People with diabetes are at increased risk of developing diabetes erectile dysfunction (Ed). It is estimated that about half of men with diabetes also have ED. It occurs when the nerves and blood vessels in the penis are damaged and a person is unable to get or maintain an erection.
While this can be an embarrassing topic, the sooner you discuss it with your healthcare provider, the sooner you can treat it and improve your quality of life.
Learn more about erectile dysfunction, how diabetes affects it, prevention and treatment.
What is erectile dysfunction?
Erectile dysfunction (ED) occurs when you are consistently unable to obtain or maintain an erection strong enough for satisfactory intercourse. It is more common with age, and ED can occur about 10-15 years earlier in men with diabetes. However, age is not the cause, and there are often vascular, endocrine, or neurological factors that contribute to ED.
ED behaves differently in different situations. For example, you may not be able to get an erection when you want to have sex. This is sometimes common, but if it happens often, it can be problematic. Or you can get an erection, but not long enough for sexual intercourse. Some people cannot get a full erection.
Diabetes and ED
The development of ED in diabetic patients is complex and has many physiological and psychological factors. Many people with diabetes and ED also have underlying medical conditions, such as obesity, high blood pressure, and atherosclerosis (hardening of the arteries due to the buildup of plaque in the lining of arteries), all of which can lead to ED.
For a man to get and maintain an erection, they need adequate blood flow to the penis. Diabetes disrupts blood flow due to high blood sugar (hyperglycemia). Over time, elevated blood sugar reduces the amount of nitric oxide (NO) produced. NO helps relax the muscles of the penis and increase blood flow.
Low levels of NO are common in people with diabetes and those who are overweight or obese. Endothelial dysfunction, in which blood vessels narrow rather than dilate or open, is another complication of low NO levels caused by hyperglycemia.
Long-term high blood sugar can lead to neuropathy (nerve damage). Autonomic neuropathy increases the risk of ED by disrupting nerve impulses to the penis and reducing the body’s ability to relax the muscles of the penis.
People with diabetes have an increased risk of hormonal imbalances (such as low testosterone), another factor that contributes to ED.
Can ED be reversed?
Due to its complexity and multiple contributing factors, ED treatment may be involved. However, if people with diabetes are able to keep their blood sugar levels at target levels, ED can be prevented or delayed. This is not always simple, as diabetes self-management is also complex and multi-layered.
Controlling and maintaining blood sugar is an ongoing process. But you can find support, resources and education to help you achieve your goals. Here are some simple steps to get you on your way.
Meet with an expert
Whether you have just been diagnosed with diabetes or have had diabetes for many years, meeting with a Certified Diabetes Care and Education Specialist (CDCES) is an important step in your diabetes journey. CDCES specializes in all things diabetes related. They can customize plans to meet your individual needs and educate you on topics like meal planning, blood sugar management, diabetes medications, insulin injections, and more.
Research shows that meeting with CDCES and receiving diabetes self-management education (DSME) can help people improve blood sugar control, As well as reducing healthcare costs, losing weight and improving quality of life. Good blood sugar control is associated with preventing and improving ED and reducing the risk of diabetic complications.
There is no one-size-fits-all diet plan for people with diabetes. In fact, the American Diabetes Association (ADA) believes that meal plans should be tailored to the individual. People with diabetes should also be able to maintain the pleasure of eating.
A balanced and nutritious diet includes eating a variety of fruits, vegetables, whole grains, legumes, nuts, seeds, and lean proteins such as poultry, fish, lean beef, eggs, and low-fat dairy. The ADA supports high-fiber diets that are dense in whole foods and limit processed foods.
Understandably, we all have different preferences. Maybe you want to try a Mediterranean, flexitarian, or low-carb eating plan. Whichever method you choose, it’s important to understand that carbohydrates, such as grains, breads, fruits, starchy vegetables, snacks, and desserts, have the greatest impact on your blood sugar.
