Diabetes and Men
It’s not easy to talk about health—especially sexual health—but don’t drop the ball. Speak with your doctor about managing diabetes-related problems that could keep you on the sidelines.
OK guys, let’s be honest. Some of you don’t take great care of your health. You walk off injuries. You may not pay attention to signs that something’s wrong. And the No. 1 reason you don’t go to the doctor? Research shows it’s because you don’t want to hear bad news. But that means you won’t get to hear the good news either. We’ll get to that below.
As a guy, you’re more likely to get type 2 diabetes at a lower weight than women. One reason is that men store more fat in their bellies—a known risk factor. And more men than women have diabetes that’s undiagnosed; maybe it’s that “don’t want to hear bad news” thing.
Diabetes puts both men and women at greater risk for heart disease, stroke, vision loss, kidney failure, even amputation of a toe, foot, or leg. But some diabetes problems hit guys directly below the belt:
Erectile Dysfunction (ED)
With ED, a man can’t get or keep an erection firm enough for sex. ED is common in middle-aged and older men – as many as 30 million in the United States have it. Men with diabetes are three times more likely to have ED. Getting older doesn’t cause ED, but it does increase your chance of getting it.
First, some facts. Here’s what ED isn’t:
- Occasional trouble having an erection. That really does happen to everyone.
- Less interest in sex. ED happens when a man wants to have sex but can’t have or keep an erection.
- Problems with ejaculation, which can mean a structural problem with the penis.
It’s not uncommon to have trouble getting an erection sometimes, but if it gets worse, happens often, or prevents you from living the life you want, it’s time to get it checked out.
Men who have diabetes are more likely to have heart disease, and ED can be a warning sign of blood vessel problems. If you have both, talk to your doctor about treatment. Some ED medicines are not safe to take with certain heart medicines, though, so make sure you let your doctor know about any medicines you’re taking.
Causes of ED
- Damage from high blood sugar or high blood pressure to nerves and blood vessels needed to have an erection
- Some medicines for high blood pressure, depression, or allergies (don’t stop taking them, but do talk with your doctor to see if you can take a different medicine or lower the dose)
- Treatment for prostate cancer or an enlarged prostate
- Surgery that affects the pelvic area or spinal cord
- Using tobacco or alcohol
- Sleep disorders
It’s important to visit your doctor to find out if any of these causes are contributing to ED.
It can be tough to talk about ED, but it’s a conversation you need to have with your doctor so you can get treated. The good news is more than 95% of men – you and almost all of the other guys in the waiting room with you – can be treated successfully.
- Medicine: If you have normal nerve function, you could take a type of medicine that increases blood flow to the penis. Sometimes these medicines don’t work well for guys with diabetes and should NOT be taken if you’re also taking nitrates for your heart. Be sure to check with your doctor about any possible medicine interactions.
- Testosterone: Sometimes having low testosterone (low T) can cause ED. Men with diabetes are twice as likely to have low T than men who don’t have diabetes. Taking testosterone may help you have normal erections or help ED medicine work better. It can also make low blood sugar worse and increase blood pressure, so make sure to get regular checkups to spot and manage any problems.
- Vacuum device: This is a plastic tube that fits over the penis, creating a low-pressure vacuum that causes an erection. An elastic ring is slipped onto the base of the penis to hold blood in and maintain the erection. With training, about 75% of men can get an erection firm enough for sex.
- Injection or suppository: For an immediate erection just before sex, you can inject a medicine into the side of the penis with a very small needle, or place a tiny pill in the urethra (the tube urine comes out of).
- Implant: A penile implant placed inside the penis by surgery is often recommended if other treatments don’t work. However, if you’re having trouble managing your blood sugar, your chance for infection after surgery is higher and your doctor may advise against an implant.
Sometimes treatment for ED can cause a long-lasting erection. If yours lasts more than two to four hours, go to your doctor or the emergency room right away. This very painful condition can lead to permanent damage if not treated immediately.
ED doesn’t have to sideline you. Almost all men can be treated successfully. Talk to your doctor!
In addition to ED, nerve damage from diabetes can cause other problems for men, including:
- Overactive bladder (needing to urinate often, urinating often at night, leaking urine)
- Male incontinence (leaking urine)
- Urinary tract infections (UTIs)
- Retrograde ejaculation (semen is released into the bladder)
These problems could mean you need to change how you’re managing your diabetes.
Work with your health care team to keep your blood sugar levels close to your target to avoid or lessen nerve and blood vessel damage. The less damage, the better your body will be able to function in every part of life. Healthy habits help you stay in the game – being active on most days, eating healthy food, checking your blood sugar, managing your blood pressure and cholesterol levels, and going to doctor appointments.
Be sure to take advantage of diabetes self-management education and support services. Working with a diabetes educator can help you stay on track no matter what life throws at you.
Ready to step up your game? Find a doctor you can be open with. And earlier is better for best results. The ball is in your court!