Over 500,000 Bulgarians live with the diagnosis of diabetes, a condition characterized by impaired glucose (blood sugar) levels and disorders in insulin sensitivity and synthesis. Many doctors focus the patient’s attention on the health of the eyes, nervous system, kidneys and heart when it comes to the consequences of uncontrolled diabetes. However, few explain the issue of sexual health to diabetics unless the patient requests it. Many men suffering from erectile dysfunction, for example, later discover that it is caused by undiagnosed diabetes. For men and women already diagnosed with diabetes, sexual dysfunction can be directly or indirectly caused by the disease and can be due to neuronal damage, arterial plaque deposits and blockages, and even hormonal imbalance. Sexual disorders in diabetes are completely reversible and controllable, but only with the right treatment and lifestyle. Severely decreased libido, or sexual desire, is a serious problem affecting both men and women suffering from diabetes. The first step in identifying this symptom is to check your blood sugar – unbalanced levels are a common cause. Certain medications, such as antidepressants, may also be responsible. The most common cause of both low libido and erectile dysfunction in men is low testosterone. Men with type 2 diabetes, obesity, or both have more than twice as much testosterone as healthy men. There are therapies to increase testosterone levels, but it can also be done naturally through weight control, physical activity and proper nutrition. NEWS_MORE_BOX For women, the problem is also serious. Hormonal therapies are considered much more dangerous with them, and the lowered libido itself can also be due to psycho-emotional disturbances. They are rooted in the fact that women suffering from diabetes experience neurological disorders that lead to vaginal dryness and impaired blood circulation to the genitals twice as often as women without diabetes. Also, due to neurological impairments, both sexes may experience strong difficulties in reaching orgasm. Women with diabetes are much more prone to vaginal infections and men to inability to ejaculate. Most symptoms can improve with good blood sugar control, but some require medical intervention: the sooner, the more likely it is to return to normal sexual function.