Diabetes doesn't necessarily impair the sex lives of older adults, according to a new study.

The results show almost 70 percent of partnered middle-aged men with diabetes and 62 percent of partnered women with diabetes engaged in sexual activity two or three times a month, a rate comparable to that of middle-aged people without diabetes.

For some however, the disease does take a toll on both the desire and the rewards of sexual activity. Men diagnosed with diabetes were more likely to express a lack of interest in sex and to experience erectile dysfunction. Both men and women reported a higher rate of orgasm difficulties, such as climaxing too quickly (men) or not at all (men and women).

"Patients and doctors need to know that most middle age and older adults with partners are still sexually active despite their diabetes," said study author Dr. Stacy Lindau, associate professor of obstetrics and gynecology and of medicine at the University of Chicago. "However, many people with diabetes have sexual problems that are not being addressed."

Under-diagnosed diabetes

The survey, performed between July 2005 and March 2006, was part of the National Social Life, Health and Aging Project. It involved an in-home interview, a self-administered questionnaire, a medication audit and a blood test to assess diabetes status for 1,993 participants aged 57 to 85.

The researchers found, based on blood tests, that 47 percent of the men had diabetes. About 25 percent of men tested were aware they had diabetes, and 22 percent had the disease but had not yet been diagnosed. Almost 40 percent of women had diabetes: 20.5 percent were previously diagnosed and 19 percent were undiagnosed. These rates were comparable to those found in previous studies of people over 60, and consistent with the estimate of 12 million persons with diabetes in the United States over the age of 60.

Until now, very little has been known about sexuality among people with undiagnosed diabetes, who are typically earlier in the course of their disease and lack knowledge of their diagnosis.

The results suggest that some of the sexual problems experienced by patients with diabetes are not merely psychological, because some of the patients were unaware they had the disease, according to the reserachers.

"Ignorance of the diagnosis protects individuals from the psychological burden and stigma associated with having diabetes," Lindau said. "The elevated prevalence of orgasm difficulties in people unaware of their diabetes suggests that these are predominantly physical."

However, "The erectile dysfunction and loss of interest among men with a diagnosis may be due in part to the psychological burden of diabetes," she said.

Talking to a doctor

Women with diabetes who had a partner were more likely than men to avoid sex because of a problem, and were far less likely than men to discuss a sexual problem with their doctors, Lindau said.

"Failure to recognize and address sexual issues among middle-age and older adults with diabetes may impair quality of life and adaptation to the disease," said study researcher Dr. Marshall Chin, also a professor at the University of Chicago. "Sexual problems are common in patients with diabetes, and many patients are not discussing these issues with their physicians."

The results are published in the September issue of the journal Diabetes Care.