What is Erectile Dysfunction?
The Joslin Diabetes Center defines erectile dysfunction as being unable to reach or maintain an erection sufficient for intercourse in more than 25 percent of your encounters. Other related sexual performance difficulties include premature or delayed ejaculation and decreased sex drive.
Does Diabetes Cause ED?
Diabetes does not directly cause erectile dysfunction, although several common side effects of diabetes directly contribute to its occurrence. The American Diabetes Association reports that over half of the men diagnosed with type 2 diabetes suffer from some form of erectile dysfunction, with diagnosis occurring nearly 15 years before that of men without diabetes.
How Does Diabetes Contribute to Erectile Dysfunction?
Low testosterone is a common problem among diabetics. In fact, it is twice as common among men with diabetes as men without, according to the American Diabetes Association. Low testosterone levels are a common culprit in erectile dysfunction.
Poorly controlled blood sugar — particularly over an extended period — can cause nerve and vascular damage. Vascular damage can reduce the blood flow to the genitals, reducing the natural arousal response while nerve damage lessens sensation. Joslin Diabetes Center records indicate that the most common cause of erectile dysfunction among diabetic men is nerve damage.
High cholesterol and heart disease are common among diabetics. Medications used to treat these conditions, as well as anti-depressants, can cause reduced sexual response and low libido. Stress surrounding the daily care of diabetes and anxiety over erectile dysfunction symptoms can affect sexual response, worsening existing difficulties
Testing and Diagnosis
A physician’s diagnosis is necessary for thorough treatment of erectile dysfunction. Neurological exams can identify nerve damage and isolate the extent of the damage. If a neurologist is necessary, this exam will identify that need. Other testing includes ultrasounds, analysis of penile veins for leakage, and injections directly into penile tissue.
What Treatments are Available?
Isolating the cause of erectile dysfunction is crucial to identifying the proper course of treatment. Some cases may be resolved with therapy alone while other cases may require medications or other measures. Oral medications are the first course of treatment if there are no indicators of surgical need or other problems.
Urethral suppositories may be prescribed if oral medications are unsuccessful. Penile injections are also available in several medications and combinations. The success rate with Trimix, one combination medication, is nearly 90 percent according to the University of California San Francisco. Proper education from a health care specialist is necessary to avoid long-term penile damage.
Vacuum pumps are an alternative treatment method that eliminates the need for medications. Vacuum pump users must be able to obtain a partial erection for success with this treatment method. They are an inexpensive alternative to medications without the risk of drug interactions or side effects.
Prosthesis and surgical correction are treatment options used only if all other methods fail to provide relief. Prosthesis allows the user to control erections at will, with all nerves remaining intact. Vascular reconstruction is possible when erectile dysfunction is the result of venous leakage.
Mayo Clinic: Erectile Dysfunction and Diabetes
National Diabetes Information Clearinghouse: Sexual and Urologic Problems of Diabetes