Male Sexual Dysfunction and Hypogonadism in Young Adults with Type 2 Diabetes Mellitus: A Cross Sectional Study.

Abstract

Background: Male sexual dysfunction (MSD) is a common occurrence in diabetic patients, which is not routinely assessed in clinical settings.

Aim: The aim of the study was to assess the prevalence of MSD and hypogonadism in young type 2 diabetes mellitus (T2DM) patients aged between 20 and 40 years and its association with duration, glycaemic control and complications of diabetes.

Settings and design: This is a cross-sectional study involving 70 men with T2DM of 20-40 years of age visiting the endocrinology department in a tertiary care centre. This study was conducted from November 2021 to March 2023.

Materials and methods: Seventy subjects satisfying inclusion criteria were included in the study and assessed using the International Index of Erectile Function-15 questionnaire, intravaginal ejaculation latency time, androgen deficiency in ageing male questionnaire, hormonal parameters (Luteinising Hormone, Follicle stimulating hormone, Testosterone and sex hormone-binding globulin) and penile Doppler.

Statistical analysis used: The statistical analysis was done using SPSS version 21. A P < 0.05 is considered statistically significant. Data were checked for normality using Kolmogorov-Smirnov and Shapiro-Wilk tests. For determining statistical significance between continuous variables with non-normal data, the Mann-Whitney U test and Kruskal-Wallis tests were used. Pie charts, bar diagrams and scatter plots were used for descriptive statistics. Frequency, percentage, means, median, range and standard deviation were used for all quantitative data. The Chi-square test was used to find a significant association between categorical variables.

Results: Sixty per cent of men had at least one form of MSD. Hypoactive sexual desire disorder (HSDD) - 44.28% was the most common MSD, followed by erectile dysfunction (ED) - 42.85% and ejaculatory disorders - 18.57%. Penile Doppler was done in 15 patients, of whom 9 patients had normal Doppler, venous incompetence was present in 3, followed by mixed (arterial and venous) in 2 and arterial insufficiency in 1 subject. Hypogonadism was present in 27.14% of men and secondary hypogonadism was the most common cause (84.21%). There was a significant association between neuropathy and ED and between hypogonadism and HSDD. There was also a significant association between fasting plasma glucose, post-prandial plasma glucose and MSD.

Conclusion: MSD is common in young T2DM men, which should be given due importance in clinical practice to improve their quality of life. Glycaemic control is of utmost importance in these men.