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Diabetic Men with Erectile Dysfunction: What to Do

If you're a man with diabetes and erectile dysfunction, there are things you can do to improve your situation. Learn about your options and take action to improve your sexual health.

What Should Diabetic Men with Erectile Dysfunction Do?

Erectile dysfunction (ED) is a common complication of diabetes. The prevalence of ED is 37% in men with diabetes, and it has been estimated that up to 75% of men with diabetes will experience ED. The etiology of ED in diabetic men probably involves both vascular and neurogenic mechanisms. Evidence indicates that endothelial dysfunction plays a role in the development of ED in diabetes. The pathogenesis of diabetic ED remains uncertain, and multiple factors are implicated in its development. Diabetic men are more likely to have subclinical CVD, and ED amplifies the adverse vascular effects of diabetes. Diabetic men with ED have greater impairment in endothelial function than men with diabetes without ED. Although a causal relationship between microvascular damage and ED in diabetes has not been established, it is likely that there is a relationship between the two. Diabetic men with ED have a higher prevalence of CV risk factors than men without ED. In the Massachusetts Male Aging Study (MMAS), ED was present in 39% of men with diabetes and in 22% of men without diabetes. The prevalence of erectile dysfunction was higher in men with diabetes (39%) than in men without diabetes (22%), but this difference was not statistically significant. There are a number of effective treatments for ED in diabetic men, including oral phosphodiesterase type 5 inhibitors, intracavernosal injections of vasoactive agents, vacuum devices, and penile prostheses. In conclusion, diabetic men with ED have a high prevalence of CV risk factors and CV morbidity. They should be counseled on lifestyle changes, including smoking cessation, weight loss, and increased physical activity. Oral phosphodiesterase type 5 inhibitors and intracavernosal injections of vasoactive agents are effective treatments for ED in diabetic men. Penile prostheses should be considered in men who are not responsive to medical or surgical treatments.

Learn about diabetes erectile dysfunction and impotence. MDs answer your diabetes questions.

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Video transcription:

Erectile dysfunction is a very, very common problem in men, with typically long-standing and poorly controlled diabetes. It’s estimated that about 60% of men with diabetes have problems with impotence and, unfortunately, in these patients, the the treatment risk of this response to the the tablets, Viagra, Cialis and levitra is not very good, and that’s in part due to the fact that impotence in men with diabetes is due to multiple factors. It’s due to neuropathy, it’s due to hormonal deficiencies and it’s due to poor blood flow in the pelvic region. So when the oral therapies fail, we look at other routes to treat this problem, and one of the first steps that should be done is to measure your testosterone level and again. Recent studies have shown that a majority of men with impotence actually have very low testosterone levels and if there’s no reason why you can’t be placed on testosterone, we can actually supplement your your hormonal levels and in many men they then can achieve a normal erection. There are some some situations in which we can’t use testosterone therapy. The most common one is in those individuals with prostate cancer. In addition to normalizing the testosterone level, there are other possible treatments. Some men can use an injectable drug which will allow for improved blood flow to the pelvic region and a normal erection. There’s a vacu erection device which is placed externally and in most men, will permit a normal election for sexual function that doesn’t allow much spontaneity and I think that’s one of the biggest criticisms of the vacu erection device and then in individuals who have failed. The treatments we’ve talked about kind of a last-ditch resort is an implantable penile implant, and that is a very successful treatment for those men that have failed more traditional approaches.

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