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Does diabetes cause erectile dysfunction?

Erectile dysfunction (ED), sometimes called impotence, is the inability to get or keep an erection firm enough for sexual intercourse. Diabetes is one of the leading causes of ED because it can damage nerves and blood vessels necessary for getting and maintaining an erection. Men with diabetes are 3 times more likely to experience ED than men without diabetes. In this article, we’ll explore the connection between diabetes and ED, look at the statistics, causes, risk factors, and treatments.

Does diabetes cause ED?

Yes, diabetes is a major cause of erectile dysfunction. According to the American Urological Association, 35-75% of men with diabetes will experience ED within 10 years of their diagnosis. The risk of ED increases with age and duration of diabetes. After 15 years of diabetes, approximately 50% of men develop ED.

Statistics on diabetes and ED

Here are some key statistics on diabetes and erectile dysfunction:

  • 50% of men with diabetes over the age of 50 have ED.
  • Up to 75% of men with diabetes will experience ED at some point.
  • Men with diabetes are 3 times more likely to have ED than men without diabetes.
  • For men under 45 years old with diabetes, ED rates can be as high as 50% within 5 years of diagnosis.
  • After 10 years of diabetes, 15% of men develop severe ED and 35% experience moderate ED.
  • In the Massachusetts Male Aging Study, the prevalence of ED was 3 times higher in men with treated diabetes compared to men without diabetes.

These statistics clearly demonstrate that diabetes significantly increases the risk of developing erectile dysfunction. As diabetes duration increases, so does the prevalence of ED.

Causes of ED in diabetics

There are a few reasons why diabetes commonly leads to erectile dysfunction:

Nerve damage (neuropathy)

Over time, high blood sugar from diabetes can damage the nerves throughout the body, including the penis. Damaged nerves cannot properly initiate and regulate blood flow needed for an erection. Between 50-75% of diabetic men with ED have neuropathy as a contributing cause.

Blood vessel damage

Diabetes affects the blood vessels and causes them to become stiff, restricting blood flow. Healthy blood vessels are needed to achieve full erections. Blood vessel damage also contributes to neuropathy.

Low testosterone levels

Men with diabetes frequently have lower than normal testosterone levels, which are necessary to stimulate sexual arousal and erections.


Some medications commonly used to manage diabetes, such as thiazide diuretics, can also increase ED risk.

Obesity and inactivity

Being overweight and physically inactive, common in type 2 diabetes, can lead to poor blood flow and nerve function required for erections.

Risk factors for ED in diabetic men

Certain factors increase the risk of developing erectile dysfunction with diabetes. These include:

  • Poor blood sugar control – High HbA1c levels over time dramatically increase ED risk.
  • Longer duration of diabetes – The longer someone has diabetes, the more damage can occur and higher the ED rates.
  • Neuropathy – Nerve damage is present in about 50% of men with ED and diabetes.
  • Retinopathy – Men with diabetic retinopathy are more likely to experience ED.
  • Use of insulin – Men with type 2 diabetes using insulin have increased risk of ED.
  • Obesity – Being overweight contributes to ED through related health issues.
  • Age – ED risk rises with age, especially after 50 years old.
  • Smoking and alcohol use – These activities can impair blood vessel function.
  • Inactivity – Lack of exercise negatively impacts nerve and vascular function.
  • Hypertension – High blood pressure damages blood vessels.
  • Dyslipidemia – Abnormal cholesterol and triglyceride levels contribute to ED.
  • Depression – Mental health disorders are associated with sexual dysfunction.

The more risk factors present, the higher the likelihood of developing ED. Consulting a doctor can help assess personal risk.

Treatments for ED in diabetic men

There are several effective options to treat erectile dysfunction caused by diabetes. Treatments include:

Oral medications

Oral drugs like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra) can help relax muscles in the penis and improve blood flow to facilitate erections. They are effective for many diabetic men. These medications should be used with caution in those also taking nitrate drugs for heart disease.

Vacuum erection devices

These involve using a pump to mechanically increase blood flow to the penis. A constriction ring can help maintain the erection. Studies show satisfaction rates of 50-75% among users.

Penile injections

Drugs like alprostadil, papaverine, and phentolamine can be injected directly into the penis to relax muscles and widen blood vessels. Erection success rates are 70-85% but may cause pain.

Testosterone therapy

Men with low testosterone may benefit from testosterone prescribed by their doctor, available as pills, gels, patches, injections or pellets. However, testosterone therapy alone doesn’t fix ED in diabetics.

Penile implants

Surgical options like penile implants involve placing inflatable rods or malleable rods inside the shaft of the penis. This provides rigidity for intercourse. Implants have over 90% satisfaction rates but carry risks of infection and mechanical failure.

Lifestyle changes

Quitting smoking, losing weight, eating healthy, exercising, reducing alcohol use, and controlling blood sugar levels can help minimize ED severity. Men should talk to their doctor before starting an exercise program.

Preventing ED with diabetes management

While oral medications can treat ED, the most effective way to prevent ED is to properly manage diabetes itself. This involves:

  • Keeping blood sugars in the target range with diet, exercise, medication, and regular testing.
  • Getting regular eye and foot exams to check for neuropathy.
  • Seeing doctors regularly to monitor for complications.
  • Taking all medications as prescribed.
  • Maintaining healthy blood pressure and cholesterol levels.
  • Doing regular exercise appropriate for health status.
  • Avoiding smoking, excess alcohol, and recreational drugs.
  • Practicing good sleep habits and stress management.
  • Working with dieticians and diabetes educators for support.

Proper diabetes care reduces the risk of developing erectile dysfunction. But if ED occurs, numerous effective treatments are available. The outlook for maintaining sexual health with diabetes is good with proper management.


In summary, diabetes is a major risk factor for erectile dysfunction due to its effects on nerves and blood vessels. As many as 75% of men with diabetes will experience ED to some degree over their lifetime. The causes include neuropathy, blood vessel damage, low testosterone, medications, obesity, and other factors. Risk rises with age, duration of diabetes, and poorly controlled blood sugars. Thankfully, ED in diabetic men can be effectively treated and often prevented through comprehensive diabetes management, healthy lifestyle choices, and medications if needed. Addressing ED and diabetes together will help maintain physical and emotional health.