If your weight affects your blood sugar control, losing about 5% of your body weight can help you improve blood sugar control. In some cases, weight loss can actually relieve diabetes. Changing your eating habits can help you achieve and maintain your weight loss goals.
Exercise helps improve circulation and blood sugar control by increasing insulin sensitivity. People with diabetes are encouraged to exercise every day. The type and intensity of physical activity depends on your overall physical fitness, abilities and interests.
All types of physical activity, including aerobic exercise, resistance training, stretching, and reducing sedentary behaviors, have been shown to be beneficial and are a step toward helping to naturally increase testosterone levels (which may be lower in people with diabetes).
Get medical clearance from your doctor before starting any exercise program. Once you do, find something you enjoy doing and get started. Start slowly and increase gradually to prevent fatigue and burnout.
Smoking causes vascular dysfunction, which is a risk factor for ED. By quitting smoking, you may see improved blood flow. However, more research is needed. The current literature suggests that improvement is limited to younger men with a low smoking history and no comorbidities (other co-occurring conditions).On the other hand, quitting smoking has been shown to benefit overall health, including cardiovascular health.
Treatment of ED
Whether or not ED can be completely reversed depends on a variety of factors. A person’s overall health and the frequency, duration, and severity of ED are all contributing factors. Some studies show that nearly 95 percent of men with ED can be successfully treated. Although ED is more difficult to treat in men with diabetes, There are a variety of treatment options available.
Treatment for ED includes the same strategies needed to prevent it. Lifestyle changes, such as those mentioned above, can improve blood flow and blood sugar control. Additionally, ED patients with diabetes have a variety of medical and surgical options to choose from.
Talk to your healthcare provider
Since everyone’s ED is different, discuss your individual symptoms with your healthcare provider and make sure you remind them of the medications you’re taking. Certain medications, such as blood pressure medications and those used to treat depression, can cause ED. Sometimes simply changing medications can improve ED.
Certain medications can help increase blood flow. These may be contraindicated for people with diabetes, depending on their prescription medications and whether they have any comorbidities. Discuss your options with your healthcare provider.
Hormonal imbalances such as low testosterone can lead to ED. If you have diabetes, you are at increased risk of low testosterone levels, so hormone therapy may be needed.
Other options may include:
- vacuum device
- injection or suppository
- penile implants
ED can be stressful for you and your partner. Stress, anxiety, and worry can also make ED worse. Therefore, it is very important to seek help when needed. In fact, research shows that counseling can improve ED symptoms and sexual satisfaction alongside treatment of the disorder. A licensed mental health professional can help you find ways to cope.
Erectile dysfunction may be more common in people with diabetes, especially if you are older and have a history of high blood sugar or vascular disease. But ED is preventable and treatable. If you suspect you have ED, talk to your healthcare team right away. While this can be a difficult conversation, discussing your concerns will help you identify and deal with the problem. Your healthcare team can help you make lifestyle changes and educate you about potential treatment options. Having a healthy sex life can improve your quality of life and prolong your life.
Frequently Asked Questions
How Can Diabetics Overcome Erectile Dysfunction?
Lifestyle changes to improve blood sugar control, such as healthy eating, exercise, and smoking cessation, are important steps in the prevention and treatment of ED. If these changes don’t work, discuss medications and other treatment options with your healthcare provider. Seek help from a mental health professional for emotional support.
Can diabetes stop you from ejaculating?
Will not. Erectile dysfunction occurs when you are unable to achieve or maintain an erection for long periods of time. It has nothing to do with ejaculation.
What is the fastest way to cure ED?
There are no shortcuts to treating ED. However, achieving glycemic control and improving circulatory and vascular health are important steps in the treatment of ED. Discuss your specific concerns with your healthcare provider so they can develop the best plan for you.
Can metformin help with erectile dysfunction?
Glucophage (metformin) is an oral medication used with a healthy diet and exercise as first-line therapy for the treatment of type 2 diabetes. It can help improve ED by improving blood sugar control. However, other studies have shown that it can reduce the libido that leads to ED. More research is needed.