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CONTACT INFORMATION |
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J. Francois Eid, M.D.
50 East 69th Street
New York, NY 10021 |
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Ph: 212-535-6690 |
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Fax: 212-535-7025 |
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Diabetes and Erectile Dysfunction |
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Diabetes, high blood pressure (hypertension), elevations in blood lipids or cholesterol are considered blood vessel problems and have all been associated with Erectile Dysfunction. The blood vessel abnormalities caused by these diseases affect vessels throughout the body and often produce other symptoms of vascular diseases. Diabetics and patients with hypertension frequently have heart disease. These conditions typically interfere with the ability of the penile vessels to work properly and ultimately cause ED.
Prevalence:
Diabetes is one of the most common causes of ED. Men who have Diabetes are three times more likely to have Erectile Dysfunction than men who do not have Diabetes. Among men with ED, those with Diabetes are likely to have experienced the problem as much as 10 to 15 years earlier than men without Diabetes. A recent study of a clinic population revealed that 5% of the men with ED also had undiagnosed Diabetes. The risk of ED increases with the number of years you have Diabetes and the severity of your Diabetes. Even though 20% to 75% of men with Diabetes have ED, it can be successfully managed in almost all men.
In regards to high blood pressure, this makes the heart work harder to pump blood which can prevent blood flow from reaching the penis and in turn prevent an erection. Recent reports say that close to 2 out of 3 men report a change in the quality of their erections if they have high blood pressure.
Risk Factors
It is established that Diabetes affects not only peripheral nerve function but peripheral blood flow as well. The association between Diabetes and ED was first documented in 1978. Men with Diabetes have four main risk factors for ED.
First, diabetes can cause damage to nerves (neuropathy) throughout your body-including the nerves to your penis. Damage to penile nerves can interfere with your body’s ability to send messages to and from the penis, which can lead to ED.
Second, Diabetes can aggravate a condition known as atherosclerosis, in which the blood vessels become narrow or harden. Narrowing or hardening of these blood vessels prevent blood flow into and out of your penis, which can cause ED.
Third, men with Diabetes need to control their blood sugar levels. When your blood sugar is not under control, your body does not produce enough Nitric Oxide(NO) and vascular tissues don’t respond as effectively to NO. When enough blood flows into the penis, penile veins close off and block the blood from flowing out. This process results in an erection. If your body does not produce enough NO or if your penile tissues do not respond to NO, the pressure of the blood flowing into your penis is not sufficient to trap the blood, you penis will not get hard.
Finally, about 12% of all men with Diabetes have low levels of the male hormone testosterone, which is required for normal erectile function.
In summary:
- Diabetes - Nerves or blood vessels that control the flow of blood to the penis may become permanently damaged as a result of diabetes. Damage to either can lead to ED.
- Cardiovascular Disease - Vascular problems, such as hardening of the arteries, can slow the blood flowing into the penis, making it difficult to get or keep an erection. (Since this affects the small vessels before it affects the bigger vessels, finding an ED problem could signal the presence of a cardiovascular disease.)
ED Treatment.
Various treatment options are available for men with Erectile Dysfunction and a proper evaluation should be done before prior to starting any therapy.
Typically, the first goal in treating ED is to get your blood sugar level or blood pressure under control. If you smoke cigarettes, it is strongly recommended that you stop, as tobacco causes blood vessels to narrow.
Next, I would recommend oral Drugs- you may also be prescribed one of the three oral PDE5 Inhibitors- Cialis, Levitra or Viagra.
However, studies have shown that fewer then 50% of men with Diabetes respond to Oral medicines. For these men the Internal Penile Implant is currently the best option. The Penile Implant is an approved medical option that has been used for over 30 years. During the course of a 45-minute outpatient procedure, the pump is inserted through a small one-inch opening in the scrotal sac. By squeezing the pump, fluid is pumped, resulting in a long lasting erection. Once inserted, there is no maintenance required for the pump and can remain in place for a lifetime.
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