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Diabetes & Erectile Dysfunction: What's the Connection?

Diabetes & Erectile Dysfunction: What's the Connection?
Key Takeaways
  • Men with diabetes are more likely to experience erectile dysfunction due to nerve and blood vessel damage, with approximately 2 out of 3 diabetic men affected.

  • Controlling blood glucose levels is essential for preventing and managing erectile dysfunction in men with diabetes, as high blood sugar contributes to nerve damage and poor blood flow to the penis.

  • Healthy habits like regular exercise, a balanced diet, weight management, and avoiding smoking and excessive alcohol intake can improve both diabetes control and reduce the risk of erectile dysfunction.

Erectile dysfunction (ED) is common in men with diabetes; studies have found that approximately 2 out of 3 men with diabetes have erectile dysfunction. Continue reading to learn more about diabetes, and erectile dysfunction, their connection, and how they can both have an impact on men’s health.

What Is Diabetes?

Diabetes, a chronic disease in which blood glucose (blood sugar) levels are higher than normal, results from the body’s inability to produce insulin (type 1) or become resistant to insulin (type 2). Insulin is a hormone made by the pancreas that regulates the movement of glucose from the blood to the body’s cells for energy. When the body can’t utilize insulin properly, glucose stays in the blood and cannot get inside cells, leading to elevated blood glucose. 

Besides nerve damage, uncontrolled diabetes can cause damage to many organs in the body, including the kidneys, eyes, and heart. High blood sugar is also linked to erection problems in men. 

Effective treatments for diabetes are available. Men diagnosed with diabetes need to manage the condition and keep blood glucose levels in check to prevent diabetes-related health problems, including diabetes erectile dysfunction.

What Is Erectile Dysfunction (ED)? 

Erectile dysfunction (impotence) is an inability to get or keep an erection that is firm enough for satisfactory sexual intercourse.

Many men have occasional erection problems, and this is not a cause for concern. However, if erectile dysfunction (ED) is an ongoing problem, it should be evaluated to find the underlying cause. Erectile problems can be a sign of both mental health issues like depression and physical health conditions such as cardiovascular disease and diabetes. 

 

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Causes of Erectile Dysfunction in Men with Diabetes  

Physiological Causes

Yes, diabetes can cause erectile dysfunction. In men with diabetes, over time, high blood sugar levels cause damage to the nerves and blood vessels in the penis. This damage can contribute to problems with getting or keeping erections that are firm enough for satisfactory sex (erectile dysfunction).

Psychological Factors

ED can develop due to mental health issues like depression, stress, or relationship problems. The CDC says that people with diabetes are 2-3 times more likely to have depression. Therefore, there is a link between depression, diabetes, and ED in men.

Other Health Conditions

Erectile problems can be a sign of many medical conditions (see list below). Some of these conditions have common risk factors for diabetes, for example:

  • Hypertension (high blood pressure)

  • Hyperlipidemia (high cholesterol

  • Atherosclerosis (clogged blood vessels)

  • Heart disease

  • Obesity

  • Metabolic syndrome (high blood pressure, diabetes, high cholesterol, and central obesity)

  • Sleep disorders such as obstructive sleep apnea (OSA)

  • Lifestyle factors like smoking, alcohol use, or substance abuse

Other health conditions linked to erectile dysfunction (impotence) include:

Medication Side Effect 

Erectile dysfunction can be a side effect of certain over-the-counter and prescription medications, including:

Risk Factors and Warning Signs  

Common Risk Factors for Diabetic ED  

Common risk factors for diabetes and ED include:

  • Obesity

  • Inactivity or lack of exercise

  • High blood pressure

  • High cholesterol

Early Warning Signs of Erectile Dysfunction in Diabetic Men  

Early warning signs of erectile dysfunction in men with diabetes include:

  • Losing morning erections.

  • Being unable to get an erection sometimes, but not every time you want to have sex.

  • Being able to get an erection but not keeping the erection long enough for satisfactory sex.

  • Being unable to get an erection at all.

At What Age Are Diabetic Men Most At-Risk For Erectile Dysfunction? 

Erectile dysfunction is more common as men age, but men with diabetes may experience it earlier, even in their 30s or 40s. 

Because erectile dysfunction is more common in younger men with diabetes, many men are diagnosed with diabetes when they go to healthcare providers with complaints of erection difficulties.

Studies have also found that the severity of erectile dysfunction is highly dependent on the type, duration, and treatment of diabetes as well as the presence of other co-existing health conditions that increase the risk of ED. In other words, having diabetes mellitus type 2, having diabetes for a long time, having untreated diabetes, and having other risks like cardiovascular disease increases the risk of erection difficulties.

Diagnosis and Medical Evaluations: How Do Doctors Diagnose ED?  

Many men feel embarrassed about erectile dysfunction (ED). However, as mentioned, ED can be the first sign of serious health conditions such as diabetes and heart disease. In addition, ED itself can affect a person’s quality of life and relationships. It is, therefore, vital to get an early diagnosis and treatment for erectile dysfunction. 

Medical Tests and Procedures for Diagnosing ED   

A urologist can make a diagnosis of erectile dysfunction based on your symptoms, medical history, physical exam, and test results. This may include blood tests and urine tests. For example, your doctor may check testosterone levels and blood sugar levels. You and your partner may also be referred for a psychological evaluation to find out if there are psychological causes for ED. Your healthcare provider will also check to see if any of your medications could be causing erectile dysfunction.

