Erectile Dysfunction and Diabetes

It is been estimated that about 35%-75% of men with diabetes will experience at least some degree of erectile dysfunction -- also called ED or impotence -- during their lifetime.

Men with diabetes tend to develop erectile dysfunction 10 to 15 years earlier than men without diabetes. As men with diabetes age, erectile dysfunction becomes even more common. Above the age of 50, the likelihood of having difficulties with an erection occurs in approximately 50%-60% of men with diabetes. Above age 70, there is about a 95% likelihood of having some difficulty with erectile function.

Why Do Men With Diabetes Have Erectile Dysfunction?

The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel, and muscle function.

To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection. Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.

What Treatments Are Available for Men With Diabetes and Erectile Dysfunction?

Men with diabetes having trouble with achieving and/or maintaining an erection can take oral medications like Viagra, Cialis, Stendra, or Levitra.

However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and cause dangerous interactions with your heart medicine. Talk to your doctor to determine what treatment is best.

Additional treatments men with diabetes might want to consider include intracavernous injection therapy, vacuum constriction devices, intraurethral therapy, and sex therapy.

So what treatment is best? It depends on many factors including a man's health and his ability to tolerate the treatment. Ask your doctor if you should see a specialist (a urologist) to determine the best treatment for your situation.

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Atherosclerosis and Erectile Dysfunction

Atherosclerosis and Erectile Dysfunction

Erectile dysfunction is a widespread problem. Up to 39% of 40-year-old men report some degree of erectile dysfunction, and two-thirds of men over age 70 have significant symptoms.

Erectile dysfunction isn't life-threatening, but that doesn't mean it's not serious. Men with erectile dysfunction (ED) are more likely to feel depressed and report less enjoyment in life.

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Thanks to advertisements for drugs that treat it, you may have heard more about erectile dysfunction than you ever cared to. But did you know that atherosclerosis -- hardening of the arteries -- is the main cause of ED?

The link between atherosclerosis and erectile dysfunction is well known to doctors. If you have ED, understanding the connection might just save your life.

Atherosclerosis and Erectile Dysfunction: Slowing the Rush

The blood supply to the penis comes from arteries in the abdomen (belly). Smaller arteries branch off to carry blood down into the penis. When it's time for an erection, these arteries dilate. More blood flows into the penis, causing it to swell.

The rush of blood creates high pressure in the penis that also slows down the flow of blood out of the penis. This produces a firm erection that can be maintained until orgasm -- if the blood vessels are healthy.

Atherosclerosis and Erectile Dysfunction: Dam Blockages?

To get and maintain an erection, blood vessels in the penis have to be robust, to rapidly increase blood flow. Erectile dysfunction usually means blood vessels everywhere aren't in perfect health. This can be a signal of increased risk, long before blockages from atherosclerosis form.

To understand what goes wrong, think of blood flow as a river over a dam. Engineers control the flow: they can increase flow to make rapids, or narrow it to a trickling stream.

A similar mechanism is at work in your arteries. In your penis, blood flow needs to open wide during sexual arousal. Likewise, you need wide open blood flow to your heart's arteries during exercise. The inside lining of blood vessels (endothelium) releases chemicals on demand to accomplish this.

The endothelium can be damaged by high cholesterol, high blood pressure, smoking, or diabetes. They also cause atherosclerosis.

Once damaged, the endothelium can't expand arteries to increase blood flow as well. Less blood flow into the penis means a less firm erection.

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Erectile Dysfunction: Psychological Causes

Erectile Dysfunction: Psychological Causes

Psychological factors are responsible for about 10%-20% of all cases of erectile dysfunction, or ED. It is often a secondary reaction to an underlying physical cause. In some cases, the psychological effects of ED may stem from childhood abuse or sexual trauma. However, the most common psychological causes of ED include:

Stress: Stress can be job-related, money-related, or the result of marital problems, among other factors.

Anxiety: Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to "performance anxiety," or a fear of sexual failure, and consistently lead to ED.

Guilt: A man may feel guilty that he is not satisfying his partner.

Depression: A common cause of ED, depression affects a person physically and psychologically. Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.

Low self-esteem: This can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance.

Indifference: This may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple's relationship.

All men at one time or another will experience ED. Only if the problem becomes persistent -- occurs more than half the time -- or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. For men whose erectile dysfunction is caused by psychological problems, therapy may be needed.

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