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Diabetes and Erectile Dysfunction

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.


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.


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. 

Patient Concerns

Question: I am a 43 year old type 2 diabetic. I have tried viagra, cialis and levitra and they no longer work. Currently using the pump which works but it is a little cumbersome. I want to look into my options. Blue cross blue shield of minnesota is my provider. 

Answer: Medications such Cialis, Viagra and Levitra only work in 50% of men suffering from diabetes and erectile dysfunction. Cialis is currently the preferred drug since it is the only one that may be taken on a full stomach and lasts for 36 hours. This favors a more romantic and natural sexual interaction. Planning kills the mood! 

 Other treatment options such as penile self-injection therapy, external vacuum pumps and the medicated urethral system for erection are on rare occasions an effective long-term treatment. A very small percentage of men will continue with these treatments as evidenced by a very high drop out rate and a very low refill rate for these treatments. These procedures require extensive planning which interfere with sexual spontaneity and are really not a realistic long-term treatment for young patients with permanent ED. 

Men who do not respond or tolerate oral medications are best treated with an internal penile pump (IPP) commonly known as an inflatable implant. This cures the ED and men no longer have to think about it. 

Please explore our website in order to evaluate which option you think is best for you. 

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