How to Manage Erectile Dysfunction When You Have Diabetes

April 22, 2024

4 mins

Erectile dysfunction (ED) is a common issue for men that affects quality of life and relationships. ED is the inability to reach or maintain an erection.

Several issues can be the source of erectile dysfunction. Certain preexisting health conditions like diabetes can increase the risk of a man developing ED. 

Studies suggest that 35 to 75% of men with diabetes experience some degree of erectile dysfunction. Around 11% of people in the United States have some form of diabetes. Some studies suggest that almost 50% of men with diabetes can develop ED within 10 years of a diagnosis.

This article explores how diabetes can lead to erectile dysfunction and tips on managing it.

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What is Diabetes?

Diabetes occurs when the pancreas isn’t producing enough insulin. This leads to blood sugar levels that are too high or too low. Glucose (sugar) is what creates energy for the body to keep a person alert throughout the day. It’s metabolized in the mitochondria into energy for the cells.

Untreated or poorly diabetes can lead to kidney disease, vision loss (diabetic neuropathy), and heart disease. It can also lead to nerve complications like diabetic neuropathy.

What is the difference between type 1 and type 2 diabetes?

Type 1 diabetes is less common than type 2 diabetes. With type 1 diabetes the body does not produce enough insulin. Cells mistakenly attack cells responsible for producing insulin. Most people are diagnosed with type 1 diabetes early in life.

People with type 2 diabetes are more likely to be diagnosed later in life. The body experiences insulin resistance — the pancreas does not process insulin in the body correctly. An overproduction of insulin raises blood sugar levels. 

Can Diabetes Stop You From Ejaculating?

Diabetes affects more than just how insulin is processed in the body. It’s a chronic health condition that has to be managed carefully to prevent complications in other parts of the body including the penis.

How diabetic neuropathy can lead to ED

High blood sugar levels from diabetes can cause damage to small blood vessels. Severe diabetes can lead to diabetic neuropathy — damage to nerves in different parts of the body. The nerves play a key role in reaching an erection. Damage to the nerves disrupts the signals between the brain and reproductive organs.

Common symptoms of diabetic neuropathy are pain and numbness in internal organs like the bladder. Autonomic neuropathy is a type of diabetic neuropathy that can lead to problems with sex organs like erectile dysfunction and delayed ejaculation.

Nerve damage from diabetes can lead to retrograde ejaculation — semen goes back into the bladder through the urethra.

How hormonal imbalances can lead to ED

In some cases, diabetes can cause low testosterone levels. Men with type 2 diabetes have a higher risk of having low testosterone. Erectile dysfunction and low libido are some of the most common symptoms of low testosterone.

How stress and diabetes can lead to ED

It’s important to manage stress to avoid worsening your overall health. High stress levels while maintaining a chronic health condition like diabetes can be anxiety-inducing. Men with diabetes may experience performance anxiety and depression surrounding sex.

Can Diabetes Medication Cause ED?

Insulin injections are the standard medication for treating diabetes. Some people with diabetes may administer their medication using needles while others may opt for an insulin pump. An insulin pump provides a precise amount of insulin to inject into the body. 

While insulin injections do not directly cause erectile dysfunction, improperly administering the medication can lead to erectile dysfunction. A healthcare provider may prescribe metformin to help control blood sugar levels. ED is a common symptom of metformin because of its effect on hormone levels.

Diabetes increases the risk of high blood pressure. Along with insulin, a healthcare provider may recommend taking high blood pressure medications. Erectile dysfunction is a potential side effect of blood pressure medications.

Most Effective ED Treatments for People with Diabetes

Diabetes is a life-long health condition. There are changes men can make in their daily lives to improve their quality of life and manage their diabetes. If erectile dysfunction persists, there are devices and treatment plans that may help with erectile dysfunction.

1. Lifestyle changes to prevent ED

It’s possible to completely avoid erectile dysfunction by following a healthy diabetic-friendly diet and getting regular exercise. Health experts recommend getting at least 150 minutes of physical activity a week.

