Long-standing diabetes often leads to sexual problems. By age 43, about 45% of men with type 1 (childhood-onset) diabetes experience impotence. This is also known as erectile dysfunction. Men with type 2 (adult-onset) diabetes have a similar rate of impotence. Some women also report reduced sexual response. This probably is caused by damage to nerves in the skin.
In a man, blood flow, nerves and hormones all play a role in causing an erection. Psychological factors and emotions are also important. Diabetes can affect any or all of these systems. Nerve or blood vessel problems are the usual causes of sexual performance problems for men.
Impotence occurs most often in men who:
- Have had diabetes for a long time
- Have poor blood sugar control
- Have other types of nerve damage
Anxiety and depression also can cause or contribute to impotence. This problem may be temporary or more long-lasting.
The good news is that several devices and medicines can improve sexual function. Some men with diabetes are helped by the drugs sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra). All of these improve blood flow in the penis. These drugs are approved for treatment of sexual dysfunction in men only. Penile implants are another treatment option.
Good control of blood sugar can prevent, or at least delay, nerve damage that causes impotence. Maintaining normal blood pressure also may help.
Careful study has shown that regular exercise minimizes the chance of developing impotence. It can restore sexual function in some men.
Smoking can make nerve damage from diabetes worse. For this and other reasons, smokers should stop.