Men with diabetes are at a higher risk of erectile dysfunction (ED) or impotence, especially if their diabetes is not well controlled. Erectile dysfunction means you cannot have an erection that is sufficient to perform sexual intercourse. Many men experience short-term episodes of erectile dysfunction but, for about one in 10 men, the problem may continue.
Physical erectile dysfunction happens over a period of months or years and is often a gradual loss of function. If erections still occur spontaneously overnight or in the morning, this indicates that the problem may be psychological.Men with diabetes tend to develop erectile dysfunction 10 to 15 years earlier than men without diabetes. As men with diabetes age, erectile dysfunction becomes even more common. Above the age of 50, the likelihood of having difficulty with an erection occurs in approx 45% to 50% of men with diabetes.
Erectile dysfunction can be caused by physical and psychological factors including:stress, anxietyand nervousness, problems in relationships,poor health, drinking too much alcohol, cigarettesmoking, poordiet,hormonal problems such as low testosterone, some medication taken for hypertension or depression.
Erectile dysfunction can be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease. It is common in men who have diabetes, especially those with type 2 diabetes. It can stem from damage to nerves and blood vessels caused by poor long-term blood sugar control. Men with diabetes are more likely to develop erectile problems when their diabetes is not well controlled. Over the long term, poor control may result in increased damage to the nerves and circulation that controls blood flow to the penis. If blood glucose levels are kept in the normal range, it will help reduce the chance of these problems occurring.
The natural history of ED in people with diabetes is normally gradual and does not occur overnight. Both vascular and neurological mechanisms are most commonly involved in people with diabetes.
The connection between diabetes and ED is related to your circulation and nervous system. Poorly controlled blood sugar levels can damage small blood vessels and nerves. Damage to the nerves that control sexual stimulation and response can impede a man’s ability to achieve an erection firm enough to have sexual intercourse. Reduced blood flow from damaged blood vessels can also contribute to ED.
Treatments depend on the cause of the erectile dysfunction, which may include:
Psychological causes – it may help to treat the causes of stress. Behavioural therapy and counselling can also be successful, particularly if your partner is involved.
Physical causes – there are several possible treatments, depending on the physical cause. If the problem is related to nerve damage or poor blood supply, options include medications, vacuum devices or surgery.
Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction.
Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
Limit or cut out alcohol. Excess alcohol can contribute to erectile dysfunction.
Having Balance diet- Eating a balance diet will help the individual for better control of their blood sugar levels and lessen the amount of damage to their blood vessels and nerves. A proper diet geared at keeping their blood sugar levels in check can also improve their energy levels and mood, both of which can help reduce the risk of erectile dysfunction.
ED is an under-recognized, under-discussed, and commonly untreated complication of diabetes. It is important for both physicians and patients to be educated and aware of the causes and treatments of ED.
BY: Dr Pradeep Gadge, A leading Diabetologist, Gadge Diabetes Centre