Erectile dysfunction is a common complication of
diabetes. And left untreated, it can erode the
quality of life for you and your partner. Sexual
problems can increase your level of stress,
frustration and discouragement; trigger depression;
and even make you less likely to manage your
doesn't have to be that way, though. You can reduce
your risk of developing erectile dysfunction,
prevent it from worsening and, in many cases, safely
and effectively treat it enabling you to lead a
satisfying sexual life.
dysfunction is the inability to achieve or sustain
an erection of sufficient rigidity for sexual
intercourse. That is, your penis fails to become or
stay hard enough. Erectile dysfunction, also called
impotence, isn't fleeting or isolated sexual
failure, which many men experience at some point in
their life. Rather, it's erectile failure more than
75 percent of the time during attempted intercourse.
Erectile dysfunction isn't the same as having low
sexual desire or having problems with ejaculation
Any man can develop erectile dysfunction. But the
condition has distinctive features among those with
more often. As many as 80 percent of men
with diabetes develop erectile dysfunction,
compared to about 22 percent to 25 percent of
men without diabetes. More precise percentages
are difficult to estimate because many men don't
talk to their doctors about the issue and
because of variations in the way erectile
dysfunction is defined.
earlier. Erectile dysfunction most
frequently develops after age 65. In men with
diabetes, however, it tends to occur 10 or 15
years earlier, on average. Men in their 30s and
younger with diabetes have also experienced
The longer you've had diabetes and the more severe
it is, the more likely you are to develop erectile
dysfunction has many causes, both physical and
psychological. It may not be the result of your
diabetes. Medical conditions such as heart or liver
disease can cause erectile dysfunction, as can
surgery or trauma. Depression, stress and excessive
worry about sexual performance can all interfere
with normal erectile function, whether you have
diabetes or not. And certain medications, such as
those used to treat high blood pressure, can also
cause temporary erectile dysfunction.
But when you have diabetes, the main risk factors
for developing erectile dysfunction are:
A look at normal
male physiology shows how these risk factors affect
contains two cylindrical, sponge-like structures
that run along its length. Those cylinders, the
corpora cavernosa, make up the bulk of the erectile
tissue of the penis. The corpus spongiosum is a
chamber that surrounds the urethra and becomes
engorged with blood during an erection. An artery
runs deep through the center of each corpus
cavernosum, allowing blood to flow in. Blood flows
back out through a system of veins around the
outside of each corpus cavernosum.
function requires the interplay of both the nervous
and vascular systems, as well as physical, sensory
and psychological events.
First, you become
sexually stimulated. In response, your body releases
neurotransmitters such as nitric oxide in the penile
area. These are chemical messengers, telling smooth
muscle cells in the erectile tissue to relax. When
they relax, the central artery and other blood
vessels widen, and blood rushes into the penis.
the corpora cavernosa fill with blood, the spongy
tissue presses up against the veins, compressing
them and preventing blood from flowing out of the
penis. That produces an erection as the trapped
blood straightens and stiffens the penis. When the
stimulation ends, the muscles contract, pressure
decreases and the penis becomes flaccid, returning
to its non erect size and shape.
Affects Normal Sexual Function
In men with
diabetes, normal sexual function may be disrupted
for a number of reasons related to nerve and blood
cause neuropathy or damage to nerves throughout your
body, including the penis. Damaged nerves can't
communicate properly. So even though you might be
emotionally stimulated to have intercourse, nerve
damage means that information isn't relayed to the
penis, and it doesn't respond.
In addition, poor
blood sugar control can inhibit nitric oxide
production. Lack of nitric oxide can prevent the
pressure of blood in the corpora cavernosa from
rising enough to close off penile veins, allowing
blood to flow out of the penis instead of remaining
trapped for an erection.
Blood vessels can also become narrowed or hardened
(atherosclerosis) by conditions that often accompany
diabetes, such as cardiovascular disease. When
atherosclerosis occurs in arteries that supply the
penis or pelvic area, sexual function may be
What You Can Do
This sort of damage isn't inevitable. And you can
take steps to help prevent erectile dysfunction from
occurring or worsening.
your doctor. Initially, you might be
embarrassed to talk to your doctor about sexual
health. But because erectile dysfunction is a
common diabetes-related problem, your doctor
won't be surprised when you mention the topic.
Your doctor may ask you about it first, in fact.
Talking to your doctor before a problem occurs
can help you prevent or delay erectile
dysfunction. Your doctor can also help determine
if erectile dysfunction is the result of
diabetes or another condition.
your blood sugar. Good blood sugar control
can prevent the nerve and blood vessel
complications that lead to erectile dysfunction.
If you're having trouble controlling your blood
sugar, talk to your doctor about refining your
tobacco. Smoking and other tobacco use cause
blood vessels to narrow, contributing to
blockages that can lead to erectile dysfunction.
Smoking also can decrease nitric oxide levels.
excessive alcohol. Drinking excessive
amounts of alcohol can cause erectile
dysfunction by damaging blood vessels. In
general, for men that means no more than two
alcoholic drinks a day, and for women, no more
urologist. Urologists have special expertise
in sexual health. Some specialize specifically
in erectile dysfunction. They can help assess
your condition, determine its cause, and
identify safe and effective treatments.
less invasive option is a vacuum tube that you place
over your penis. A gentle vacuum develops as you
pump air out of the tube, causing the penis to
become erect. Once enlarged, you can place a ring at
the base of your penis to maintain the erection.
health treatment. Stress, anxiety and
depression can cause erectile dysfunction. Even
the fear of having erectile problems can make
them worse. Talk to your doctor to see if these
issues are playing a role in your erectile
dysfunction. Treatment with a mental health
professional might help.
your cardiovascular disease risk. Men with
diabetes who also have cardiovascular disease,
such as heart disease or high blood pressure,
face an even greater likelihood of developing
erectile dysfunction because of the added damage
to blood vessels. Reducing your risk of
developing cardiovascular disease, or taking the
right steps to control existing conditions, can
help prevent erectile dysfunction.
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