Sexual Dysfunction and Diabetes
It is believed that about 35 to 75% of men with diabetes suffer from erectile dysfunction. Research has shown that about half of men who are diagnosed with type 2 diabetes will develop erectile dysfunction within five to 10 years from their diagnosis. It is a common problem, but our patients oftentimes have difficulty asking about this condition with their doctors.
Erectile dysfunction is the inability to maintain an erection firm enough for sex. It can be due to poor control of diabetes, which can damage the nerves and blood vessels. Erectile dysfunction can be distressing not only to the patient but to his partner as well.
It is frustrating! But you could cope with this problem by discussing this openly with your doctor. The first step is to manage your diabetes. Is your diabetes in control? Are you following your prescribed diet, exercising regularly and taking your medications? Are you keeping to your desired weight and avoiding too much calories? Be in control and you have made that big step towards improving your sex life.
Be physically active. The recommendation is to exercise at least 30 minutes daily for most days of the week. Not only can it improve your blood sugars, but exercise can also improve your blood circulation and general state of mind, and can do wonders for your performance in bed.
Lose weight if needed. If you are overweight or obese, losing 5-10% of your weight will improve your metabolic profile. This will improve your blood sugars, lower your blood pressure and improve your cholesterol. You will also be ready for the sexual activity you so desire.
Check your medications. Your diabetes medications usually do not affect your ability to have an erection but there are some hypertension and depression pills that could affect or worsen erectile dysfunction. Work with your doctor to change these.
Are you anxious? Are you depressed? Are you stressed out with so much work? All these could affect your ability to perform. Fatigue can be a cause of sexual dysfunction. Stress can interfere with sexual arousal. Reduce stress and get enough sleep (at least 7 hours a night). Set aside time to do things that you enjoy. This will keep your stress levels down. Be open to your feelings. Talk to your partner about your problem and she maybe able to help you. If you feel you need more help, seek the help of a qualified mental health professional.
If you are still smoking, quit the habit. Tobacco use narrows your blood vessels, which can worsen erectile dysfunction. Smoking also decreases levels of the chemical nitric oxide. This decreases blood flow to penis, worsening erectile dysfunction. Ask your doctor to help you quit smoking.
Cut back on alcohol consumption. Drinking more than two drinks per day can damage your blood vessels and contribute to erectile dysfunction. Being mildly intoxicated can also make it hard to achieve adequate erections and may interfere with sexual activity.
Is erectile dysfunction reversible? Most cases of nerve damage could actually improve with good control of your diabetes but unfortunately sometimes the damage is permanent. It is important therefore to control your blood sugars for erectile dysfunction to improve.
It is normal to fail once in awhile. Look for new experiences with your partner and do not let fear and anxiety overpower you. This might create a vicious cycle and is most important that you break this.
A number of oral medications are now available to treat erectile dysfunction. Ask your doctor if oral medications are appropriate for you. These include sildenafil, tadalafil or vardenafil. The function of these prescription drugs is to facilitate blood flow to the penis, making it easier to maintain and keep an erection. They are generally well tolerated by most men and can safely be used for many years. There are contraindications especially if you are on nitrates. Other options for erectile dysfunction may include a medication injected at the base or side of the penis for erection to occur. Others make use of a vacuum constriction device or penis pump to maintain adequate erections.
It is important to control diabetes and hypertension. Exercise regularly, stop smoking, lose weight if needed, and reduce stress. For more information about diabetes and other endocrine problems, you may visit us at the Diabetes, Thyroid and Endocrine Center of St. Luke’s Medical Center-Quezon City or call us at 7230301 ext. 5210.
Dr. Roberto Cachola Mirasol is the head of the Section of Endocrinology, Diabetes and Metabolism of the St. Luke’s Medical Center-Quezon City. He finished his fellowship in endocrinology at the University of the Philippines and Lidcombe Hospital, University of Sydney in Australia. He was past president of the ASEAN Federation of Endocrine Societies, Philippine Society of Endocrinology Diabetes and Metabolism and the Philippine Association for the Study of Overweight and Obesity.
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