Erectile Dysfunction

What To Know About Erectile Dysfunction and Diabetes

July 30, 2021

Erectile dysfunction happens, and it happens to a lot of guys. Causes can vary: medical conditions, certain medications, and lifestyle choices can all increase your chances of developing ED. That's partly because getting an erection requires a combined effort from a variety of physiological systems, including mechanisms from the central nervous system, hormones, circulatory and cardiovascular system, and penis.

Because of the myriad possible causes of erectile dysfunction, it's important to understand the many potential risk factors too. One condition that can meaningfully increase your chances of developing erectile dysfunction is diabetes.

Below is a detailed look at diabetes and how it relates to the sexual health of men. It's particularly relevant today as almost 10% of the U.S. population are diabetic.

What is Diabetes?

The human body is incredibly complex, but one of the most important fuel sources is also the simplest. Glucose, the simplest sugar that's available in many of the foods we eat every day: fruit, carbohydrates like bread and pasta, dairy products, and more. Glucose is important, but it's also best in moderation.

Glucose in the blood is taken in through cell membranes where they are metabolized by the mitochondria into a usable form of energy for your cells. Diabetes affects the regulation of blood sugar by impacting the transport of sugar across the cellular membrane. When you eat a high carbohydrate meal, the body digests those carbs into glucose, which then enters the bloodstream through the intestines. This results in a spike in blood sugar. In response to elevated blood sugar, the pancreas releases the hormone insulin. The insulin hormone then increases the ability of sugar to be transported into cells and utilized, returning blood sugar back to a normal range.

With diabetes, the body has some deficiency in the insulin-glucose pathway, and the pancreas does not produce sufficient insulin to regulate blood sugar in the blood. Because the body is unable to adequately regulate sugar with insulin, people with diabetes may need to take insulin by injection and closely monitor their diet to ensure they don't go enter a hyperglycemic or hypoglycemic state: high or low blood sugar. Either one can result in organ damage and death left unaddressed.

What is the Difference Between Type 1 & Type 2 Diabetes?

There are two main forms of diabetes: type 1 and type 2. Both types require a similar treatment, however the cause and mechanism behind blood sugar management differs.

Type 1 diabetes occurs when the body produces little to no insulin. In most cases, people with type 1 diabetes are completely unable to produce insulin. Type 1 diabetes typically presents early in life. Many forms of type 1 diabetes are thought to be caused by an autoimmune response that results in the body attacking the cells that produce insulin in the pancreas. Regardless of its cause, type 1 diabetes requires lifelong treatment and supplementation of insulin.

Type 2 diabetics, unlike type 1, are generally able to produce some of their own insulin. In type 2 diabetes, the insulin receptors throughout the body become less sensitive to the effects of insulin. As a result the body essentially builds up a resistance to insulin. This deficiency results in type 2 diabetics needing extra insulin to make up the difference. Typically type 2 diabetes develops later in life as a result of poor health and lifestyle choices. Unlike type 1, type 2 diabetes can typically be avoided through lifestyle modifications and can be managed effectively through healthy lifestyle modifications.

Effects of Diabetes on the Body

The largest impact that diabetes presents to the body is that it affects blood sugar levels, which require tight regulation because the body needs glucose to fuel cells but not too much.

People with diabetes can live an entirely healthy and normal life as long as the condition is properly managed. When diabetes is left untreated it can cause many complications. One potential threat that diabetes presents is diabetic shock or a diabetic coma if sugar levels are left unchecked.

If diabetes is continually left poorly managed, it can cause a number of long lasting health effects, including diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy. Having physiologically unfavorable glucose levels in the bloodstream for too long or consistently strains systems throughout the body, which is thought to lead to these conditions.

Can Diabetes Cause Erectile Dysfunction?

Erectile dysfunction may seem like a completely unrelated issue to diabetes, but these two conditions can be connected in a variety of ways. The sexual response in humans is quite complex and involves many aspects, including psychological state, circulation, nervous signaling, and hormonal signaling.

Diabetes can have a drastic impact on many of these systems and is a leading reason why nearly 50% of diabetics develop ED within 10 years of their diagnosis.

The first way diabetes can cause erectile dysfunction is that poorly managed diabetes can negatively impact your nervous system. The sexual response cycle requires proper neural function, which is an important component of getting an erection. Conditions like diabetic neuropathy can lead to diminished autonomic and peripheral nerve functioning which can lead to ED.
Diabetes can also affect your circulatory system. Damaging smaller blood vessels in the body reduces circulatory efficiency, and blood flow is incredibly important to a firm erection (the penis can hold as much as seven times its usual amount of blood during an erection). This can include the blood vessels in the kidneys, which can reduce the body’s ability to maintain a proper fluid level and blood pressure. An erection requires good circulation in addition to proper blood pressure. When your cardiovascular system runs sub-optimally it can affect the ability to get or maintain an erection.
Another aspect to consider is that the same underlying causes of type 2 diabetes can also contribute to erectile dysfunction. The largest contributors to type 2 diabetes are poor diet, sedentary lifestyle, being overweight, and unhealthy lifestyle choices like smoking. Obesity is a key risk factor for ED and diabetes both, and while it can be tempting to attribute your ED to diabetes, they may simply be symptoms of a broader issue: poor cardiovascular and metabolic health. The same set of factors that cause diabetes may lead to ED.

Can Diabetes Medications Cause Erectile Dysfunction?

Typically, one of the first things to be assessed in ED patients is their intake of medications or supplements. Many medications and supplements can impact the ability of a man to get an erection and maintain it.

Insulin is the hormone that diabetics require to properly use sugar for fuel. Insulin must to be administered directly into the body by injection. Some diabetics may choose to utilize needles for the administration, while others may opt for an insulin pump, which is a device that provides precise amounts of insulin through a lead into the body at any time. In addition to insulin, some diabetic patients may take prescription blood pressure medications to avoid further complications. Abnormal blood glucose due to improper insulin dosage can cause ED over time, however there is no indication that insulin itself causes ED.

Medications used for heart and cardiovascular function, like high blood pressure medications, can cause ED (read more here). These medications are typically prescribed to those with acquired type 2 diabetes to control blood pressure associated with an unhealthy lifestyle.

How to Treat Erectile Dysfunction If You Have Diabetes

Diabetes can have a clear effect on men's sexual health, and it's a key risk factor for developing ED.

The commonality between the two is that they're both closely tied to cardiovascular and nervous system function. Damage one of these critical systems, as with diabetes, and you may impact your ability to get an erection. And, lifestyle choices carry implications for the development of both conditions.

Improving the status of your diabetes through lifestyle modifications like regular exercise and a quality diet can also improve your ability to get an erection. It's a common point of relief for diabetics who dramatically address their metabolic function.

While lifestyle modifications represent the best long term approach to helping your ED and health in general, medications like Viagra®, Cialis®, and Levitra® can all help you get back to a happy sex life in the short-term. Rex MD can help, with medications like these prescribed by licensed clinicians online, if approved. Click here to get started with our free online consultation.

The Takeaway

Erectile dysfunction is complex because it has a variety of potential causes, but diabetes is a key risk factor for the development of ED. As many as 50% of men with diabetes get ED as well. For many diabetics, their health issues can be addressed with lifestyle changes like regular exercise and proper diet.