Diabetes and Erectile Dysfunction: Understanding the Connection

Diabetes is a common issue in people today. The latest International Diabetes Federation (IDF) reports that about 11.1 or 1 in 9 adults between the ages of 20 to 79 years suffer from diabetes [1]. Over time, suffering from diabetes can lead to other health conditions, including sexual health conditions. So, now the question arises, can a diabetic man be sexually active?

In this blog, we will go through the relationship between diabetes and erectile dysfunction and ways to manage these conditions effectively.

What Is Erectile Dysfunction?

Erectile dysfunction is a condition that makes it difficult for a man to get and maintain an erection. Your feelings play an important role in getting and maintaining an erection. It is normal to suffer from ED at times, but having it constantly can be a matter of concern [2].

Erectile dysfunction can arise from numerous factors.

Understanding Diabetes and Its Impact on the Body

Diabetes is a condition that occurs when the blood sugar level is too high [3]. It develops when the pancreas is not able to make enough insulin or any at all. It can also occur when your body stops responding to the effects of insulin properly. Diabetes can affect people of all ages. In most cases, it is a chronic disorder, but it is manageable with lifestyle changes and medications.

Suffering from diabetes over time can damage blood vessels and nerves [4]. This can cause serious complications like kidney failure, heart disorder, nerve pain, stroke, foot problems, and vision loss. It can also affect your immune function, digestion, brain health, and skin.

How Does Diabetes Cause Erectile Dysfunction?

Men suffering from diabetes are three times more likely to suffer from erectile dysfunction than men without diabetes [5]. ED is more likely in men with obesity and older men suffering from type 2 diabetes. Suffering from diabetes over a long period of time can damage nerves and blood vessels, including the ones that supply the abdomen and penis. This damage can affect the amount of blood flowing to the penis and can further cause loss of feeling and sensation. Lack of blood flow to the penis is a major cause of ED.

Urinary tract infections and yeast infections (thrush)

In a few people with diabetes, urinary tract infection and thrush may occur due to high blood sugar and intake of few diabetes medicines. Suffering from such an infection may prevent you from having intercourse until the infection clears up [6].

How Does Diabetes Affect A Woman Sexually?

A 2010 study suggests that women with diabetes are more likely to stop all sexual activity compared to men. They are also more likely to have sexual issues [7]. Studies also found that diabetic women taking insulin treatment are at a higher risk of experiencing issues with orgasm and lubrication [8].

How Sexual Intercourse Affects Blood Sugar Levels?

Like any exercise, engaging in sexual activity can affect your blood sugar levels. In people who feel anxious or nervous before intercourse, see a release of adrenaline hormone that may increase their heartbeat, energy, and blood flow. This may also cause a brief spike in the blood sugar levels.

In people who use insulin or other medicines that can lower their blood pressure, there is also a risk of suffering from hypoglycaemia (deficiency of glucose in the bloodstream) [6].

Risk Factors That Increase ED in Men with Diabetes

A 2024 study suggests that the risk factors associated with ED in men with diabetes include-

• Age
• Duration of diabetes
• Cardiovascular disease
• Hypertension
• Microvascular complications
• Vascular disease
• Depression
• Metabolic syndrome
• Diuretic treatment [9].
• HbA1C levels- Blood test that shows the average blood sugar level over the past 2 to 3 months.
• existing diabetic complications (neuropathy, retinopathy, nephropathy, foot problems).

The other risk factors further include obesity, low testosterone, depression, smoking, sedentary lifestyle, and certain medicines such as BP medicines. These factors can affect the blood vessels and nerves that are important for an erection.

Symptoms and Warning Signs

The symptoms and warning signs for Diabetes include-

• Weight loss
• Frequent urinating
• Pain and numbness in the hands and feet.
• Cuts and bruises that are slow to heal.
• Extreme fatigue
• Feeling hungry
• Feeling thirsty [10].

Symptoms of ED include-

• Trouble getting an erection.
• Difficulty keeping an erection.
• Wanting to have less sex [11].

Treatment Options for Diabetes-Related Erectile Dysfunction

There are many effective ways to help improve erectile dysfunction caused by diabetes. You can talk to your doctor about any of the following treatment options based on your preferences-

Vacuum erection device

These are also called the penis pump and are a hollow tube that you can put over your penis. This pump can draw blood to the penis to create an erection. Following this, a band is placed at the base of the penis that can help in keeping the erection after the tube is removed [12].

Penile Implants

When medicines and a penis pump do not show an effective result, you can opt for penile implants. A surgical implant is safe and an effective option for many men with ED [12].

Oral ED medicines

ED medicine belongs to the drug class PDE5 inhibitors that work by improving the blood flow to the penis. Some of the common and popular PDE5 inhibitors recommended by doctors include Sildenafil, Vardenafil, and Tadalafil. These ED tablets work within 30 minutes of intake; however, the duration of action may vary based on the medication.

Lifestyle Changes to Improve Sexual Health

Some lifestyle changes for better sexual functioning include-

Managing your weight

Being overweight can cause inflammation throughout the body. This can increase substances called reactive oxygen species or ROS, which can fight against nitric oxide and make it less effective. Therefore, losing weight can decrease inflammation and also decrease ROS in your body. This can thus increase the level of nitric oxide in the body, thus helping you get a firm erection [13].

Reduce your stress level

When you are going through stress, your body can respond by constricting the blood vessels. This can therefore reduce your blood flow in the body, including to the penis. This restriction in blood flow can result in ED.

Drinking Responsibly

Drinking alcohol in moderate levels is advisable, and this can also help with relaxation and getting in the mood for intimacy. However, drinking in excess can worsen erectile dysfunction.

Quit smoking

Smoking can not just affect your sexual health but can also result in numerous other health issues. When you stop smoking, it decreases the impact of ROS has on the nitric oxide production in your body [13].

Prevention: Reducing the Risk of ED in Diabetes

You can reduce your risk of lower sexual issues related to diabetes in the following ways-

• Go for a diabetes health checkup- Doing a HbA1c blood test, checking your cholesterol level, and blood pressure will help your doctor keep your blood sugar level and other factors contributing to ED in check. This can thus lower the risk of ED.
• Maintaining your blood sugar levels- Maintaining your blood sugar level will help in reducing blood vessel and nerve damage that can affect your blood flow, which is a key factor in getting and maintaining an erection. This will also help you lower the risk of UTIs and thrush.
• Take blood sugar medicines.
• Stay physically active- You can go for a run, jog, or walk for 15 to 20 minutes to keep your blood sugar level in control. This can also lower the risk of other factors that can contribute to ED.
• Eat a healthy and balanced diet- Eating right that contains enough vitamins and minerals will help you protect against nerve damage. It also promotes early repair of the nerves [6].

Diabetes And Erectile Dysfunction- Our Final Thoughts

Diabetes is a long-term condition that can significantly affect many aspects of health, including sexual well-being. Erectile dysfunction is a common complication of diabetes, mainly due to prolonged high blood sugar levels that damage blood vessels and nerves essential for achieving an erection.

With early diagnosis, proper blood sugar control, and timely medical intervention, diabetes-related erectile dysfunction can be effectively managed. A combination of medical treatments, such as oral ED medications or devices, along with healthy lifestyle changes, including weight management, regular physical activity, stress reduction, quitting smoking, and responsible alcohol consumption, can greatly improve sexual function and overall quality of life.