Erectile Dysfunction (ED) and Diabetes

What is the link between diabetes and erectile dysfunction?

Last reviewed: 09 Mar 2019

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Key takeaways

  • Diabetes can lead to erectile dysfunction because of the effects it has on blood vessels, nerves, cholesterol levels, and blood sugar

  • Diabetes medication can also cause erectile dysfunction as a side effect

  • Erectile dysfunction in diabetes can be treated with PDE5-inhibitor medications like Viagra, Sildenafil, and Cialis

  • There is no cure for diabetes-related erectile dysfunction. Controlling your diabetes symptoms and your weight can help though

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Erectile dysfunction, which is also called ED or impotence, can be caused by many factors. One common cause of erectile dysfunction is diabetes. In fact ED may be the first symptom of diabetes in some men. Studies show that as many as 75% of men with diabetes will go on to develop erectile dysfunction. Depending on what’s causing your ED, lifestyle changes and medication may help.

Why can diabetes cause erectile dysfunction in men?

The causes of ED are complex, and so is the link between diabetes and ED. ED is commonly caused by changes to nerve, muscle and blood vessel functions.

It’s thought that men with diabetes will tend to develop ED between 10 and 15 years earlier than other men. There are several reasons for this.

A chemical called nitric oxide goes into the bloodstream when a man gets sexually aroused. It acts as a chemical message to tell the arteries and muscles in the penis to relax. This allows more blood flow into the penis, resulting in an erection. If your blood sugar level is too high, for example as a result of poorly managed diabetes, it can affect your nerves and blood vessels and stop the release of nitric oxide. This can mean there’s not enough blood flowing into the penis to get or keep an erection.

If you have diabetes, it’s quite common to also have high cholesterol. High levels of LDL (bad) cholesterol can cause fatty deposits to build up in your artery walls. This can also reduce the blood flow to your penis.

Lifestyle can play a part in ED, particularly smoking. Smoking can reduce the blood flow all around your body, including to your penis.

Sometimes, the medication you’re taking to manage diabetes, or other conditions that go with it, can cause you to experience ED. If this is the case, ask your doctor if you can try another medication instead. Don’t stop taking your prescribed medicine without speaking to your doctor first.

Does diabetes medication cause erectile dysfunction?

It can do. Side effects of drugs are thought to be responsible for up to 25% of ED and the list of other prescription medications known to affect sexual function includes:

  • blood pressure drugs
  • antidepressants
  • antipsychotic drugs
  • sedatives
  • seizure medications

How common is it for men with diabetes to experience erectile dysfunction?

It’s very common. Up to 75% of men who have diabetes will have ED at some point in their life. If you’re over 70, there's a 95% chance that you will experience some degree of ED.

This can also lead to depression, low self-esteem and anxiety, which are known causes of ED. It’s thought that between 10% and 20% of ED is caused or made worse by psychological factors.

How can you treat erectile dysfunction when you have diabetes?

If you think that your ED may be caused by diabetes, it’s important to get your diabetes under control. You may find that once you start to manage your diabetes effectively, the ED symptoms clear up.

There are drugs called PDE-5 inhibitors that your doctor can to prescribe to help with ED, and men with diabetes are entitled to NHS prescriptions for them. They are:

These drugs work for about 4 hours and are taken when you need them, except for Cialis. They usually take around 30-60 minutes to take effect. With Cialis the effects can last up to 36 hours, making it more suitable for situations like a weekend away.

Another drug called alprostadil might also help if PDE-5 inhibitors don’t seem to work for you. It’s available as an injection into your penis or as a pellet which you have to insert into your urethra (the tube that takes urine away from your bladder). Depending on the dose, you should get an erection between five and 25 minutes after using the pellets/injection.

If you think that your ED might be caused by a medicine you’ve started taking, ask your doctor for advice. A different medication might help.

Can you cure erectile dysfunction when you have diabetes?

There’s no medicine that will cure ED caused by diabetes, and surgery is usually only used in cases where ED has been caused by an injury or physical problem.

If getting your diabetes under control and reviewing your medication hasn’t helped, you could consider lifestyle changes.

There are a few factors that lead to a higher risk of diabetes which may also impact on ED. Drinking too much alcohol is known to affect sexual performance, and a study carried out in Finland in 1999 proved a definite link between smoking and a loss of sexual function. Limiting your alcohol and stopping smoking are two things you can try for yourself to see if they help your ED.

Being overweight, obese and inactive are also risk factors for ED and type 2 diabetes. If you lose weight you might find that it’s easier to manage your diabetes and your ED symptoms improve too.

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Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015.

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Last reviewed: 09 Mar 2019

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