It is estimated that approximately 50% of men with diabetes will experience erectile dysfunction (impotence) as a result of their condition. It can be estimated as up to 75% from some sources. To discover the link between the two and advice on combating both conditions, read on.

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Can type 2 diabetes cause erectile dysfunction?

Erectile dysfunction is approximately two to three more likely to occur in men with diabetes (type 1 and type 2) than men without the chronic condition. Diabetes is a slow-building disease with long-term implications that will damage nerves and blood vessels due to blood sugar levels. This nerve damage can spread around the body thus affecting the erection process in many men. Men with diabetes are also more likely to experience impotence at a younger age. Diabetes.co.uk say that men with diabetics may develop impotence "between 10-15 years earlier" than men without diabetes. The risk factors include:

  • If your blood pressure isn't controlled
  • Stress, anxiety or depression
  • Poor diet including food and drink
  • If you aren't active
  • If you are overweight or obese
  • Excessive alcohol consumption
  • Certain medications (including type 2 diabetes medication)
  • If you don't managed blood sugar effectively

How common is erectile dysfunction and diabetes

A number of sources state different figures but the overall analysis is that it is common to have both conditions simultaneously.

Webmd.com states that the estimate is in-between "35%-75% of men" with diabetes will develop some form of sexual dysfunction. This doesn't mean you'll have both conditions from the very beginning, or you're guaranteed to get impotence if you have diabetes, but it's A) more likely and B) more likely to develop later on in life. This is compared to roughly 26% of the general population. Luckily, lifestyle factors can be adjusted and treatment options are available to help combat both conditions.

Healthline states that men with diabetes are at least twice as likely to develop erectile dysfunction as a result of the chronic condition than men without, with approximately 50% of men diagnosed with type 2 diabetes developing ED within 10 years.

As mentioned above, all sources agree that diabetes diagnosis does increase the likelihood of experiencing impotence at a younger age. There is also an increase with age whether you have been diagnosed with diabetes or not.

  • You are up to 35%-75% more likely to develop erectile dysfunction if you have been diagnosed with diabetes.
  • Men with diabetes may experience impotence between 10-15 years earlier than men without diabetes.
  • You are 50%-60% more likely to be diagnosed with ED over the age of 50 if you have diabetes.
  • You are 95% more likely to be diagnosed with ED if you're over the age of 70 and you have diabetes.

It's important to note that obviously age plays a key factor in the diagnosis.

Is erectile dysfunction caused by diabetes reversible?

Treatment for type 2 diabetes can be in the form of prescription medication for most, but this should always include lifestyle choices such as a decent diet, exercise, quitting smoking and reducing alcohol intake. By improving these factors, you may find that erectile dysfunction is completely reversible. As long as the condition is suitably controlled, impotence is often temporary.

Below we have a list of lifestyle factors and self-help techniques that can help you control type 2 diabetes, and quite possibly, erectile dysfunction.

How does diabetes affect an erection?

Diabetes can affect erections in a number of ways. To obtain an erection, you must want the desire to have sex, which can be affected with diabetes if you suffer from fatigue or have emotional implication such as depression and anxiety. Diabetes increased the likelihood that you're overweight, which can affect self-confidence depending on the individual. Healthy blood vessels need to transport the blood flow to the right area; this is directly affected with diabetics. Nerves communicate the correct feelings around the body, including sexual desire, which can be hindered. You also require a healthy dose of the male hormone testosterone to encourage an active libido (sex drive). The two main reasons as to why diabetes and impotence are linked have been explored below.

How diabetes affects blood vessels to cause erectile dysfunction

To get an erection, blood must be pumped and arteries widen to increase the blood flowing to the area causing the penis to stiffen. Diabetes can affect blood vessels and arteries used to transport blood around the body. With narrowed tubes hindering blood flow, it is not reaching the area quick enough to cause an erection.

Uncontrolled blood sugar levels can damage blood vessels, in particular the blood vessels in the kidneys and eyes. This is because high blood sugar can cause them to become thicker. Other conditions that often occur alongside diabetes, such as cardiovascular disease, can also cause damage to nerves. This is known as atherosclerosis and can cause blood vessels to become hard, meaning they are unable to perform effectively.

How diabetes damages nerves to cause erectile dysfunction

There is a secondary element that links diabetes with erectile dysfunction. For an erection to happen you must sexually aroused and this is caused by nerves communicating psychological excitement to the rest of the body. If the nerves are damaged, the right signals are disrupted, or are not communicated quickly enough to form and maintain an erection. So even if a man is aroused, disruption to the nerve impulses can still make it physically difficult to respond to sexual stimulus.

Damaged Nerves Diabetes

It's not fully understood how exactly uncontrolled blood sugar levels harm nerves, but it has been shown that it disrupts the nerve cells' ability to transmit signals properly. As a consequence of nerve damage, muscles can become weak and even painful.

Can metformin cause impotence?

Diabetes.co.uk has stated that the type 2 medication Metformin can also be used to combat erectile dysfunction, however, it is not to be prescribed to combat impotence on its own.

Metformin can increase the levels of nitric oxide in the body. This is a naturally-occurring chemical formed in the body that improve the state of blood vessels by making them larger and more flexible. Metformin is one of the most common medications for type 2 diabetes, and whilst studies aren't conclusive about the affects on humans, it's worth mentioning to your doctor for their professional opinion.

High level of glucose (hyperglycemia)

Blood vessels in the penile area perform an extremely important role, and if circulation in the penile area is inhibited it can lead to impotence. In order for an erection to occur that is strong enough for sexual intercourse, blood needs to be able to enter the penile arteries to increase pressure. If this can't happen as normal, pressure won't be enough to make an erection sustainable.

