A connection you can ignore

Dr. Jamin Brahmbhatt is a urologist and robotics surgeon with an associate professor at Orlando Health and Central Florida University.

When most of us think of sugar, I bet we don’t think about our sex life. We think of dessert. I am writing this with the help of a vanilla ice cream bowl.

Sugar makes us feel good at the moment, but over time, too much of it may lose some of the most intimate moments of our lives.

2025 Everyone was bustling for GLP-1 injections to help control sugar and lose weight. This new drug class has helped many achieve meaningful health care, including improved blood sugar, weight loss – and even improve people’s sex life (because they can also sleep better).

My goal here is not to relieve drug GLP-1 or to believe that people accept them unnecessarily (although some people may be). I am going to encourage a broader conversation: What if we also pay more attention to the main reasons: our love of sugar and its downstream mood, metabolism, sex and more?

Is your blood sugar normal?

Most people associate diabetes in blood sugar, but few know what is “normal”.

Blood sugar can be checked by a simple time with a simple finger rod, a home glucose monitor or through portable devices such as permanent glucose monitors (those coins size devices you can see on people’s upper hands) that provide all day feedback on glucose.

What do we see when this test is done? The following is the range of American Diabetes Associations associated with blood glucose levels, but they are not designed to diagnose diabetes. In most cases, your service provider may double or even triple these numbers before marking you with diabetes.

All numbers should be evaluated by your health care provider.

Fasting blood sugar (no food is at least eight hours):

• Normal: less than 100 mg/dl (milligrams in each deciliter)

• Prediabet: 100 to 125 mg/dl

• Diabetes: 126 mg/dl or greater

Random blood sugar (taken at any time of the day):

• Diabetes mellitus is often diagnosed with symptoms of 200 mg/dl or more.

The image of the glucose test point provides a instantaneous picture, but there is one laboratory that tells the whole story-Hemoglobin A1C.

What is hemoglobin A1C, and why is it important?

This blood test measures the percentage of hemoglobin protein in your blood, which attached glucose to it by giving you and your health care providers an image of average blood sugar in the last two or three months. This makes it a reliable indicator of how well your body controls glucose over time.

This is how the American Diabetes Association breaks it:

• Prediabet: 5.7% to 6.4%

As a surgeon, my work, checking A1C before any procedure, especially those involved in implants, is a standard practice. Increased A1C levels are strongly associated with poor recovery, risk of infection and surgical complications. So, whether it’s the main urological procedure or something else, keeping your glucose more than most people understand.

What is an elevated blood sugar in your sex life

Sexual health is rarely the first thing people associate with blood sugar, but chronically high levels of glucose can affect intimacy – everyone.

In men, high blood sugar levels can damage the nerves and blood vessels necessary to achieve and maintain an erection. Over time, this may be erectile dysfunction before a man is ever diagnosed or believed to be at risk of diabetes. High blood sugar can also reduce testosterone levels, which reduces libido and energy.

Many of my patients who do not receive the usual selection from their primary care providers come to see me because of changes in sexual activity – only later will they find that their blood sugar is not controlled. For these patients, the first understanding that something was wrong, there was no thirst, weight loss or fatigue (as many as possible signs of diabetes) – were a problem in the bedroom.

Women in high blood sugar can reduce blood flow and hormone imbalances, which can cause vaginal dryness, painful gender or orgasm problems. It can also increase the risk of recurring urinary tract infections, which may cause intimacy to be painful or less attractive. Many women may feel disappointed and confused about whether these changes are expected due to aging, menopause, stress or anything else. Poor sugar levels are usually the last one in their heads.

As treated with high blood sugar

Diabetes is incredibly widespread – according to US Disease Control and Prevention Centers, about 38 million Americans have it – and nearly 1 in 4 do not even know it.

Traditionally, diabetes treatment has begun with oral medications such as metformin, which helps reduce glucose due to reduced liver sugar production. Other classes of tablets work differently, increasing insulin release or helping the kidneys clean excess sugar. These drugs are usually given to people in previous stages of diabetes or with a mildly enlarged A1C.

Injections may be needed when oral tablets are not sufficient to treat the disease. For many years, this often meant daily insulin injections, which many patients found that there is a burden, but necessary. Insulin should be carefully planned with eating and dosage can be difficult. There is also a real fear of episodes of low blood sugar, which makes some people hesitant to start or adhere to therapy.

Over the past few years, GLP-1 receptor agonist medicines have become part of many people’s treatment regimes. This class of drugs is known by names such as Semaglutid, Liraglutide and Tiurzepatide. These injections mimic the natural hormone in your body, which helps regulate your blood sugar, slows down digestion and makes you feel more fuller.

Although they were originally developed for the treatment of type 2 diabetes, they received all over the world to help people lose weight. In fact, many patients now ask and receive these medicines against any other option – not only to control blood sugar, but also to lose weight.

Better sugar control can improve testosterone

These drugs can also help normalize testosterone levels in men with obesity or type 2 diabetes based on preliminary studies presented at this week’s annual endocrine society meeting.

Researchers followed 110 men who were given GLP-1 injections but had no testosterone therapy. In 18 months, when participants lost an average of about 10% of their body weight, the number of men with a normal testosterone level increased from 53% to 77%. This rise emphasizes how medicines for diabetes and weight loss can also improve the amount of male hormones.

Although this summary has not yet been reviewed and requires more research, this data increases more and more evidence that weight loss and blood sugar management may have almost all health aspects-including testosterone, energy and sexual function.

Try this heavier alternative first

Do not underestimate what consistent lifestyle changes can do not only because of blood sugar, but also for a lifetime.

Regular exercise improves insulin sensitivity, maintains weight loss, increases energy and even enhances sexual function by improving blood circulation and hormonal balance. A balanced diet rich in food, fiber and lean protein can stabilize blood sugar and reduce inflammation, which contributes to a chronic disease. Better sleep, reduced alcohol and stress management also plays an important role.

So if you are debating between the injection or a new routine, maybe this time reach the gym bag before trying something else. You may just notice that this is changing more than your laboratories. It can change how you feel yourself.

When it comes to me, next time I help myself to write that ice cream, I will remember that this is not just my waistline – it is about my energy, my heart and sexual health. And now that I finish this article, I’ll pick up my gym bag and walk (to the gym) I talk about here.

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