Does diabetes cause erectile dysfunction?

Reviewed by our clinical team

Diabetes is a condition which causes our blood sugar levels to become too high due to low levels of insulin, a hormone that controls glucose levels in the blood. 

There are two types of diabetes, Type 1, where your body’s immune system attacks the cells that produce insulin, and Type 2, where your body simply doesn’t produce enough insulin. It’s thought that around 90% of all diabetes cases in the UK are Type 2.

Depending on the type of diabetes present, there can be a number of potential symptoms. One particular concern for men is the link between diabetes and erectile problems. 

In this article, we’ll take a look at how diabetes can affect your erectile function, and what you can do about it.

Factors which increase risk of diabetes

Glucose is one of the most important sources of fuel for our body, particularly for our muscles and brain. Both Type 1 and Type 2 diabetes lead to excessive amounts of sugar in the blood, causing serious health problems.

An at-home blood test can show your risk of developing prediabetes or type 2 diabetes.  

There are a few factors which can increase your risk of developing diabetes.

Type 2 risk factors include:

• You’re of South Asian, African-Caribbean or Black African descent.
• Being 40 if you’re white, over 25 if you’re African-Caribbean, Black African, or South Asian
• You have a parent, brother, sister or child with diabetes
• You’ve ever had high blood pressure
• You’re carrying extra weight, especially around your middle/waist
• You smoke
• You get gestational diabetes when you’re pregnant
• You have polycystic ovary syndrome
• You have mental health conditions like schizophrenia, bipolar disorder or depression
• You live a sedentary lifestyle
• You drink too much alcohol
• You have trouble sleeping

Type 2 diabetes can be delayed or even prevented by changing your lifestyle, such as by losing weight, eating a healthy diet, and exercising regularly.

Risk factors for Type 1 diabetes are not as clear as Type 2, as it is an immune reaction. Some known risk factors include:

• Your family’s medical history - if one of your parents has Type 1 diabetes, you’re more likely to get it
• Environmental factors - this could be things like a viral illness
• You have cells that damage your immune system (autoantibodies)
• Geography/location - certain countries like Finland and Sweden, have higher rates of Type 1 diabetes.

We don’t currently know how to prevent Type 1 diabetes.

Sexual impact of diabetes 

There are a few areas in which diabetes can affect your sex life:

Erectile function 

Can diabetes cause erectile dysfunction? A high level of glucose in your blood, when left untreated, can cause damage to blood vessels, including those that supply your sexual organs. This often leads to erectile dysfunction, also known as impotence, where you are unable to achieve or maintain an erection. Long-term diabetes can increase the risk, and around 50% of men over 50 with diabetes report erectile dysfunction. 

Erectile dysfunction can also be caused by some medications, or emotional and psychological issues, which can themselves be made worse by a chronic condition like diabetes.

Achieving climax/orgasm 

High levels of glucose can also damage nerves (known as neuropathy), leading to reduced pleasure when having sex or masturbating, and making it more difficult to achieve orgasm.

Libido/sex drive

Diabetes does not directly influence your libido, but many of the symptoms can lead to reduced enjoyment of sex and generally lower your libido. Being very tired, depressed, or having low self-esteem can affect how much you want to have sex, and diabetes can worsen all of these, impacting your sex drive.

You may also be very self-conscious when it comes to using an insulin pump or hypo device, which causes you to avoid sex. Boosting your testosterone levels may help with loss of libido, but you should talk to your doctor about this first.

Whatever the reason, it’s important to talk about these emotions and process them properly, either with a friend, partner, or GP.

Does the type of diabetes you have affect erectile dysfunction? 

The type of diabetes that you have can influence your sexual health in different ways.

Type 1 diabetes and erectile dysfunction 

Impotence caused by Type 1 diabetes might occur in short episodes. But for about one in 10 men with Type 1 diabetes the condition can be more long term. Type 1 diabetes can also cause hardened arteries, restricting blood flow to the penis. Nerve damage could also be a contributor.

