More than 221 million people worldwide are affected by diabetes mellitus (DM). Approximately 60­–78% of men with DM also experience erectile dysfunction (ED)—32% of men with Type 1 DM and 46% of men with Type 2 DM. In some cases, erectile dysfunction is the first noticeable symptom in men with Type 2 Diabetes.

The high incidence of erectile dysfunction in diabetic men is generally caused by one or more of three conditions associated with DM—reduced peripheral nerve function, reduced peripheral blood flow and testosterone deficiency.

Men with DM-associated erectile dysfunction often report more serious effects on their quality of life—depression, etc.—than non-diabetic men with ED. However, a full range of effective treatments for ED is available to diabetic men.

Oral Medication

Three FDA-approved oral medications, sildenafil, tadalafil, and vardenafil are available. These drugs are phosphodiesterase type 5 (PDE-5) inhibitors that can prolong levels of cGMP in tissue allowing improved smooth muscle relaxation, thus facilitating an erection. PDE-5 inhibitor drugs are effective in 56-63% of diabetic men with ED. More stringent glycemic control can improve these results. Men with testosterone deficiency may benefit from a combination of oral ED medication and testosterone supplementation.

Vacuum Therapy Device

90-95% of men with DM-associated erectile dysfunction can be successfully treated with vacuum erection devices (VED) or vacuum therapy. External vacuum therapy devices apply negative pressure to the penis, producing an inflow of blood to the cavernosal tissues of the penis, causing an erection.

Other Treatments

Other effective Diabetic Erectile Dysfunction Treatment therapies available include (a) an intraurethral suppository of the vasodilator drug alprostadil (prostaglandin E1), (b) intracavernosal self injection (penile self injection) of the non-specific PDE drug papaverine, the non-selective alpha-adrenergic antagonist phentolamine, and the vasodilator prostaglandin E1, used alone or in combination, or (c) penile prostheses (penile implants).

Together, you and your physician can select the effective ED therapy best suited to your needs.

 

Sources:

Dey J. “Evaluation and treatment of erectile dysfunction in men with diabetes mellitus.” Mayo Clinic Proceedings 77. 2002. 276-282. Shabsigh R. “Erectile Dysfunction in Men with Diabetes Mellitus.” Men’s Sexual Health Consult Collection. 2006 Nov. Moore C, Wang R. “Pathophysiology and treatment of diabetic erectile dysfunction.” Asian J Andrology. 2006 Nov. 8: 67-684. Penson D, Latini D, Lubeck D, Wallace K, Henning J, Lue T. “Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than general population of impotent patients?” Diabetes Care 26. 2003. 1093-1099. Sun P, Cameron A, Seftel A, Shabsigh R, Niederberger C, Guay A. “Erectile dysfunction – an observable marker of diabetes mellitus? A large national epidemiological study.” Journal of Urology 176. 2006. 1081-1085.