Diabetes manifests with variable symptoms and wreaks havoc on different systems in the body, but did you know that it can have debilitating effects on sexual performance as well?
Men with diabetes—especially those with type 2 diabetes—commonly have erection problems. Statistically, erectile dysfunction or ED is among the prevalent symptoms of diabetes in men, with 50% of men experiencing ED within ten years of a diabetes diagnosis.
What are the Signs of Erectile Dysfunction or ED?
Erectile dysfunction, or ED, is defined as the inability to get or sustain an erection with enough firmness to conduct sexual intercourse.
About 10% of men will suffer from ED at one point. In many cases, ED is a symptom of an underlying problem, like diabetes.
Men must also note that ED is not normal at any age. It can also be associated with problems around decreased desire or libido, orgasm issues, and problems with ejaculation. Thus, ED may co-occur with other problems interfering with sexual intercourse.
What are the Symptoms of Diabetes?
According to studies cited by the Australian Institute of Health and Welfare, diabetes is more common in men (4.8%) than women (3.8%) in an age-controlled study. In 2020, nearly 1.3 million Australians were found to be living with diabetes. The prevalence of diabetes mellitus is associated with an increase in age. By age 80 to 84, almost 20% of Australians were diagnosed with diabetes. Such statistics are 30 times the numbers for the under-40 demographic, which is 0.7%.
Men may present with erectile dysfunction (ED) symptoms and get diagnosed with diabetes. The relationship between ED and diabetes is multi-factorial, and patients may be treated for both conditions.
How Can Diabetes Cause Erectile Dysfunction (ED)?
As diabetes affects several body systems, it may disrupt one's reproductive and sexual function. The penis is a highly vascular organ. It also requires nervous stimulation to perform its function. Thus, damage to the circulation, blood vessels, and nerves contribute to a lack of penile function or sexual responsiveness.
To get an erection, a man needs healthy and well-functioning nerves and blood vessels. High blood sugar levels, a consequence of uncontrolled diabetes, give rise to oxidative stress and an increase in clotting factors, increasing the probability of blood clots. The triggered cascade also causes inflammation and constriction of the blood vessels. All of the effects contribute to blood vessel and nerve damage over time. The resulting functional abnormalities in the inner lining of blood vessels disrupt the blood flow to the penis. Without proper blood flow, you cannot get or sustain an erection.
The relationship between diabetes and ED is complex. Apart from the blood vessel and nerve damage, which can affect multiple organs, complications and hormonal issues in diabetes may also contribute to ED. In some cases, diabetes medications may worsen ED.
Understanding ED in diabetes requires comprehension of many factors involved with penile erection. Here is a list of the factors involved in diabetes-related ED:
Nerve damage in diabetes is called diabetic neuropathy. There are two main types of neuropathy in diabetes, peripheral and autonomic. Peripheral neuropathy impairs the sensory impulses from the penis to the erectile centre and motor impulses to the pelvic floor muscles. This damage reduces the contraction of the muscles necessary to keep an erection. Autonomic neuropathy decreases the mechanism responsible for relaxing the smooth muscle in the penis. Those smooth muscles need to relax for the penis to fill up and expand with blood during an erection. Moreover, the nerves that produce Nitric Oxide Synthase, which initiates erection, are damaged. Thus, having diabetic neuropathy compromises the initiation and maintenance of an erection.
People with diabetes are often overweight. The excess body fat, especially around the abdominal area or belly, is linked to a higher incidence of ED. Men who are overweight also more commonly have low testosterone levels, which can be a factor in ED.
Testosterone influences your ability to have an erection in many ways. It affects arousal, desire, and the actual erection mechanism itself. About half of diabetic men aged 45 and older have low testosterone.
There is a complex relationship between weight, diabetes, and cholesterol levels. The vicious cycle worsens when low testosterone causes cholesterol levels and fat to become abnormal. If you believe you may be "low-T" or suffering from the effects of low testosterone, a comprehensive assessment of whether you qualify for TRT (Testosterone Replacement Therapy) could be the next step.
People who are diagnosed with diabetes mellitus are more prone to develop mental health issues than non-diabetics. Studies have shown that those with clinically diagnosed diabetes are two times more likely (2x) to experience depression than non-diabetics. Mental health struggles may arise from worries about the future, the stress of discovering and managing their chronic disease, and experiencing general symptoms of ill health daily.
To complicate the scenario, anti-depressants, anti-anxiety, and other psychiatric medications may contribute to erectile dysfunction. The treatments that help alleviate one problem of diabetes may worsen the other.
It is sometimes unclear whether ED or depression arose first in a patient. In any case, ED should be managed alongside mental health issues.
Thus, managing and treating diabetes is a careful balance.
Chronic Untreated Diabetes and Erectile Dysfunction
Erectile dysfunction (ED) is considered the most notable type of sexual dysfunction in those with diabetes. When diabetes is undiagnosed, untreated, or chronic, ED becomes a noticeable problem. Some diabetes patients present with ED upon consult and are subsequently diagnosed with diabetes mellitus (DM).
Men with diabetes have a 3.5-fold higher prevalence of ED than those who are diabetes-free.
Treating ED Alongside Diabetes: Your Options
Diabetes is considered a risk factor for erectile dysfunction. Conversely, erectile dysfunction can present as a sexual dysfunction symptom under diabetes. Both conditions should be managed together when they co-occur.
Moreover, when a diabetic patient has erectile dysfunction, it could mean they are developing long-term complications of diabetes. The suspicion of chronic diabetes in patients with ED could lead to further lab work-ups of other organs—the heart, eyes, kidneys, and extremities.
ED treatment options may include lifestyle changes like quitting smoking and a healthy diet, medications, mechanical treatments like penis pumps, or prosthetic surgery.
Since treatments cover different aspects of one's lifestyle, consulting an ED professional or a specialized men’s health clinic is advised to get the best results possible.
Reversing ED if You Have Diabetes
Is it possible to reverse ED when you have diabetes? It depends on the whether you are managing your disease well or not. Essentially, you need to know how far along you are with the disease. The effective and diligent control of blood sugar contributes to dramatic changes in a diabetic's prognosis.
A comprehensive treatment plan that involves lifestyle changes and addressing other factors in ED helps patients further. However, if you have existing damage to nerves and blood vessels from previously uncontrolled or untreated diabetes, the effects may not be fully reversible. Hence, time is of the essence when asking for help reversing ED caused by diabetes.
Take Control of ED and Diabetes Today: There’s No Time to Waste
When treating the effects of diabetes on ED, time is a significant factor. Anyone who suspects ED or ED caused by diabetes must consult an expert or specialized clinic right away to avoid the permanent effects of diabetes on erectile function—which includes irreversibly damaged nerves and blood vessels.
The sooner you consult an ED specialist, the better your chances of reversing ED caused by diabetes. Men's Health Clinic (MHC) offers a multi-disciplinary approach to managing the symptoms and conditions associated with the combined incidence of ED and diabetes. To determine whether you qualify for MHC's groundbreaking treatment approach to ED and its associated diseases, take the quiz now.
With one of our Senior Patient Coordinators who can provide you with more information regarding bespoke treatment options.