High Blood Glucose Levels

More about blood flow

Diabetes affects nitric oxide production, which is an important compound in the erection process. Nitric oxide is what signals the penile blood vessels to widen and allow more blood into the penile tissues. Reduced levels of nitric oxide can, therefore, influence erection strength.

How do you know if diabetes is causing erectile dysfunction?

It can be difficult to establish a link between the two conditions especially if one or the other hasn't been professionally diagnosed. To be diagnosed with erectile dysfunction you first must be a sexually competent adult, aka you must want to have sex and have a healthy libido. This includes experience pleasure from sex and having an orgasm. If you have the desire of sex but find it unsuccessful most of the time (at least 75% of encounters) than you may have erectile dysfunction.

Like other chronic conditions, individuals with type 2 diabetes don't necessarily know they have the condition initially as symptoms can be subtle or confused with something else. Symptoms of type 2 diabetes include the following:

  • Fatigue (extreme tiredness)
  • Other low mood factors (anxiety, stress and depression)
  • Increased thirst
  • Weight loss
  • Genital itching
  • Infections that take a while to heal

For men, developing erectile dysfunction below the age of 45 can be a symptom (or indication) in itself that you have type 2 diabetes.

Being diagnosed with diabetes and erectile dysfunction will involve a number of factors including your medical history and your current medical statistics. This may involve a physical examination as well.

If you have been diagnosed with either erectile dysfunction or diabetes and have noticed a crossover in the symptoms of each condition, this is the clearest indication there is a link between the two. Arrange an appointment with a doctor or specialist to establish the next steps.

What to do if you have diabetes and erectile dysfunction

The first thing to do is visit your doctor. They will be able to give you medical information and some advice on how to treat erectile dysfunction linked with diabetes. They can also establish whether diabetes is the main cause of erectile dysfunction, or if there are other underlining factors to consider.

You'll need to decide how to approach the situation. Type 2 diabetes requires a healthy lifestyle to control the condition, as well as possible prescription medication. This could be enough to combat erectile dysfunction linked with diabetes. If you would like to try ED medication, you can take tablets like Viagra and Cialis at the same time as diabetes treatment, but you must have this confirmed by your doctor first.

Treating diabetes and erectile dysfunction

The first thing to establish is whether other medications are causing or worsening erectile dysfunction. For example, it is not uncommon for men to develop various other health conditions alongside diabetes and/or erectile dysfunction. One of these may be a high blood pressure and many medications for hypertension list impotence as a side effect.

Secondly, addressing lifestyle choices can have a significant effect on both erectile dysfunction and chronic conditions such as diabetes. Addressing these will be the recommendation from your doctor and will benefit many aspects of your lifestyle. Below you will find a section on lifestyle factors that can improve diabetes and erectile dysfunction.

Lifestyle factors to alter if you have diabetes and erectile dysfunction

Diabetes is a chronic condition that needs to be controlled. This will limit the potential damage it can cause to the body. You may find that lifestyle factors alone can help to curb erectile dysfunction.

Treatment for diabetes is often recommended to help control the symptoms and reduce the risk of complication in the future. In addition, altering existing lifestyle choices can be hugely beneficial. Being overweight, smoking and not exercising enough can all contribute to erectile problems.

  • A healthy diet
  • Reducing alcohol intake
  • Monitoring your intake of sugar
  • Regular exercise
  • Keeping active
  • Quit smoking
  • Promote good mental health
  • Losing weight if you're obese or overweight

Erectile dysfunction treatments

Diabetics can use a number of treatments for erectile dysfunction including prescription medications, vacuum devices or penile implants.

  • Prescription tablets including Viagra, Cialis, Levitra and Sildenafil can be prescribed by your doctor after a mandatory health check. These are specifically designed to combat erectile dysfunction.
  • Penile injections are effective for the majority of men and contain alprostadil. They last up to 30 minutes at a time and can be injected around 12 times a month.
  • Penis pumps (vacuum devices) can be inserted onto the penis. This clear plastic cylinder is then pumped by hand or battery, and a band is based on the base of the penis to keep the blood in the area.
  • Penile implants are a surgical option that should only be considered after other options have been exhausted. This is either a rod place in the penis which you can move to become erect, or an inflatable tube with an air or liquid pump to form an erection.

Prescription pill medications remain a popular choice for men with erectile dysfunction and diabetes, however this must be prescribed by a certified doctor to ensure it is safe for you to use, especially if you have cardiovascular conditions.

Not all men with diabetes may be able to use these treatments, particularly if they have an existing heart condition for which you are taking medications. In these instances, vacuum devices and other forms of hormone therapy can be helpful.

Counselling and other therapies

Diabetes can often be caused by being overweight, which in turn affects your self-confidence. Some medications can prompt low mood such as depression and anxiety. Lastly, erectile dysfunction can be connected to a host of psychological aliments, whether that was the original cause or feelings of sadness and anxiety that have become secondary symptoms of the condition.

To address these issues you may consider counselling, which is available through the NHS or privately. In addition, you may be interested in couple's counselling if you feel like the conditions are having a detrimental affect on your relationship.

Which treatment is best for diabetes and erectile dysfunction?

If you have a healthy heart, medications such as Viagra are a popular choice, however, it's important to note there are other options if you wish to explore them. Medications are available in a number of dosages depending on what you find tolerable. If you are diabetic and wish to address sexual dysfunction as well, do your research and speak to a medical professional.

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