Diabetes and erectile dysfunction

The hallmark of diabetes is a raised level of glucose (sugar) in the blood. There are a number of reasons why men with diabetes are particularly prone to erectile dysfunction. Diabetes can damage the nerves, the erectile tissue and small blood vessels in the penis, as well as other tissues in the body. This can cause erectile dysfunction - the medical term for impotence and you should talk to your doctor about this.

Damage to the nerves, known as neuropathy, may mean that there is less sensation in the penis and less signalling to it from the brain, making it more difficult to get and maintain an erection. Damage to the erectile tissue will prevent the muscle fibres within it from adequately relaxing, so that the penis cannot fill with blood during erection. Damage to the blood vessels will also prevent the erectile tissues from filling with blood. This is why diabetes and erectile dysfunction are closely linked.

Smoking and poor control of blood sugar makes these diabetic complications more likely, so it is important that your antidiabetic treatment is optimised to gain good control of your blood sugar. Stopping smoking is always a good idea.

In addition, men with diabetes are more prone to high blood pressure, and many of the medicines used to treat high blood pressure can be responsible for causing ED.

Type 2 diabetes is the commonest form and is the type generally found in people over 40. In this condition people are still able to produce insulin - the essential hormone that controls our blood glucose level – but they do so inefficiently. Treatment is usually with diet restriction and oral tablets to lower the blood sugar, although occasionally insulin may also be used.

Type 1 diabetes is more common in younger people and is due to a lack of insulin production. Type 1 diabetes always needs to be treated with insulin injections.

The complications of long-standing diabetes, such as erectile dysfunction, are common to both Type 1 and Type 2 diabetes.

Many people with Type 2 diabetes are overweight and many of them have only mild symptoms (such as thirst and the desire to pass urine more often) for years before the diabetes is even noticed. Unfortunately, having mild symptoms does not mean that the diabetes isn't causing some nerve and artery damage, and a high proportion of people newly diagnosed with Type 2 diabetes already show problems such as ED by the time they are recognised to have diabetes.

Treatment for erectile dysfunction

If you have diabetes and feel that it has caused problems with your sex life, you should discuss it with your doctor. Then s/he can check if there are significant problems with the arteries or the nervous system and occasionally these aspects might need special attention in their own right.

Fortunately, the treatment of erectile dysfunction in diabetes has improved considerably over the last decade. There is no reason why diabetes should bring a couple's sex life to a halt. Often the first step - recognition of the problem - is the biggest hurdle.