More than seven in ten men attending diabetes clinics in a southern Nigerian city were found to have sexual dysfunction, and those affected were far more likely to rate their overall quality of life as poor, according to a cross-sectional hospital-based study published in Discover Endocrinology and Metabolism. Among the men with dysfunction, erectile problems were nearly universal, affecting 97.4 percent, and the link with diminished quality of life reached a statistical significance level of p < 0.0001.
The study, conducted by Unwana Osom, Unyime Eshiet and Paul Nwafor, recruited 213 male patients with type 2 diabetes mellitus aged between 30 and 75 years. Participants attended the diabetic outpatient clinics of two facilities in Uyo, Akwa Ibom State: the University of Uyo Teaching Hospital, a 500-bed tertiary centre serving more than three million people in the south-south geopolitical zone, and the University of Uyo Health Centre, a 21-bed secondary facility on the university campus. Recruitment ran over a twelve-month period from January 2016 to January 2017, with patients enrolled consecutively until the required sample size was reached.
The largest group of participants, 88 men or 41.3 percent, were aged between 50 and 59 years, and 52.6 percent had attained tertiary education. Men with acute psychiatric illnesses were excluded, and all participants gave written informed consent. Ethical approval came from the Health Research and Ethics Committee of the University of Uyo Teaching Hospital, with a single approval covering both study sites.
To measure sexual function, the researchers used the International Index of Erectile Function questionnaire, a 15-item instrument widely regarded as the gold standard outcome measure in erectile dysfunction research. It scores five domains of male sexual function on Likert scales: erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. Health-related quality of life was assessed with the World Health Organization quality of life instrument short version, known as WHOQOL-BREF, a 26-item generic questionnaire covering physical health, psychological health, social relationships and environmental health. Domain scores were transformed to a 4-to-20 scale, and respondents scoring below 50 in a domain were classified as having poor health-related quality of life, while those above 50 were classified as having good quality of life.
The headline result was that 153 of the 213 participants, or 71.8 percent, were identified as having sexual dysfunction. When the researchers examined the 153 affected men across the five domains of the questionnaire, dysfunction was high in every domain, with erectile dysfunction the most frequent form at 97.4 percent, with a 95 percent confidence interval of 93.4 to 99.3 percent. The authors noted that the majority of respondents with erectile dysfunction also reported problems with intercourse satisfaction, overall satisfaction and orgasmic function, which they attributed to the dependence of a satisfactory sexual act on adequate erection.
The association with quality of life was stark. Among participants who reported a poor overall quality of life, 85.6 percent were men with sexual dysfunction, while only 14.4 percent of men without dysfunction reported poor overall quality of life. The difference was statistically significant at p < 0.0001. The authors concluded that sexual dysfunction significantly impairs the health-related quality of life of male patients with type 2 diabetes, affecting overall quality of life as well as general health satisfaction.
Not every characteristic the team examined was linked to dysfunction. Chi-square analysis of socio-demographic variables including age, marital status, work status, educational level, ethnic group and income level found a significant association only with ethnic group. No significant associations emerged for the other characteristics, although the authors noted that previous research among clinically diagnosed diabetic patients has reported links between sexual dysfunction and age, increased weight, education level, employment status and income.
The 71.8 percent prevalence sits at the upper end of estimates reported elsewhere. The authors note that previous Nigerian research has indicated prevalence rates of roughly 60 to 80 percent, while across Africa estimates typically range from 50 to 75 percent, and global figures for men with type 2 diabetes generally fall between 35 and 75 percent. They attribute variation across studies to differences in sample sizes, study environments, diagnostic criteria and cultural factors influencing reporting, and suggest that higher-income countries may report slightly lower prevalence due to better diabetes management and earlier intervention. Erectile dysfunction itself has been reported in 30 to 85 percent of diabetic men in earlier studies cited by the authors, and is attributed to vascular damage, neuropathy and hormonal imbalances resulting from chronic hyperglycaemia.
The findings come with important caveats that the authors themselves set out. Because the study is cross-sectional, it cannot establish whether sexual dysfunction causes poorer quality of life or vice versa; the authors state that it is difficult to explain the causal association between the two. The data were self-reported and therefore prone to subjectivity. Selection bias is possible, since patients willing to participate may differ from those who decline. The authors also flag confounder bias: clinical parameters not assessed in the study, such as blood glucose, blood pressure and body mass index, could affect either sexual dysfunction or health-related quality of life. They additionally note that changes in clinical management, diagnostic criteria or population characteristics since the data were collected might affect the applicability of the findings to current practice, a consideration worth weighing given the 2016 to 2017 recruitment window.
Despite those limitations, the authors argue that the burden they documented justifies a change in routine care. They recommend that evaluation of male patients with type 2 diabetes for sexual dysfunction should form part of routine clinical assessment, with the aim of implementing suitable interventions to improve patients’ health-related quality of life. They point out that sexual dysfunction is a common and highly prevalent complication of diabetes that has been poorly diagnosed and treated, and that although it is not life-threatening, its impact on quality of life can be devastating because sexual function is considered one of the important indices of quality of life. They also cite prior work indicating that diabetic patients with erectile dysfunction show higher levels of frustration and discouragement, lower acceptance of their condition, worse metabolic control and higher levels of depressive symptoms, and that the presence of sexual dysfunction and diabetes is associated with increased risk of depressive symptoms. In a region where the authors describe information on sexual dysfunction and health-related quality of life as sparse, the study offers a detailed local estimate and reinforces a broader message from the international literature: sexual health deserves a place in comprehensive diabetes management for men.
Subject of Research: Prevalence of sexual dysfunction and its impact on health-related quality of life among male patients with type 2 diabetes in Nigeria
Article Title: Effect of male sexual dysfunction on the health related quality of life of persons with type 2 diabetes mellitus
Article References: Osom, U., Eshiet, U., & Nwafor, P. (2026). Effect of male sexual dysfunction on the health related quality of life of persons with type 2 diabetes mellitus. Discover Endocrinology and Metabolism, 2(1), Article 8. https://doi.org/10.1007/s44417-026-00020-9
Image Credits: AI Generated
DOI: 10.1007/s44417-026-00020-9
Keywords: type 2 diabetes, sexual dysfunction, erectile dysfunction, quality of life, men's health, Nigeria, cross-sectional study, IIEF questionnaire, WHOQOL-BREF, diabetes complications, Effect, male
News Source: Ophelia Keating. (October 29, 2026). Sexual Dysfunction Common and Tied to Poor Quality of Life in Men with Type 2 Diabetes. Scienmag.
