Erectile dysfunction (ED) is a sensitive topic, even taboo in more conservative cultures. From experience (not that I am old enough to have tons), I have only witness one patient who consulted a doctor for it. Even so, it was a very awkward situation, with uncomfortable silences (I think it was mainly because he was desperately in need of help, and there were 10 medical students in the room) and bashful responses. Mind you, 10 students between the ages of 19-20 who are glancing at each other as the patient started to tell his sorrowful tale did not help at all! He also began his tale saying it was “night troubles,” and I was naïve enough to ask a friend what it meant. Nevertheless, the doctor did not phase and the case took off successfully.
In the past, it was believed to be an inevitable consequence of aging or due to psychological problems. Combined with the reluctance of men to discuss their sexual problems and possibly inexperience and unease on the physician’s part with sexual issues, it has not been successfully addressed.
Studies have shown that ED is more prevalent in men with diabetes (35-75%) compared to the general population (26%). This condition also has 10-15 years of earlier onset in diabetics compared to non-diabetics. In diabetics, the cause of ED is usually due to atherosclerosis (blockage) of the penile and pudendal arteries, leading to limited blood flow into the penis.
Studies have revealed that risk factors for ED in diabetics are likened to those of heart disease. A group of scientists found that 93% of men had ED within the last 2 years before an episode of a heart attack. Diabetic women may face similar problems such as vaginal dryness, vaginal thrush, and decreased libido.
The prevention of ED includes the common steps for diabetes management. The strategies include blood glucose control, reduced alcohol consumption, cessation of smoking, increased physical activity, getting enough sleep (lack of sleep can cause high blood glucose), and keeping stress levels to a minimum (stress contributes to poor glucose control).
If you are a diabetic with ED, it is important to discuss it with your doctor. Although it is under-recognized, it is one of the most treatable complications. Available treatment options include oral medications, vacuum devices, injectable drugs, and prosthesis. It is equally important that both physicians and patients are educated regarding the link of diabetes and ED.
[expand title=”References“]
Chu NV, Edelman SV. Diabetes and erectile dysfunction. Clinical diabetes. 2001; 19(1):45-47.
Srivastava SK. Darling not tonight. Times of India. 2017.
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