Erectile dysfunction is a common problem faced by men who have diabetes. Erectile dysfunction refers to the inability to get or maintain an erection that is firm enough to allow sexual intercourse. It is especially common in men who have type 2 diabetes. It is estimated that around 35 to 75 percent of men with diabetes experience at least some extent of erectile dysfunction, also known as impotence or Erectile dysfunction, during their lifetime.(1, 2)
Even though diabetes and erectile dysfunction are two different conditions, but they often occur together. Men who have diabetes are nearly two to three times more likely to develop erectile dysfunction. And it has also been observed that men between the ages of 45 and under, who develop erectile dysfunction, might get diagnosed with type 2 diabetes.(3)
People develop diabetes when there is too much sugar circulating in the bloodstream. There are two major types of diabetes – type 1 diabetes and type 2 diabetes. Type 1 diabetes is the rarer form, affecting less than ten percent of the population, and type 2 diabetes accounts for over 90 percent of the diabetes cases in the world. One of the common causes of why people get type 2 diabetes is due to being overweight or obese or having a sedentary lifestyle.(4, 5)
It is estimated that ten percent of men between the ages of 40 to 70 have severe erectile dysfunction, while another 25 percent suffer from moderate erectile dysfunction.(6) Erectile dysfunction becomes more common as men age, though it is not always a natural part of aging. For many men, health conditions like diabetes often contribute to the chances of developing erectile dysfunction.
What Is The Link Between Erectile Dysfunction In Men With Diabetes?
According to the Boston University Medical Center, there are around half of men who are diagnosed with type 2 diabetes and go on to develop erectile dysfunction within five to ten years of receiving their diabetes diagnosis.(7) If these men also have cardiovascular disease, their likelihood of becoming impotent is much higher.
However, the results from a 2014 study show that if you have diabetes but change your lifestyle to a healthier one, you may be able to reduce your symptoms of diabetes and also improve the risks of getting erectile dysfunction while boosting your sexual health.(8) Some healthy lifestyle habits you should incorporate include eating a nutritious and balanced diet and exercising regularly.
The link between diabetes and erectile dysfunction in men with diabetes is connected to the circulatory and nervous systems. Poorly controlled blood sugar levels in diabetes can cause damage to the small blood vessels and nerves in the body. Such type of damage to the nerves that control sexual stimulation and response in men can cause a disruption in a man’s ability to get a firm enough erection that would allow him to have sexual intercourse. Reduced blood flow due to damaged blood vessels can also lead to Erectile dysfunction.
What Are The Risk Factors For Erectile Dysfunction?
There are many risk factors that are known to increase the chances of developing complications from diabetes, including erectile dysfunction. You may be at a higher risk if you have the following:(9)
- Chronic stress
- Poorly managed blood sugar
- Eat an unhealthy diet
- You are overweight or obese
- Having a sedentary lifestyle
- You are a smoker
- You drink excessive amounts of alcohol
- Take medications that have Ed as a side effect
- Have uncontrolled hypertension (high blood pressure)
- Take prescription drugs for depression, pain, or high blood pressure
- Have an abnormal blood lipid profile(9)
How Is Erectile Dysfunction Diagnosed?
If you have diabetes and you notice a change in the duration or frequency of your erections, you should let your doctor know or make an appointment with an urologist at the earliest. There is no doubt that many men feel embarrassed and find it difficult to bring up such issues with their doctor. However, your reluctance to discuss this problem will only worsen the problem and prevent you from getting the treatment you need.(10)
It is possible to diagnose erectile dysfunction by reviewing your entire medical history. Your doctor will assess your symptoms and perform a physical examination to check for any nerve problems in the testicles or penis. Urine and blood tests will be prescribed to help diagnose problems such as low testosterone or diabetes in those men who have not been diagnosed before.
Your doctor will also prescribe medication and refer you to a professional who specializes in sexual dysfunction. There are many treatment options for erectile dysfunction, and your doctor will work with you to find the best possible option for you.(11)
In case you have been diagnosed with type 2 diabetes or heart disease but have not experienced any symptoms of erectile dysfunction, it is a good idea to discuss the possibility of a potential future diagnosis with your doctor. They will be able to help you understand what preventive steps you should take from right now itself.
Treatment for Erectile Dysfunction
If you are diagnosed with erectile dysfunction, your doctor will first recommend taking an oral medication like Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil).(12) These prescription medicines work by improving the blood flow to the penis and are usually well-tolerated by most people.
In most cases, having diabetes does not interfere with your ability to have any of these medications. Neither do they interact negatively with any of the commonly prescribed diabetes medications such as metformin (Glucophage) or insulin.(13)
While there are several types of Erectile dysfunction treatment, including penile implants and penis pumps, you should generally begin by taking an oral medication first. These other treatments are not as effective and might lead to further complications.
Can You Prevent Erectile Dysfunction If You Have Diabetes?
There are many positive lifestyle changes that you can make to not only manage your diabetes better but also lower the risk of developing erectile dysfunction. These include:
- Control Your Blood Sugar Levels By Following A Healthy Diet: The most important thing you can do to cut down the risk of developing Erectile dysfunction and also to manage your diabetes better is to control your blood sugar by eating a diabetes-friendly diet. This helps you maintain your blood glucose levels and also reduces the amount of damage that happens to your nerves and blood vessels. A proper diet is geared at keeping your blood sugar levels under control and improving your energy levels and mood. Managing your blood sugar levels can also reduce the risk of erectile dysfunction. A good idea is to work together with a dietitian, especially one who is also a certified diabetes educator, to help you come up with the ideal diet plan.
