Risk factors
The one between diabetes and erectile dysfunction is a long-known combination, confirmed by numerous epidemiological studies. It is precisely the statistical data that tell us that:
- erectile deficit is three times more frequent in the diabetic patient than in the healthy control population. The prevalence of this disorder in the diabetic population varies from 30% to 60% of subjects and increases:
- with aging:
- in case of poor glycemic control expressed by high values of glycated hemoglobin
- as the duration of diabetic disease increases
- in case of microvascular complications and neuropathy
- in case of arterial hypertension associated with diabetes, and intake of anti-hypertensive drugs (beta blockers, methyldopa and especially diuretics)
- if the subject is a smoker
- to the increase of alcohol consumption
- in case of obesity associated with a sedentary lifestyle
- Diabetes and erectile dysfunction are so closely related that erection problems are the onset symptom in 12% of male patients.
Causes
To explain why diabetes is so often associated with erectile dysfunction, various etiopathogenetic elements have been identified, which can complement each other:
- psychogenic causes: the awareness that diabetes is a chronic disease often associated with erectile dysfunction and other complications, can trigger performance anxiety in men. Fear of failure during sexual intercourse is a common cause of erectile dysfunction and contributes to feed erectile deficits of another nature
- macro-vascular alterations: in the presence of diabetes not adequately controlled by drug therapies, excess glucose binds to the wall of blood vessels making them less elastic and altering their functionality. Diabetes is often associated with atherosclerosis, which reduces the patency of the great arteries by limiting the blood supply to the corpora cavernosa of the penis. Atherosclerosis can also directly affect the penile arteries.
- nerve alterations and endothelial dysfunctions: the alterations of the small blood vessels that carry blood, oxygen and nutrients to the nerves, cause damage to the same (neuropathy). This reduces the synthesis of nitric oxide by the endothelium and nerve endings (nitric oxide is the fundamental mediator of erection)
Treatment
Identifying the causes of erectile dysfunction in the diabetic is the first step in establishing a suitable treatment to give a satisfying sex life. For his part, therefore, the diabetic patient with erectile deficit should first of all consult a doctor, avoiding the spontaneous recourse to commonly used drugs for the treatment of erectile dysfunction.
Beyond the additional risks deriving from a possible supply through channels other than the pharmacy, considering that among diabetics there are common complications affecting the heart, liver and kidneys, which among other things require specific therapies with possible drug interaction, the drugs used for the treatment of erectile dysfunction (such as Viagra, Cialis, or Levitra) may be contraindicated in the presence of diabetes. We therefore recommend that you consult your doctor to determine the nature of this unpleasant sexual problem and remedy it through the numerous medical and pharmacological treatments available .
