Treatments for Diabetes-Related Erectile Dysfunction
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 adverse “Quality of Life” effects of ED – depression, etc. – than non-diabetic men with ED. However, a full range of effective treatments for ED is available to diabetic men.
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.
70-75% 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 effective 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.
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