DARE TO ASK: You were always on my mind

By PHILLIP MILANO, The Times-Union

Question

If a man is medically impotent, as from diabetes, does he still have a sex drive?

Amy, 56, Jacksonville

Replies

Sexual excitement is a personal matter that can vary, but where there is a will there is a way! With a loving, caring partner, all kinds of good things can still happen. Intimacy in sexuality and a broader repertoire of activities can help. It depends on the degree of neuropathy as well. Diabetics often do not respond as well to drugs such as Viagra, etc., but they have very good response with the drug Caverject. It works with or without a strong libido.

Paul, 53, diabetic, Normal, Ill.

I've been on certain medications for some time that inhibit my sexual performance. But I still have a sex drive.

Bill, 43, Naples

Many times someone who has this type of condition will still have a sex drive; that is something that is biologically in you. Nerve damage and things like that do not seem to have a relation.

Saluki Girl, Carbondale, Ill.

I am a borderline (Type 2) diabetic. A man can certainly continue to some degree to have sexual desire and arousal and release. Unless something is really wrong psychologically, a man desires sex, virtually all the time.

Jerry, 58, Jacksonville

Expert says

The endocrinological, psychological and societal implications of diabetes and other manifestations of impaired glucose metabolism in humans can impact regimens such as insulin therapies conducted to ameliorate the disorder and/or its inherent side effects.

(OK, now that all the kids have stopped reading, let's get on with the real column.)

Why is Paul pushing this Caverject stuff, anyway? Does he realize where it's injected?

To get at the nut of this matter, we must first remember that the question is not about the heavy lifting, but wanting to do the heavy lifting.

And that desire is not affected by diabetes, says Robert Rizza, past president of the American Diabetes Association and professor of medicine at the Mayo Clinic in Minnesota.

"Diabetes can affect a variety of things, but not libido," he said.

"It involves changes in blood flow in various parts of the body, and it can damage nerves and blood vessels and cause impotence."

To prevent the impotence, take care of the diabetes that's causing it, he added. That means healthful eating, exercise, blood glucose testing and possibly insulin therapy. An aspirin a day helps control blood vessels, Rizza said.

Who should care? About 10 percent of all U.S. males over age 20 (and their significant others, we guess). That's how many of them have diabetes, according to the American Diabetes Association. And of those, up to 75 percent will experience impotence because of it.

Phillip Milano, author of I Can't Believe You Asked That! (Perigee), moderates cross-cultural dialogue at Y? The National Forum on People's Differences. Visit www.yforum.com to submit questions and answers, or mail to Phillip Milano, c/o The Florida Times-Union, P.O. Box 1949, Jacksonville, FL 32231. Include contact information. For Dare to Ask podcasts, go to Jacksonville.com keyword: milano.