TYPE II DIABETES AND ITS RELATIONSHIP TO SEXUAL DYSFUNCTION & INFERTILITY
It's fascinating to me just how many couples I see in my clinic who are unable to get pregnant. While it's true that I have seen any number of women get pregnant after chiropractic adjustments (HERE'S THE MECHANISM), in the 25 years I have been in practice, it is becoming less and less likely this will happen (HERE'S WHY). Mostly it has to do with INFLAMMATION, which I showed you in the paragraph above, is the root of most of our most common health problems. In fact, there is an entire industry that revolves around this increasingly common problem (IVF). And this does not even begin to touch on the issue of libido. One thing we know for sure about sex drive is that it correlates inversely with two health problems that are almost always joined at the hip --- the Siamese twins of ill health; type II diabetes and obesity. Before I show you how to solve the majority of cases of both problems on your own, I want to hit you with some studies in no particular order (everything is cherry-picked due to constraints on both time and space) concerning the topic of today's post.
- According to last month's issue of Sexual Medicine Reviews (Diabetes & Sexuality) diabetes is a major destroyer of sexual function for both men and women. "Deterioration in sexual functioning is one of the major and serious complications of diabetes. This common metabolic disorder not only affects sexuality through microvascular and nerve damage but also has psychological aspects. In men, the primary complications are erectile dysfunction, ejaculatory dysfunction, and loss of libido. Women similarly experience sexual problems, including decreased libido, decrease in arousal and lubrication resulting in painful intercourse, and loss of orgasm." Diabetes lowers testosterone levels in men (HERE). With women, it's a mixed bag. Low T in women likewise causes low libido. But as often as not, blood sugar dysregulation in the fairer sex often leads to high testosterone, which not only causes sexual dysfunction, but is a chief component of PCOS as well --- the number one reason for female infertility in America.
- The March issue of the German journal Wiener Medizinische Wochenschrift (Sexuality in Overweight and Obesity) essentially said the same thing, but added their two cents on how to treat the dysfunction. "The association between obesity and sexual dysfunction has been described in many studies. Neurobiological, hormonal, vascular and mental disturbances are the main reasons in male and in female gender." The authors then mentioned several new drugs and hormones used to treat this problem in women. The only one mentioned that was really new was FLIBANSERIN ("Female Viagra"); a terrible drug that will undoubtedly soon be pulled off the market due to side effects and an almost 0% rate of effectiveness.
- Lancet Diabetes & Endocrinology recently published a study (Novel Concepts in the Etiology of Male Reproductive Impairment), which, as I have shown you time and time again, puts the onus for a large percentage of infertility squarely on the shoulders of the male ---- something I feel that most of the public has not been made aware of (women seem to get most of the "blame" for this issue). "Infertility is a widespread problem and a male contribution is involved in 20–70% of affected couples" A study published a few months later, in the June issue of Reproduction, Fertility, and Development (High Glucose Levels Affect Spermatogenesis....) added to this by stating, "systemic diseases such as diabetes mellitus may further exacerbate a decline in male fertility. This metabolic disease, clinically characterized by a hyperglycaemic phenotype, has devastating consequences in terms of human health, with reproductive dysfunction being one of the associated clinical complications."
- Just last month, the Journal of Diabetic Complications (Diabetes Mellitus and Functional Sperm Characteristics: A Meta-Analysis of Observational Studies) revealed that, "Insulin resistance and diabetes mellitus (DM) are well defined causes of female infertility. Current evidence suggests that the presence of DM seems to influence functional sperm characteristics. DM seems to decrease the seminal volume and the percentage of motile cells." For us men it just keeps getting crazier and scarier. Case in point.....
- A study from the March issue of Fertility & Sterility (Increased Risk of Incident Chronic Medical Conditions in Infertile Men: Analysis of United States Claims Data) looked at chronic disease in men as it relates to infertility. Not surprisingly, the authors concluded that, "after adjusting for confounding factors, men diagnosed with infertility had a higher risk of developing diabetes." But they didn't stop there. Some of the other diseases that were also associated with infertility included, "hypertension, diabetes, hyperlipidemia, renal disease, pulmonary disease, liver disease, depression, peripheral vascular disease, cerebrovascular disease, heart disease, injury, alcohol abuse, drug abuse, anxiety disorders, and bipolar disorder." Folks; this list includes almost every major category of disease you can name. The scariest thing about this study, however, was that the average age of the over 13,000 participants was (gulp) 33.
- The April issue of Frontiers in Physiology carried a study called Poly Cystic Ovarian Syndrome: An Updated Overview. "Poly Cystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual dysfunction and androgen [testosterone] excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease (CVD), infertility, cancer, and psychological disorders." What I find interesting is that even though PCOS is an American epidemic, few women (whether struggling to get pregnant or not) seem to be aware of it unless it has caused them pain (a ruptured cyst). In light of the severity of this next study, it's clear that doctors need to be doing a better job of educating their female patients about this subject.
