Diabetes has greatest impact on sexuality, says sexologist Leemans

Intimate difficulties like erectile dysfunction, vaginal dryness, painful sex, and ejaculatory disorders hit people with diabetes harder than other chronic health conditions unrelated to genital health, according to findings reported by Medscape.

Why Diabetes Takes a Greater Toll on Intimacy Than Other Chronic Illnesses

Chronic conditions alter daily routines, energy levels, and self-image, but few target sexual well-being quite like diabetes. In a 2024 study found that among chronic conditions unrelated to genital health, diabetes had the greatest impact on sexuality. Charlotte Leemans, a sexologist and psychologist in the urology department at the Notre-Dame de Grâce Clinic in Gosselies and a doctoral student at UCLouvain in Ottignies-Louvain-la-Neuve, Belgium, laid out the comparison plainly.

When we compare diabetes with other chronic diseases, such as kidney failure, heart failure, or chronic pain, it really is the one that has the greatest impact on sexuality.

Patients do not always connect these intimate changes to their blood sugar levels. Sometimes, these physical symptoms act as the first red flag for an undiagnosed condition. Among patients who seek care for sexual complaints, routine blood tests frequently uncover developing diabetes or prediabetes. Once blood sugar levels return to normal range, those symptoms often disappear, though that outcome is not universal.

The Silence in the Clinical Exam Room

Despite these clear physiological links, conversations about sexual health rarely happen during routine medical appointments. Healthcare professionals typically wait for patients to raise the subject. Yet, if a clinician stays silent, patients often blame age, everyday stress, or relationship strain rather than looking at their metabolic health.

Several barriers keep doctors and nurses from bringing up the topic. Sexuality rarely serves as the primary reason for a clinic visit, pushing it down the priority list. Consultations run short, providers worry about offending patients, and personal embarrassment still plays a strong role. Misconceptions about age and family status—such as assuming single people or nursing home residents do not have active sex lives—further compound the problem.

Many clinicians simply do not know where to send a patient once the topic is open. To bridge that gap, professional groups like the Flemish Association for Sexology and the Society of University Sexologists of Belgium, where Leemans is the president, offer patient access to qualified professionals with insurance reimbursement options.

Four Practical Approaches for Clinicians

Opening the door does not require a lengthy seminar. A single, well-phrased question paired with enough time to listen can shift the dynamic entirely. Drawing on research by Nathalie Michaud, MD, Leemans outlines four distinct ways providers can start the dialogue:

Asking directly about frequency: Some diabetic patients experience sexual difficulties. Do you have any questions about this?
Framing the discussion as part of regular monitoring, much like standard eye or kidney screenings.
Acknowledging up front that sexuality is deeply personal before asking if the patient wants to talk about it.
Beginning with a broader relationship check-in: How is your relationship?

Even if a patient stays quiet at first, the clinician has planted a seed, letting the individual know that support is available.

Using Sexual Health to Drive Treatment Adherence

When patients understand that keeping their blood sugar stable directly protects their sex life, their motivation changes. For individuals who prioritize intimacy, this connection offers a tangible incentive to adopt healthier daily habits and stick closely to their prescribed treatment plans.