Blood vessel problems and diabetes are the leading causes of not being able to get or sustain an erection in men. “ED” is a very common diagnosis, perhaps more so now than ever before, partly due to the increase in diabetes but also because there are more treatments available now and men are less likely to suffer in silence.
Diabetics tend to get the problem 10 to 15 years earlier than other men. The degree of glycaemic control over time is a significant factor as this determines the extent of microvascular and macrovascular complications. Neuropathy, insulin resistance, endothelial dysfunction, and atherosclerosis all affect the mechanisms behind erectile function.
Even men who are not diabetic but are aged over 50 and have features of metabolic syndrome are at almost a 50% more chance of getting ED. Indeed the severity of ED reflects the degree of blood pressure, waist fat, and abnormal blood fat pattern that a man may have. If a man with diabetes has ED he is at significant risk of coronary artery disease. Low testosterone is a risk factor for ED by itself and makes metabolic syndrome and diabetes worse as well.
The main drugs to treat ED, such as Viagra and Cialis, rely on an intact neural response, so they don’t always work that well when this is impaired in diabetics. Testosterone replacement therapy can reduce cardiovascular risk in men and also enhance the response to these sorts of drugs. When drugs are still not successful vacuum devices, penile injection drugs, and penile prostheses can be used.
Men can find that following a Mediterranean style of diet can improve erectile response as can exercise.
So in brief:
Keep to as normal a weight as you can.
Keep blood sugars control as good as you can for as long as you can.
Make exercise part of your daily routine.
Eat a low carbohydrate diet with plenty of olive oil, fresh vegetables and moderate amounts of fruit.
Keep your blood pressure under control.
Seek medical advice if you have abnormal blood lipids especially low HDL and high triglycerides.
Include a testosterone check if you notice your waistline creeping up or erectile problems when you have your other diabetic blood tests.
Maintain a normal blood pressure.
Ask your doctor’s advice if you are on medication because many anti- hypertensives and anti-depressants interfere with penile function.
If you do have ED and diabetes discuss cardiac assessment with your doctor.
Based on the article: Endothelial dysfunction is the link between ED, DM and CAD by Sabair Pradhan, Doctor of Pharmacy Candidate USF College of Pharmacy. Published in Diabetes in Control February 2016.