Impotence and Diabetes

There is no reason why people with diabetes should not enjoy their sex life. Impotence does not affect all men with diabetes and having diabetes does not mean that you will automatically have problems but if it happens then there are things that can be done to help.

What is impotence?

Impotence is also called erectile dysfunction (ED). It means that you may not be able to get or keep an erection for long enough to have sexual intercourse with your partner.

How common is it?

All men can and will experience failure to achieve an erection at some time in their lives and this increases with age. Approximately one in ten men over the age of 40 has ED whether they have diabetes or not. This figure can rise to three in ten in diabetes.

How will it affect me?

Throughout history men have linked their self worth to the performance of their penis. If your penis fails you, you may feel that you are no longer ‘a man’ but that is not at all true. You may feel embarrassed, frustrated and guilty – as if it’s your fault and you have done something wrong. It is important that you feel you can seek help for this problem especially if it has become distressing. Keeping it a secret may cause worry and do more harm than telling somebody and getting help. Don’t forget that it may also affect your partner in the same way and they may start to fell rejected or even angry. Not talking to each other about it will make matters worse.

What causes impotence?

It is generally accepted that the causes of impotence are complex. It may have physical or psychological causes or be a mix of the two.

• The psychological factors are very important. Stress in your life, problems in your relationship and worrying about your sexual performance and about whether you are going to be able to get an erection will can cause impotence in their own right.

• Alcohol is an obvious cause as are a number of illegal drugs.

• Some medications used to treat high blood pressure and depression can cause it.

• Diseases of the circulation causing hardening or narrowing of the arteries that prevent blood from pumping up the penis to make it stiff. Sometimes the veins inside the penis are leaky and can’t hold the blood in the penis to keep it stiff.

• Operations on your bowel, prostate or bladder or damage to your spinal cord may cause impotence damaging the nerves that connect to the penis.

• A lack of testosterone, a male hormone, can cause impotence and a loss of interest in sex.

• Diabetes, in its own right, can also cause damage to muscles, nerves or blood supply to the penis, all of are needed to get an erection.

• Some people with diabetes may experience anxiety related to the fear of hypoglycaemia during sex.

How do I know if the cause is mainly psychological?

These factors always play a part and sometimes they are the main cause of the problem. Think about all the factors that are causing you stress and worry and how they might be affecting you and think about you alcohol intake. A good guide is that if you get good erections when you wake up in the morning or whilst masturbating but not whilst trying to have sex with your partner, then it may well be a psychological problem. Even so, seek help if you are finding difficulty dealing with it.

Seeking advice and what care to expect

If you are worried about impotence then talk to your medical team about it – they cannot help if they do not know.

As you can see, there are many reasons why you may be experiencing problems with impotence.

Men are often too embarrassed to ask questions about their sex life. Discuss it with your partner first if you can. You may decide that you do no want to have anything done about impotence and that you are happy as you are. There is nothing wrong in that. However, if you do then wish to seek help or further advice, then approach your GP or your Diabetes Specialist team. Remember they are used to talking to people about these issues.

They will take a full history of the problem and examine you. They will review your medications. Blood tests will be arranged. At the end of that process they will be able to tell you what the most likely cause of the problem is. Then, there usually some simple advice that can be given and there is a wide a range of treatments available if needed. Provided the tests have not shown some other problem, and there is no reason why you should no take them, then you are most likely to be given a test dose of a tablet by mouth such as Viagra. If all of this doesn’t help, then there is a specialist service for impotence to which you can be referred to take matters further.