How is diabetes linked to erectile dysfunction?
The majority of erectile dysfunction cases occur in men older than 50, but those with diabetes often get ED 10-to-15 years earlier than those without. Men with diabetes are also four times as likely to be diagnosed with ED. Although there are many other causes, about 50 percent of diabetic patients have ED—making diabetes one of the most common causes.
Men with diabetes may also suffer with worse ED symptoms than those without. They may also experience increased severity of ED as they get older and with poor diabetes control. Therapy and cardiovascular complications can also worsen symptoms of ED.
If you have diabetes, make sure you treat it properly to decrease the risk of ED, but keep in mind that risk will not be eliminated.
The reasons so many diabetics end up with ED are numerous.
Diabetics often exhibit changes of blood sugar levels because they produce little to no insulin, a hormone that changes glucose into energy the body needs for daily life. Since people with diabetes experience high blood sugar levels, the penis can be affected in a variety of ways, including blood vessel damage, nerve damage or even erectile tissue damage—all of which can cause ED.
Diabetes also affects the nervous system through neuropathy (damage to nerves). When nerves are damaged, it inhibits the brain’s ability to relay proper information to the penis, making it difficult to maintain a firm erection for sexual intercourse.
Since diabetic men have poor blood sugar control, the formation of chemicals (like nitric oxide) in the penis that enable erections is inhibited. Nitric oxide is the main neurotransmitter involved in getting and sustaining an erection. Erections are nearly impossible without this chemical, because the pressure of blood can’t raise enough to shut off the valve mechanism which allows blood to flow away from the penis.
Diabetes also causes the hardening and narrowing of blood vessels. When blood vessels become too narrow or hard, it results in poor circulation of blood and oxygen to the penis—causing ED by affecting pressure in the penis.
Diabetics also produce chemicals called advanced glycation end products (AGE), which can stiffen erectile tissue and other tissues. When the erectile tissue becomes stiff, the valve mechanism inside the copora cavernous can become defective—otherwise known as a venous leak. This can lead to severe ED and poor response to ED medications such as Viagra, Cialis and Levitra.
Without proper levels of insulin, glucose levels in the blood are quite high in diabetics, and when these levels are prolonged, ED is more likely. Diabetics also commonly experience neuropathy (nerve damage) to the body, including the penis, which leads to ED.
Coronary atherosclerosis (narrowing of the coronary arteries), symptomatic coronary artery disease or asymptomatic (silent) coronary artery disease are other factors that leads to ED.
Diabetics are also at risk of ED when they have damaged nerves, the longer they have diabetes and the older they get.
Diabetics with ED also commonly exhibit chronic diabetes complications like endothelial dysfunction, which is closely related to atherosclerosis and cardiovascular disease. Their presence could be an early warning for early or silent cardiovascular diseases such as coronary heart disease, peripheral vascular disease or even a stroke.
It’s possible that oral ED medications won’t work as well for diabetic men. Often, men with diabetes and ED opt for penile injections of medication or
penile implants. These implants, also known as
penile prostheses, are a permanent ED treatment option that replaces spongy tissue with malleable or inflatable cylinders inside the penis.
