Erectile Dysfunction and Diabetes: Is There a Link?

While erectile dysfunction and diabetes are two different conditions, it has been observed that they often tend to go hand-in-hand. Erectile dysfunction is defined as having difficulty in achieving or maintaining an erection all the way to ejaculation. Men who have diabetes are two to three times more likely to develop erectile dysfunction. At the same time, when men aged 45 and under suddenly develop erectile dysfunction, it may also be a sign of type 2 diabetes. So is there a connection between type 2 diabetes and erectile dysfunction? Let’s take a look.

Erectile Dysfunction and Diabetes: Is There a Link?

Men who have type 2 diabetes are nearly two to three times more likely to develop erectile dysfunction.(1) At the same time, if men who are aged 45 or under suddenly develop erectile dysfunction, it might be a symptom of type 2 diabetes. Diabetes occurs when there is too much sugar circulating in your bloodstream. There are two major types of diabetes – type 1 diabetes, which affects less than 10% of people who have diabetes, and type 2 diabetes, which accounts for over 90 percent.(2) Type 2 diabetes usually develops because of being overweight or having an inactive lifestyle. According to the American Diabetes Association, it is estimated that nearly 30 million Americans have diabetes, and around half of them are men.(3, 4)

Meanwhile, it is estimated that nearly ten percent of men between the ages of 40 to 70 years have severe erectile dysfunction, while another 25% have moderate erectile dysfunction.(5) Erectile dysfunction is more commonly observed as men age, though it is not necessarily an inevitable part of aging. For many men, there are underlying health conditions, such as diabetes, that contribute to the likelihood of getting erectile dysfunction.(6)

What Is The Science Behind This?

According to research carried out by the Boston University Medical Center, around half of men who are diagnosed with type 2 diabetes go on to develop erectile dysfunction within five to ten years after their diagnosis.(7) If these men also have heart disease, then the risk of becoming impotent is even higher.

However, according to findings from a 2014 study, if you have diabetes but adopt a healthy lifestyle and manage your blood sugar levels, you may be able to reduce your diabetes symptoms and also improve your sex life. Some of these lifestyle habits include exercising regularly and eating a balanced diet.(8)

What are the Causes of Erectile Dysfunction in Men with Diabetes?

The major association between diabetes and erectile dysfunction is connected to the nervous and circulatory systems. Unmanaged or poorly controlled blood sugar levels can cause damage to the nerves and small blood vessels. Damage to the nerves that control the main sexual stimulation and response in the body can have an effect on a man’s ability to achieve and maintain an erection firm enough to allow him to have sexual intercourse. Decreased blood flow from these damaged blood vessels can also be a cause of erectile dysfunction in men with diabetes.(9,10)

What are the Risk Factors for Erectile Dysfunction?

There are many risk factors that increase your likelihood of developing diabetes-related complications, like erectile dysfunction. You are more likely to be at risk if you:

  • Have poorly managed blood sugar levels
  • Have depression
  • Have an inactive lifestyle
  • Eat an unhealthy diet
  • Have anxiety
  • Are stressed
  • Are obese or overweight
  • Smoke
  • Drink excessive amounts of alcohol
  • Take medications that have erectile dysfunction as a possible side effect
  • Have uncontrolled hypertension
  • Have an abnormal blood lipid profile
  • Take prescription drugs for the treatment of depression, pain, or high blood pressure

How is Erectile Dysfunction Diagnosed?

If you suddenly find a change in the duration or frequency of your erections, you should let your doctor know or make an appointment with an urologist. Many men might feel embarrassed or shy to bring up these issues with their doctor, but remember that this reluctance to discuss the problem will only prevent you from getting the help that you need to fix the problem.

Your doctor will diagnose erectile dysfunction after reviewing your entire medical history and assessing all your symptoms. They are also going to perform a physical examination to check for any possible nerve problems in the penis or testicles. Urine and blood tests will also be prescribed as these can also help diagnose any problems, including diabetes or low testosterone.(11,12)

Your doctor will prescribe certain medications and also refer you to a healthcare professional who specializes in sexual dysfunction. There are many treatment options available for erectile dysfunction, and your doctor will work closely with you to find the best option that suits your individual condition.

