Although erectile dysfunction has been largely ignored by physicians in the past as being attributable to either advancing years or emotional issues it is now widely accepted as a significant complication of being a diabetes sufferer.
This is largely due to the fact that the mechanics of male sexual function are far better understood and studies into erectile dysfunction in men with diabetes show that it’s incidence ranges from 35 - 75% as opposed to 26% in the male population as a whole. It has also been shown that the onset of ED in men with diabetes 10 - 15 years earlier than the male population as a whole.
Firstly we need to differentiate between type 1 and type 2 diabetes
The body does not have the ability to produce enough insulin; this type can affect people of any age
The body develops a resistance to insulin as a result of insulin overproduction. This tends to occur in people over the age of 45
The causes of ED in men suffering from diabetes can be quite complex but generally speaking, it is associated with reduced blood supply to the penis alongside damage to the nerves which are responsible for the erection process. In addition, decreased levels of testosterone production in diabetic men may be another factor to consider.
High blood sugar levels, which can occur in either type of diabetes can cause problems including irreversible nerve damage and narrowing of blood vessels. Both these effects can cause erectile dysfunction as the nerve damage affects the function and sensitivity of the penis the constriction of blood vessels to the penis will affect its ability to engorge with blood and so become erect.
In addition, there are conditions which may contribute to erectile dysfunction that men with diabetes are more likely to suffer from such as hypertension (high blood pressure), heart problems, hormone production issues and depression. To further add to this, many of the medications, including those for hypertension and depression can cause erectile dysfunction
There are other contributory lifestyle choices which may have a bearing on ED in diabetic men:-
If blood sugar levels are managed properly then erectile dysfunction problems can improve but if this has been done and the ED problems do not improve it is worth speaking to your GP in order to rule out any other possible underlying causes.
There are now a number of drugs available including Viagra, Levitra and Spedra which may be suitable for men with diabetes. However, there are some drugs used in the treatment of diabetics such as blood thinners and alpha-blockers that may interact with the ED drugs so this should be discussed with your doctor who can help decide which drug or treatment is most suitable in your particular case
Sildenafil (Viagra) was first licenced in the UK in 1988 and it has been used to successfully treat diabetic and non-diabetic men ever since. Whilst around 50% of men with type 1 diabetes and around 60% of men with type 2 diabetes report improved erections there are still a large number of diabetic men with erection issues who do not respond. So what can we do to help these men?
It may be that the user has experienced very bad side effects from the drug which renders them an unsuitable therapy. Possible side effects include severe headaches, temporary vision issues and congestion.
If the drugs fail to improve the ED it may be as a result of the user not experiencing any sexual or genital stimulation before attempting intercourse. Adequate stimulation is required in order for ED drugs to work properly.
It has also been found that a high-fat meal eaten before or at the same time as taking the drug can reduce its absorption in the gut which in turn will affect its efficacy
Finally, anxiety surrounding sexual intercourse will interfere with the ability to achieve and maintain an erection with or without the drugs!
It may be that the sufferer needs to work more closely with his doctor to ensure that he is taking the drugs properly, for example, by avoiding high-fat food whilst taking the drug and engaging in foreplay before sexual intercourse.
There are other approaches that can be taken like varying the dose of the drug or taking a lower dose of the drug daily or switching to another type of oral medication. We can also consider using oral drugs in combination with a vacuum pump or a penile injection of Alprostadil
It is also worth checking the testosterone levels of the sufferer to ensure that a testosterone supplement isn’t required
I think that the message is ‘don’t give up at the first attempt’!
Diabetes and erectile dysfunction https://www.diabetes.co.uk/diabetes-erectile-dysfunction.html
Erectile dysfunction and diabetes https://www.nhs.uk/news/heart-and-lungs/erectile-dysfunction-and-diabetes/
Diabetes and erectile dysfunction https://clinical.diabetesjournals.org/content/19/1/45
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Effective for up to 4 hours
For daily or intermittent use
Effective for up to 5 hours
Works in 15-30 minutes
Sildenafil, Tadalafil, Vardenafil
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