Login      Sign Up

Erectile Dysfunction in Diabetic Population

Author: Dr. Saumya Mittal - Sexual Health
Last reviewed at: 03.Oct.2018  



Erectile dysfunction is a condition when the person is not able to achieve or maintain an erection adequately to have intercourse. It is common in diabetes patients. Diabetics are at a higher risk (three times more likely) of developing erectile dysfunction compared to non-diabetic people. At least half the diabetics develop erectile dysfunction and the risk increases with age. So, why does erectile dysfunction happen? Why does diabetes lead to impotence? Here we discuss why.

Erectile dysfunction is a condition when the person is not able to achieve or maintain an erection adequately to have intercourse. It is common in diabetics. People with diabetes are not only at a higher risk (three times more likely compared to nondiabetic people) of developing erectile dysfunction compared to non-diabetic people, but they also develop it at an earlier age (preceded by at least 10 to 15 years). At least half the diabetic people develop erectile dysfunction, and the risk correspondingly increases with age.

How Does Erection Happen Normally in the First Place?

Understanding this will help you understand the “why” of erectile dysfunction in diabetes mellitus.

The penis, in its normal and more common physiological state, remains flaccid. The other physiological state for this organ is the erection. The fluctuation between these two states results due to the activity of muscle cells in the corpora cavernosa. The contraction of the muscles leads to the flaccid state, and the relaxation of the same muscles leads to the erect state. The erection occurs by the release of chemical messengers like nitric oxide, acetylcholine, etc. This relaxation of the smooth muscles leads to the increase in blood flow to the penis. The arterial supply increases due to the arteriolar dilatation.

On the other hand, there is a venous compression. This leads to the reduced outflow of the blood from the penis in the venous system. This causes a rise in the pressure within the urethra of the penis, and this leads to the change of the physiological position from the dependant (or flaccid) state to the full erection phase. Some other muscles also help the erection allowing the rigid erection phase.

Therefore, to shatter another common myth, neither the age or race of a person nor the size of the penis in the dependant (flaccid) state, affect or predict the erectile length of the penis. So, why is this article shattering this myth here? Because, a lot of diabetic males are overly concerned about the length of the erect penis and wrongly call a shorter length of the penis as erectile dysfunction.

Why Does Diabetes Mellitus Lead to Impotence?

A longer duration of diabetes mellitus, poor control of sugar, older population and patients with diabetic neuropathy are at a higher risk of developing erectile dysfunction. These factors also cause erectile dysfunction to be more severe as compared to that in the nondiabetic population. Such patients also report a lower response to medicines. Therefore, both, the impairment and the reduction in the quality of life, is higher in the diabetic population.

The Mechanism of Erectile Dysfunction in People Who Suffer from Diabetes Mellitus Are:

1. It is a neuropathic process - diabetic neuropathy involves both, autonomic as well as somatic nerves. These nerves are the ones that are largely responsible for penile erection. Nitric oxide (also known as endothelium-derived relaxing factor) is a signaling molecule (or a chemical biological messenger) in the body that is supplied through the nerve. The cell lining of the blood vessels all over the body uses nitric oxide to allow vasodilatation which increases the blood flow. When the nerves are affected, this messenger is reduced and the usual normal relaxation of the corporal smooth muscle does not happen. This relaxation of the corporal muscle is the main reason behind the occurrence of a penile erection. Since the mechanism of release of nitric oxide is impaired due to the nerve damage, an erection does not happen.

2. It is also a vascular problem - diabetic vascular dysfunction occurs due to lipid deposition in the blood vessels (a process also known as atherosclerosis). This lead to a reduction of the diameter of the vessel wall lumen where the lipids are deposited. The reduction in the lumen wall reduces the blood flowing in the blood vessels (and therefore to the penis). Thus, an erection is not achieved. This vascular damage also affects the release of nitric oxide (whose need is already explained above).

3. It is a hormonal problem (other than diabetes mellitus) - there is a lower testosterone level in diabetic men because of affect on the ‘master endocrine gland’, the pituitary. This reduces the reproductive functioning and sexual desire amongst the diabetic men.

4. It has a large psychological component in a huge number of patients - depression, a common psychiatric condition, is much more commonly seen in diabetic men. This, coupled with other factors described above, aggravate erectile dysfunction further. Erectile dysfunction itself increases mental stress which affects personal relationships, sexual life, and quality of life. This further propagates the depression.

