Sugar, Sex, and Your Health: Connections You may be ignoring

Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida School of Medicine.

When most of us think about sugar, we must not be thinking about our sex life. We’re thinking about desserts. I am writing this with the help of a bowl of vanilla ice cream by my side.

Sugar makes us feel good in that moment, but over time, too many can be lost in some of the most intimate moments of life.

In 2025, everyone was busy about GLP-1 injections, helping to control sugar and lose weight. This new class of medication has helped many people achieve meaningful health benefits, such as improving blood sugar levels, weight loss, and even improving people’s sex lives (as sleep can also be improved).

My goal here is not to underestimate the use of GLP-1 medications or to suggest that people are taking them unnecessarily (though it may be for some). My intention is to induce a broader conversation. What if we pay more attention to the underlying cause: our love for sugar and its downstream influence on mood, metabolism, gender, etc.?

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

Blood glucose levels can be checked in real time with a simple finger stick, either via a home glucose monitor or via wearable devices such as a continuous glucose monitor (a coin-sized device displayed on a person’s upper arm).

What do we see when this test is done? Below is the American Diabetes Association’s reference range for blood sugar levels, but it is not intended to diagnose diabetes. In many cases, providers can even double or triple check these numbers before labeling them with “diabetes.”

All figures should be evaluated by the health care provider.

Fasting blood sugar levels (no food at least 8 hours ago):

Random Blood Glucose (Photographed Anytime):

The Point of Care glucose test provides snapshots, but there is one lab that tells the complete story. It’s hemoglobin A1c.

What is hemoglobin A1c and why is it important?

This blood test measures the percentage of hemoglobin protein in the blood that has glucose attached to it. This gives you and your healthcare provider a photo of your average blood sugar for the past 2-3 months. This makes it a reliable indicator that your body manages glucose well over time.

Here’s how the American Diabetes Association breaks it down:

In my job as a surgeon, it is standard practice to check A1C before procedures, especially those involving implants. Elevated A1C levels are strongly associated with poor recovery, risk of infection, and surgical complications. So, whether it’s a major urological procedure or something else, it’s more important to suppress glucose than most people realize.

Sexual health is rarely associated with blood sugar levels first, but chronically high glucose levels can affect intimacy for everyone.

In men, hyperglycemia can damage nerves and blood vessels, which are essential to achieving and maintaining an erection. Over time, this may be present as erectile dysfunction before it is thought to be at risk for diabetes or diagnosed. Hyperglycemia can also lower testosterone levels, which reduces sexual desire and energy.

Many of my patients who do not receive routine screening from primary care providers come to see me because of changes in sexual performance. For these patients, their first clue that something was wrong was not thirst, weight change, fatigue (a more common early sign of diabetes), but trouble in the bedroom.

In women, hyperglycemia can lead to reduced blood flow and hormonal imbalances, leading to vaginal dryness, painful sex, or orgasmic issues. It can also increase the risk of recurrent urinary tract infections, which makes intimacy less painful or attractive. Many women can be frustrated and confused as to whether these changes are expected from aging, postmenopausal, stress, or something else. Low sugar levels are usually the last thing in their minds.

Diabetes is very common – about 38 million Americans have it – and nearly one in four people don’t know about it, according to the Centers for Disease Control and Prevention in the US.

Traditionally, diabetes treatment began with oral medications like metformin, which helped to lower glucose by reducing liver sugar production. Other classes of tablets work in a variety of ways, either by increasing the release of insulin or by helping the kidneys wash away excess sugar. These medications are usually prescribed in people with early stages of diabetes or mildly elevated A1C.

If oral pills are not sufficient to treat the illness, you may need an injectable medication. For years, it often meant daily insulin injections, but many patients found it to be burdensome but necessary. Insulin needs to be carefully timed with your diet and can be difficult to do. There is also real fear of hypoglycemic episodes. This may make some people hesitate to start or stick to treatment.

Over the past few years, GLP-1 receptor agonist drugs have become part of the treatment regimen of many people. This class of drugs is known by names such as semaglutide, liraglutide, and tilzepatide. These injections mimic natural hormones in the body to regulate blood sugar, slow digestion, and make you feel faster.

They were originally developed to treat type 2 diabetes, but are gaining global attention to helping people lose weight. In fact, many patients now ask and take these medications before other options to not only manage their glucose but also to lose weight.

According to a preliminary study presented at the Endocrinology Society’s annual meeting this week, these drugs could also help normalize testosterone levels in men with obesity or type 2 diabetes.

The researchers followed 110 men who were prescribed GLP-1 injections but were not receiving testosterone therapy. Over the course of 18 months, the number of men with normal testosterone levels increased from 53% to 77% as participants lost an average of approximately 10% of their body weight. This rise highlights how drugs originally designed for diabetes and weight loss can improve hormone levels in men.

While this summary has not yet been peer-reviewed and requires more research, these findings add to much of the evidence that managing body weight and blood glucose in almost every aspect of health, including testosterone, energy, and sexual function, can have ripple effects.

Before you turn to your medication immediately, don’t underestimate that you can make consistent lifestyle changes, not just for your blood sugar, but for the rest of your life.

Regular exercise improves sexual function by improving insulin sensitivity, supporting weight loss, increasing energy, and improving blood flow and hormone balance. A balanced diet – a diet rich in whole foods, fiber and lean proteins – can stabilize blood sugar and reduce inflammation that contributes to chronic disease. Better sleep, reduced alcohol and managing stress all play a role.

So, if you’re discussing between injections or new routines, this time you might reach the gym bag before trying anything else. You may notice that it changes more than your lab. It may change how you feel about yourself.

As for me, the next time I write, I remember that when I help out with an ice cream scoop, it’s not just my waistline, it’s about my energy, my mind, and my sexual health. And now, I’ve finished this post, so I’ll pick up my gym bag and take a walk here talking (to the gym).

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