DM) patients. Method This study was conducted between February 2020 and May 2020 at the University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, in Turkey. A total of 155 patients with type 1 DM between the ages of 18-65 were included in the study. QoL was evaluated with the Audit of Diabetes Dependent QoL questionnaire and HL was evaluated with the Newest Vital Sign (NVS) questionnaire and obtained results were compared. Results The weighted impact score for the overall QoL scale was higher for patients who did not have complications than those with complications (p=0.004). Retinopathy and nephropathy were higher in the group with low HL (p=<0.001; p=0.032; p=0.012, respectively). The weighted impact score for the overall QoL scale was lower in married individuals (p=0.040) and it was higher for high school and above education levels than those with lower education levels (p=0.004). The sex life weighted impact score was higher in the group with DM less than 10 years (p=0.045). Conclusion Patients with high HL status are more adaptable to their physician's recommendations, less frequent complications will occur in these patients and the QoL of the patients will be better in the absence of complications.

Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire

INTRODUCTION

The literature showed the need for a better understanding of the male sexual response, which has historically been considered as simpler and more mechanistic compared with that in women.

AIM

To examine the literature on biopsychosocial factors associated with the level of sexual desire in men and discuss some interesting directions for future research.

METHODS

A systematic literature review was conducted.

MAIN OUTCOME MEASURES

169 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library about male sexual desire and related biopsychosocial factors.

RESULTS

We found a lack of multidimensional studies on male sexual desire. Most existing research has focused on hypoactive sexual desire disorder in coupled heterosexual men. Biological factors play important roles in the level of sexual desire, but they are insufficient to explain the male sexual response. Psychological, relational, and sexual factors (eg depression, anxiety, emotions, attraction, conflicts, communication, sexual functioning, distress, satisfaction) are involved in the development/maintenance of lack of sexual interest in men. Cultural influence is also relevant, with cognitive factors linked to gender roles and sexual scripts of masculinity identified as important predictors of low sexual desire.

CONCLUSION

Male sexual desire is characterized by an interplay among biological, psychological, sexual, relational, and cultural elements. This interplay merits further study to better understand how sexual desire works and how treatments for low sexual interest could be improved. Nimbi FM,Tripodi F, Rossi R, et al. Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire. Sex Med Rev 2020;8:59-91.

"My wife's mistrust. That's the saddest part of being a diabetic": A qualitative study of sexual well-being in men with Type 2 diabetes in sub-Saharan Africa

Introduction

Sexual dysfunction is a common complication for men with diabetes, yet little is known about the lived experiences of sexual difficulties within the context of diabetes, particularly in low-and-middle-income countries. This study explores how men with type 2 diabetes in three sub-Saharan African settings (Cape Town and Johannesburg, South Africa; Lilongwe, Malawi) perceive and experience sexual functioning and sexual well-being, and the biopsychosocial contexts in which these occur and are shaped.

Methods

We used a qualitative research design, including individual interviews (n = 15) and focus group discussions (n = 4). Forty-seven men were included in the study. We used an inductive thematic analysis approach to develop our findings. A biopsychosocial conceptual model on the relationship between chronic illness and sexuality informed the interpretation of findings.

Results

Men across the study settings identified sexual difficulties as a central concern of living with diabetes. These difficulties went beyond biomedical issues of erectile dysfunction, comprising complex psychological and relational effects. Low self-esteem, related to a sense of loss of masculinity and reduced sexual and emotional intimacy in partner relationships were common experiences. Specific negative relational effects included suspicion of infidelity, mutual mistrust, general unhappiness, and fear of losing support from partners. These effects may impact on men’s ability to cope with their diabetes. Further stressors were a lack of information about the reasons for their sexual difficulties, perceived lack of support from healthcare providers and an inability to communicate with partners about sexual difficulties.

Conclusion

More in-depth research is needed to better understand sexual functioning and well-being within the context of diabetes, and its potential impact on diabetes self-management. Holistic and patient-centered care should include raising awareness of sexual problems as a potential complication of diabetes amongst patients, their partners and care providers, and incorporating sexual well-being as part of routine clinical care.