Erectile Dysfunction and Diabetes: Keys to Prevention and Treatment

Source: Mayo Clinic

Men with diabetes are about three times more likely to have erectile dysfunction than others. Here’s how to take steps to prevent or successfully treat it.

Erectile dysfunction is a common complication of diabetes. And left untreated, it can erode the quality of life for you and your partner. Sexual problems can increase your level of stress, frustration and discouragement; trigger depression; and even make you less likely to manage your diabetes effectively.

It doesn’t have to be that way, though. You can reduce your risk of developing erectile dysfunction, prevent it from worsening and, in many cases, safely and effectively treat it – enabling you to lead a satisfying sexual life.

What is erectile dysfunction?

Erectile dysfunction is the inability to achieve or sustain an erection of sufficient rigidity for sexual intercourse. That is, your penis fails to become or stay hard enough. Erectile dysfunction, also called impotence, isn’t fleeting or isolated sexual failure, which many men experience at some point in their life. Rather, it’s erectile failure more than 75 percent of the time during attempted intercourse. Erectile dysfunction isn’t the same as having low sexual desire or having problems with ejaculation and orgasm.

Any man can develop erectile dysfunction. But the condition has distinctive features among those with diabetes:

• It occurs more often. As many as 80 percent of men with diabetes develop erectile dysfunction, compared to about 22 percent to 25 percent of men without diabetes. More precise percentages are difficult to estimate because many men don’t talk to their doctors about the issue and because of variations in the way erectile dysfunction is defined.


• It occurs earlier. Erectile dysfunction most frequently develops after age 65. In men with diabetes, however, it tends to occur 10 or 15 years earlier, on average. Men in their 30s and younger with diabetes have also experienced erectile dysfunction.

The longer you’ve had diabetes and the more severe it is, the more likely you are to develop erectile dysfunction.

What causes erectile dysfunction?

Erectile dysfunction has many causes, both physical and psychological. It may not be the result of your diabetes. Medical conditions such as heart or liver disease can cause erectile dysfunction, as can surgery or trauma. Depression, stress and excessive worry about sexual performance can all interfere with normal erectile function, whether you have diabetes or not. And certain medications, such as those used to treat high blood pressure, can also cause temporary erectile dysfunction.

But when you have diabetes, the main risk factors for developing erectile dysfunction are:

• Nerve damage (neuropathy)


• Blood vessel (vascular) damage


• Poor blood sugar control

How diabetes affects normal sexual function

In men with diabetes, normal sexual function may be disrupted for a number of reasons related to nerve and blood vessel damage.

Diabetes can cause neuropathy or damage to nerves throughout your body, including the penis. Damaged nerves can’t communicate properly. So even though you might be emotionally stimulated to have intercourse, nerve damage means that information isn’t relayed to the penis, and it doesn’t respond.

In addition, poor blood sugar control can inhibit nitric oxide production. Lack of nitric oxide can prevent the pressure of blood in the corpora cavernosa from rising enough to close off penile veins, allowing blood to flow out of the penis instead of remaining trapped for an erection.

Blood vessels can also become narrowed or hardened (atherosclerosis) by conditions that often accompany diabetes, such as cardiovascular disease. When atherosclerosis occurs in arteries that supply the penis or pelvic area, sexual function may be disrupted.

What you can do

This sort of damage isn’t inevitable. And you can take steps to help prevent erectile dysfunction from occurring or worsening.

• Talk to your doctor. Initially, you might be embarrassed to talk to your doctor about sexual health. But because erectile dysfunction is a common diabetes-related problem, your doctor won’t be surprised when you mention the topic. Your doctor may ask you about it first, in fact. Talking to your doctor before a problem occurs can help you prevent or delay erectile dysfunction. Your doctor can also help determine if erectile dysfunction is the result of diabetes or another condition.


• Control your blood sugar. Good blood sugar control can prevent the nerve and blood vessel complications that lead to erectile dysfunction. If you’re having trouble controlling your blood sugar, talk to your doctor about refining your treatment strategy.


• Avoid tobacco. Smoking and other tobacco use cause blood vessels to narrow, contributing to blockages that can lead to erectile dysfunction. Smoking also can decrease nitric oxide levels.


• Avoid excessive alcohol. Drinking excessive amounts of alcohol can cause erectile dysfunction by damaging blood vessels. In general, for men that means no more than two alcoholic drinks a day, and for women, no more than one.


• See a urologist. Urologists have special expertise in sexual health. Some specialize specifically in erectile dysfunction. They can help assess your condition, determine its cause, and identify safe and effective treatments.


• Reduce your cardiovascular disease risk. Men with diabetes who also have cardiovascular disease, such as heart disease or high blood pressure, face an even greater likelihood of developing erectile dysfunction because of the added damage to blood vessels. Reducing your risk of developing cardiovascular disease, or taking the right steps to control existing conditions, can help prevent erectile dysfunction.

Knowing more about how diabetes-related complications can lead to erectile dysfunction may help you take measures to avoid the condition or prevent it from worsening.