In case you have not experienced any symptoms of erectile dysfunction yet, but you have been diagnosed with type 2 diabetes or heart disease, it is a good idea to discuss the possibility of a future diagnosis with your doctor so that you can start taking the required preventive steps from right now itself.

What is the Treatment of Erectile Dysfunction?

If you have been diagnosed with erectile dysfunction, your doctor will first recommend an oral medication, such as tadalafil (brand name Cialis), sildenafil (brand name Viagra), or vardenafil (brand name Levitra). These prescription medications will help boost the blood flow to the penis and have been found to be well-tolerated by a majority of men.(13,14,15)

If you have diabetes, it will not interfere with your ability to take these medications along with your diabetes medications. They are not known to interact adversely with any diabetes drugs, including insulin or Glucophage (metformin).

Although there are many other treatments for erectile dysfunction, including penile implants and pumps, it is better to begin the treatment with an oral medication first. The other treatments usually are not as effective as may lead to some additional complications.

Conclusion

Diabetes is a chronic health condition that you will have for the rest of your life. Nevertheless, both type 1 and type 2 diabetes can be managed well through proper diet, exercise, and medications. Although erectile dysfunction due to diabetes can become a permanent condition, this is usually not the case for men who experience occasional erectile difficulties. If you have diabetes, it is still possible for you to overcome erectile dysfunction by following a healthy lifestyle which includes getting proper sleep, no smoking, reducing your stress, and following a balanced diet.

References:

  1. 2021. [online] Available at: <http://diabetes.niddk.nih.gov/dm/pubs/sup/#men> [Accessed 2 December 2021].
  2. Centers for Disease Control and Prevention. 2021. National Diabetes Statistics Report, 2020. [online] Available at: <https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html> [Accessed 2 December 2021].
  3. Diabetes.org. 2021. Statistics About Diabetes | ADA. [online] Available at: <https://www.diabetes.org/resources/statistics/statistics-about-diabetes> [Accessed 2 December 2021].
  4. Cdc.gov. 2021. Diabetes Data and Statistics | CDC. [online] Available at: <https://www.cdc.gov/diabetes/data/index.html> [Accessed 2 December 2021].
  5. Bumc.bu.edu. 2021. Epidemiology of ED » Sexual Medicine » BUMC. [online] Available at: <https://www.bumc.bu.edu/sexualmedicine/physicianinformation/epidemiology-of-ed/> [Accessed 2 December 2021].
  6. Diabetes.org. 2021. Erectile Dysfunction | ADA. [online] Available at: <https://www.diabetes.org/resources/men/erectile-dysfunction> [Accessed 2 December 2021].
  7. Clinical.diabetesjournals.org. 2021. [online] Available at: <https://clinical.diabetesjournals.org/content/diaclin/19/1/45.full.pdf> [Accessed 2 December 2021].
  8. 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.
  9. Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., Faggiano, A., Pozzilli, P., Isidori, A. and Gianfrilli, D., 2021. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments.
  10. Kamenov, Z.A., 2015. A comprehensive review of erectile dysfunction in men with diabetes. Experimental and Clinical Endocrinology & Diabetes, 123(03), pp.141-158.
  11. Wang, C., Jackson, G., Jones, T.H., Matsumoto, A.M., Nehra, A., Perelman, M.A., Swerdloff, R.S., Traish, A., Zitzmann, M. and Cunningham, G., 2011. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes care, 34(7), pp.1669-1675.
  12. Diaz-Arjonilla, M., Schwarcz, M., Swerdloff, R.S. and Wang, C., 2009. Obesity, low testosterone levels and erectile dysfunction. International journal of impotence research, 21(2), pp.89-98.
  13. Hatzimouratidis, K. and Hatzichristou, D.G., 2005. A comparative review of the options for treatment of erectile dysfunction. Drugs, 65(12), pp.1621-1650.
  14. Goldstein, I., Lue, T.F., Padma-Nathan, H., Rosen, R.C., Steers, W.D. and Wicker, P.A., 1998. Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), pp.1397-1404.
  15. Mobley, D.F., Khera, M. and Baum, N., 2017. Recent advances in the treatment of erectile dysfunction. Postgraduate medical journal, 93(1105), pp.679-685.