Erectile dysfunction is a very common problem in men with diabetes. It is known that this problem occurs on average 4 times more in diabetic patients compared to healthy men. Diabetes, which has become a global health problem today, also causes erectile dysfunction 10-15 years earlier than men without any disease.
On the other hand, if the severity of erectile dysfunction in diabetic patients is not controlled with the treatments started at the right time, it increases even more. In some cases, erectile dysfunction is considered as a symptom of diabetes.
In this case, it may be important for men with sexual dysfunction to consult a doctor for the solution of the problem, in terms of recognizing possible diabetes.
Sexual dysfunction in men with diabetes
Sexual dysfunction is any problem that prevents an individual from being satisfied during sexual activity. Although sexual dysfunctions can be seen in men at any age, their incidence generally increases in advanced age.
The most common causes of sexual dysfunction in men are ejaculation problems, erectile dysfunction and decreased sexual desire. These problems can usually be corrected by treating the underlying cause.
However, sexual dysfunctions caused by diabetes occur due to neuropathic reasons, especially in type 2 diabetics. Neuropathy means that involuntary nerves degenerate and lose their function and show meaningless reactions. Such mixed reactions lead to loss of function in the organs where the nerves are distributed.
What causes erectile dysfunction in diabetes?
Erectile dysfunction is the inability to initiate or maintain an erection enough to have sexual intercourse and is common in diabetics, especially in type 2 diabetes patients. So much so that, according to the results of many examinations, erection problems begin to occur in an average of 5-10 years in a large proportion of patients diagnosed with type 2 diabetes.
On the other hand, it can be said that erectile dysfunction in diabetics occurs due to the following reasons:
- Inability to control blood sugar well,
- Diabetic neuropathy,
- Damage to the vessels of the penis,
- Having hypogonadism, known as testosterone hormone deficiency,
- Venous insufficiency,
- High blood pressure and heart diseases due to diabetes,
- The lack of nitric oxide, which is important in the formation of erection in the penis,
- Endothelial dysfunction and
- Damage to some vessels and nerves as a result of increased free radicals.
Risk factors for diabetic patients
It is possible to talk about some risk factors that cause erectile dysfunction in diabetics. It can also be said that erectile dysfunction begins earlier in patients with risk factors.
It is very important for men with diabetes to be informed about these issues and to get expert support for appropriate lifestyle changes. Risk factors that can accelerate erection problems in diabetics include:
- High levels of stress, anxiety and depression,
- Inability to control blood sugar well,
- Alcohol and cigarette use,
- Unhealthy and malnutrition or obesity,
- A sedentary lifestyle,
- High blood pressure or cholesterol and
- The use of certain drugs that adversely affect the erection.
Diabetes is a chronic disease that has negative effects on many systems of the body, and a specialist physician must regularly check people with this disease.
Erectile dysfunction and other complaints can be prevented or delayed by avoiding the aforementioned risk factors, improving other related disorders in the body, and controlling blood sugar. In this way, it is possible to improve the general quality of life of the patients.
What should diabetics plus erectile dysfunction men do?
Erectile dysfunction is a disease that causes serious problems between spouses and has a social aspect in this regard.
On the other hand, it has been observed exercising more, keeping blood sugar under control, and quitting smoking can sometimes eliminate that erectile dysfunction, especially seen in diabetic patients. In addition to these, some drug treatments are also available.
Advice for patients with diabetes and erectile dysfunction
People who have diabetes and think that erection problems have started, of course, should first consult a specialist doctor. In this way, the most appropriate treatment options can be evaluated. In this process, it is also important to follow a detailed diet recommended and to eat a balanced diet accordingly.
If patients have some chronic health problems other than diabetes, these should also be taken into account. With the knowledge of conditions such as high blood pressure, heart disease, high cholesterol, treatment can be directed correctly.
Diabetes can cause some mood disorders, especially in the future, and erection problems may increase in the process. In this regard, it may be beneficial for patients to receive psychiatric help.