- Stop Smoking: Smoking also narrows the blood vessels and also reduces the levels of nitric oxide in the bloodstream. This dramatically reduces the blood flow to your penis, which worsens erectile dysfunction.(14, 15)
- Reduce Your Alcohol Consumption: Drinking more than two drinks a day can cause damage to your blood vessels, which can cause erectile dysfunction. If you are even mildly intoxicated, it can make it difficult to get an erection and also interfere with your sexual functioning.(16)
- Stop Living A Sedentary Life: It is important to get active if you have diabetes. Including regular exercise in your daily routine will help control your blood sugar levels and also improve blood circulation improve, energy levels, and also reduce stress levels. All these can help you fight erectile dysfunction.(17)
- Manage Your Stress Levels: Stress is known to interfere with sexual arousal as well as the ability to get an erection. Meditation, exercise, and just making some time for yourself doing the things you enjoy can help lower your stress and also reduce the risk of developing erectile dysfunction. If you feel you have the symptoms of depression or anxiety, you should consider making an appointment with a mental health professional. They may be able to help you work through whatever it is that is causing you stress.
- Get a Good Night’s Rest: Sleep is essential for almost everything. Being tired can also be a cause of sexual dysfunction. Making sure to get an adequate amount of sleep every night can help significantly lower the risk of developing Erectile dysfunction.
Diabetes is a long-term or chronic health condition that you will have for the rest of your life. However, both type 1 and type 2 diabetes can be controlled and managed correctly through the right medication, exercise, and a proper diet.
While there is a chance of erectile dysfunction becoming a permanent condition, this is usually not the case for those who only experience erectile difficulties occasionally. If you have diabetes, it is possible to overcome erectile dysfunction by following a healthy lifestyle that includes no smoking, proper sleep, good nutrition, and reduced stress.
Medications for Erectile dysfunction are typically well-tolerated and do not interact with any diabetes medicines. These medications can be used along with your diabetes medicines for many years to manage any Erectile dysfunction issues.
- Malavige, L.S. and Levy, J.C., 2009. Erectile dysfunction in diabetes mellitus. The journal of sexual medicine, 6(5), pp.1232-1247.
- Kouidrat, Y., Pizzol, D., Cosco, T., Thompson, T., Carnaghi, M., Bertoldo, A., Solmi, M., Stubbs, B. and Veronese, N., 2017. High prevalence of erectile dysfunction in diabetes: a systematic review and meta‐analysis of 145 studies. Diabetic Medicine, 34(9), pp.1185-1192.
- 2022. [online] Available at: <http://diabetes.niddk.nih.gov/dm/pubs/sup/#men> [Accessed 13 August 2022].
- 2022. [online] Available at: <https://www.cdc.gov/diabetes/pdfs/data/2014-report-generalinformation.pdf> [Accessed 13 August 2022].
- Diabetes.org. 2022. Statistics About Diabetes | ADA. [online] Available at: <http://www.diabetes.org/diabetes-basics/statistics/> [Accessed 13 August 2022].
- Bumc.bu.edu. 2022. Epidemiology of ED » Sexual Medicine » BUMC. [online] Available at: <https://www.bumc.bu.edu/sexualmedicine/physicianinformation/epidemiology-of-ed/> [Accessed 13 August 2022].
- Goldstein, I., 2004. Epidemiology of erectile dysfunction. Sexuality and disability, 22(2), p.113.
- Maiorino, M.I., Bellastella, G. and Esposito, K., 2014. Diabetes and sexual dysfunction: current perspectives. Diabetes, metabolic syndrome and obesity: targets and therapy, 7, p.95.
- McMahon, C.G., 2019. Current diagnosis and management of erectile dysfunction. Medical Journal of Australia, 210(10), pp.469-476.
- Pastuszak, A.W., 2014. Current diagnosis and management of erectile dysfunction. Current sexual health reports, 6(3), pp.164-176.
- Levine, L.A., 2000. Diagnosis and treatment of erectile dysfunction. The American journal of medicine, 109(9), pp.3-12.
- Razdan, S., Greer, A.B., Patel, A., Alameddine, M., Jue, J.S. and Ramasamy, R., 2018. Effect of prescription medications on erectile dysfunction. Postgraduate medical journal, 94(1109), pp.171-178.
- Chu, N.V. and Edelman, S.V., 2002. Erectile dysfunction and diabetes. Current diabetes reports, 2(1), pp.60-66.
- McVARY, K.T., Carrier, S. and Wessells, H., 2001. Smoking and erectile
- dysfunction: evidence based analysis. The Journal of urology, 166(5), pp.1624-1632.
- Tostes, R.C., Carneiro, F.S., Lee, A.J., Giachini, F.R., Leite, R., Osawa, Y. and Webb, R.C., 2008. Cigarette smoking and erectile dysfunction: focus on NO bioavailability and ROS generation. The journal of sexual medicine, 5(6), pp.1284-1295.
- Cheng, J.Y.W., Ng, E.M.L., Chen, R.Y.L. and Ko, J.S.N., 2007. Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies. International journal of impotence research, 19(4), pp.343-352.
- Silva, A.B., Sousa, N., Azevedo, L.F. and Martins, C., 2017. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. British Journal of Sports Medicine, 51(19), pp.1419-1424.