Diabetes and erectile dysfunction (ED) are different health conditions but may occur in tandem. Erectile dysfunction is a condition where a man is not able to maintain or get an erection. It affects about 34% to 45% of Canadian men with diabetes. Moreover, men with diabetes may get ED 10-15 years earlier than the general population.

Diabetes is a long-term disorder where there is insulin resistance or deficiency. Insulin is a hormone produced by the pancreas and is essential for glucose absorption by the body cells.  In the case of insulin resistance (seen in type 2 diabetes) or insulin deficiency (seen in type 1 diabetes), cells cannot utilize glucose, increasing its level in the blood.

Unattended diabetes may cause damage to various body parts and systems. Erectile dysfunction in men with diabetes may stem from damaged blood vessels and nerves caused by abnormal blood sugar levels.

Besides, ED is also associated with other diabetes-related complications, such as heart disorders and hypertension Having ED with diabetes can be challenging. But managing these conditions will help you get sex back on track.

Type 1 diabetes and ED

Unmanaged high blood glucose levels with type 1 diabetes may increase the risk of ED. High blood sugar levels may damage blood vessels and nerves that may cause ED.

Type 2 diabetes and ED

While ED can happen to anyone, having type 2 diabetes just like type 1 diabetes, increases its risk. It is more common in men with type 2 diabetes than in type 1 diabetes. Besides, if men under the age of 45 develop ED, it may indicate type 2 diabetes.

Causes of ED with Diabetes

Numbers show that the risk of ED is 50% higher in men with type 1 or type 2 diabetes compared to those without it. Moreover, aging increases the risk of ED, but men with diabetes develop erectile dysfunction five to ten years earlier than the general population. 

The erection is a complex process and involves the nerves, muscles, and blood vessels. This means that to get a healthy erection, a man needs normal functioning of nerves, blood vessels, male hormones (testosterone), and an eagerness to be sexually stimulated.

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Uncontrolled diabetes results in high blood sugar that can damage nerves and blood vessels that influence erection. So, even with the desire to have sex and normal testosterone levels, you may not be able to get an erection. It is also essential to know that other ED causes include emotional issues, vascular disorders, or problems with nerves supplying the penis. Diabetes can cause or worsen these issues.

Here are some complications due to diabetes:

  • Low testosterone levels: It is seen that every one in four men with diabetes has low testosterone levels. As testosterone plays a significant impact on sexual health, low testosterone levels may cause ED.
  • Damage to blood vessels: Uncontrolled diabetes causes high blood sugar levels, damaging small blood vessels. This, in turn, may cause loss of vision, kidney damage, and nerve pain. Besides, damaged blood vessels may make it harder to maintain or get an erection. So, ED is worse in men with high blood sugar levels than the general population. Also, men with high blood pressure and heart disorders have an increased risk of ED.
  • Medication side effects: Men with diabetes are on multiple medicines to lower the risk of diabetes-related complications or heart problems. Some of these medicines may cause ED by lowering blood pressure or causing other adverse effects that may make an erection difficult.
  • Depression: Men with diabetes have an increased risk of anxiety or depression due to the stress of managing a long-standing condition. For instance, lack of sleep may cause loss of morning erections. Further, anxiety may cause loss of erection or make it difficult to maintain an erection.

Diagnosing ED

If you have diabetes and feel that the duration or frequency of erections has changed, consider consulting a doctor. It may be embarrassing to bring these issues with your physician, but avoiding talking can only keep you from managing the problem.

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Your doctor will ask you questions and perform a physical exam to find out nerve problems in the testicles or penis. Urine and blood tests can also help confirm issues such as low testosterone levels or diabetes.

Once ED is confirmed, they may prescribe you medicines or refer you to a specialist in sexual health. There are several treatment options for ED and your doctor can help you find the best suitable for you. 

Besides, even if you do not have ED symptoms but are diagnosed with heart disease or diabetes, you can discuss the probability of ED in the future with your doctor. They can help you with the precautions you can take now.

Preventing ED

If you have diabetes, there are many lifestyle modifications that not only help manage blood glucose levels but also lower the risk of ED:

  • Consume a healthy diet: Having diabetes-friendly foods will help control blood sugar levels and prevent damage to the nerves and blood vessels. A healthy diet that keeps a check on your sugar levels can also improve your mood and energy levels, which lowers the risk of ED. You can take the help of a dietitian to curate a diet plan to manage blood sugar levels.
  • Limit your alcohol intake: Consuming more than two drinks per day may damage blood vessels and cause ED. Besides, being mildly intoxicated may interfere with your sexual functions.
  • Exercise: Being physically active improves blood circulation, maintains blood sugar levels, improves your energy, and lowers your stress levels. All these may help combat ED.
  • Stop smoking: Smoking decreases nitric oxide levels and narrows blood vessels. This lowers blood flow to the penis, worsening ED.
  • Manage your stress levels: Stress alters your ability to get an erection and sexual arousal. Meditation, exercise, and doing things you like will help to keep your stress levels down, lowering the risk of ED. If you feel you are developing symptoms of depression or anxiety, consult your doctor. They will help you with a therapist who will guide you to work through anything that may be causing stress.
  • Get adequate sleep: Better sleep improves your mood. It also combats fatigue that is a cause of ED So, get enough sleep to lower the risk of ED.
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Treating ED in Diabetes

If your doctor feels you have ED, they will mostly recommend oral medicines such as tadalafil (Cialis), sildenafil (Viagra), or vardenafil (Levitra). These are prescription medicines that improve blood flow to the penis.

As diabetes or medicines used for diabetes do not interfere with your ability to take medication, it is safe to take them unless advised otherwise by your doctor.

Other treatment options are available, such as penile implants and pumps, if the medicines fail to help. 

Living with Diabetes and Sexual Health Care

Following the lifestyle changes mentioned above and managing blood sugar levels usually help reverse minor sexual problems, and it will be possible for you to achieve an erection.

Meanwhile, you can also try the following:

  • Just go with the flow. Planning does help, but do not get nervous if sex happens instantaneously. 
  • Approach sexual activity just like exercise. This will make you less apprehensive about the activity.
  • You can also prepare a sex arsenal kit. This can include anything you may need for optimal sexual experiences, such as test supplies or glucose tablets.
  • Get creative. You can try watching porn together, trying different positions, and massaging each other. This will help keep you feel close to your partner. 
  • Get help for emotional issues or mental health problems such as anxiety and depression. 

Final Thoughts

Diabetes is a long-standing condition, but both type 1 and type 2 diabetes can be well-controlled through diet, medications, and exercise.

Although ED may be long-standing, it is not the case in many cases. It is important to remember that if you have diabetes, you may still be able to reverse ED through medicines and lifestyle modifications, such as not smoking and sufficient sleep. ED medicines are tolerated by most men with diabetes and can be used for many years to overcome ED.

You can work with your physician and dietitian to manage glucose levels and prevent ED.

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