Ejaculatory dysfunction in men with diabetes mellitus

Table 1 Ejaculatory behavior in diabetic animals

Ref.	Animal model	Effects observed on ejaculatory function	Type of treatment and response
Sach et al[31], 1982	STZ-induced diabetic rats	No sexual performance difference between diabetic and control rats.
Clark[32], 1995	STZ-induced diabetic rats	No sexual performance difference between diabetic and control rats.
Scarano et al[33], 2006	STZ-induced diabetic rats	No sexual performance differences in EL after 15 d.
Steger et al[34], 1990	STZ-induced diabetic rats	Prolonged EL (DE or AE)	Delayed insulin replacement (4 wk) cannot prevent ejaculatory dysfunction.
Murray et al[35], 1992	Diabetic BB/WOR rats	Prolonged EL (DE or AE) after 28 wk
McVary et al[36], 1997	Diabetic BB/WOR rats	Prolonged EL (DE or AE) after 40 wk, reduced number of ejaculations.
		No differences regarding serum testosterone, FSH, and LH.
Ebiko et al[37], 2006	STZ-induced diabetic rats	Deteriorated spontaneous seminal emission after 5 wk.	Early insulin replacement can prevent ejaculatory dysfunction.
		In 15 and 30 wk, occurrence of SSE was almost completely suppressed.
Yonezawa et al[38], 2009	Streptozotocin (STZ)-induced diabetic rats	Deteriorated spontaneous seminal emission after 5 wk.	Early insulin replacement can prevent ejaculatory dysfunction. Once dysfunction occurs, insulin cannot restore it.
		Decreased ejaculated semen and decreased seminal vesicle fluid.
Suresh et al[39], 2012	STZ-induced diabetic rats	Prolonged EL suggesting DE. -Low serum testosterone.	Mucuna pruriens showed recovery of EL.
De et al[40], 2016	STZ-induced diabetic rats	Prolonged EL suggesting DE. -Low serum testosterone.	l-Norvaline (arginase inhibitor) reduced EL.
Shi et al[41], 2017	STZ-induced diabetic rats	Prolonged EL suggesting DE.	Lycium barbarum polysaccharide reduced EL.
Li et al[42], 2019	STZ-induced diabetic rats	Prolonged EL at 62 d suggesting DE.	No effect of vitexin (herb) on EL.
Lert-Amornpat et al[43], 2016	STZ-induced diabetic rats	Lack of copulatory behavior suggesting AE.	Kaempferia parviflora (herb) showed recovery of EL.
Fernández-Collazo et al[44], 1970	Rats with subtotal pancreatectomy	They did not AE.
Hassan et al[45], 1993	STZ-induced diabetic rats	Rats exhibited AE in diabetics. -Low serum testosterone.	Sabeluzole treatment was beneficial to correct dysfunction.
Pontes et al[46], 2011	STZ-induced diabetic rats	Lack of the sperms ejaculated into the uterus. -Low serum testosterone.	Testosterone supplement did not restore ejaculatory function.
Ghaheri et al[47], 2018	STZ-induced diabetic rats	Shorten EL after 28 d suggesting PE.	Stevia Bertoni extract improved EL.
Minaz et al[48], 2019	STZ-induced diabetic rats	Shorten EL after 8 wk suggesting PE. -Low serum testosterone.	Inhibition of soluble epoxide hydrolase prolonged EL.

AE: Anejaculation; DE: Delayed ejaculation; EL: Ejaculation latency; FSH: Follicle stimulating hormone; LH: Luteinizing hormone; PE: Premature ejaculation; STZ: Streptozotocin.