Erectile dysfunction, or ED, can occur for a variety of reasons. Sometimes, ED is psychological—a result of anxiety, discomfort or nervousness about sex. More often, however, it’s a result of a physical condition, such as obesity or high blood pressure. Unfortunately, erectile dysfunction and diabetes are a perfect example.
The science is out: Men with diabetes are more likely to experience ED than average. Diabetes also increases the chance that you will develop ED earlier in life, often by 10 to 15 years.
In this guide, we’ll look at the the link between diabetes and erectile dysfunction, as well as how diabetes can directly cause erectile dysfunction. We’ll also cover the most effective treatment options for men with diabetes and ED.
Erections occur through a complex process involving arteries, nerves, blood vessels and bodies of soft tissue that make up the penis.
When you’re sexually aroused, your brain signals to the arteries in your penis to increase blood flow to the corpus cavernosum—an area of soft erectile tissue in the penis that’s responsible for storing blood during sexual activity.
As blood flows into the corpus cavernosum, the penis hardens, creating an erection. A range of factors can determine the level of hardness you achieve during sexual activity, from the amount of sexual stimulation, to your body’s ability to pump blood into the penile tissue.
Diabetes and erectile dysfunction are linked because diabetes directly affects your body’s ability to supply blood to the penis by damaging both blood vessels and nerves. Men with diabetes typically have narrower, more constricted blood vessels that just aren’t as capable of supply blood to parts of the body such as the penis.
In short, the same diabetes-related blood vessel damage that causes numbness in the feet and other limbs can also affect the penis, making it much more difficult to get and maintain an erection.
ED is extremely common in men with diabetes. Current studies put the rate of ED amongst men with diabetes at 35 to 75 percent. Men with diabetes also tend to develop ED anywhere from 10 to 15 years earlier than health men without diabetes.
Sexual performance issues are particularly common in older men with diabetes. Above age 50, men with diabetes have a 50 to 60% chance of being affected by ED. This increases to 95% as diabetes-affected men reach the age of 70.
To put this in perspective, approximately 70% of healthy, non-diabetes men aged 70 and above experience some degree of ED.
Luckily, erectile dysfunction and diabetes don't have to always make a recipe for disaster. A variety of ED treatment options are available for men with diabetes, many of which are highly effective. The most widely used of these treatment options are oral medications such as sildenafil, tadalafil and vardenafil.
These medications inhibit PDE5, an enzyme that regulates blood flow to tissue in the penis. A standard dose of ED medication such as sildenafil can increase the rate of blood flow to penile tissue, making it easier to develop and maintain an erection if you have diabetes.
ED medications vary in their onset of action and half-life, with some (such as tadalafil) providing effects that last and others (such as sildenafil), designed to provide effects that last for three to four hours. Our guide to what you should expect from ED medication goes into more detail on these drugs.
Because ED medications such as sildenafil, tadalafil and vardenafil can also have effects on the cardiovascular system, it’s important to speak to your doctor before using any of these drugs to treat diabetes-related ED.
ED medications can also interact with some medications used to treat high blood pressure—a common issue for people with diabetes—making it important not to use any ED drugs without first consulting your doctor.
It's also important to remember that there's no definitive best ED pill for diabetics. The best option you have is to seek out professional advice from a medical doctor as soon as possible.
In addition to traditional ED medications, there are alternative treatments available for diabetics, such as injections and vacuum erection devices (VEDs). Non-pharmaceutical treatments such as sex therapy can also be effective in improving sexual performance and preventing recurring ED.
As always, if you're noticing a link between your erectile dysfunction and diabetes, the best solution is to talk to your doctor about your situation. ED is a common issue for men with diabetes, meaning most endocrinologists are well informed on the most effective treatment options. If you want to learn more about all the common erectile dysfunction treatments and drugs available to you, check out our guide.