Everything about Diabetes and Erectile Dysfunction Explained

Diabetes and Erectile Dysfunction

What is Diabetes?

In the simplest terms, Diabetes or diabetes mellitus is a chronic, metabolic disease; that is characterized by much-increased levels of blood glucose or blood sugar, which in turn over a period leads to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. 

Types of Diabetes

What is Erectile Dysfunction?

Erectile Dysfunction or ED is a medical condition when men find it really difficult to attain a penile erection or maintain the same for successful intercourse or for adequate sexual pleasure. 

Can Diabetes cause Erectile Dysfunction or ED in men?

Erection problems, often termed erectile dysfunction or ED, are common problems in men with diabetes, specifically in those with type 2 diabetes. 

Erectile dysfunction also can be caused by high blood pressure and heart disease, which are again common conditions among men with diabetes. 

Although aging is a predominant reason behind ED, erectile dysfunction often occurs earlier in men with diabetes. 

Men might notice problems with erections even before being diagnosed with diabetes or heart disease. 

People with diabetes have a higher risk for erectile dysfunction (ED). In fact, ED is 3.5 times more likely in men with diabetes than in men without.

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Why or How does Diabetes lead to Erectile Dysfunction (ED) in men? 

The attaining, maintaining, and ending of a penile erection is a much more complex process involving mood, nerves, blood vessels, muscles, and so on. Diabetes can influence every part of the process. Let us understand how. 

1. Damage to blood vessels or microvascular disease

When high blood sugar runs over a long period of time, it can damage the nerves and small blood vessels that supply blood to the penis. This is called a microvascular disease or microvascular endothelial dysfunction. 

Damage to small blood vessels in the penis means that the muscle walls of small blood vessels are not working properly, which reduces the amount of blood flow. This obviously means that the natural process of getting and sustaining an erection is not going well. Hence, the risk of ED is higher in men with long-standing diabetes and those with blood glucose levels. 

In men with diabetes and high blood pressure, high blood pressure can also damage the blood vessels in your penis and increase the likelihood of ED. 

2. Higher Risk of Cardiovascular Diseases due to Diabetes, leading to ED 

People with diabetes also have a higher risk for cardiovascular or heart problems, and it boils down to the same reason, i.e., over time, high blood sugar levels will eventually damage the blood vessels and nerves that supply blood to the key organs and structures in the body. 

Again, if the heart falls into a problematic state, then it will pump lesser blood, and there will not be sufficient blood to the penis for a proper erection. 

3. Damage to nerves or diabetic neuropathy

High blood sugar levels can also damage nerves. Healthy nerves and blood vessels are what make it possible to have and maintain an erection that is satisfying enough for sex. As the nerves are key to the process of getting and maintaining an erection, any damage to the nerves in your penis can cause erection problems.  

4. Abnormal fat and cholesterol levels

Having unhealthy fat and cholesterol levels like high LDL cholesterol, low HDL cholesterol, and high triglyceride levels increases the risk for ED; by severely damaging the blood vessels.

5. Excess weight gain 

It is quite common for people with diabetes, specifically with type 2 diabetes, to put on excess body weight. Having a lot of body fat, especially around the abdominal area is directly linked to ED problems. It’s also common for men with heavier weights to have lower testosterone levels, which can also play a role in erection problems. 

6. Low testosterone levels

Diabetes can lower testosterone levels. In fact, as many as 50% of men aged 45 and older with type 2 diabetes have low testosterone levels. Testosterone, on its part, affects your sexual life in multiple ways, like influencing sexual drive or arousal to erections themselves. 

The relationship between testosterone, diabetes, weight, and cholesterol is quite complex. To further fuel the vicious cycle, low testosterone can cause abnormal fat and cholesterol levels. 

Treatment with testosterone replacement, like gels, patches, or injections, may help.  

7. Mood and mental health struggles

People with diabetes are more likely to have mental health struggles than those without. In fact, people with diabetes are twice as likely to have depression than people without diabetes. This often comes from the combined stress of managing a chronic disease, worrying about the future, and experiencing ill health. 

In this was not enough, Depression, anxiety, and antidepressant medications can all lead to erectile dysfunction. Stress, depression, excess weight, high blood pressure, and medications can all contribute. Together, they increase the likelihood of having ED. In fact, diabetes has been described by some researchers as a “melting pot of circumstances” that can contribute to impotence. 

It is not always clear what comes first, ED or depression. But either way, it is often hard to solve ED without addressing mental health.   

8. Medication side effects

Many men who have diabetes take multiple medications to reduce their risk of heart problems or complications from diabetes. Unfortunately, some of these medications may also contribute to ED, for example, blood pressure medications and antidepressants, as a part of their side effects. 

Can Erectile Dysfunction caused by Diabetes be reversed? 

With careful blood sugar control and treatment of other factors that contribute to ED, it is possible to stop ED from happening or from getting worse. But, existing damage to nerves and blood vessels caused by diabetes can not be reversed.

With the combination of lifestyle changes, careful diabetes management, mental health, relationship support, if needed, and ED medications, treatments for ED in people with diabetes can be successful. 

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