Advice on Type 1 Diabetes and Retrograde Ejaculation

Certified diabetes educator Jennifer Smith of Integrated Diabetes Services answers your answers about blood glucose management. Send your questions

Q: I have had Type 1 diabetes for several years and met with my urologist due to impotency and retrograde ejaculation. He told me to control my blood sugars. I’ve tried, but I still have issues with retrograde ejaculation. Is there anything else that I can do about this?

A: Sexual dysfunction is a very frustrating experience, and unfortunately there often aren’t many quick answers.

The one thing to know is that you’re not alone in experiencing issues. Many men and women experience sexual problems related to diabetes. These issues can include erectile dysfunction, impotence, retrograde ejaculation, vaginal dryness, lack of desire, as well as loss of genital sensation. They result because of damage to the small blood vessels and nerves in the genital area, which are particularly sensitive. Retrograde ejaculation occurs in men when semen goes into the bladder rather than out through the urethra during ejaculation.

Your doctor is right that optimizing blood glucose control can help prevent further damage. There are some medications that can assist with retrograde ejaculation, like Imipramine, Midodrine, Ephedrine, and Chlorpheniramine. These medications, which usually are developed for other conditions, are meant to strengthen the muscles of the sphincter of the bladder. Many of these drugs have side effects that can affect blood glucose levels, so it’s important to discuss your treatment options with your diabetes medical team.

Sexual dysfunction can be a result of high blood sugars, mental health issues, or some combination of the two. Many issues can be improved or overcome, but only if you take the first step of discussing the problem with your medical care provider(s). Thank you for asking this question for others who may have been too shy to discuss it!

Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes “coaching” services are available in-person and remotely via phone and online for children and adults. Integrated Diabetes Services offers specialized services for insulin pump and continuous glucose monitor users, athletes, pregnancy & Type 1 diabetes, and those with Type 2 diabetes who require insulin. For more information, call 1-610-642-6055, go to or write

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Jennifer Smith holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a registered and licensed dietitian, certified diabetes educator, and certified trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. She has lived with Type 1 diabetes since she was a child,and thus has first-hand knowledge of the day-to-day events that affect diabetes management.

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