How to Tell If Erectile Dysfunction Is Due to Psychological Cause or a Disease?

The patients with a psychological cause usually report a sudden onset of erectile dysfunction. It occurs in specific situations and usually does not bother them when they masturbate. Often, spontaneous erections do occur. It usually signifies a relationship problem, a significant life event or problem that is causing anxiety or depression or fear.

These features are not observed if one actually has erectile dysfunction due to a disease like diabetes mellitus. Often, these patients complain of associated pain in the penis.

Proper treatment of diabetes mellitus, a regular screening for low testosterone, and early detection of erectile dysfunction can improve the health and quality of life of these people.



Ask your health query to a doctor online?
* guaranteed answer within 4 hours.

Related Questions & Answers

Homeopathy Treatment for Erectile Dysfunction

Article Overview: Erectile dysfunction has now become a prominent problem in this era. Statistically speaking, 152 million men are affected worldwide. Let us understand more about what is erectile dysfunction (ED).
Dr. Adnan Reyaz Ahmed Siddiqui
Homeopathic Physician

What Is ED ED is defined as an inability to get or sustain an erection firm enough for sexual activity. In easy terms, it is a problem where the male partner is unable to keep the erection firm during sex. Having trouble with an erection from time to time is not a cause for concern but if happens ha ...  Read Full »
Query: Dear Doctor, I am 33 years old. No desire for sex. No erection in penis since last 3 months. I am a regular tobacco user. Give me advice.
Dr. Duraisamy Palanisamy

Answer: Hi, Welcome to icliniq.com. Kindly quit tobacco immediately. Tobacco usage is also the cause for sexual dysfunction. You can take capsule Nano-Leo two capsules in the morning and night after food for three months, which is slow acting. After a month let me know how do you feel. ...  Read Full »
Query: Hello doctor, I do not know why, but I do not feel confident and cannot get a boner with this new partner I have. I am depressed and this is nothing new to me. I have dated her before and it was the same thing. She really intimidates me and this does not happen with other partners I have had. Pleas...
Dr. Ramchandra Lamba

Answer: Hi, Welcome to icliniq.com. Probably, you are suffering from erectile dysfunction situational type. It can be managed by two different approaches: Non-drug - Dual sex therapy and behavioral therapy. Drug treatment includes the Sildenafil, Vardenafil, Tadalafil, Phentolamine, etc. It is diff...  Read Full »
Query: Hello doctor, I am very frustrated with my life, and I have lost every hope in life. I did excess masturbation in the past, and now I am suffering from many symptoms from the past four years. The symptoms are post-void dribbling, slow urine speed, and precum after urination. After urinating, I feel ...
Dr. Aditya Gupta

Answer: Hello, Welcome to icliniq.com. First of all, I would like you to know that masturbation does not cause any weakness, sexual dysfunction, or any ill effect, contrary to popular belief. It is the guilt associated with it, it being labeled wrong culturally which causes problems. In my opinion, you sh...  Read Full »
Query: Hello doctor, I am a 72-year-old male with a height of 5 feet 6 inches and a weight of 78 kg. I have been on Eltroxin 100 mcg and Amloz 5 mg for two years for hypothyroidism. I am feeling fatigued and have an intense appetite. I have lost fertility for the last one year. My ESR value is 41. I also ...
Dr. Naresh Kumar Monigari
Internal Medicine Physician

Answer: Hello, Welcome to icliniq.com. I had gone through all the details and reports (attachment removed to protect patient identity). The TSH (thyroid-stimulating hormone) report is not available. So kindly review the TSH report again. Coming to ESR (erythrocyte sedimentation rate) at 41, it need not ...  Read Full »
Query: Hi doctor, I am 28 years old working bachelor planning to get married in next 4 to 5 months. But I am very tensed and concerned about my penis size and erectile potential. For last 5 to 6 months penis is not erecting properly and less hardness. Please suggest me some Ayurdevic remedies to improve h...
Dr. Ishwar Chandra Rai
Ayurveda Specialist

Answer: Hi, Welcome to icliniq.com. Definitely, I would like to help you. It is good to hear that you are planning for marriage. Erection and hardness of penis mostly depend on your psychology. According to your thoughts, some hormonal activities occurs which leads to increase blood flow in penile blood c...  Read Full »