Introduction

You may have erectile dysfunction (ED) if you repeatedly cannot get an erection (your penis won’t get hard) or your penis won’t stay hard long enough to be able to have sex (sexual intercourse). Not being able to get or keep an erection once in a while doesn’t necessarily mean that you have ED. However, if you can’t get hard on a regular basis for more than 3 months, you probably have ED.

ED is not just about sex and quality of life. In fact ED is sometimes the first sign that something else is wrong with your body. If you think you have ED, the sooner you talk to your doctor about it, the better. You may feel reluctant or embarrassed to discuss this problem, but ED is not something that you can treat yourself, and it usually gets worse if you ignore it. Your doctor will look very carefully for things like problems with cholesterol, blood pressure, smoking, diabetes and depression, among other medical conditions.

Left untreated, ED can leave you feeling frustrated, discouraged or depressed, leading to sexual discontentment in you and your partner. For married couples, ED may be the source of tension within the marriage. ED however, can be treated for most patients, but you have to take an active role in treating and preventing ED.

How Diabetes Causes ED In Men

ED is a common problem for men who have diabetes, scientific research has shown that men who have diabetes are three times more likely to have ED compared to other men. Any man can develop ED, but when you have diabetes, this is what happens to your body:

• High levels of glucose in your blood circulation can damage the nerves and blood vessels responsible for erections. Your brain therefore might be ready to have sex, but the information cannot be relayed from your brain to your penis. So it doesn’t respond and you can’t get an erection.
• Other complications resulting from diabetes, such as cardiovascular disease, can narrow or harden your blood vessels. This may reduce blood flow to your penis, again making it difficult to achieve or maintain an erection.
• Poor blood glucose control can also inhibit the release of a chemical known as nitric oxide. Too little nitric oxide may hamper blood flow to your penis, which again makes it difficult to achieve and maintain an erection.The longer that you have diabetes and the more severe it is (i.e. uncontrolled blood glucose levels), the more likely that you have ED.

What You Can Do To Prevent And Treat ED

Just because you have diabetes doesn’t mean that ED is inevitable. In addition to discussing the problem with your doctor, there are several steps that you can take today to prevent and treat ED:

• Control your blood glucose level.Good blood sugar control can prevent the nerve and small blood vessels damage that leads to ED. If you have trouble controlling your blood glucose level or following your diabetes treatment plan, please talk to your doctor or diabetes educators.

• Manage your medications.If you are taking any medication that may be contributing to ED such as certain drugs used to treat hypertension or depression, please do not stop taking the medication. Instead, talk to your doctor to see if you can take a different medicine.

• Stop smoking!Smoking and using other types of tobacco narrow your blood vessels. This contributes to the blockages in your blood vessels that can lead to ED. Smoking can also decrease nitric oxide levels which again may limit blood flow to your penis.

• Limit how much alcohol you drink.Drinking too much alcohol can damage your blood vessels and make ED more likely.

• Reduce stress. Stress can hamper your erections. To keep stress under control, evaluate and prioritise your tasks. Set realistic expectations, deadlines and limits, and ask for help when you need it.

• Get physically active.Regular exercise can keep your arteries clear, boost your stamina and keep your heart healthy.

• Fight fatigue.If you are well rested, you are less likely to struggle with ED.

• Deal with anxiety and depression. Anxiety and depression can cause ED. Even the fear of having erectile problems can make ED worse. If you are struggling with anxiety or depression, talk to your doctor because treatment is available.

• Consider drugs to treat ED.Your doctor may recommend oral medication to treat ED. There are several drugs available but they are not safe for all men especially those who take nitrates to treat heart disease or alpha blockers to treat prostate enlargement or hypertension. Pills are not the only way to treat ED. Please discuss with your doctor regarding other methods which may be available.

Speaking As A Couple

For women, ED is not just your partner’s problem. You are affected too. Although treatments are generally focused on your partner, these treatments are much more successful if you take part in the treatment process from the start. The involvement of both of you as a couple may reduce stress and anxiety, helping the two of you to talk. Talking is important, because facing all the feelings that ED brings up can be very difficult. Although communication is key, you both will need patience, understanding and sensitivity to work through this problem together toward a happy and satisfying sex life. There are several tips for you to follow:

• When you first start using the new treatment, both you and your partner might feel stressed out about having sex again, especially if it has been a while. Try to be patient with each other during this adjustment period.
• Bringing romance and intimacy back into your lives can help. Try spending quality time together, doing activities you both enjoy.
• Fondling, caressing, and kissing each other can help get you both in the mood to have sex.

Remember that ED can be treated. By talking to your doctor, you have taken the first step back to a healthy sex life. Talking about ED can be embarrassing. But don’t let embarrassment keep you from enjoying a healthy sexual relationship with your partner. Work closely with your diabetes team to prevent ED or keep it from interfering with your sex life.