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, sociocultural 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.
Aktuelle Urologie. 2015 Jul 30 [Epub]
M Zitzmann, S Kliesch
Abteilung für Klinische Andrologie, Universitätsklinikum Münster. , Abteilung für Klinische Andrologie, Universitätsklinikum Münster.