Type 2 diabetes and erectile dysfunction 

A study by the Boston University School of Medicine showed that around half of men diagnosed with Type 2 diabetes will develop erectile dysfunction within 5 to 10 years. Men with both Type 2 diabetes and heart disease are more likely to experience erectile dysfunction.

Can diabetics take Viagra?

You can take Viagra or other erectile dysfunction medicines when you are diabetic. You might be prescribed Levitra/Vardenafil. 

Benefits of Viagra for diabetics 

Better erections

Most common erectile dysfunction medications are what are known as PDE5 inhibitors. They work by blocking an enzyme known as PDE5, controlling blood flow and relaxing arterial blood vessels, whilst constricting veins. This mismatch in blood flow allows men to more easily achieve an erection.

Higher libido

Whilst Viagra and other ED meds do not directly increase your libido, not having to worry about erectile dysfunction or sexual performance can make you less stressed and, in turn, more likely to seek out sex.

Potential risks of Viagra for diabetics 

There are no particular additional risks for men with diabetes who choose to take ED medication when compared with men without diabetes, but most ED pills do come with side effects that should be considered. These include:

• headaches
• muscle and back pain
• hot flashes
• runny or stuffy nose
• dizziness
• nausea
• problems with your vision

There’s no guarantee that you will experience side effects when using Viagra, whether or not you have diabetes, but you should consult your doctor beforehand to make sure Viagra is right for you.

It is possible for Viagra to interact negatively with other medications, including blood pressure medications, so you should speak to your doctor before starting Viagra if you are concerned.

Other treatment options for diabetic erectile dysfunction

If Viagra or another type of ED medication doesn’t work for you, or if your doctor decides it’s not suitable, there are some other methods you can try.

Vitaros cream

Vitaros, also known as alprostadil, is a type of cream which can be applied to the tip of the penis to improve blood flow. Alprostadil is a synthetic hormone that works similarly to other ED medications, widening the blood vessels and making it easier to become erect. Erections with Vitaros last around two hours.

It’s often recommended when Viagra or other types of ED medication are shown to be ineffective. Men should not use Vitaros more than once a day, or more than three doses in a week. Pain in the penis is a commonly reported side effect.

Alprostadil injections

Alprostadil can also be injected into the base of the penis. If your doctor decides this is the best course of action, you will be shown how to administer the injection yourself. You usually start on a small dose and increase as needed. 

Alprostadil, when injected, takes about 15 minutes to work and lasts for about an hour. Again, you should not administer more than one dose a day, and no more than three per week. As with the cream, penis pain is a potential side effect.

Penile implants

Also known as a penile prosthesis, this is generally a last resort option when other ED treatments have failed. A surgeon will place an inflatable or flexible rod into your penis, and a saline pump into your scrotum. You can press the pump to inflate the implant, giving you an erection.

Testosterone replacement therapy

As mentioned above, testosterone replacements or boosters can help to improve erections when low testosterone is a contributing factor. This is a lifelong treatment which can be administered in a few ways, including injections, gels, creams, pills, and implants. Each method has its own benefits and drawbacks, and you should ask your doctor for advice before beginning any kind of testosterone therapy.

Natural remedies

There are some natural remedies for ED caused by diabetes, but very little evidence to support their effectiveness. You should discuss any natural remedy with your doctor first.

Conclusion

Sexual and erectile dysfunction can be very stressful, particularly when it occurs alongside or is caused by another life-altering condition like diabetes. It can also be frustrating when medication designed to solve one problem causes problems elsewhere.

Whilst both types of diabetes can impact your sex life, it’s important to know that treatments are available, and you shouldn’t suffer in silence. Whatever the cause, speaking to your doctor is the best course of action, as they can diagnose the problem properly and provide the right course of treatment.

References

https://www.nhs.uk/conditions/diabetes/
https://diabetesmyway.nhs.uk/resources/internal/sex-and-diabetes/
https://www.bumc.bu.edu/sexualmedicine/physicianinformation/epidemiology-of-ed/
https://www.diabetes.org.uk/preventing-type-2-diabetes/diabetes-risk-factors
https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
https://jdrf.org.uk/information-support/living-with-type-1-diabetes/health-and-wellness/impotence/