- In the spring of this year, the Czech journal Vnitřní Lékařství (no, I have no earthly idea how to pronounce it either) published a study called Clinical Implications of Polycystic Ovary Syndrome. In this study, they concluded that, "Polycystic ovary syndrome (PCOS) belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications. Reproduction disorders include hyperthyroidism, menstruation cycle disorders, infertility and pregnancy complications as well as early abortions, gestational diabetes and pregnancy induced hypertension. Long-term metabolic risks of PCOS include type 2 diabetes mellitus, dyslipidemia, arterial hypertension and endothelial dysfunction. The available data confirms higher incidence of cardiovascular diseases in women with PCOS. In particular among obese women PCOS is more frequently associated with non-alcoholic hepatic steatosis, sleep apnea...... and autoimmunity. Women with PCOS are more prone to suffer from insufficient confidence with higher incidence of anxiety, depression, bipolar disorder and eating disorders." Every one of these problems, including SLEEP APNEA, are intimately associated with obesity.
- Earlier this year, the journal PLoS One carried a study called The Gut Microbiome Is Altered in a Letrozole-Induced Mouse Model of Polycystic Ovary Syndrome. Researchers revealed that, "PCOS is the most common endocrine disorder in women, with an estimated world-wide prevalence of... up to 15% using the Rotterdam Consensus criteria." The authors went on to say how any number of diseases, including diabetes and obesity have deleterious and well know affects on the MICROBIOME. For this study; shortly after birth, a slow release form of letrozole (trade name Femara --- an estrogen blocker similar to Tamoxifen) was implanted into female mice. Although I don't have time to do it justice, the results of the study were far worse than the conclusions make is sound. "Letrozole treatment of peripubertal female mice decreased mouse gut bacterial diversity and precipitated species-specific and time-dependent shifts in the relative abundance of particular Bacteroidetes and Firmicutes, many of which have been implicated in other mouse models of metabolic disease. Our observation of gut microbiome alteration in a letrozole-induced PCOS mouse model suggests that a “dysbiosis” or microbial imbalance in the gut microbiome may also occur in women with PCOS." I have shown you time and time again that drugs in general --- both ANTIBIOTICS and NON-ANTIBIOTICS alike --- are notorious for creating the (all too common) nightmare known as DYSBIOSIS. Which, like PCOS, is fed by sugar.
- What causes PCOS? The very same thing that causes diabetes. Just remember, however, that contrary to popular belief, Type II Diabetes is not technically a sugar problem. It's an INFLAMMATION PROBLEM, that just happens to be driven (for the most part) by one of our national pastimes --- over-consuming sugar, high glycemic carbohydrates, and JUNK FOOD. This is clearly seen when looking at the abstract of June's Western-Style Diet, Sex Steroids and Metabolism, found in the journal, Biochimica Et Biophysica Acta. "Today, the increased consumption of simple sugars and high-fat food brought about by Western-style diet and physical inactivity are leading causes of the growing obesity epidemic in the Western society. The extension of human lifespan far beyond reproductive age increased the burden of metabolic disorders associated with overnutrition and age-related hypogonadism. Sex steroids are essential regulators of both reproductive function and energy metabolism, whereas their imbalance causes infertility, obesity, glucose intolerance, dyslipidemia, and increased appetite." Did you happen to catch the last two words? That's right folks, the more junk you eat, the more junk you want.
All this is great information, but I know what you're thinking. What about that point where the rubber meets the road? How in the world can both men and women go about fixing sexual dysfunction and infertility? As is almost always the case, drugs are rarely a good or long-term solution.
- The journal above concluded the quote from above by saying, "Clinical and translational studies suggest that dietary restriction and weight control can improve metabolic and reproductive outcomes of sex hormone-related pathologies, including testosterone deficiency in men and natural menopause and hyperandrogenemia in women. Minimizing metabolic and reproductive decline through rationally designed diet and exercise can help extend human reproductive age and promote healthy aging. This article is part of a Special Issue entitled: Oxidative Stress and Mitochondrial Quality in Diabetes / Obesity and Critical Illness Spectrum of Diseases."
- The French OB/GYN journal Gynécologie Obstétrique & Fertilité took this concept even further with publication of their April issue (Infertility: A Key Time to Follow a Medical Nutritional Management. Our Experience on 78 Patients). After admitting that the desire to get pregnant, "is a strong motivational lever to weight loss" the authors concluded that said weight loss, "leads to satisfying pregnancy rate". What do you know? It works!
What sort of diet and exercise to I recommend? Firstly, remember that what you eat is infinitely more important that what or how much exercise you do (HERE). I had a patient come in the other day whose entire family, elderly parents included, had gone PALEO. The grandfather, who has struggled with jacked blood sugar for years, despite any number of DIABETES DRUGS, dropped his blood sugar over 100 points in 3 days. Read that again, because it was not a misprint. It's all about glycemic control via controlling inflammation. And don't forget the STRENGTH TRAINING as well. If you want to see a template on what it might take to get your schwerve back or even get pregnant, HERE is the link ---- critical if you are not only overweight and struggling with PCOS, but DEPRESSED and ADDICTED TO SUGAR AND JUNK CARBS as well.
Rest assured that sugar consumption and obestity are not the only cause(s) of sexual dysfunction, infertility, and particularly PCOS. Many studies do mention "genetics" as a etiological factor. However, it is critical to realize that raw genetics --- your genes --- do not determine your health nearly as much as you have been led to believe. Otherwise the Human Genome Project would have actually accomplished what it claimed it would accomplish when it began 25 years ago --- ridding human kind of sickness and disease. The truth is, EPIGENETICS is largely what determines your genetic expression, and if you don't understand this, it's critical you click the link and read the short post.