Men’s Sexual Health
The media portrays sex as endlessly exciting, gratifying and
straightforward. However, for many people and couples the reality is
quite different. Sexual problems are very common, but because sex often
involves complex emotions, patients (and doctors) can find these
problems difficult to raise and discuss. The focus of this section is
erectile dysfunction (ED), a common sexual problem in men with
diabetes..
Definition of ED
ED is defined as the persistent inability to get or maintain an erection
that is satisfactory for sexual activity. Most men will experience
erectile problems during their life, but if the problem lasts for 3
months or longer, it is clinically defined as ED.
Although ED affects most men at some point in their lives, it is much
more common in men with diabetes. In fact, in up to 12% of men with
diabetes, ED is the first sign that leads to the diagnosis of diabetes.
Fifty percent of men will experience ED within 10 years of diagnosis of
diabetes. Older men with a longer duration of diabetes, poor blood
glucose control, and who smoke, have high blood pressure, high
cholesterol and heart disease, are at highest risk.
Diabetes causes damage to the walls of the blood vessels, which affects
circulation and blood flow to the penis. In addition, nerve damage can
affect erection quality. ED can also be a side effect of drugs that are
often prescribed to men with diabetes (these include some blood
pressure-lowering drugs and anti-depressants).
Diagnosing ED — the first step in getting help
The first step is telling your doctor that you are having sexual
problems. He or she will ask you specific questions about the quality of
your erections and sexual intercourse. Your doctor may also do a
physical exam, check your blood pressure, your heart function and order
other tests for your eyes, kidneys, blood glucose control, cholesterol
and testosterone levels. The Canadian Diabetes Association’s 2008
Clinical Practice Guidelines for the Prevention and Management of
Diabetes in Canada recommend that all adult men with diabetes be
regularly screened for ED with a sexual function history. If your doctor
doesn’t bring up the topic, you should.
Treating ED
There are a number of effective treatments for ED. It is important for
sexual partners to be involved in any discussion about treatment
choices.
Drugs called PDE5 inhibitors (available in Canada under the trade names
Viagra, Cialis and Levitra) help a man achieve and maintain an erection.
With sexual stimulation, these drugs increase blood flow to the penis,
allowing an erection to occur naturally. They can be used safely in most
men with diabetes, including select elderly men. However, they are not
safe for men with certain heart conditions or men who take nitrates
(which are often used to treat angina).
For men who can’t take PDE5 inhibitors or find that they don’t work,
other options include other drugs, injections, hormone replacements,
mechanical devices such as vacuum constriction devices, implants and
surgery.
It also makes sense (for many health reasons other than ED) to keep your
blood glucose, blood pressure and cholesterol in the target range, to
quit smoking and start exercising. These will all lead to better overall
health and, in turn, better sexual health.
For more information
While there is a huge amount of information about erection problems on
the internet, much of it is unreliable and posted by companies selling
drugs, supplements or devices that are not medically tested and which
make claims that are not supported by research. Such companies rely on
the fact that many men are uncomfortable discussing sexual problems and
will therefore be tempted to buy products they can try in privacy.
ED is a real medical problem that needs to be treated by a real medical
team. Do not attempt to self-diagnose or self-treat based on what you
read on the internet. If you have questions about ED or any aspect of
healthy sexual functioning, talk to your doctor or a member of your
diabetes healthcare team. Once you’ve consulted your doctor,
The media portrays sex as endlessly exciting, gratifying and
straightforward. However, for many people and couples the reality is
quite different. Sexual problems are very common, but because sex often
involves complex emotions, patients (and doctors) can find these
problems difficult to raise and discuss. The focus of this section is
erectile dysfunction (ED), a common sexual problem in men with
diabetes..
Definition of ED
ED is defined as the persistent inability to get or maintain an erection
that is satisfactory for sexual activity. Most men will experience
erectile problems during their life, but if the problem lasts for 3
months or longer, it is clinically defined as ED.
Although ED affects most men at some point in their lives, it is much
more common in men with diabetes. In fact, in up to 12% of men with
diabetes, ED is the first sign that leads to the diagnosis of diabetes.
Fifty percent of men will experience ED within 10 years of diagnosis of
diabetes. Older men with a longer duration of diabetes, poor blood
glucose control, and who smoke, have high blood pressure, high
cholesterol and heart disease, are at highest risk.
Diabetes causes damage to the walls of the blood vessels, which affects
circulation and blood flow to the penis. In addition, nerve damage can
affect erection quality. ED can also be a side effect of drugs that are
often prescribed to men with diabetes (these include some blood
pressure-lowering drugs and anti-depressants).
Diagnosing ED — the first step in getting help
The first step is telling your doctor that you are having sexual
problems. He or she will ask you specific questions about the quality of
your erections and sexual intercourse. Your doctor may also do a
physical exam, check your blood pressure, your heart function and order
other tests for your eyes, kidneys, blood glucose control, cholesterol
and testosterone levels. The Canadian Diabetes Association’s 2008
Clinical Practice Guidelines for the Prevention and Management of
Diabetes in Canada recommend that all adult men with diabetes be
regularly screened for ED with a sexual function history. If your doctor
doesn’t bring up the topic, you should.
Treating ED
There are a number of effective treatments for ED. It is important for
sexual partners to be involved in any discussion about treatment
choices.
Drugs called PDE5 inhibitors (available in Canada under the trade names
Viagra, Cialis and Levitra) help a man achieve and maintain an erection.
With sexual stimulation, these drugs increase blood flow to the penis,
allowing an erection to occur naturally. They can be used safely in most
men with diabetes, including select elderly men. However, they are not
safe for men with certain heart conditions or men who take nitrates
(which are often used to treat angina).
For men who can’t take PDE5 inhibitors or find that they don’t work,
other options include other drugs, injections, hormone replacements,
mechanical devices such as vacuum constriction devices, implants and
surgery.
It also makes sense (for many health reasons other than ED) to keep your
blood glucose, blood pressure and cholesterol in the target range, to
quit smoking and start exercising. These will all lead to better overall
health and, in turn, better sexual health.
For more information
While there is a huge amount of information about erection problems on
the internet, much of it is unreliable and posted by companies selling
drugs, supplements or devices that are not medically tested and which
make claims that are not supported by research. Such companies rely on
the fact that many men are uncomfortable discussing sexual problems and
will therefore be tempted to buy products they can try in privacy.
ED is a real medical problem that needs to be treated by a real medical
team. Do not attempt to self-diagnose or self-treat based on what you
read on the internet. If you have questions about ED or any aspect of
healthy sexual functioning, talk to your doctor or a member of your
diabetes healthcare team. Once you’ve consulted your doctor,