Treatment Options for Diabetic Erectile Dysfunction  

Diabetes Management

If you have a diagnosis of diabetes and it is uncontrolled, the first step in treating erectile dysfunction will be better management of your blood glucose levels. As noted, high blood glucose can lead to vascular and nerve damage in the penis, which can cause erectile dysfunction.

Lifestyle Modifications  

Modifiable risk factors for erectile dysfunction include a lack of physical activity, an unhealthy diet, obesity, metabolic syndrome, smoking, and excessive alcohol consumption. Interestingly, these are also risk factors for diabetes. As mentioned, there is a known link between diabetes & impotence. Making lifestyle changes to correct these risks can help with both conditions (diabetes and erectile dysfunction).

Medications

Yes, Viagra (sildenafil) helps with ED due to diabetes. Medication options for men with ED include:

  • PDE-5 Inhibitors: A group of oral medications called phosphodiesterase 5 (PDE5) inhibitors are commonly used to treat erectile dysfunction. Examples of these drugs include sildenafil (Viagra), tadalafil (Cialis, Adcirca), avanafil (Stendra), and vardenafil (Levita, Staxyn). These oral medicines for erectile dysfunction work in the presence of sexual stimulation. They increase blood flow to the penis and make it easier to get and keep an erection.
  • Intraurethral suppository. If you do not want to or cannot take Viagra and other similar drugs, your doctor may recommend a urethral suppository called alprostadil (MUSE). This is a small drug pellet that you insert into the tip of your penis before sex. 

  • Penile injection. Intracavernosal alprostadil (Caverject) is an injectable treatment for ED that can be self-administered at the base or side of your penis. This injection drug also works by increasing blood flow to the penis.

Other Treatment Options for ED: Devices and Surgery  

  • Penile pumps: A penis pump, also called a vacuum erection device or vacuum pump, is a plastic tube that goes over your penis. It is connected to a battery-powered or hand-powered pump. It comes with a tension ring that helps to maintain the erection. Penis pumps are a good option for people who cannot take Viagra and other similar drugs due to side effects and those who prefer a non-drug treatment for ED. 

  • Penile implants: A surgeon can surgically place an inflatable or semi-rigid penis implant or penile prosthesis. This is usually recommended for men who have not responded to other treatments for erectile dysfunction. However, it is worth noting that penile implants should be used with caution in men with uncontrolled diabetes.

Prevention Strategies and Managing Diabetes  

Lifestyle Changes to Prevent ED and Diabetes

Lifestyle modifications that can help control both diabetes & erectile dysfunction

include:

  • Eating a healthy, well-balanced diet.

  • Getting regular exercise.

  • Losing weight if you are overweight or obese.

  • Stopping smoking if you smoke.

  • Avoiding alcohol or drinking in moderation (less than 2 drinks per day or 14 drinks per week for men is defined as moderate alcohol intake).

Managing Blood Sugar Levels for Improved Sexual Health  

As mentioned, high blood glucose levels cause blood vessel and nerve damage, which leads to erectile dysfunction and other men’s health conditions. Therefore, keeping blood glucose levels in check and following your doctor’s diabetes treatment plan is the best way to prevent erectile problems and improve your sexual health.

Long-Term Strategies for Reducing ED Risk

Managing diabetes and following the recommendations from your diabetes care team is the best way to reduce ED risk long-term. 

FAQs on Diabetes and ED

Can A Diabetic Man Get A “Hard-On”?

A diabetic man can get a “hard-on” (erection); however, a man who has diabetes is at a higher risk of experiencing erection difficulties (problems with getting and keeping an erection).

Is Diabetes ED Reversible?

Diabetes ED may be reversible in some men. However, sometimes ED symptoms don't improve even after getting your diabetes under control because the nerve damage has already occurred. Managing diabetes can stop ED and sexual function from getting worse. If you don’t see improvement in ED symptoms after getting your diabetes under control, talk to your healthcare provider about treatment options for erectile dysfunction. 

What Age Do Diabetics Get Erectile Dysfunction?

Diabetics can get erectile dysfunction at an earlier age, even in their 30s and 40s. Studies have shown that among men with diabetes: 

  • 15% have ED at age 30.

  • 55% have ED at age 60.

For comparison, ED is diagnosed in less than 10% of men under 40 years of age in the general population.

How Does Diabetes Affect Erectile Dysfunction?

Diabetes can cause erectile dysfunction (ED) due to blood vessel and nerve damage in the penis. In addition, uncontrolled diabetes can lead to worsening ED symptoms due to ongoing damage to penile tissues. The severity of ED has been linked to poor control of diabetes and the duration of diabetes. This means men with severe diabetes or longstanding diabetes are at a higher risk of severe erection problems and sexual dysfunction.

How To Increase Blood Flow To The Penis?

Ways to increase blood flow to the penis and treat erectile dysfunction include:

  • Taking oral medicines like Viagra.

  • Using a urethral suppository such as MUSE.

  • Injecting alprostadil into the base of the penis.

  • Using a penis pump (vacuum erection device).

What Is Often One Of The First Signs of Diabetes In Men?

Erection problems can be the first sign of diabetes in men. Besides diabetes impotence, other warning signs of diabetes include increased thirst, frequent urination, increased hunger, neuropathy (numbness and tingling in the hands and feet), and blurry vision.

References:

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  3. https://www.houstonmethodist.org/blog/articles/2021/aug/diabetes-erectile-dysfunction-did-you-know-theres-a-connection/

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  7. https://www.cdc.gov/diabetes/living-with/mental-health.html#:

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  17. https://www.bumc.bu.edu/sexualmedicine/patientinformation-physicians/diabetes-and-ed/#:

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