Table of Contents
Key Takeaways
Men with diabetes are more likely to experience ED due to blood vessel and nerve damage caused by poor blood sugar control.
Managing blood sugar through lifestyle changes, diet, and exercise can improve overall health and sexual function.
Treatment options for people with diabetes and ED range from medication and vacuum devices to surgical implants, though effectiveness varies person to person.
More than half of men with diabetes experience erectile dysfunction (ED). It affects 37.5% of men with type 1 diabetes and 66.3% with type 2 diabetes. People with diabetes have a 3.5-fold higher prevalence of erectile dysfunction than those without. What’s the connection? (1)
Read on to learn how diabetes affects sexual health and ways men can manage erectile dysfunction.
Understanding How Diabetes Affects the Body
Diabetes is a metabolic disease that affects the pancreas’s ability to produce insulin, a hormone that controls blood sugar (glucose) levels. People with type 1 diabetes don’t make any insulin, and people with type 2 diabetes don’t make enough.
As a result, the cells don’t use glucose efficiently, which can dangerously raise blood sugar levels (hyperglycemia). Over time, poor blood sugar control can damage the body, especially the nervous system and cardiovascular (heart and blood vessel) system. People with diabetes manage their blood sugar through regular monitoring, lifestyle changes, and medications. (2)
The Connection Between Diabetes and ED
Both the nervous system and cardiovascular system are key to sexual health, especially arousal. When they’re damaged, it impacts a man’s ability to get an erection.
During arousal, blood rushes into the penis. This causes an erection. Unhealthy blood vessels in the penis can prevent blood flow. ED has a close relationship with cardiovascular health — in fact, ED can predict cardiovascular disease. If you’re diagnosed with ED, it may be a sign to start addressing heart and blood health to lower the risk of more serious complications (like a stroke).
People with diabetes may develop a nerve condition called diabetic neuropathy. This occurs when small, damaged blood vessels stop providing nutrients to portions of nerves. When the brain isn’t communicating effectively with the penis, it may not signal the blood flow needed for an erection. (1, 3)
Related Factors Linked to ED
Diabetes and ED have overlapping risk factors that can lead to ED. These include: (1)
High blood pressure (hypertension)
High cholesterol (dyslipidemia)
Obesity
Certain medications used to treat these issues can make it difficult to get erections, too. For example, blood pressure medications can impact the blood flow to the penis. (3)
The emotional toll of managing a long-term disease may also impact arousal. People with diabetes are twice as likely to develop depression as those without diabetes. Symptoms of depression can reduce desire (libido) and decrease how often you have sex. Depression can also negatively influence self-care, which may affect how people manage their diabetes and become an unhealthy cycle. (1)
Management Options
If you have ED and diabetes, talk to your doctor about treatment options. You may be able to improve arousal with controlled blood sugar, medication, non-invasive devices, or surgery.
Control Blood Sugar
Since many risk factors overlap between ED and diabetes, changing your lifestyle and focusing on blood sugar control could improve overall health.
Improving your diet and exercising regularly are linked to a healthier metabolism and improved sexual function. Losing just 5% of weight has other positive effects on cardiovascular health (which can improve arousal), and greater weight loss provides additional benefits. (1)
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Take ED Medication
Several medications are available to treat ED. PDE5 inhibitors (PDE5i) are the first-line option, which include sildenafil, tadalafil, vardenafil, and avanafil. PDE5 is an enzyme that tightens blood vessels. Blocking PDE5 widens blood vessels and improves blood flow to the penis.
Unfortunately, it’s only 50% effective in men with diabetes. Experts believe this is due to blood vessel and nerve damage as well as low testosterone levels (a common issue among men with diabetes), which may affect how well the medicine works. Experts also think pairing PDE5s with testosterone replacement therapy could help, but research isn’t sure how effective this is yet.
Aprostadil is another medication used to treat ED. It’s currently available as a suppository or an injection, though a cream version is undergoing clinical trials and has shown promising results. (1)
Total Diabetes Supply now offers prescription treatment for sexual health. You just need to complete an online consultation to begin. If you’re eligible for treatment, a licensed provider will evaluate your health history and provide your prescription treatment. Medications arrive discreetly at your door. Enroll in our Rx Program today.
Use Non-Invasive Treatments
You can try non-invasive options, like vacuum erection devices. These are cylindrical devices placed over the penis. When you manually pump the device, it creates a vacuum that draws blood into the penis and causes an erection. They’re not the most comfortable treatment option, but they’re up to 75% effective in men who use them, especially in combination with ED medication. (1)
Our Total Diabetes Supply shop sells several vacuum therapy kits. For example, the Owen Mumford Rapport Classic Vacuum Therapy ED Device comes with a carrying case, lubrication gel, and five tension ring sizes. Our shop also carries extra tension rings in multiple sizes.
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Get Surgery
For men who don’t respond to other treatments, surgery could be an option. The most popular and effective option is a penile prosthesis, which implants an inflatable device into the penis.
Up to 95% of people with penile prosthesis are satisfied with the result, but men with diabetes are at risk for infection if blood flow issues affect healing. You can work with your doctor to weigh the advantages and disadvantages of surgery based on your overall health. (1)
Bottom Line
Erectile dysfunction is common among men with type 1 and type 2 diabetes. It’s primarily linked to poorly controlled blood sugar levels and resulting damage to blood vessels and nerves.
Men with diabetes can treat ED with blood sugar control and ED medication, but these methods may not work for everyone. Vacuum therapy is an effective option for many. Men seeking more permanent solutions may opt for surgical implants, but infection is a risk.
References
Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., Faggiano, A., Pozzilli, P., Isidori, A. M., & Gianfrilli, D. (2021). Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes/Metabolism Research and Reviews, 38(2), e3494. https://doi.org/10.1002/dmrr.3494
World Health Organization: WHO & World Health Organization: WHO. (2024, November 14). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
American Diabetes Association. (n.d.) Sex and Diabetes. https://diabetes.org/health-wellness/sexual-health/sex-diabetes
Tseng, C. H. (2022). Metformin’s effects on varicocele, erectile dysfunction, infertility and prostate-related diseases: A retrospective cohort study. Frontiers in Pharmacology, 13, 799290. https://doi.org/10.3389/fphar.2022.799290
FAQs
Does Viagra work even if you have diabetes?
Viagra (sildenafil) is one of the first-line ED treatments, but it could be less effective in men with diabetes because of blood vessel and nerve damage or testosterone levels, according to experts. (1)
Can you reverse erectile dysfunction from diabetes?
It can be possible to reverse erectile dysfunction with conservative treatments, like changing your lifestyle and taking medication to lower blood sugar.
Men with diabetes who continue to experience erectile dysfunction may consider alternative treatments, like taking ED medication or using devices designed to cause an erection. Surgery is usually the last resort.
Does metformin cause erectile dysfunction?
Metformin and other medications used to treat diabetes are generally believed to protect against ED, but research is mixed. More recent studies suggest that sexual dysfunction could be a side effect for some people with type 2 diabetes. (1,4)
