Treatment for diabetes and Erectile Dysfunction

 

If you are a man with diabetes, we’ve got good news and bad news about your sex life.

The bad news: Men with diabetes are three times more likely to report having problems with sex than non-diabetic men. The most common sexual problem is Erectile Dysfunction, or ED, sometimes called impotence. Even worse, because ED is such a private issue, many men feel embarrassed to discuss the problem with their doctor, or even their partner, so the problem is never addressed.

The good news: ED is one of the most treatable complications of diabetes. In fact, over 95 percent of cases can be successfully treated. With proven treatments available, diabetic men with ED have options. It isn’t something you—or your partner—should have to live with.

What ED Is—and What It Isn’t
ED means the repeated inability to achieve or sustain an erection sufficient for sexual intercourse. Although sexual vigor generally declines with age, a man who is healthy, physically and emotionally, should be able to produce erections, and enjoy sexual intercourse, regardless of his age. ED is not an inevitable part of the aging process.

ED does not mean:
• An occasional failure to achieve an erection. The adage is true: It really does happen to everyone. All men experience occasional difficulties with erection, usually related to fatigue, illness, alcohol or drug use, or stress. It isn’t fun, but it is totally normal.

• Diminished interest in sex. ED occurs when a man is interested in sex, but still cannot achieve or maintain an erection. Many men with diabetes also experience a decreased sex drive, often as a result of hormone imbalances or depression. Decreased sex drive is quite treatable, but it is treated differently from ED.

• Problems with ejaculation. Such problems often indicate a structural problem with the penis. The most common treatment is surgical.

How Diabetes Causes ED
Human sexual response requires several different body functions to work properly and together: nerves, blood vessels, hormones, and psyche. Unfortunately, diabetes—and even the treatment for diabetes—can affect many of these functions.

• Nerves: One of the most common complications of diabetes is neuropathy, or nerve damage. Erection is a function of the parasympathetic nervous system, but orgasm and ejaculation are controlled by the sympathetic system. Neuropathy to either system can cause ED.

• Blood Vessels: Diabetes damages blood vessels, especially the smallest blood vessels such as those in the penis. Diabetes can also cause heart disease and other circulatory problems. Proper blood flow is absolutely crucial to achieving erection. “Erection is a hydraulic phenomenon that occurs involuntarily,” says Arturo Rolla, MD, of Harvard University School of Medicine. “Nobody can will an erection!” Anything that limits or impairs blood flow can interfere with the ability to achieve an erection, no matter how strong one’s sexual desire.

• Hormones: Diabetes often causes kidney disease, and kidney disease, in turn, can cause chemical changes in the type and amount of hormones one’s body secretes, including the hormones involved in sexual response.

• Psyche: Psychological issues can cause a diminished sex drive, but they can also lead to ED even when sex drive is fine. ED can follow major life changes, stressful events, relationship difficulties, or even the fear of ED itself. The physiological changes associated with fear can themselves cause ED!

• Medications: About 25 percent of ED cases are caused by drugs. Many medications, including common medicines prescribed for diabetes and its complications, can cause ED. The most common offenders are blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug). In addition, over-the-counter medications, including certain eye drops and nose drops, have been associated with ED. That does not mean you should stop taking these medications! Rather, you should discuss them with your doctor to determine whether a different dosage, an alternate medicine, or additional treatments will resolve the ED.

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