How Does Diabetes Affect Male Fertility?

According to a recent study, in the three months before conception, men taking metformin, a popular drug for type 2 diabetes, experienced a 40% higher risk of birth defects in their offspring. While not definitive, this illustrates that diabetes can affect male fertility. Common fertility issues, like erectile dysfunction and low sperm quality, can occur with type 1 and type 2 diabetes. While diabetes has no cure, you can properly manage it by controlling your blood sugar, taking insulin regularly, and making lifestyle changes.

The Role of Diabetes in Male Fertility

Research shows that men are more likely to be diagnosed with adult-onset type 1 diabetes, a non-preventable autoimmune condition. They’re also almost twice as likely to develop the more common type 2 diabetes, in which blood sugar (glucose) is too high (hyperglycemia).

Research suggests that for men with poor diabetes control, the combination of erectile dysfunction (ED), reduced sex drive, and lower ejaculate volume triggers a lack of sperm formation (spermatogenetic arrest). Diabetes may remove part of the Y chromosome, which biologically defines manhood, while making it difficult for men to spread their genes.

Erectile dysfunction

Erectile dysfunction (ED), in which men are consistently unable to get or maintain an erection, is caused by diabetic nerve damage and blood circulation issues. Typically, it affects men with long-term or untreated diabetes, developing in about half of men with diabetes.

Diabetes causes hyperglycemia, which can disrupt blood penile flow, affecting erections. Over time, it can reduce the production of nitric oxide (NO), which helps to relax the muscles in the penis and increases blood flow. Hyperglycemia also causes neuropathy (nerve damage), disrupting the nerve impulses to the penis and reducing its muscles’ ability to relax. Men with diabetes may be at higher risk of hormonal imbalances, like low testosterone, which contributes to ED. These erection problems and nerve damage may decrease libido, or sexual desire, in men.

Ejaculation Issues

Retrograde ejaculation occurs when part or all of your semen enters your bladder instead of out of your penis during ejaculation, where it’s safely urinated out. Some men may have no ejaculate at all. While retrograde ejaculation isn’t considered serious, you may have problems conceiving without assisted reproductive technology (ART).

Diabetes may also cause retarded, or delayed ejaculation. With this, you need a lot of time and stimulation to reach sexual climax and ejaculate, if at all. Again, ART services may be required.

Sperm Quality

Type 1 and 2 diabetes can damage sperm quality (the ability to fertilize an egg). Diabetes may also affect other sperm factors, like motility (movement) and DNA integrity. Obesity, closely associated with diabetes, may also affect sperm quality.

Low Testosterone Levels

Low testosterone levels (hypogonadism) may be linked with diabetes and infertility. Men with type 2 diabetes are twice as likely to experience this as men without diabetes. The symptoms may include diminished sexual interest, erectile dysfunction, reduced lean body mass, depressed mood, and a lack of energy. While incurable, hormone levels may increase with medication, ART, and lifestyle changes, like weight loss.

The Benefits of Diabetes Management

You can maintain your good health through proper diabetes management, including regularly taking insulin and other medications, and consistently testing your glucose levels. You should also control your cholesterol and blood pressure levels.

Your doctor can prescribe a glycosylated hemoglobin test (hemoglobin A1C), which details your average blood sugar levels for the previous 2-3 months. Ideally, this should be below 7%. You can also follow a healthy lifestyle, including diet, physical activity, and avoiding smoking.

Schedule A Consultation About Diabetes & Fertility in California

Diabetes can damage male fertility, including erectile dysfunction and semen quality. If you have any questions about fertility, please contact us for an appointment.