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Home / Erectile Dysfunction / What is the link between diabetes and erectile dysfunction?

What is the link between diabetes and erectile dysfunction?

Let’s start with some facts…

  • Not all diabetes is a result of poor diet
  • In 2019, roughly 4 million people had diabetes in the UK
  • 422 million people have diabetes worldwide
  • Men with diabetes are three times more likely to suffer from ED
  • Complications of diabetes can be very serious, including amputations and blindness

Diabetes is a common condition that has the potential to be very serious. It can have wide-reaching effects on your overall health and lead to secondary and tertiary conditions such as erectile dysfunction.

Fortunately, there are many ways to remedy diabetes, from oral medications to lifestyle changes. Read on to learn more about the link between diabetes and ED, and discover how to best treat them individually and together.

How does an erection work?

An erection is the direct result of increased blood flow to the penis. Inside your ‘member’ is an artery called the cavernosa artery or penile artery. It runs all the way up the shaft and divides into two separate tubelike chambers, the corpora cavernosa.

When you are aroused, your brain signals your body to pump blood into these chambers which fill up and make the penis hard. At this point, a membrane around the corpora cavernosa traps the blood in place.

Once you have ejaculated, your body will produce an enzyme called PDE-5. This enzyme breaks down the erection and blood will drain out.

How can poor circulation cause erectile dysfunction?

There are various causes of ED, stemming from psychological and physical conditions. However, by far and large, the biggest cause is vascular. Good blood flow is essential to erections. Any blockages or narrowing in the arteries can prevent sufficient blood from reaching the penile artery and filling the corpora cavernosa.

Anatomy of flacid and erect penis

How does diabetes affect circulation?

At the back of your stomach is a gland called the pancreas. This organ produces a hormone called insulin, which is essential for how your body regulates ‘energy’.

When you eat, your digestive system converts carbohydrates into sugars (or glucose). These sugars pass into your blood, which is why we talk about “blood sugar levels”. Blood glucose is used by all the cells in your body for energy so that they can perform their specific tasks. However, for the glucose to be absorbed by cells in your body, insulin needs to signal to your cells. Where there is excess sugar in your blood, insulin is also responsible for storing the leftovers in your liver.

If you have diabetes, your pancreas cannot produce enough of the hormone insulin. In some cases, you may not produce any insulin at all. The importance of this hormone’s role in energy conversion can be seen in some of the symptoms of diabetes, for example, weight loss and fatigue.

If you have uncontrolled high blood sugar, your blood vessels can become damaged. This happens when too much glucose decreases the levels of important nitric oxide. Nitric oxide is a vasodilator, which means it keeps your blood vessels widened. Restricted blood vessels mean blood cannot travel as freely through the body. One consequence of impeded blood flow is difficulty achieving an erection - good arterial health is necessary to pump blood to the penis.

Symptoms of diabetes related to circulation also include numbness of the extremities, wounds taking longer to heal, and increased susceptibility to infections.

Artery with atherosclerosis

How can I improve ED and diabetes* with lifestyle changes?

*If you have type-1 diabetes, the only treatment is regular insulin shots. Type-2 diabetes can be managed through diet.

Diet and lifestyle changes are often neglected for medications and surgery. Despite this, eating healthily and exercising regularly can be more effective and pose far fewer health risks than pills like Metformin, Janumet and Competact.

You should always follow the advice of your doctor, and if you have been prescribed treatment, take it as instructed. However, it is also always beneficial to exercise, improve the foods you are consuming, and (if you are overweight) reduce portion sizes.

image of the diabetes medication Metformin

Obesity is a leading cause of diabetes. The spikes in blood sugar levels when you overeat can cause the insulin-producing cells in your pancreas to overwork, eventually leading to their failure. Obesity can also cause high cholesterol where fatty plaques can form in your arteries, narrowing an already narrow space - this is especially dangerous if you have been diagnosed with diabetes.

Maintaining a healthy lifestyle guards against secondary conditions like high cholesterol and high blood pressure (hypertension) and will prove effective in the long-term management of diabetes. In turn, this improves cardiovascular health and may cure some cases of erectile dysfunction.

Contrary to popular belief, there is no “diabetes diet”. Instead, you should ensure you are consuming plenty of fruit and vegetables, reducing overall fat intake (especially saturated fats), avoiding processed meats and increasing fibre intake with wholegrain foods.

It’s not just about weight. What's another risk factor?

Stress has also been identified as a contributing factor to both diabetes and ED.

When you are stressed, your body produces the hormone cortisol. This raises your blood pressure, heart rate and blood sugar levels as your body prepares itself to work harder. Unfortunately, this can impact your management of diabetes, as all of these burden an already impaired circulatory system.

With ED, not only is the impaired circulation an obstacle in achieving a strong erection, but poor mental health can also cause sexual dysfunctions. Depression and anxiety can damage self-esteem and affect libido. Stress both causes and exacerbates mental health issues.

If you suspect you have depression or anxiety, you should seek treatment from a healthcare professional.

It is easy to reduce daily stress and improve quality of life - try adopting one or more of the suggestions below:

  • experiment with relaxation techniques like deep breathing
  • take time out of your day to meditate
  • go for a brisk walk in the evenings/mornings
  • eat a healthy, varied diet
  • talk about any issues with a friend or relative
Man meditating

What ED medications are diabetes-friendly?

If diabetes is the cause of your ED, you can expect PDE-5 medications to be effective as these increase blood flow. The most famous of this class of medication is Viagra (containing the active ingredient sildenafil), however, not all men find it the most effective option, especially if they have secondary health conditions.

Levitra is a great alternative to Viagra that many diabetic men find effective. Levitra contains the active ingredient vardenafil and is available in lower concentrations than other ED pills. If you have tried other pills, such as Viagra and found you experience side effects, Levitra should be more tolerable.

Cialis is another treatment for ED that contains the active ingredient tadalafil. The advantage of Cialis is that its effects can last for up to 36 hours - this makes it the best option for spontaneous sexual intercourse over a prolonged period.

It is important to note that these treatments will only work if the cause of your ED is poor circulation. There are many other causes of the condition, including psychological factors, low testosterone and nerve damage. You should always speak with a doctor or urologist before starting any prescription treatment - they will advise whether or not it will be effective and ensure it is safe for you to use. If it is not, they will recommend other treatment options and ways to improve your sex life.

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