The Link Between Diabetes and Erectile Dysfunction

Conditions associated with blood vessel problems are linked to Erectile Dysfunction (ED). The most common of these conditions are diabetes, high blood pressure (hypertension), coronary disease, and elevations in blood lipids (cholesterol).

Diabetics and patients with hypertension frequently have heart disease. These conditions often interfere with the ability of the penile vessels and erectile muscle tissue to work properly. 

This blog post will focus on the link between diabetes and erectile dysfunction.

The Risk Factors

Diabetes affects not only peripheral blood flow; it also affects peripheral nerve function. The association between diabetes and ED was first documented in 1978. Men with diabetes have the four main risk factors for ED. 

1. Diabetes can cause damage to nerves 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.

2. Diabetes can aggravate a condition known as atherosclerosis, in which the blood vessels become narrow or hardened. Narrowing of the lumen or hardening of the wall of these blood vessels prevent blood flow into and out of the penis, which can cause ED. This leads to alteration of the erectile muscles and tendons that results in a condition known as Peyronie's Disease, which can foreshorten and deform the erection. Utlimaely, this leads to veno-oclusive dysfunction, also known as a venus leak. 

3. Men with diabetes need to control their blood sugar levels. When blood sugar is not under control, the 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 the penile muscle has deteriorated and does not produce NO or if the penile muscle does not respond to NO, the pressure of blood flowing into the penis is not sufficient to expand the muscle and trap the blood. The penis will not get fully hard or an erection will be obtained but not maintained.

4. About 12% of all men with diabetes have low levels of the male hormone testosterone, which is required for normal erectile function.

Erectile Dysfunction Can Be a Sign that You Have Diabetes

Diabetes is the most common cause of ED. Men who have diabetes are three times more likely to have ED than men who do not. These men are also much less likely to respond to oral medications to treat ED. Men who have diabetes tend to have ED 10-15 years before men without diabetes.

The risk of ED increases the longer that you have the disease and with the severity of your diabetes. Even though 20% to 75% of men with diabetes have ED, it can be successfully managed in most patients.

ED may be the first symptom of undiagnosed diabetes. A recent study of a clinic population revealed that 5% of the men with ED also had undiagnosed diabetes.

Dr. Eid screens his patients for medical conditions including diabetes, hypertension, hypercholesterolemia, prolactin secreting pituitary tumor, and rare conditions such as systemic fibrosis, lupus and Marfan’s syndrome.

Erectile Dysfunction Treatment Options for Diabetics

Various treatment options are available for men who have both diabetes and ED.

Typically, the first step 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, Dr. Eid would recommend a trial with oral medications – there are four oral PDE-5 Inhibitors: Cialis, Levitra, Viagra, and Stendra.

However, studies have shown that fewer then 50% of men with diabetes respond to oral medicines. For most of these men the Inflatable Penile Implant is 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 implant pump is inserted through a small one-inch opening in the scrotal sac. By squeezing the pump, fluid is pumped into the penis, resulting in a long-lasting erection. Once inserted, there is no maintenance required for the pump and it can remain in place for a lifetime.

Schedule your consultation to learn more

Call Dr. Eid today at 212-535-6690, or schedule a virtual visit to talk more about these treatments and the best option for you.