Autonomic Neuropathy and Urinary Problems

Diabetes often strikes below the belt, in a manner of speaking. Normally, when the bladder fills up, nerve signals to the brain instruct you to visit the restroom, and the sooner the better. If those nerves become damaged, however, your bladder can fill up and bulge to three times its normal size, but you may never realize it. Eventually, you may become incontinent -- that is, urine will spill out of the bladder, whether you want it to or not. Studies show that people with diabetes are significantly more likely than the general population to develop incontinence.

Autonomic neuropathy can cause incontinence, erectile dysfuction, and other problems.

Nerve damage can also weaken the bladder, making it difficult to empty completely during a visit to the powder room. Over time, bacteria may breed in urine left behind in the bladder, leading to a urinary tract infection (UTI). UTIs are no darn fun; they can cause pain while urinating and make you feel like you need to "go" all day and especially at night, among other symptoms. Having diabetes seems to raise the risk for this pesky problem.

For example, a 2002 study found that postmenopausal women with diabetes were more than twice as likely to develop a urinary tract infection as postmenopausal women without diabetes. What's more, women with diabetes tended to develop more serious and painful infections.

Now, let's make our way from the bathroom to the bedroom, because it's time to broach an even more sensitive issue: Your love life and how nerve damage from diabetes can put a damper on it.

Erectile dysfunction is perhaps the most common male sexual disorder caused by diabetes-related nerve damage. In fact, men with diabetes are three times more likely to develop the problem than men who don't have the disease. Estimates vary, but between 20 and 85 percent of male diabetes patients will experience erectile dysfunction, often called simply ED. For an erection to occur, the brain has to communicate with the penis via a network of nerves; damage to those nerves can spoil the fun.

Another problem, called retrograde ejaculation, occurs more often than normal in men with diabetes. When a male ejaculates, the bladder usually closes. If nerve damage disables the muscles that seal the bladder, semen backs into the organ. As a result, the man ejaculates little or no semen. Although retrograde ejaculation is physically harmless for the man, it can cause infertility. It also turns urine cloudy.

Diabetes is an equal opportunity nuisance when it comes to sexual disorders, however. In fact, at least one study involving patients with type 1 diabetes found that sexual problems were more common in women (27 percent) than men (22 percent). In one survey, the most common sex-related complaint among women with diabetes was vaginal dryness, which results from damage to cells lining the vagina that provide lubrication. Lack of lubrication can make intercourse painful. Add side effects from medications you might be taking, plus anxiety or depression about your health, and it's no surprise that women with diabetes often lose interest in sex or have trouble having orgasms, too.

Losing one's eyesight is one of the more frightening complications associated with diabetes. Learn how autonomic neuropathy can cause vision problems on the next page.

For more information on diabetes and its related conditions, try the following links:  

• Diabetic Neuropathy is a complex injury that should not be left undiagnosed. Learn more about it in this informative article.
• To learn more about how diabetes can disrupt your urinary tract, read Diabetes and Bladder Problems.
• Damage to the eyes is a common complication associated with diabetes. Find out more on our Diabetes and Eye Problems page.  
• Diabetes Symptoms covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.  
• To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.