Signs and symptoms of autonomic neuropathy vary, depending on which parts of your autonomic nervous system are affected. They may include:

  • Dizziness and fainting upon standing caused by a drop in blood pressure.
  • Urinary problems, including difficulty starting urination, urinary incontinence and an inability to completely empty your bladder, which can lead to urinary tract infections.
  • Sexual difficulties, including problems achieving or maintaining an erection (erectile dysfunction) or ejaculation problems in men, and vaginal dryness and difficulties with arousal and orgasm in women.
  • Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach (gastroparesis). This can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.
  • Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature.
  • Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night.
  • Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level.

When to see a doctor

Seek medical care promptly if you begin experiencing any of the signs and symptoms of autonomic neuropathy. If you have diabetes, a compromised immune system or another chronic medical condition, see your doctor regularly to be checked for nerve damage.

The American Diabetes Association (ADA) recommends that people with type 2 diabetes be screened every year for autonomic neuropathy starting as soon as they receive their diabetes diagnosis. For people with type 1 diabetes, the ADA advises annual screening beginning five years after being diagnosed with diabetes.

Jul. 12, 2012