Men's Sexual Health and Diabetes

Among men, the diagnosis of diabetes brings with it the concern about impotence or erectile dysfunction (ED). But, are problems with erections really more common in men with diabetes than men without diabetes? Because so many men suffer in silence, it's difficult to count how many men with and without diabetes actually have a problem. Here's what we do know:

• ED is age related. It is primarily a problem among men over 40, with and without diabetes.
• Of all men with diabetes over the age of 50, it is estimated that 50 to 60 percent have some degree of ED.

ED has a range of severity. The numbers about ED count all types, from occasional to complete impotence. Complete impotence occurs much less often. So just what is impotence?

Being impotent means that most or all of the time, the penis fails to become or stay hard enough for sexual intercourse. If, on occasion, you fail to maintain or achieve an erection, you're not impotent. You are also not impotent if you experience a decrease in sexual desire, have premature ejaculation, or if you fail to ejaculate or reach orgasm. If you are impotent, you can't achieve or maintain an erection. However, many of these other problems can also occur with impotence.

Paul had been diagnosed with type 2 diabetes a few years ago. He had been keeping his blood glucose levels in check, but had recently been traveling quite a bit. He wasn't exercising very often and was eating out most of the time, and he also noticed that he had put on a few pounds. But the worst part was the effect on his sex life. For the past several months, it had become increasingly difficult to sustain an erection. And he had been unable to achieve an erection the last dozen or so times he attempted sexual intercourse. Now he had just given up trying.

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ED can be caused by physical or psychological factors or both. The most common causes in men with diabetes are blood-vessel and nerve-related damage. If you have experienced neuropathy or cardiovascular complications of diabetes, you are at risk for ED. The way to reduce your risk is to keep your blood glucose levels as close to normal as possible. In addition, it will help to quit smoking, decrease your alcohol intake, and keep blood pressure near normal. Psychological factors, depression in particular, are also common culprits in men with diabetes.

Figuring out why ED occurs can be difficult. Sexual desire begins in the brain, and signals are sent through the nervous system to the blood vessels to trigger an erection. The male sex hormone testosterone is also involved in sexual desire and achieving erection.

Hearing so much about ED can create fear that contributes to the problem. And if you know that you are at increased risk because you have diabetes, you may even expect it to happen.