Diabetes and Erectile Dysfunction
Enjoying sexuality is an important part of life for most healthy adults. But, occasionally, everyone can experience sexual problems. These problems may have nothing to do with diabetes but it may cause some specific sexual problems. Don’t let your age be a barrier to seeking medical help. It is normal for men and women to enjoy sexual activity throughout their life.
Impotence or erectile dysfunction (ED) are names given to the condition where a man cannot get or maintain an erection in circumstances in which he would normally expect to do so. “We will all at some stage in our lives have sexual difficulties” says Dr Tom Kelly, who has practised in the area of sexual medicine for over 25 years. “The problems are common. Most people with sexual problems tend to think they are unique, but there are very few things in sex that if you experience millions of others are not experiencing too.”
It’s true that certain sexual problems are related to diabetes, but there are plenty of people without diabetes who also have sexual problems. Whether or not someone has diabetes there are lots of effective treatments for erectile dysfunction.
“Lots of men wait years and years before they approach a doctor for treatment and that is a mistake. The earlier it is treated, the more effective the treatment is,” says Dr Kelly speaking on www.irishhealth.com. If you are truly feeling embarrassed at the start of the consultation, then say so. Being honest about the way you feel is a good start.
Myths about sex and diabetes
There are many myths about sexual problems and diabetes. It is important that you put these aside. Diabetes does not affect everyone the same way. Nor do all people perceive and solve problems the same way. If you have questions about the effect of diabetes on sexuality, or if you are experiencing a problem, talk to the members of your diabetes care team.
Most men will have had problems in getting or maintaining an erection at some point in their lives. Erection problems can be caused by stress, tiredness or too much alcohol. These reasons are nothing to worry about and many men will experience them, but they can lead to fear of failure. This is when you become so preoccupied with previous failure that you are no longer able to enjoy sexual stimulation to get an erection. Men with psychological reasons for erectile dysfunction may still experience ‘morning erections’. This means that the physical workings behind the erection are fine. If erectile dysfunction is due to physical problems, the man may have noticed that things were getting worse as time went on.
Possible causes may include:
• Poor blood flow to the penis because of blocked arteries (atherosclerosis)
• Too much blood draining from the penis (venous leak)
• Damage to the nerves in the penis
• Side-effects from certain drugs
• Alcohol and drug abuse
• Diabetes – poor control increases the chances of ED
• Heavy smoking
• High cholesterol
• Nervous system problems such as multiple sclerosis or after a stroke
• Prostectomy (surgical removal of the prostate gland)
Keep blood sugar under control
Keeping your blood sugar under good control is important in order to maintain health and general wellbeing. In the short-term, avoiding hypo- and hyperglycaemia can indirectly affect your sexual pleasure. In the long-term, good control of blood sugar can help prevent blood vessel and nerve complications from diabetes, both of which may interfere with sexual function.
Hyperglycaemia
Prolonged hyperglycaemia can make you feel tired. This may reduce your sexual desire and interfere with erections. Hyperglycaemia can also promote the growth of fungal infections.
Improved diabetes control and use of a fungicide cream will normally cure the infection within a few days.
Hypoglycaemia
Hypoglycaemia may cause you to feel uncomfortable and interfere with sexual enjoyment. The fall in blood sugar during intercourse is usually small and the risk of passing out is low. Still, many people have experienced hypoglycaemic episodes during intercourse, or later during the night.
Activity prior to intercourse, such as dancing or drinking alcohol, may contribute to these episodes. In any case, the fear of hypoglycaemia may reduce sexual desire and satisfaction.
Long-term complications
Diabetes can damage nerves related to sexual performance. If diabetic neuropathy affects the nerves that supply the blood vessels to the penis, erection may be diminished, or impossible.
Treatment
There are a number of treatments available. Even if you’ve received treatment in the past, it is important to talk to your doctor again since other treatments are now available that might be right for you.
Oral treatments
There are four oral treatments available, that is, tablets that can be taken b the mouth, these are:
• Cialis
• Levitra
• Uprima
• Viagra
These are either swallowed or placed under the tongue and work when there is sexual stimulation.
These treatments vary in the way they work and it may be worth discussing these further with your doctor. For example, depending on which treatment you take, it may begin to work at 20 minutes and continue to work for between 4 and 36 hours. With some of these treatments, the effect can be delayed if you take the tablet with food or alcohol. As your doctor will tell you, most of these treatments cannot be taken with nitrates (a group of treatments used for treating chest pain or angina).
While side-effects are generally mild to moderate, they vary from treatment to treatment, and it is advisable to discuss these with your doctor or nurse as there are a number of other treatments available.
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If you are worried about what to say to your doctor, here are some opening lines that can help:
- "I'm having some marital problems"
- "I've got a problem that I find quite difficult to talk about. It's of a sexual nature"
- "I'm have high blood pressure. I have heard that this can cause erection problems. Is this true?"
- "Is is possible that the tablets I am taking are causing me to have erection problems?"
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For further information on this subject see www.manmatters.ie
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Sheila O Kelly, Diabetes Ireland
Diabetes Ireland Magazine
Volume 7 Issue 1 Spring 09
APP/KOL/AC 15-05-2009