Diabetes is a condition that affects more than 5.8 million people in the UK, with a further 6.3 million at risk of developing type 2 diabetes. There are many complications of being diabetic, including weakened immunity, vision loss, and poor circulation. However, many people do not realise that it can also cause sexual problems.
In fact, Diabetes.co.uk reported that erectile dysfunction (ED) is hugely common among diabetic men, affecting between 35 and 75 per cent of males with diabetes. This increases to 95 per cent for men over 75 years old.
While ED is something that can affect any man, someone with diabetes often develops it ten to 15 years earlier than others.
According to Diabetes UK, men with diabetes are three times more likely to have ED than their peers. Furthermore, those who have type 2 diabetes and are living with obesity are at greater risk of poor sexual performance.
So, what is the link between ED and diabetes and what can be done about it?
What causes ED in men with diabetes?
There are several reasons why diabetic men are at greater risk of developing ED, but the main one is due to nerve damage, otherwise known as neuropathy.
- Neuropathy
This is when persistently high blood sugar levels cause damage to nerves. However, healthy nerves in the penis are needed to be able to achieve and maintain an erection. Otherwise, it is likely the erection will not be firm enough for sex.
- Angiopathy
Angiopathy, or blood vessel damage, is another reason why men with diabetes are likely to struggle with their sex life. This is because diabetes commonly affects blood vessels, which are crucial for obtaining an erection.
The damage to the blood vessels means the amount of blood flowing to the penis is restricted. Therefore, without the necessary blood flow, this prevents an erection from occurring.
At the same time, angiopathy can cause a loss of sensation in the penis, which makes it harder for it to become aroused. Therefore, this can have a big impact on erectile performance.
- Hormonal imbalances
Diabetes is also known to cause an imbalance in hormones, and these are needed to feel turned on and help blood flow to sexual organs.
- High blood pressure and heart disease
High blood pressure and heart disease are also linked with ED, and these are common conditions in men with diabetes. Therefore, anyone who has diabetes together with cardiovascular complications has a high chance of suffering with erectile problems.
- Other causes of ED
Other factors linked with ED include high blood pressure, cholesterol, being overweight, smoking, not exercising enough, medications such as antidepressants and blood pressure drugs, anxiety, depression, low self-esteem and concerns about sexual performance.
How to diagnose erectile dysfunction
ED is most commonly diagnosed when taking the patient’s history about their sex life. There are also physical and even psychological assessments that can take place, which can help rule out other causes. If low levels of testosterone are discovered, for instance, this would explain the ED.
The British Society for Sexual Medicine (BSSM) has linked erectile dysfunction in men with type 2 diabetes with a deficiency in testosterone. So much so that over 70 per cent of men with ED with type 2 diabetes could experience ED as a result of a lack of this male hormone.
Some people might go to the doctors for their erectile issues even before they know about their diabetes, as this may have caused more difficulty than any other symptom till then. Therefore, in some cases, it can be an indication of diabetes in those who remain undiagnosed.
The impact of ED on men
It is important that men who are experiencing problems in the bedroom seek help as soon as possible, as it can have a big impact on their wellbeing.
For a start, it would affect their sex life, which can put an end to intimacy in a relationship and make them feel disconnected to their partner, or prevent a couple from getting closer to one another.
It can also cause a lot of mental health issues, as they could end up feeling embarrassed, ashamed, stressed, concerned, and self-conscious. All these negative emotions also make it harder to feel aroused and sexual; therefore, it becomes even more difficult to achieve or maintain an erection.
What are the treatments available for men with diabetes and ED?
There is a wide choice of treatment options for men who have both diabetes and ED, depending on whether you want to take medication, make changes to your lifestyle, or manage your diabetes more.
Lifestyle changes
When it comes to lifestyle changes, it is important to eat a healthy, balanced diet, and take supplements. These will help protect against future nerve damage and potentially repair any that has already been caused.
Being overweight can increase the chances of getting ED or make it worse; therefore, it is essential to eat well to achieve or maintain a healthy weight. Some men might have to lose fat, as this can exacerbate poor bedroom performance. Consequently, eating in a calorie deficit and exercising more could improve the situation.
Exercise also helps with other conditions that are risk factors for ED. For instance, as well as stimulating fat loss, it boosts blood flow, reduces stress and improves sleep.
It is also sensible to limit alcohol intake to fewer than 14 units in a week. This should be drunk over at least three days, avoiding binge drinking. Alcohol can have a big impact on sexual performance; therefore, if this is something you are worried about, it is worth cutting back or even going tee-total.
Smokers should also consider quitting, as tobacco narrows blood vessels. It also reduces the level of nitric oxide, which gives your body signals to let the blood flow to the penis. This means less blood is able to get to sexual organs, making it harder to get an erection.
Diabetes management
There are ways for people with diabetes to manage their condition to reduce the impact it has on their life. For a start, it is essential to go for regular diabetes health checks to make sure blood sugars, cholesterol and blood pressure are all being monitored.
It is also important for you to ensure blood sugars are within the target range on a daily basis through a combination of diet, exercise and medication, if needed. This will limit neuropathy and angiopathy. Therefore, it will not be as difficult for blood to flow to the penis, as the nerves and blood vessels will not be damaged.
Medication
If you have made lifestyle changes or consider yourself to be healthy, you might want to think about oral medications for ED.
PDE5 inhibitors, such as Viagra prescriptions, have been proven to be very effective for many who suffer from diabetes-related erectile problems.
Viagra is the brand name for sildenafil, while Cialis and Adcirca are tadalafil, and Stendra is vardenafil or avanafil. These work by helping the blood flow to the penis more easily, which makes it easier to get an erection.
Finding the right medication can make all the difference for many men, as it can boost their confidence in the bedroom again. This increase in self-esteem and no longer being stressed or anxious could also have a positive knock-on effect on sexual performance, reducing the risk or incidences of ED in the first place.
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