Diabetes and Erectile dysfunction
Erectile dysfunction is the ability to get or maintain an erection firm enough for intercourse. This condition is common in males who have diabetes, most especially with type 2 diabetes.
Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease. Erectile dysfunction might occur earlier in men with diabetes than in men without the disease. Difficulty maintaining an erection might even precede the diabetes diagnosis.
Having erectile dysfunction can be a real challenge. It can leave you and your partner feeling frustrated and discouraged. Take steps to cope with erectile dysfunction, and get your sex life back on track.
A normal male sexual function requires a complex interaction of vascular, neurological, hormonal, and psychological systems. The initial obligatory event is the acquisition and maintenance of an erect penis, which is a vascular phenomenon.
Normal erections require blood flow into the corpora cavernosae and corpus spongiosum. As the blood accelerates, the pressure within the intracavernosal space increases dramatically to choke off penile venous outflow. This combination of increased intracavernosal blood flow and reduced venous outflow allows a man to acquire and maintain a firm erection.
Diabetes and Erectile dysfunction Causes
Diabetes can cause ED because it can damage the blood supply to the penis and the nerves that control an erection. When a man becomes sexually aroused, a chemical called nitric oxide is released into his bloodstream. This nitric oxide tells the arteries and the muscles in the penis to relax, which allows more blood to flow into the penis. This gives the man an erection.
Men with diabetes struggle with blood sugar level swings, especially if their condition isn’t managed poorly. When their blood sugar levels get too high, less nitric oxide is produced. This can mean that there is not enough blood flowing into the penis to get or keep an erection. Low levels of nitric oxide are often found in those with diabetes.
Other causes of erectile dysfunction can be:
- Damage to blood vessels
Diabetes means there’s more sugar (glucose) in the bloodstream, and this can damage small blood vessels (called microvascular disease). This is what leads to kidney damage, loss of vision, and nerve pain. But, damage to small blood vessels in the penis also makes it harder to have and maintain an erection. That’s why ED is worse in men with long-standing, uncontrolled diabetes. Men with diabetes and high blood pressure may also see an increased risk of ED due to further damage to the vessels in the penis.
- Low testosterone levels
It’s estimated that 25% of men with diabetes have low testosterone levels. As testosterone has a large impact on sexual function in men, low testosterone can lead to ED.
Many men with diabetes may become depressed or have anxiety due to the stress of having to manage a difficult disease. Depression can lead to various issues with having an erection. One example is a lack of sleep that causes a loss of morning erections (“morning wood”), which is natural in healthy men. Anxiety can cause men to suddenly have a loss of an erection during sex or have difficulty making an erection.
- Medication side effects
Many men who have diabetes are treated with multiple medications to reduce their risk of heart problems or complications from diabetes. Some of these medications may also lead to ED by lowering blood pressure or causing other side effects that make an erection difficult.
- Pelvic injury or surgery on the prostate, bowel or bladder may cause damage to nerves connected to the penis. This nerve damage can also lead to ED.
Erectile dysfunction can as well be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease. Erectile dysfunction might occur earlier in men with diabetes than in men without the disease. Difficulty maintaining an erection might even precede the diabetes diagnosis.
Diabetes and Erectile dysfunction Test and Diagnosis
Having erectile dysfunction can be a real challenge. It can leave you and your partner feeling frustrated and discouraged. Take steps to cope with erectile dysfunction and get your sex life back on track.
For a doctor to diagnose erectile dysfunction, the following tests are some of the tests that will be done:
- Blood tests to check for a raised blood sugar level, which may indicate diabetes.
- Hormone tests to measure the levels of testosterone and other hormones.
- Nervous system tests, such as blood pressure and sweat tests, which can rule out nerve damage to the heart, blood vessels, and sweat glands.
- Urinalysis to test for sugar in the urine, which might indicate diabetes.
- Physical examination to assess the genitals and nerve reflexes in the legs and penis.
- Patient history to help determine why someone is having problems with erections and under what circumstances.
- Sexual health (SHIM) questionnaire to help diagnose the presence and severity of ED.
- Injection of a drug into the penis to check that the blood supply to the penis is normal.
Diabetes and Erectile dysfunction Control
Talk to an expert
When it comes to erectile dysfunction, many men are always reluctant to discuss their condition with their doctors because of embarrassment. however, one small conversation can make a big difference. Here are some of the things one can do:
Tell your doctor what’s going on.
Your doctor will consider the underlying causes of your erectile dysfunction and can give you information about medication and other erectile dysfunction treatments. Find out your options.
Ask if there’s anything you can do to better manage your diabetes.
