Diabetes

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Updated 04 April 2018

Man talk: Let’s chat diabetes and erectile dysfunction

Diabetes can damage the blood vessels and nerves that control erections.

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Erectile dysfunction (ED) is common in men with diabetes, with a prevalence of 20 to 85%.1 Men who have diabetes are thought to develop erectile dysfunction between 10 and 15 years earlier than men who do not suffer from the condition, regardless of insulin dependency status.1

To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection. Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.2

The most common cause of erectile dysfunction is damage to arteries, smooth muscles and fibrous tissues which can in turn be caused by diabetes, kidney disease and multiple sclerosis.3

Unfortunately, ED can also be a side effect of some common medications for example those used for conditions such as high blood pressure and depression. Always ask your doctor if you're taking any medications that might be worsening your erectile problems as making a change to your medications might help4.

Even when the underlying cause of ED is physical, such as diabetes, psychological factors like anxiety can play an important secondary role when a man who has had some erectile difficulty starts to anticipate and fear sexual failure3

Treatment and management of erectile dysfunction

Although you may feel uncomfortable at first, it is important to speak to your healthcare professional as soon as possible so that he can determine the exact cause of your ED and work out a treatment plan accordingly.

Part of your treatment plan might include the following suggestions:

1. Maintain good glycaemic control 4

ED stems from damage to nerves and blood vessels caused by poor long-term blood sugar control. Improving your blood sugar levels can help prevent nerve and blood vessel damage that can lead to erectile dysfunction. You will also feel better overall and improve your quality of life.

2. Say no to bad habits 3,4

Try to limit or avoid habits such as smoking, and drinking alcohol3. Tobacco use, including smoking, can narrow your blood vessels which can lead to or worsen erectile dysfunction4. Excess alcohol can also contribute to erectile dysfunction so if you do drink, choose to do so in moderation4. Try to limit your daily intake of alcohol to one drink a day for men older than 65, and up to two drinks a day for men age 65 and younger4.  Follow a healthy, balanced eating plan and try to engage in regular exercise to help you lose weight, reduce stress and increase blood flow4.

3. Ask about other health problems 4

It can be quite common for men who have diabetes to be diagnosed with other chronic conditions that can cause or worsen erectile dysfunction. Work with your doctor to make sure you are taking care of all health problems you may be dealing with.

4. Seek counselling 4

Anxiety and stress can make erectile dysfunction worse and this could lead to a negative impact on your intimate partner. Remember that in addition to the number of oral medications and even injections that are available to treat ED, a psychologist, counsellor or other mental health specialist can also be of great benefit in order to help you and your partner find ways to cope with this condition.

Most importantly, always speak to your healthcare professional to find the right treatment plan for you that still enables optimal diabetes therapy.

References:

1. Awad H, Et al. Erectile function in men with diabetes type 2: correlation with glycemic control. International Journal of Impotence Research (2010) 22, 36-39

2. WebMD. (2017) Erectile dysfunction and diabetes. [online] Available at: https://www.webmd.com/erectile-dysfunction/guide/ed-diabetes[Accessed 14 February 2018].

3. Health24. (Updated 2017) Erectile dysfunction Condition Centre. Causes of and Treatment of Erectile dysfunction. [online] Available at: https://www.health24.com/Medical/Erectile-dysfunction/Overview/Treatment-of-ED-20140515[Accessed 13 February 2018]. Reviewed by Dr Dave Bowden MBBCh (Wits), FCS (SA) Urol. Specialist Urologist in private practice, Christiaan Barnard Memorial Hospital, Cape Town. (February 2015)

4. Mayo Clinic. (2018) Erectile dysfunction and diabetes: Take Control Today. [online] Available at:  https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20043927[Accessed 14 February 2018].

 

Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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