All men have trouble getting or keeping an erection sometimes. It is a perfectly normal part of life. It can happen when someone is tired, has drunk too much alcohol, or is just feeling a little distracted, for example.
Sometimes, it can happen regularly and get in the way of life and relationships. Doctors call this erectile dysfunction. It is a type of sexual dysfunction and it is common in lots of long-term health conditions.
Men with Type 2 diabetes are at a higher risk of
developing erectile dysfunction than the general population. That does not mean it is inevitable. There are things people can do to avoid the problem, and to deal with it if it does happen.
How are diabetes and erectile dysfunction linked?
There are lots of reasons for this. When a man has an erection, his penis fills with blood to make it hard enough for sex. But high blood sugar, or glucose, levels can damage the blood vessels
and reduce blood circulation and make it difficult for the blood to move into the penis. Diabetes can also damage the nerves
, which must be working properly if a man is to get and keep an erection.
Sometimes, erectile dysfunction might be a medication side effect. Drugs for high blood pressure or depression
, for example, can have this affect. Lots of men with diabetes take medication for other conditions.
Psychological factors also play a role. It is not easy living with diabetes sometimes. This can impact people emotionally and result in sexual problems. Sometimes, worrying if erectile dysfunction could make it worse, can sometimes mean that men find themselves stuck in a vicious circle.
Additionally, men with diabetes may experience other forms of sexual dysfunction. They may lose their libido, find they are unable to ejaculate, or they may ejaculate too early.
The good news is that most of these problems can be prevented or treated. The complications of diabetes are not caused by the disease, but by uncontrolled blood sugar levels.
How does sexual dysfunction affect men with diabetes?
Even though lots of men with diabetes experience erectile dysfunction, they can often find it difficult to talk about.
Sex is an important part of many people’s lives and relationships. Having Type 2 diabetes does not change that. Erectile dysfunction can leave couples feeling frustrated and damage the intimacy between them.
Lots of men who experience it find that it impacts on their wellbeing. Doctors call this a reduced quality of life. Not talking about it can make things even worse.
How is erectile dysfunction treated?
If you start to experience erectile dysfunction, it is really important that you speak to your healthcare team. There is nothing to be embarrassed about – doctors and nurses talk about these things all the time.
As a first step, they will usually see if there is anything you can do to better manage your blood glucose levels
. This will help to prevent the nerve and blood vessel damage that can lead to erectile dysfunction.
The healthcare team might also ask about your medical history and other health conditions. They will also check any medications that have been prescribed. Any of these things could be contributing to your sexual problems.
The healthcare team may also suggest counselling. Anxiety and stress can make erectile dysfunction worse, and erectile dysfunction can cause anxiety and stress. Talking it through might help to break this vicious cycle. It may also help to discuss their feelings with their sexual partner.
Erectile dysfunction cannot be reversed, but treatment options are available. Your healthcare team will be able to advise you which treatment is best for you.
Tablets such as sildenafil (Viagra) and avanafil (Stendra) work by making it easier for blood to get to the penis. Doctors call these oral medications PDE5 inhibitors.
Viagra can be bought over the counter at pharmacies. It is effective but not always suitable for everyone. Those who take certain heart disease medications
, for example, need to be careful.
Men should speak to their diabetes healthcare team before taking PDE5 inhibitors.
Not everyone can take PDE5 inhibitors. Sometimes, doctors might recommend other treatments that increase blood flow to the penis and help them to maintain an erection.
These include tiny suppositories that men insert into the tip of their penis before sex, or penis injections.
Doctors sometimes call this a penis pump. The man places the hollow tube over their penis, then uses a pump to draw blood into it. Before removing the device, the man places a band at the base of the penis. This helps the man to maintain the erection.
Can erectile dysfunction be prevented?
Not every man with diabetes will develop erectile dysfunction. Long-term, uncontrolled blood sugar levels can cause it, but not the condition itself.
The best way to prevent diabetes-related erectile dysfunction is to control blood glucose levels. For most people, this means working with your healthcare team to follow a care plan that will include
- taking any medicines as prescribed
- following a balanced diet
- maintaining a healthy weight
- staying physically active
- attending regular check-ups
Smoking and drinking alcohol are both risk factors for erectile dysfunction. They make it more likely because they reduce blood flow around the body, including to the penis. Avoiding them can also help men with diabetes to prevent sexual problems.
Of course, it is not always easy to make and stick with lifestyle changes. You should always remember that your healthcare team is there to help you with any questions and advice.