Improving your blood sugar levels can help prevent nerve and blood vessel damage that can lead to erectile dysfunction. You’ll also feel better overall and improve your quality of life. Ask your doctor if you’re taking the right steps to manage your diabetes.
Ask about other health problems.
It’s common for men with diabetes to have other chronic conditions that can cause or worsen erectile dysfunction. Work with your doctor to make sure you’re addressing any other health problems.
Check your medications.
Ask your doctor if you’re taking any medications that might be worsening your erectile problems, such as drugs used to treat depression or high blood pressure. Making a change to your medications might help.
Anxiety and stress can make erectile dysfunction worse. Erectile dysfunction can also have a negative impact on your relationship with your intimate partner. A psychologist, counselor or other mental health specialists can help you and your partner find ways to cope.
Consider treatment options
Erectile dysfunction medications include sildenafil (Viagra), tadalafil (Cialis, Adcirca), vardenafil (Levitra, Staxyn) or avanafil (Stendra). These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see whether one of these medications is a safe choice for you.
If pills aren’t a good option for you, your doctor might recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base or side of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.
This device also called a penis pump or a vacuum pump is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection.
A band placed at the base of the penis maintains the erection after the tube is removed. This hand- or battery-powered device is simple to operate and has a low risk of problems.
If a vacuum-constriction device is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it’s made by a reputable manufacturer.
In cases where medications or a penis pump won’t work, a surgical penis implant might be an option. Semirigid or inflatable penile implants are a safe and effective option for many men with erectile dysfunction.
Practice good lifestyle
The following are some of the different approaches that can help make a difference in your life and improve erectile dysfunction and your overall health:
Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis.
If you’ve tried to quit on your own but couldn’t, don’t give up — ask for help. There are a number of strategies to help you quit, including medications.
Lose excess weight. Being overweight can cause — or worsen — erectile dysfunction.
Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
Limit or cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks a day for men age 65 and younger.
Diabetes and Erectile dysfunction Treatments
Treatment of ED will depend on the cause and there is a range of good treatment options. These are the same for men with diabetes and men who have ED from other causes.
Doctors can switch any prescription medications that may contribute to ED. The most common treatment is with oral tablets. These have been shown to work well in many men with diabetes, restoring sexual function. Certain drugs called PDE-5 inhibitors are used to treat ED.
The four most commonly prescribed are:
- Sildenafil (Viagra)
- Vardenafil (Levitra)
- Tadalafil (Cialis)
- Avanafil (Spedra)
These drugs cause an erection by increasing blood flow to the penis. They require sexual stimulation to be effective. They should be taken 30-60 minutes before sexual intercourse.
There are several other forms of treatment for ED. These include:
Hormone therapy: Testosterone replacement therapy is recommended for men with ED who show low levels of testosterone.
Penile injection therapy: Injection of alprostadil (Caverject) directly into the penis before intercourse has been approved for men who do not respond to oral drug therapy. This hormone injection increases the blood supply to the penis to produce an erection.
Vacuum pump therapy: A plastic tube connected to a pump is placed over the penis. The pump empties the air out of the tube and this causes blood to be drawn into the penis. A ring is then placed on the base of the penis to maintain the erection during intercourse.
Penile prosthesis: This is only considered when all other treatment options have failed as it requires major surgery. An inflatable rod is implanted into the penis to make it erect for intercourse.
Psychological support: If erectile dysfunction is caused by psychological conditions, such as anxiety or depression, the patient may benefit from counseling.
Diabetes and Erectile dysfunction FAQs
Why Do Men With Diabetes Have Erectile Dysfunction?
The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel, and muscle function. To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated.
Diabetes can damage the blood vessels and nerves that control erection. Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.
Can sexual and bladder problems be symptoms of diabetes?
Yes. Changes in sexual function or bladder habits may be a sign that you have diabetes. Nerve damage caused by diabetes, also called diabetic neuropathy, can damage parts of your body—like your genitals or urinary tract. For example, men with diabetes may develop erectile dysfunction (ED) 10 to 15 years earlier than men without diabetes.
When should I see a doctor about my sexual or bladder problems?
See a health care professional for problems with sex or your bladder. These problems could be a sign that you need to manage your diabetes differently. You may find it embarrassing and difficult to talk about these things. However, remember that health care professionals are trained to speak with people about every kind of health problem. Everyone deserves to have healthy relationships and enjoy the activities they love.
Is it safe for a diabetic to take Viagra?
Diabetic men with erectile dysfunction might consider a prescription for a drug like Viagra to be a permanent cure for a temporary issue.
Can you take metformin and viagra together?
No interactions were found between metformin and Viagra. This does not necessarily mean no interactions exist. Always consult your healthcare provider.