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Sexual Activity and Diabetes

Men with diabetes face many difficulties, but few problems are more frustrating than erectile dysfunction, especially for younger men. Although stress and other factors can interfere with a healthy sex life, diabetes counters the physical reactions that lead to erections.

Indeed, about half of all men who have diabetes suffer from erectile dysfunction, and the problem can be more severe and less responsive to treatment than what men with impotence generally experience.

Diabetes is bad for your penis

Diabetes is linked to many abnormalities, but two key disruptions are directly responsible for erectile dysfunction, says Ira D. Sharlip, MD, an assistant clinical professor of urology at the University of California, San Francisco The first is diabetic neuropathy, which damages the nerves throughout the body, including those to the penis. Even if men are emotionally aroused, the nerve damage may interfere with the natural reflex that causes erections.

The second problem relates to blood vessels narrowing, a common occurrence with diabetes. In addition to causing other complications, such as heart disease, a lack of good circulation means that not enough blood can flow in and out of the penis. Added together, these effects of diabetes make it especially difficult for men to achieve or maintain an erection and often lead to complete male impotence.

Fortunately, there are many steps that men with diabetes can take to prevent and potentially overcome erectile dysfunction. Sharlip says that the same advice for managing your diabetes applies to bolstering your sexual function. "Control your weight, control your cholesterol, control your blood pressure, and don't smoke," he says. Such lifestyle changes can lead to better sugar control and improve complications of diabetes, including the development of erectile problems. But Sharlip cautions whether such steps can completely reverse erectile dysfunction on their own. "It's very tempting to think that the control of those risk factors would reverse erectile dysfunction," he says. "But there are no studies yet which prove that's the case."

Along with lifestyle changes, several anti-impotence drugs can be used for erectile dysfunction. The three drugs on the market — Viagra, Cialis and Levitra — are equally effective, Sharlip says. However, they don't seem to work quite as well in men with diabetes, who typically have more severe erectile problems. Still, he adds: "over 50 percent of patients with diabetes respond."

New erectile dysfunction therapies are currently being developed. In the meantime, some men may take testosterone, a natural male hormone that can improve sex drive. But unless a man with diabetes has low testosterone, there is a little chance it will help against erectile dysfunction.

There are other effective therapies besides drugs, including injections, external pumps and surgical implants. Most men find these less appealing than a simple pill, but can be a useful option when drugs fail to work.

Drew Voight