Erectile dysfunction (ED) can be ego-destroying and is all too common. Approximately 30 million American men suffer from it, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). They also estimates that between 20 and 75 percent men with diabetes also have ED.
For something this important to life, it's not surprising that we have many treatment choices. The first line of approach is to quit smoking, lose excess weight, and increase exercise.
If that doesn't do the trick, then injections, pumps, and implants are other options that have been available for years. But it wasn't until 10 years ago that drug options became available.
Treatments for ED
The drugs and other medical options sold to conquer ED are often stop-gap remedies. They can provide temporary relief. And like other treatments, they have their costs, which can be substantial, since insurance does not always cover them.
These costs, according to the manufacturer of the most popular of these drugs, also include side effects. They can include a sudden decrease or loss of vision or of hearing. That's rare, but no minor matter.
No one who takes nitrates — like nitroglycerin for chest pain — even once in a while should take this drug. The most common side effects are headache, facial flushing, and upset stomach. Less commonly, you may have bluish or blurred vision or sensitivity to light.
With these costs, why then are many of these drugs so popular? Simply because they provide such an ego-boosting service.
Many of these drugs treat the symptoms. But you can treat the cause. You can cure ED.
How diabetes is related to ED
Generally, the longer you have had diabetes the longer it will take to cure ED. That's because ED results from neuropathy or vascular disease or both. And neuropathy comes in two forms.
If your blood glucose levels have been elevated for years, you may have autonomic neuropathy, which the actual destruction of nerves causes. Dr. Richard K. Bernstein, the author of Dr. Bernstein's Diabetes Solution, gave the best explanation I've ever heard of the causes and treatments of erectile dysfunction.
If your neuropathy is autonomic, the nerves have to regrow. That takes time, but isn't impossible. "In a young, healthy non-diabetic, nerves regrow at the rate of a millimeter a day," Dr. Bernstein explained. "So to get from the tip of your toe to your spine might be one meter -- a thousand millimeters. That would be a thousand days and if you were in poor health and older, it might be two thousand days."
On the other hand, if your blood glucose level hasn't been too high for years and years, your neuropathy could be simply metabolic. By bringing your blood glucose level down to normal you can reverse metabolic neuropathy "in a matter of weeks," he says.
But the cause of ED might not be either metabolic or autonomic neuropathy. It might be due to vascular disease.
Vascular risk factors for ED
If the cause is vascular, the problem becomes more difficult, Dr. Bernstein says. But you can reverse vascular disease too. He knows, because he reversed his own vascular disease. Diagnosed with type 1 diabetes in 1946, his blood glucose levels were high and uncontrolled for many years until about 1973. "I had a number of bits of evidence of vascular disease before I started controlling my blood sugars. It certainly did serious damage to my kidneys."
Maybe just as important, Dr. Bernstein started doing strenuous cardiovascular exercise in the early 1970s. Studies show that this can reverse atherosclerosis.
"I had one of these high-speed electron beam tomographic studies done a couple of years ago," he says. "And this measures the amount of calcification of the coronary arteries. The score at this particular institution was 0 to 100. Zero means no calcification, 100 means the most severe form. And I had a score of 1, with one little fleck. At that time I was 72 years old and diabetic just below 60 years, I guess. And here had almost no vascular disease."
If you have had diabetes for a long time and are well over the age of 40, you probably have both vascular disease and neuropathy, Dr. Bernstein says. He distinguishes between these two problems by measuring penile blood pressure. If it's low, it means that the problem is vascular.
He also uses an EKG machine to do an R-R interval study of the vagus nerve. This measures the time elapsing between two consecutive R waves in the electrocardiogram."If that is grossly abnormal, it means you have neuropathic problems." Then, they confirm the results of the R-R interval study with a complete pelvic neurologic exam.
Controlling diabetes will help prevent ED
Whether the cause of ED is metabolic neuropathy, anatomic neuropathy, or vascular disease, you can cure it. Conveniently, maintaining normal blood glucose and doing strenuous exercise are exactly what we all need to do to control our diabetes.