Erectile Dysfunction and Diabetes

Diabetes and erectile dysfunction (ED) are both common conditions in the United States and are closely linked.

Men with diabetes are about three times more likely to experience ED than men without diabetes, and both conditions become more common as men age.

In fact, half of men with diabetes will develop ED.

Although diabetes can raise your risk for ED, in 95% of cases ED is treatable, including for men with diabetes. Lifestyle changes and medications can help better control your diabetes, and help address ED at the same time. 

Learn more about the connection between diabetes and ED below. 

What Is Erectile Dysfunction?

It’s entirely normal for some men to have trouble getting or keeping an erection from time to time. However, if you frequently have trouble getting or maintaining an erection to the point where it’s interfering with your sex life, your healthcare provider might diagnose ED. 

The symptoms of ED can include:

• Trouble getting an erection during sexual activity
• Trouble maintaining an erection enough to climax
• Premature or delayed ejaculation; trouble climaxing
• Decreased interest in sex

ED becomes more common with age. It’s rare in men who are less than 40 years old, but up to 44% of men who are 60 years old and 70% of men who are more than 70 years old experience ED.

How Diabetes Affects ED

Nerve damage, known as diabetic neuropathy, is a common complication of diabetes.

Neuropathy occurs when blood sugars are too high, damaging the nerves in the body, including those in the penis.

Nerve damage builds over time, so it is more common in people who:

• Have had diabetes for a long time
• Have poorly controlled blood sugar levels
• Have undiagnosed diabetes (and thus high blood sugar levels)

Autonomic neuropathy is when the nerves that control the automatic functions of the body are damaged. When this damage occurs in the penis or other reproductive organs, it can lead to ED, which is based on:

• Blood flow
• Muscle function
• Nerve function

Other Causes of ED

Erectile dysfunction is closely linked with cardiovascular disease.

If your cardiovascular or circulatory systems are unhealthy, you might not have enough blood flow to get or maintain an erection. People with diabetes are twice as likely as the general population to have heart disease. This contributes to the high rate of ED in men with diabetes. 

Sleep trouble can also contribute to ED. About half of people with diabetes experience insomnia.

In turn, insomnia can cause blood sugar levels to rise. Sleep apnea and diabetes may be associated with lower testosterone. Lower testosterone can worsen ED, and improving testosterone to normal levels can contribute in management of ED.

Diagnosis

There is no clear-cut test to diagnose ED. Instead, your healthcare provider will rely on conversations with you, a physical exam, and blood tests in order to diagnose ED. 

The healthcare provider will ask about:

• Your sex life and how your penis responds to various situations
• How often you’re able to achieve and maintain an erection during sexual activity
• Whether you have an erection during the night or in the morning, which most men with a healthy sexual system do

Next, the healthcare provider will usually perform a physical exam. This will allow the healthcare provider to identify any physical causes for ED. It will also help the healthcare provider see how the penis responds to touch, which can help identify whether you are experiencing nerve damage in the penis. 

In some cases, a healthcare provider may order blood tests to better understand hormonal imbalances that might contribute to ED; or imaging scans to study the blood flow to and from your penis. 

Prevention and Treatment

Controlling your diabetes and keeping your blood sugars within a healthy range can help you avoid ED because it will reduce your risk of nerve damage. Quitting smoking and reducing your alcohol intake can also lessen your chances of ED if you have diabetes.

Other lifestyle changes can also help you avoid and treat ED. These include:

• Being active
• Losing weight
• Eating a healthy, nutritious diet like the Mediterranean diet
• Taking care of your oral health

Medications

If you’ve been diagnosed with ED, oral medications are considered the first-line treatment. Common medications used to treat ED include:

• Viagra (sildenafil)
• Cialis (tadalafil)
• Levitra or Staxyn (vardenafil)
• Stendra (avanafil)

Unfortunately, there’s some indication that these pills might not work as well in men with diabetes as they do in men without diabetes. In addition, they shouldn’t be taken by people who are also taking nitrates for heart disease or those with other cardiac concerns.

Talk to your healthcare provider about all medications that you’re on before choosing a medication for ED. 

Other Options

If you are not able to take oral medications for ED, your healthcare provider might recommend another course of treatment, including:

• Intraurethral suppositories to maintain erection
• Injections into the penis to help maintain an erection
• A vacuum pump that helps the penis become erect
• A penile implant that is surgically implanted in the penis to facilitate an erection

A Word From Verywell

Although talking to your healthcare provider about ED can be uncomfortable, it’s important to do so. Having a healthy sex life contributes to overall wellness and quality of life. 

It can be helpful to remember that you’re not alone. Half of men who have diabetes will experience ED. Unfortunately, it’s common to have nerve damage to the penis due to diabetes. That’s purely a physical fact, not in any way a reflection on your masculinity. 

The most important thing to realize is that in 95% of cases, ED is treatable. Once you go through a one-time awkward conversation with your healthcare provider, you can return to a sex life that is fulfilling to you and your partner.