Sexual dysfunction and diabetes

If you’re like most men this is one topic of conversation you tend to ignore. But if you have diabetes, this is one touchy subject you shouldn't ignore. A full 60 percent of diabetic men over 50 have some trouble achieving or maintaining an erection long enough to have intercourse.

It is important however to realize that you can protect your sexual functioning by keeping your diabetes under control. And if the condition has already started to derail your physical relationships, your doctor can help you get back on track.

How does diabetes cause sexual dysfunction?

Erections take teamwork from several parts of the body: Your brain makes you aroused, your nerves sense pleasurable feelings, and your arteries carry a flood of blood to the penis. Unfortunately, poorly controlled diabetes can ruin that teamwork. Blood sugar that stays too high for too long can both deaden your nerves and damage the arteries that feed your penis. You can still get aroused, but you'll have trouble turning those feelings into action.

The breakdown doesn't happen overnight. Most men have diabetes for many years before they notice a problem with erections. Diabetic men rarely have any erectile dysfunction before they reach 30.

The key is controlling your diabetes. Contrary to popular belief, insulin and other diabetes drugs don't hamper erections,. By reducing your blood glucose levels, these medications slow down damage to your nerves and arteries. Such medications can actually help keep your love life healthy.

Can diabetes cause other sexual problems?

Some men with diabetes - as well as men without diabetes - develop a condition known as retrograde ejaculation. Instead of ejaculating through the penis, their semen goes backward into the bladder. This doesn't make sex less pleasurable, but a man with the condition may need medical help in order to father a child.

How is erectile dysfunction treated?

If you're a diabetic man who has a problem with erectile dysfunction, don't suffer in silence. Too many diabetic men think that this is a rare problem and that their doctor will think they are strange if they bring it up. Not every man with erectile dysfunction wants treatment. In fact, some hardly miss their erections. But even these men should tell their doctor about the condition.  The doctor can then make sure the dysfunction isn't a symptom of some other hidden disease.

To overcome erectile dysfunction linked to diabetes, you have to tackle the root of the problem: high blood sugar. Even if your blood sugar is under control, you may need an extra boost. One option is Viagra, a medication that can enhance the blood flow to your penis. But if diabetes has already deadened the nerves in your penis, Viagra may not work for you. Viagra has some potentially serious side effects, especially for men with heart disease. Since most men with diabetes are already at significantly increased risk for heart disease, it's important to be sure the drug is safe for you before trying it, and to report any unexpected side effects when they occur. Studies suggest the drug only helps one in five men who have diabetic nerve damage.

If Viagra doesn't help, there are many other treatments to consider which you should discuss with your doctor. Another method for consideration is to use a vacuum pump that can help pull blood into the penis. If you have trouble maintaining an erection, a constriction ring can help keep the penis rigid. If nothing else works, you may need inflatable implants. Today's implants are extremely effective and entail only a small risk of infections or mechanical breakdowns. Your doctor (with the help of a urologist, if necessary) can usually help you find the right treatment.

If your blood sugar is under control and the doctor rules out other possible causes, your difficulties may have a psychological basis. You may want to ask your doctor for a referral to a counseller, who can help you resolve whatever issues may be making it difficult to keep an erection.

Here are some other points to keep in mind:

A little alcohol may help put you in the mood, but too much (more than a drink or two) can actually interfere with erections.

Smoking can damage the blood vessels that feed the penis. If you value your sex life, it's time to kick the habit.

Many medications - including some antidepressants, ulcer medications, and blood pressure drugs - can cause erectile dysfunction. Ask your doctor if any of your medications could be causing trouble. A simple change of prescriptions could make a big difference. If you think your medications could be the problem, it's important to talk with your doctor before making changes on your own.

Understand that all men experience some decrease in sexual drive and performance as they age. Men of any age can still have erections, but erections may be less firm or last for shorter periods of time. This is a natural part of the aging process. But if you have good communication with your partner and doctor, sex can continue to be richly intimate and exciting.

Try to be positive!

Living with diabetes takes a lot of work: regular doctor visits, checking your blood sugar at home, taking your medications as prescribed, exercising regularly, and watching what you eat every day. If you've recently been diagnosed with the disease, you've probably discovered another challenge that few people ever talk about. Without some preparation, diabetes can drain you emotionally as well as physically. If you're going to fight this disease, you'll need to get in the right mindset, and that's easier said than done.

If you have diabetes, you have everything to gain by stepping into the modern age of medicine. Unlike patients with diabetes in decades past, you can manage your blood sugar, avoid serious complications, and lead a long, healthy, and active life - but you can't do it alone. You'll need to work carefully with your doctor to learn everything you can about your condition, and you'll have to count on friends and family for support. In short, you'll have to master the fine art of asking for help.