Of the many possible complications of uncontrolled diabetes, erectile dysfunction is the one we talk about the least. Unlike essentially all of the other complications, it doesn’t bring us physical pain, but the emotional trauma it often brings can be devastating.
It doesn’t have to be that way. If you were the only guy who had erectile dysfunction, having it might well embarrass you. But now we know that perhaps 30 million American men have it and that it increases with age. "About 4 percent of men in their 50s and nearly 17 percent of men in their 60s experience a total inability to achieve an erection," according to estimates by the National Institutes of Health. "The incidence jumps to 47 percent for men older than 75."
Those figures are for all American men. But what about men with diabetes?
Men who have diabetes are two to three times more likely to have erectile dysfunction than men who don’t have diabetes, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Nobody knows what proportion of American men with diabetes have erectile dysfunction, but it could be as high as 75 percent.
But this leading health organization says – and I emphasize – that it "is treatable at any age."
And thanks to the miracles of modern medicine you now have a variety of good ways to treat erectile dysfunction that a doctor can prescribe. A visit to a doctor might be somewhat challenging at first, but it’s a lot better than the alternative. In this new world of information on the internet this is the only personal contact you need to make – aside from your bed partner, of course.
If you want to shy away from the term "erectile dysfunction," you can call it by its common acronym. "ED is the inability to get or keep an erection firm enough for sexual intercourse," writes the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "ED can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections." We used to call it impotence, "but that word is being used less often so that it will not be confused with other, nonmedical meanings of the term."
Your doctors will probably start by suggesting the least invasive treatment:
1. Lifestyle changes, like quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity will help some men.
2. Then, perhaps some medicine that you are taking is the culprit. A blood pressure medication is a likely suspect. Maybe a lifestyle change will make it unnecessary. If not, your doctor might switch your blood pressure prescription.
3. For some people psychotherapy and behavior modifications might be a good idea.
4. Next could be an oral or locally injected drug, a vacuum device, or a surgically implanted one.
5. Only in rare cases will a doctor recommend surgery involving veins or arteries.
Men are not alone in experiencing sexual problems. The NIDDK says that one study found that 42 percent of women with type 2 diabetes experienced sexual dysfunction. Probably the most common problems are decreased vaginal lubrication and uncomfortable or painful intercourse. But a visit to a doctor can help a woman who has sexual problems just as it can help a man.
Sexual problems are all too common for both men and women who have diabetes. But unlike many of the complications of this disease, we have good ways of dealing with this complication that can stand in the way of living life fully. Enjoy!
David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.