Your Love Life: How Diabetes Can Affect ED

We often talk about poor diabetes control leading to heart disease and eye disease but it also impact a man’s ability to have intercourse. That can impair sexual pleasure for both men and women.

Erectile dysfunction (ED) or its older, more common name, impotence, describes the inability of the penis to achieve and or maintain an erection firm enough for coitus.

Poorly controlled diabetes is a big time risk factor for ED. Men with diabetes are three times more likely to experience problems with erections than the general population and some estimates indicate as many as 50 percent of men with diabetes have trouble with ED at some point in their lives. That’s the same level of risk as heart disease and can put a significant dent in one’s quality of life.

ED strikes men with diabetes 10 to 15 years earlier than those without it. And like many of the other complications of diabetes, ED worsens with age, with the duration of diabetes and poorly controlled blood glucose levels, i.e. high A1Cs are a risk for ED.

Damage to the nerve cells (as occurs in neuropathy) or reduction of blood flow (as occurs in vascular disease) can impair the function of the sex organs as easily as those of the feet or stomach. The mechanical aspect of becoming erect is a consequence of blood flow to the penis.

In order to achieve an erection the nerves and blood vessels controlling the penis must be in good shape. During an erection, the autonomic nerves (those nerves that control the internal organs) send a signal to increase blood flow to the genitals and relax the muscle tissue allowing blood to flow in. These vital processes are disabled in those with diabetic complications.

Now diabetes and its complications are not the only cause of ED. However, many people with diabetes also suffer from many of the other contributing factors to ED such as atherosclerosis, high cholesterol, high blood pressure, obesity and low testosterone levels, which is why ED is so prevalent in this population. Having diabetes also predisposes you to low testosterone levels which can compound matters.

So if this is a problem, you are not alone! You can help yourself by:

  1. Keeping your blood glucose in good control.
  2. Stopping smoking
  3. Keeping  your blood pressure in good control
  4. Exercising
  5. Limiting alcohol to moderate levels
  6. Talking with your health care provider about the treatments available including
    — Oral medications (These medications work but are less effective for people with           diabetes than they are for the general public due to the possibility of nerve                     damage, as well as severity of ED)
    — Vacuum-constriction devices
    — Penile implants
    — Penile injection therapy

But neither a firm erection nor the mechanics of coitus itself does a great sex life make. ED can increase feelings of inadequacy, stress and anxiety, which can also impair sexual functioning. So although diabetes may be responsible for the physical aspects of ED, if it has been an issue for some time, physiological and emotional remedies may also be necessary.

And what about those stories about foods? Well… the scene from Tom Jones aside, unfortunately oysters, figs and shark cartilage have no magical properties that I know of.

1 Comment

  1. This not only effects the diabetic patient, but his/her spouse, leading to both partners developing emotional and psychological issues. It would be helpful if the diabetic patient’s primary care physician or endocrinologist would be up front about all consequences of diabets, not just providing intervention after a problem develops. Many diabetic patients live in denial of the dangers of the disease and don’t comply with the regimen recommended by the treating physician; this is greatly disturbing to family members who care for the diabetic and cannot understand why the diabetic is willing to take such risks that effect not just themselves. Diagnosis of diabetes should include mandatory nutritional classes and mandatory individual and family psychotherapy, as with any life-threatening chronic disease. I know, as I often am deeply hurt by my husband’s blatant disregard of medical advice, whether its not testing his sugar, taking insulin as directed, or eating unhealthy foods; at least one of these problems occurs each and every day. I have chosen to attend counseling on my own to obtain assistance with the pain this causes me, and the attending anger towards him, the disease, etc. Any advice?

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