Diabetes and Erectile Dysfunction
Dr. Akshay Jain MD, FRCPC, FACE, CCD, ECNU, DABIM, DABOM, Clinical and Research Endocrinologist
There are two gender-specific conditions with regards to diabetes management. The first would be diabetes during pregnancy, which is a very important issue, because good blood sugar control during pregnancy will help ensure a healthy outcome.
Dr. Akshay Jain MD Patient Education Platform
With men, the main gender-specific issue is diabetes is a diabetic complication of erectile dysfunction, or ED. Erectile dysfunction in diabetes is very important, not just for its social implications and the troublesome nature that affects patients, but in actual fact, having erectile dysfunction, or impotence as it’s commonly called, is a sign that the man has a very high risk of having a heart attack or stroke in the next few years.
Diabetes damages the body very slowly over the years and in a simplistic form, you can look at damage to the large blood vessels, the small blood vessels, as well as the nerves. The large blood vessel damage is heart attacks, strokes, damage to your circulation in your legs, which is called peripheral vascular disease.
Damage to the small blood vessels includes damage to the eyes, the kidneys, the nerves, and also erectile dysfunction, which is damage to the blood vessels of the penis. The blood vessels of the penis are very exquisitely sensitive to blood sugars. The third issue is damage to the nerves directly, the toxic effect of high blood sugars.
So in terms of treatment of erectile dysfunction, we must first mention prevention. Smoking multiplies the risk of erectile dysfunction many times over. So the sooner you can quit smoking, the higher your chances of putting off erectile dysfunction or prevent it from worsening. Having your blood pressure under control, having your blood sugars well controlled, if you have diabetes. And also controlling your high cholesterol are all crucial to prevent erections from dwindling.
A small group of men who have erection difficulties have hormonal problems. They perhaps have low testosterone levels, which is generally easily treated with testosterone replacement. The larger group of men, though, have damage to the penis that we cannot reverse, but fortunately there are oral agents, they’re called PDE5 inhibitors, that are very effective in erectile dysfunction and improve circulation.
So if you’re a man who is suffering from erectile dysfunction, you should know that treatment is available. But you should also ask the question “Why has this happened to me?” And work with your healthcare provider to find out why. Is it a hormonal problem? Is it because you have uncontrolled blood pressure or perhaps high blood sugars? Is it because you’re a smoker? Is it related to stress or perhaps a side effect of another medication?
We don’t just want you to take the medication and carry on your way, because you haven’t solved the underlying problem. It’s important to discuss your particular situation with your healthcare provider, in terms of how it impacts your health. And it may have an impact on other medications that you’re taking. Remember, there’s treatment available, so it’s always a good idea to talk to your doctor about this.