Information for men
Men with diabetes may find they have difficulty getting an erection, a problem doctors call erectile dysfunction or ED. The raised glucose levels that occur in diabetes can cause damage to the nerves and blood vessels in and around the penis which are responsible for causing erections. Psychological problems, such as feeling low, worried or depressed are also likely to reduce interest in sex or raise fears about intimacy or sexual performance. Other complications relating to diabetes may also be a factor in sexual health, for example, low testosterone levels or side effects from drug treatments.
Men with diabetes should be asked about difficulties with erections at their yearly health review. At other times, men are encouraged to seek help from their GP or another Diabetes Healthcare Professional if they are experiencing problems.
Many forms of treatment are available. One option is to take a prescribed medicine called a ‘PDE5 inhibitor’. This is the group of drugs to which sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) belong. These can be used in men with diabetes, although they should not be taken alongside drugs called ‘nitrates’ (often used to treat angina), or by men who have a very weak heart and have been advised to avoid sexual activity. These drugs work by stimulating the flow of blood to the penis.
If drug treatments are not effective or are not suitable, other options should be explored. An alternative to oral drugs is to inject a drug into the penis before sex, or to insert a small pellet into the urethra, the tube that runs through the penis. Both these treatments cause the blood vessels in the penis to expand. Vacuum pumps that are placed over the penis are another option, and in rarer cases surgical implants may be offered. Finally, if there appears to be a link to emotional or psychological issues, speaking to a counsellor may be a useful approach.