Try to limit processed foods, sugary beverages, and excess saturated and trans fat in your diet. This also reduces your chances of developing severe obesity which can prolong erectile dysfunction symptoms. 

Be sure to carefully follow instructions from a healthcare provider on how to take medications for diabetes. 

If you are struggling with the mental toll of managing diabetes, a healthcare provider can help with finding counseling and therapy options related to diabetes and sexual health.

Reduced blood flow from insulin resistance and high blood sugar levels can lead to ED. Lifestyle factors like smoking tobacco can also increase the risk of blood flow to the penis. Health experts recommend limited alcohol intake that may disrupt the effectiveness of diabetes medications.

2. Medications to treat ED

For men who do not experience any improvements with ED through lifestyle changes, some medications can help treat ED. Some oral medications can help with reaching and maintaining erections. However, it’s important to speak with a healthcare provider before starting any of them. Diabetes can increase the risk of nerve and blood vessel damage in men.

A healthcare provider may recommend the following medications:

• Viagra (sildenafil)

• Cialis (tadalafil)

• Levitra (vardenafil)

A healthcare provider may also recommend testosterone therapy if needed. Several medical tests can let a healthcare provider know if testosterone levels are lower than usual. 

3. Vacuum erection device (VED)

While rare, a healthcare provider may recommend a vacuum erection device (VED) to help men maintain an erection. A VED is a plastic medical device that helps improve blood flow to the penis. A healthcare provider can prescribe you a VED or you can use an over-the-counter (OTC) option. 

The pump creates a vacuum within the plastic tube that increases the pressure. Too much pressure can lead to injury. Be sure to reach out to your healthcare provider before using one.

4. Pelvic floor exercises

Some healthcare providers may recommend pelvic floor exercises to strengthen pelvic floor muscles. Men who do these exercises can improve bladder and bowel control. When doing Kegels, men feel a tightness in the anus that mimics the feeling of holding urine.

Pelvic floor, or kegel exercises, can be done at least three times a day or as recommended by a healthcare provider.

Additional ED Treatment Options for Diabetic Men

A healthcare provider may also discuss alternative therapy approaches before prescribing medication to treat erectile dysfunction. While it may help, holistic practices like acupuncture may not help with ED in the long term.

1. Nutritional supplements

If you prefer natural remedies, be sure to have a conversation with a healthcare provider before starting any supplements. Some supplements like L-arginine and ginseng may help with erectile function but have not been FDA-approved.

2. Platelet-rich plasma therapy

Platelet-rich plasma (PRP) therapy is a treatment that increases platelets in the blood. It can heal tissue and improve erectile function. It’s a process that has also been used for chronic wounds and other diabetes-related conditions. However, it’s not yet a widely used treatment. More research is still needed on the effectiveness of the treatment for ED.

3. Mental health support

Men with diabetes have to juggle a lot of emotional and mental changes while maintaining their overall health. If things are feeling overwhelming, a healthcare provider may refer you to a licensed professional who can help with processing feelings of anxiety, stress, and depression.

What Treatments are Not Recommended for Men with Diabetes?

Some ED treatments are still in the process of being studied. Many invasive procedures may increase the risk of health complications for men with diabetes.

Other treatments that are not typically recommended for men with diabetes include:

• Penile injections: Edex (alprostadil) or a combination of other medications can be injected into the penis to improve blood flow. Injections may not be suitable for men with penile scarring or infections from blood sugar control problems.

• Penile implants: A device is surgically implanted into the penis to cause an erection.

• Shockwave therapy: While there is limited research on the safety of shockwave therapy for men with diabetes, it can help improve penile blood flow.

How Rex MD Can Help

Managing diabetes is a life-long journey. It’s important to stay consistent with checking blood sugar levels and using medications for diabetes. 

For additional help with erectile function, Rex MD does have options to improve your sexual health. 

Rex MD offers access to a variety of erectile dysfunction treatments like Viagra (sildenafil) and Cialis (tadalafil) to help you get back to a stress-free sex life.

Get started on exploring medications that may work for you today.