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Article by Dr. Sheri Colberg, Phd, FACSM

 

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TYPE 2 DIABETES AND ERECTILE DYSFUNCTION (ED)


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A common side-effect of type 2 diabetes is erectile dysfunction (ED) – the inability to achieve or sustain an erection of sufficient rigidity for sexual intercourse.

Also called impotence, ED isn't fleeting or isolated sexual failure, which many men experience at some point in their life for numerous reasons, including excessive intake of alcohol. Instead, ED refers to erectile failure more than 75% of the time while attempting sexual intercourse. Nor is ED the same as low sexual desire or having problems with ejaculation and orgasm.

Left untreated, ED can take a heavy toll on relationships and create great stress for both partners. Many men with ED become severely depressed, which can then affect other areas of their lives, including general health and the workplace.

Man sitting at desk with his head resting in his hands.But greatly improving the management of diabetes by increasing insulin sensitivity can achieve several things, beginning with reducing the risk of ED developing in the first place. It can also prevent the condition from worsening and, in many cases, it can safely and effectively reverse the disorder, enabling sufferers to return to a satisfying sexual life.

Any man can develop ED, though the condition has a distinctive pattern among persons with diabetes:

  • It occurs more often. As many as 80% of men with diabetes throughout the world develop ED, compared to about 22-25% of men without diabetes. More precise percentages are difficult to estimate because many men are too embarrassed to admit to having a problem or to talk to a doctor about the issue.
  • It occurs earlier. ED most frequently develops after age 65. In men with diabetes, however, it tends to occur on average 10 or 15 years earlier. Persons with diabetes in their 30s and younger have also experienced ED.

The longer you've had diabetes and the more severe it is, the more likely you are to develop ED.

Erectile dysfunction has many causes, both physical and psychological. Medical conditions such as heart or liver disease can cause ED, as can surgery or trauma. Depression, stress and excessive worry about sexual performance can all interfere with normal erectile function, whether you have diabetes or not. And certain medications, such as those used to treat high blood pressure, can also cause temporary ED.

When you have diabetes, the main risk factors for developing ED are:

  • Nerve damage (neuropathy)
  • Blood vessel (vascular) damage
  • Poor blood sugar control

A complex physical and psychological interaction underlies an erection. On a physical level, the penis contains two cylindrical, sponge-like structures that run along its length. Those cylinders, called the corpora cavernosa, make up the bulk of the erectile tissue of the penis.

A Man, somewhat smiling and resting his chin on his hand.The corpus spongiosum is a chamber that surrounds the urethra and becomes engorged with blood during an erection. An artery runs deep through the center of each corpus cavernosum, allowing blood to flow in. Blood flows back out through a system of veins around the outside of each corpus cavernosum.

Of course, normal sexual function in both men and women requires sensory and psychological stimulation such as erotic feelings at the same time that the nervous and vascular systems come into play.

When a man become sexually stimulated, his body responds by releasing neurotransmitters, such as nitric oxide, in the penile area. These are chemical messengers, telling smooth muscle cells in the erectile tissue to relax. When they relax, the central artery and other blood vessels widen and blood rushes into the penis.

As the corpora cavernosa fill with blood, the spongy tissue presses up against the veins, compressing them and preventing blood from flowing out of the penis. That produces an erection as the trapped blood straightens and stiffens the penis. When the stimulation ends, the muscles contract, pressure decreases and the penis becomes flaccid, returning to its non-erect size and shape.

How diabetes affects normal sexual function

In male individuals with diabetes, normal sexual function may be disrupted for a number of reasons related to nerve and blood vessel damage.

Diabetes can cause damage to nerves (neuropathy) throughout the body, including the penis. Damaged nerves can't communicate properly. So even though a man might be emotionally stimulated to have sexual intercourse, nerve damage means that the relevant information isn't relayed to the penis, so it doesn't respond.

Woman looking at a man's face while lying down.In addition, poor blood sugar control, a key symptom of diabetes, can inhibit nitric oxide production. Lack of nitric oxide can prevent the pressure of blood in the corpora cavernosa from rising enough to close off penile veins, allowing blood to flow out of the penis instead of remaining trapped for an erection. Blood vessels can also become narrowed or hardened (atherosclerosis) by conditions that often accompany diabetes, such as Cardiovascular Disease. When atherosclerosis occurs in arteries that supply the penis or pelvic area, sexual function may be disrupted.

How to fight back against ED

Erectile Dysfunction doesn't have to last forever. There are steps that can help prevent ED from occurring or worsening.

  • Control your blood sugar by increasing insulin sensitivity via more effective management of your diabetes. Good blood sugar control can prevent the nerve and blood vessel damage that may lead to ED.
  • Talk to your doctor. Initially, it can be embarrassing to talk to a doctor about sexual health. But because erectile dysfunction is a common diabetes-related problem, your doctor won't be surprised when you mention the topic. Talking to your doctor before a problem occurs can help you prevent or delay erectile dysfunction. Your doctor can also help determine if ED is the result of diabetes or another condition.
  • Avoid tobacco. Smoking and other tobacco use cause blood vessels to narrow, contributing to blockages that can lead to erectile dysfunction. Smoking also can decrease nitric oxide levels.
  • Avoid excessive alcohol. Drinking excessive amounts of alcohol can cause ED by damaging blood vessels. In general, for men that means no more than two alcoholic drinks a day. For women, it should be no more than one.
  • See a urologist. Urologists have special expertise in sexual health. Some specialize specifically in erectile dysfunction. They can help assess your condition and determine its cause.
  • Seek mental/emotional health treatment. Stress, anxiety and depression can cause erectile dysfunction. Even the fear of having erectile problems can make them worse. Talk to your doctor to see if these issues are playing a role in your ED. Treatment with a mental health professional might help.
  • Reduce your risk of Cardiovascular Disease. Men with diabetes who also have Metabolic Syndrome (Syndrome X), the cluster of increased risks for Cardiovascular Disease such as obesity and high blood pressure, face an even greater likelihood of developing ED. This is because of the added damage to blood vessels caused by Metabolic Syndrome. The risk of developing Metabolic Syndrome can be reversed by losing excess weight via a balanced, nutritious diet and regular exercise.

Man standing next to a woman with his arms wrapped around her.Taking the right steps to control existing conditions like diabetes and Metabolic Syndrome can play a vital role in reversing ED and allowing men to enjoy a healthy sex life again.

The Insulite Diabetes Advanced Management System is a scientific breakthrough that could improve your health by increasing the insulin sensitivity of your cells. Greater sensitivity can result in a huge improvement in the efficient processing of glucose and insulin, thereby reducing the amount of insulin you require to manage your diabetes.

By lowering your insulin intake and dependency through more effective management, you are likely to experience better long-term heath and a greater sense of long-term well being. You can also reduce your risk as a person with diabetes of developing such serious insulin-linked complications as failing eyesight, kidney disease and heart disease and the need for amputation.

  

 

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