The surge in diabetes cases in Singapore may well be getting in the way of a man’s ability to have kids. Listing risk factors most diabetic men have that can impact their fertility, Dr Colin Teo, the head of urology at Khoo Teck Puat Hospital, says, “These individuals often suffer from other related health issues dealing with blood vessels, nerve damage, metabolic issues and obesity.”
In 2014, some 440,000 Singaporeans 18 years and older had diabetes. And that number is set to grow to one million by 2050, according to Health Minister Gan Kim Yong. This condition increases one’s risk of blindness, nerve damage, kidney failure and heart disease. In severe cases of diabetes, permanent damage may even result ― more than 1,500 diabetes-related amputations are carried out in Singapore hospitals every year.
We take a look at the most common infertility issues faced by men with diabetes (both type I & II):
1) Low testosterone levels (Hypogonadism)
Low levels of testosterone — the male sex hormone — are common among diabetic men, which can result in a low sex drive. Points out Dr Simon Chong, a consultant urologist at Mount Elizabeth Medical Centre, “One common cause of infertility is the low frequency of sex rather than the quality of the sperm or eggs.” Pregnancy is the result when sperm fertilises an egg and for this to happen, there must be intercourse. The good news, Dr Chong notes, is that there are medications such as injections and oral medication to treat low testosterone levels. Low levels of the male sex hormone can also give rise to weight gain and general lethargy.
Low levels of testosterone — the male sex hormone — are common among diabetic men, which can result in a low sex drive.
2) Poor sperm health
Sperm that is healthy a normal shape with move well. Healthy sperm also have a high sperm count in the semen. The higher the count, the better the chances a woman has of conceiving. A low sperm count has been found in overweight or diabetic men. A 2004 Danish study showed that overweight men who had a body mass index of over 25 had a nearly 22 per cent lower sperm concentration and 24 per cent lower total sperm count compared with men of healthy weight.
3) Ejaculation issues
Diabetic men may not have any ejaculate if the nerves in their penis are damaged. Known commonly as retrograde ejaculation, Dr Teo explains that this happens when the ejaculate flows back into the bladder instead of outwards. Under such circumstances, diabetics may need to explore artificial reproductive methods. This includes options like In-vitro Fertilisation or Intra-Uterine Insemination.
Read on and find out if you should be checking out over-the-counter fertility treatments…
4) Erectile dysfunction
When a man suffers from erectile dysfunction, he cannot maintain or achieve an erection firm enough for sexual intercourse. He may be suffering from damaged nerves and blood vessels if he has high blood sugar levels as a result of diabetes. Erectile dysfunction may also be linked to high blood pressure and heart disease. In some cases, the medication you take for these conditions could cause your erectile problems.
By the way, be very wary of products, especially those available online, that claim to boost the male libido. Dr Chong notes that he is wary “of herbal products and traditional therapies as there is not much information available as to how safe and effective these are”.
“Not all testosterone therapies are suitable and some treatments can drive down the sperm production to close to none.”
That said, certain supplements, trace minerals and vitamins have been shown to improve male fertility and are generally safe to take. This includes vitamins A, C and E, says Dr Teo.
If you are keen to try treatments to enhance your sex drive, Dr Teo advises, “The best is to stick to Health Sciences Authority-approved or proper sources.” Do also refrain from thinking of these substances as “miracle workers”, he adds. “If it works, I’d congratulate the user but they should also be careful not to overdose!”
When in doubt, it’s best to err on the side of caution. Dr Chong suggests that men seek proper medical advice before embarking on therapies to try to boost one’s vitality or fertility.
He urges, “Not all testosterone therapies are suitable and some treatments can drive down the sperm production to close to none!”
Dr Colin Teo is the head of urology in Khoo Tech Puat Hospital. Dr Simon Chong is a consultant urologist at Mount Elizabeth Medical Centre.
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