Exercise Interventions and Sexual Function in Men with Type 2 Diabetes: A Multidimensional Narrative Review of Mechanisms, Clinical Evidence, and Practical Applications

Abstract

Background: Sexual dysfunction is a prevalent, underdiagnosed, and impactful complication of type 2 diabetes in men, involving multiple physiological, psychological, and social dimensions. This narrative review aimed to comprehensively examine the current evidence regarding the role of exercise interventions in improving sexual function among men with type 2 diabetes through a multidimensional lens.

Methods: A narrative review was conducted based on a systematic search of PubMed, Scopus, Web of Science, and Google Scholar databases. Eligible studies included clinical trials, systematic reviews, and basic research focused on exercise and sexual function in men with diabetes. The analysis addressed physiological mechanisms, clinical outcomes, psychological factors, and research gaps.

Results: The evidence suggests that exercise improves sexual function in men with type 2 diabetes through multiple pathways, including enhanced insulin sensitivity, increased testosterone levels, improved penile vascular function, and psychological benefits such as reduced performance anxiety, depression, and improved body image. The type, intensity, and duration of exercise were found to be crucial in determining the outcomes. This review also identified significant research gaps, such as the lack of long-term trials and limited focus on neurohormonal mechanisms.

Conclusion: It seems that exercise is a safe, non-pharmacological, and effective intervention with substantial potential to improve sexual function in men with type 2 diabetes. The findings of this review can inform integrated therapeutic protocols and guide clinical practices aimed at enhancing sexual health in this population. A personalized exercise approach, supported by a multidisciplinary team, is recommended as part of formal care for diabetic men experiencing sexual dysfunction.