Over the long term, diabetes can cause various degrees of erectile dysfunction, including impotence. Diabetes interferes with oxygen delivery and the production of the chemical nitrous oxide, which is crucial to having and maintaining an erection. Poor glucose control, along with other diabetes-related complications, such as neuropathy in the feet and retinopathy in the eyes, increases the odds of erectile dysfunction.
Up to 52 percent of diabetic men between the ages of 55 and 59 have erectile dysfunction, or ED. Having said this, there are many other problems that, either in combination with diabetes or on their own, can cause it — these include advancing age, dementia, stroke, spinal cord or back injury, multiple sclerosis, heart disease, injury to the prostate, smoking, and the use of certain types of medicines. Most antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are known to cause erectile dysfunction. Thiazide diuretics, a class of medicines typically given to treat hypertension, are also associated with erectile dysfunction, though their benefits outweigh this risk. Other drugs linked to ED include spironolactone (a diuretic), clonidine (a hypertension medication), cimetidine (an antacid), and ketoconazole (an antifungal medication). It is also important to consider psychological causes of impotence, such as depression and performance anxiety.
Improving glucose control and losing weight, if you need to, might help resolve the problem. There are also various treatments, depending on the cause of the dysfunction. Medications, including sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), are commonly prescribed and can be effective. These medicines have disturbing side effects, however, including headache, flushing, and light-headedness. Additionally, they are not recommended for individuals taking heart medicines such as nitrates. Other treatments — depending on the cause of the erectile dysfunction — include psychotherapy, prostaglandin injections, vacuum-assisted devices, surgical implantations, and testosterone injections.