Erektile Dysfunktion beim Diabetiker – Aktuelle Diagnostik und Therapie

Zusammenfassung

Sexuelle Funktionsstörungen sind eine multidimensionale nosologische Entität. Neben direkt messbaren pathophysiologischen Parametern sind praktisch immer auch psychologische und beziehungsdynamische Aspekte beteiligt. Diese können Auslöser oder Verstärker sein. Ebenso sind sozio-kulturelle Faktoren zu beachten. Bei Männern ist die Problematik häufig physiologisch fokussiert: das häufigste Symptom innerhalb des Komplexes sexueller Probleme, insbesondere beim Diabetiker, ist die erektile Dysfunktion. Es kann aber auch zu Ejakulations- und Orgasmusstörungen kommen. Über diabetes- oder adipositasbedingte Störungen der hypothalamisch-hypophysär-gonadalen Achse kann beim Mann die Testosteronproduktion eingeschränkt werden, was zu einem klinisch signifikanten Androgendefizit und damit auch einem Libidoabfall führt [1] [2].

Summary

Sexual functional dysfunctions represent a multidimensional nosological entity. Apart from the directly measurable pathophysiological parameters, psychological and dynamic partnership aspects are almost always involved. These can exert a triggering and a potentiating influence. Similarly, socio-cultural factors have to be taken into account. In men the problem most frequently has a physiological focus and the main symptom within the complex of sexual difficulties, especially for diabetic patients, is erectile dysfunction. Disorders of ejaculation and orgasm may also occur. Testosterone production in men may be impaired due to obesity-related dysfunctions of the hypothalamic-pituitary-gonadal axis and this can lead to a clinically significant androgen deficit and thus also to a decline of libido [1] [2].

Key words

sexual functional disorders - erectile dysfunction - decline of libido

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