One of the most common complications of diabetes in men is erectile dysfunction.
Erectile dysfunction is a typical complication of diabetes and significantly lowers a man’s quality of life.
Sometimes sexual problems are the first visible sign of diabetes. With age, erectile dysfunction becomes more common in men with diabetes.
Causes
In men with diabetes, the most common causes of erectile problems are:
- nerve damage (polyneuropathy);
- damage to the blood vessels of the penis (angiopathy).
These changes impair sensation and the blood supply to the penis.
How does diabetes affect erection?
In diabetes, the central and peripheral nervous system and the blood vessels are damaged, as are the endothelial cells and smooth muscle fibres that play a major role in erection.
People with diabetes develop damage to the small blood vessels – microangiopathy. The arteries of the penis narrow and become blocked, which leads to erectile dysfunction.
What problems can occur?
Sexual dysfunction in men with diabetes includes:
- erectile dysfunction;
- reduced sex drive (low libido);
- ejaculation problems – premature ejaculation or prolonged intercourse;
- orgasm problems – a sign of diabetic polyneuropathy.
When several problems occur together
It is not unusual for patients to have several problems at once – for example, erectile dysfunction, reduced sex drive and premature ejaculation. In such cases the cause of each problem has to be identified and comprehensive treatment is needed.
The role of testosterone
Testosterone, known as the “male hormone”, supports sex drive and the strength of muscles and bones. From about the age of 40 its level naturally and gradually declines – this is called andropause.
Men with diabetes and abdominal obesity more often have low testosterone levels. That is why checking hormone levels is important in erectile dysfunction.
The following signs may point to testosterone deficiency:
- reduced sex drive;
- loss of muscle strength and mass;
- lack of energy and motivation;
- sleep problems;
- difficulty losing weight and fat around the waist.
Weakness, reduced sex drive and lack of motivation should not be accepted as “normal ageing”.
Dr. Samir Shukurov
Testosterone is not just a sexual health hormone: it protects the cardiovascular system, strengthens bones and helps regulate metabolism. Men with testosterone deficiency often become depressed, and problems may develop in the cardiovascular, nervous and genitourinary systems.
Because andropause develops unnoticed, men are advised to see a doctor at least once a year after the age of 35–40. If a deficiency is confirmed, the doctor may prescribe hormone replacement therapy with testosterone preparations.
Diagnosis and treatment
Diagnosis is based on a physical examination, hormone tests and an assessment of the lipid profile (cholesterol levels). If high cholesterol or dyslipidaemia is found, cholesterol-lowering medicines may be prescribed in addition to diet.
In erectile dysfunction caused by diabetes, the first step is to bring blood sugar under control. When blood sugar is kept at a normal level and monitored, timely treatment can achieve good results.
Regular physical activity, a balanced diet, a normal body weight, regular sleep, giving up smoking and alcohol, and keeping stress under control have a positive effect on testosterone levels.
Do not be embarrassed by this problem or put it down to age. Instead of taking medicines on your own, see an endocrinologist – once the cause is identified, treatment is more effective.
This article is for general information only and does not replace a medical examination.