On the other hand, some lifestyle suggestions that will be good for erection problems may also work in this group of patients. Regular blood sugar control is one of them.
In addition, not smoking, staying away from alcohol, losing excess weight and exercising regularly will be beneficial for both the general health of the body and the improvement of blood flow to the penis. Regular and adequate sleep is also effective in preventing erection problems. Also, avoiding stress as much as possible will delay the appearance of erection problems.
Treatment options for diabetics with erectile dysfunction
Currently, effective prescription drugs used to treat erectile dysfunction in men with diabetes are called PDE-5 inhibitors. It is important to use these drugs under the supervision of a doctor in order to avoid health risks and prevent side effects.
In addition to drugs, there are techniques that assist mechanical erection, such as vacuum pumps, or methods such as injecting vasodilator substances into the erectile tissue of the penis.
In the case of a proven testosterone deficiency, hormone replacement therapy may be preferred. Accordingly, it is possible to list the treatment options, which have many varieties, as follows:
- Oral pills: These oral pills are the first choice for patients with erectile dysfunction.
- Injection treatment into the penis: This method, which is applied in cases where the drugs do not help, can increase the blood flow to the penis and thus make it possible to get an erection.
- Gels squeezed into the urethra: Just like injection therapy, gels also support increasing blood flow.
- ESWT therapy: It has been reported that shock wave therapy (ESWT) applied to the penis is effective when oral drug therapy in diabetic patients fails to produce results.
- Vacuum devices: These tube-shaped devices placed inside the penis help to achieve an erection by applying pressure with a pump.
- PRP (platelete rich plasma) treatment: In this treatment, patients’ own blood is taken and platelet-rich plasma is used by separating it from other components of whole blood by centrifugation method.
- Penile prosthesis surgery: Penile prosthesis, which is generally the last option, is also known as the happiness stick. The important thing in penile prosthesis, which has different types, is to choose the most suitable one for the use of the patient.
What should be considered in the selection of penile prosthesis?
Penile prosthesis types are of two types, inflatable and semi-rigid (bendable). Inflatable prostheses, the most widely used type of penile prosthesis, can be inflated to create an erection and deflated after intercourse.
Three-piece inflatable prostheses contain a fluid-filled reservoir placed under the abdominal wall, a pump placed in the scrotum, a relief valve, and two inflatable cylinders in the penis. Every part of it is inside the body. These can create the most natural and hard erection. However, there are more parts that can fail.
The two-piece inflatable prosthesis does not require a reservoir but provides a less rigid erection than a three-piece implant. Semi-rigid dentures have fewer parts and require an easier surgical procedure.
However, the penis is always a little stiff and it can be difficult to hide the prosthesis in clothing. Among all these, which one is most suitable for the patient is decided according to some factors.
Accordingly, the patient’s age, dexterity, penis size, body type, and general health are effective in decision-making in this process. In addition, the ratio between penile length and scrotum size, the overall size of the scrotum, and the size of the glans penis are also taken into account.
On the other hand, it is also important whether the patient has had a previous operation or not. In addition, if there is Peyronie’s disease, this is also considered a variable.
If the patient is older, has problems in using his hands, and therefore there will be problems in using pumped prostheses, wearing a one-piece prosthesis is most suitable for these patients. If the patients are young and able to use the pump system comfortably, the best option for them is inflatable prostheses. These are more natural prostheses.
How long do penile prostheses stay in the body without problems for diabetics?
One-piece penile prostheses do not have any mechanical problems and can be used for an average of 15 years without any problems. The most important problem that occurs especially in poorly controlled diabetes patients is prosthesis infection.
To prevent this, patients can be given preventive antibiotic treatment and prostheses can be kept in antibiotic solutions during surgery. In this way, the infection rate decreases to a very low level. Infection is more common especially in diabetic patients with renal failure and undergoing dialysis.
