What is autonomic neuropathy (AN)?

Damage to the nerves that help your organs and organ systems to function can cause a condition called autonomic neuropathy (AN). This nerve damage disturbs signal processing between the autonomic nervous system and the brain. Injured autonomic nerves can affect your:

  • blood pressure
  • heart rate
  • perspiration patterns
  • bowel movements
  • bladder emptying
  • digestion

AN is often associated with other medical conditions and diseases and certain medications. Your symptoms may vary based on the cause of your neuropathy and the location of your nerve damage.

Factors that might cause injury to the autonomic nerves include:

The following people have an increased risk of AN:

  • older people
  • people with high blood pressure
  • people with high cholesterol
  • people who are overweight

Other factors that may increase your risk of AN include:

AN can affect many organs and cause an array of symptoms. Early symptoms of AN include dizziness or faintness when rising or standing, and vomiting or feeling nauseated when eating. You may also have disturbances in bowel movements, bladder control, or sexual functioning.

Other symptoms may affect the functioning of specific organs and organ systems:


The symptoms affecting your bladder may include frequent urinary tract infections and urinary incontinence or an inability to empty your bladder.

Digestive system

The symptoms of AN that affect your digestive system can include:

  • frequent indigestion or heartburn
  • vomiting undigested food
  • diarrhea
  • swollen abdomen
  • constipation
  • feeling full after eating a small quantity of food
  • poor appetite

Reproductive organs

The symptoms of AN that affect your reproductive organs can include:

  • erectile dysfunction
  • premature ejaculation
  • in women, difficulty achieving an orgasm
  • vaginal dryness

Heart and blood vessels

The symptoms of AN that affect your heart and blood vessels can include:

  • dizziness when rising or standing
  • fainting
  • difficulty breathing during exercise
  • rapid heart rate at rest
  • heart attack without any warning signs


The symptoms of AN that affect your eyes can include slow pupil adjustment from dark to light and difficulty driving at night.

Sweat glands

The symptoms of AN that affect your sweat glands can include dry skin on your feet and excessive sweating or lack of sweating.

Other symptoms

Other symptoms of AN can include unexplained weight loss and low blood glucose without warning signals, such as shakiness.

See your doctor if you have symptoms of AN. Early diagnosis may improve your outlook.

Your doctor will make a diagnosis based on your risk factors, observations during a physical examination, and test results. Your doctor may conduct the following tests:

  • breathing tests to evaluate blood pressure and heart rate
  • gastric emptying tests to assess your gastric motility and muscle activity
  • a quantitative sudomotor axon reflex test (QSART) to assess nerve reactions associated with the sweat glands
  • a blood pressure test when standing and sitting
  • a tilt-table test to monitor blood pressure during posture changes
  • a thermoregulatory test to look at your sweat patterns during temperature changes
  • urine tests to assess your bladder functioning
  • a bladder ultrasound to examine your bladder structure
  • abdominal X-rays to examine your digestive tract

Treatments for AN target the damaged nerves and any underlying condition causing injury to the nerves. Different treatments are available depending on your symptoms.

Digestive and gastrointestinal treatments include:

  • taking prescription medications to help with digestion
  • taking laxatives for constipation
  • consuming frequent, small meals
  • increasing your fiber and fluid intake
  • taking tricyclic antidepressants for stomach pain or loose stools

Bladder and urinary treatments include:

  • taking prescription medication to empty your bladder
  • taking prescription medication to reduce symptoms of overactive bladder
  • scheduling your drinking and urinating to retrain your bladder
  • threading a catheter through your urethra to drain the bladder

Sexual dysfunction treatments include:

  • taking medication to help bring about an erection
  • using a vacuum pump to force blood into the penis to cause an erection
  • using vaginal lubricants to combat dryness

Heart and blood pressure treatments include:

  • a high-sodium and high-fluid diet to sustain blood pressure
  • prescription medication to reduce dizziness when rising or standing
  • prescription medication to increase your blood pressure to combat faintness
  • beta blockers to regulate your heart rate with differing activity levels
  • changes in posture, flexing your feet, and slowing your speed when rising or standing to decrease dizziness
  • sleeping with your head elevated to reduce dizziness

Abnormal sweating treatment includes:

  • taking prescription medication to reduce excessive sweating

Addressing conditions that may cause neuropathy can help prevent its development. Some suggestions include:

  • Keep your blood sugar stable if you have diabetes. Eating a low-sugar and high-fiber diet might help regulate diabetes.
  • Stop smoking cigarettes. Talk to your doctor about treatments that can help you quit.
  • Stop drinking alcohol. Seeking the services of a counselor may be helpful.
  • Exercise daily to help manage certain health conditions and lose weight if necessary.
  • Prevent high blood pressure by drinking plenty of fluids, exercising regularly, and eliminating stressors.

Your outlook varies based on the cause of your nerve damage and how well it can be treated. In some cases, the nerves can repair themselves. In others, symptoms remain the same or even worsen despite treatment.