For men with diabetes, erectile dysfunction (ED)—sometimes called impotence—is a common problem. And because it affects not only men, but also their partners, ED is really a “couples problem.”
It is hard to tell whether ED is really more common among men with diabetes than it is among those without diabetes because so many men suffer ED in silence. However, we do know that:
• ED is age-related, often developing in men older than 50. Diabetes is also more common in this older age-group.
• Men with diabetes tend to develop ED 10–15 years earlier than men without diabetes.
• Fifty to sixty percent of all men with diabetes over age 50 have some problem with ED.
Exactly what is ED?
Having ED means that all, most, or some of the time, the penis fails to become or stay hard enough for sexual intercourse. If, on rare occasions, you cannot get an erection, you do not have ED. You also do not have ED if you have a decrease in sexual desire, have premature ejaculation, or if you fail to ejaculate or reach orgasm. ED means that you can’t get or keep an erection.
What causes ED?
ED can be caused by many things. The most common causes in men with diabetes are problems related to blood vessel– and nerve-related complications. Sometimes, though rarely, ED can be caused by a hormonal imbalance. Depression can also cause ED, as can stress and excessive worrying about sexual performance. Certain medications can cause temporary ED.
Can ED be avoided?
You can reduce your risk of developing ED by keeping your blood glucose levels as close to normal as possible. Quitting smoking, drinking less alcohol, and controlling your blood pressure will also help. Exercise can improve your diabetes, strengthen your muscles, promote weight loss, reduce stress, and help you feel better about yourself.
What if I do get ED?
Left untreated, erection problems can hurt self-confidence and relationships. The good news is that ED is a very treatable condition. The first step to restoring a satisfying sex life is to seek help from your health care provider.
Then what happens?
Because ED has several causes, sorting out exactly what is causing your problem may take some time. First, make sure your doctor knows about all the medicines you are using, including over-the-counter or herbal products. Drugs frequently used to treat high blood pressure, anxiety, depression, and peptic ulcers can all cause ED. But don’t stop taking any of your medications without first talking to your doctor.
Most healthy men have several erections each night when they sleep. Your doctor may order a sleep study to test whether you do, as well. If you do, your problem may be psychological, and you and your partner may be offered counseling.
To help identify physical causes, your doctor may order tests for blood vessel damage, nerve damage, and testosterone measurement. Depending on the underlying cause, there are many possible treatments available for ED, and treatment can be tailored to your specific medical problems and lifestyle.
What are the treatments?
Treatment options include pills such as Viagra, injections, vacuum pumps, implantable pumps, supplemental testosterone, and psychological counseling. All of these treatments have pros and cons, so discuss your options thoroughly with your health care provider.
Remember that ED is a “couples problem.” Talk things over with your partner to be sure you both understand the problem you’re having and agree on the treatment and goals you hope to achieve.
And don’t forget that ED is one of the most treatable complications of diabetes. By working closely with your health care provider, you and your partner can find the solution that works best for you.
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