What is erectile dysfunction?
Erectile dysfunction (ED) is defined as “the persistent inability to get or maintain an erection that is satisfactory for sexual activity.” It is estimated that erectile dysfunction affects between 34% and 45% of adult men who have diabetes. The occurrence of ED can be episodic or chronic, and it can significantly affect a man’s quality of life and self-esteem.
What are the risk factors for erectile dysfunction?
- Age: Older men, especially those who have had diabetes for many years, are at higher risk of erectile dysfunction.
- Continually high blood glucose levels: Both type 1 and type 2 diabetes are significant risk factors due to the damage high blood sugar levels can cause to blood vessels and nerves.
- Cardiovascular disease: Conditions such as high blood pressure (hypertension) and high cholesterol levels can impair blood flow to the penis.
- Obesity: Excess weight can contribute to the development of diabetes and cardiovascular diseases, both of which are linked to ED.
- Smoking: Tobacco use can damage blood vessels and reduce blood flow to the penis.
- Medications: Some medications used to treat high blood pressure, depression, and other conditions can cause or worsen ED.
What causes erectile dysfunction?
The causes of erectile dysfunction are multifaceted, especially in individuals with diabetes. They can be broadly categorized into physiological and psychological causes:
- Vascular damage: Diabetes can cause damage to blood vessels, including those supplying blood to the penis, leading to reduced blood flow.
- Neuropathy: High blood sugar levels can lead to diabetic neuropathy, damaging the nerves that control erections.
- Hormonal changes: Diabetes can affect hormone levels, such as testosterone, which is essential for sexual function.
- Psychological factors: The stress of managing diabetes and its complications can contribute to anxiety and depression, further exacerbating ED.
How is erectile dysfunction treated?
The good news is that you don’t have to live with erectile dysfunction. There are some treatments available that can help you achieve and maintain an erection:
- PDE5 inhibitors (such as Viagra®, Cialis® and Levitra®) help men achieve and maintain an erection. With sexual stimulation, these drugs increase blood flow to the penis, allowing an erection to occur naturally. They can be used safely in most men with diabetes. However, they are not safe for men with certain heart conditions or men who take nitrates (which are used to treat angina).
- Mechanical devices, such as a vacuum tube and pump, draw blood into the penis to help achieve an erection.
- Lifestyle changes, such as adopting a healthy diet, exercising regularly, losing weight, quitting smoking, and limiting alcohol intake can improve ED.
- Counseling or therapy can help address psychological factors contributing to ED.
- In severe cases, surgical options such as penile implants may be considered.
Preventing or delaying erectile dysfunction
To ensure your overall health – and your sexual health – it makes sense to keep your blood glucose, blood pressure and cholesterol levels in their target ranges. If you smoke, try to quit. Maintaining a healthy lifestyle and managing stress are also beneficial. All of these initiatives will all lead to better overall health and, as a result, better sexual health.
Talk to your healthcare team!
It may be difficult to accept that you have erectile dysfunction, and even more difficult to talk about it. But sharing this information with your healthcare team is the only way that you can learn how erectile dysfunction can be treated, and then get the help you need. It’s perfectly natural to be embarrassed while talking about an intimate and personal issue. However, you’ll find that your healthcare team is well-equipped to discuss this with you in a professional and supportive manner.
