Autor: Carlos Fernandes Updated | February 2021 Diabetes can be defined as a group of metabolic diseases involving hyperglycemia . This hyoerglycemia is cause of lesions and failure of a number of tissues and organs, such as nerves and blood vessels. Diabetes mellitus is also often associated with: Obesity; High blood pressure; Increases in lipid profile (total cholesterol and triglycerides). These factors also affect blood flow in different organs. What is the connection between erectile dysfunction and diabetes? Diabetes is connected with erectile dysfunction, because it affects almost all the mechanisms needed for a normal erection : The blood vessels that supply the penis; The nerves that stimulate erection; The penile trabecular smooth muscle that is essential for erection Studies have shown that erectile dysfunction is three to four times more common in patients with diabetes mellitus and occurs at younger ages (50% of patients with erectile dysfunction Erectile dysfunction is more common in patients with diabetes for a long time, with a bad glycemic control and with other diabetes-related complications, such as retinopathy or autonomic neuropathy . We also know that patients with diabetes mellitus and erectile dysfunction experience a significant reduction in quality of life and an increase in symptoms of depression . Another important association is the fact that erectile dysfunction in diabetes patients is associated with a higher risk of cardiovascular complications , such as stroke and heart attack. So erectile dysfunction here serves as a warning for these possible complications. It should be noted that most patients involved in the studies that allowed these results to be obtained, had never been asked by doctors about their sex life during their diabetes mellitus follow-up. It is difficult subject for both patients and health professionals. Erectile dysfunction and diabetes: how are they assessed? Erectile dysfunction is a fundamental question in the approach to diabetics. When a patient complains of erectile dysfunction, we must consider diabetes control , diabetic complications and other contributing factors , such as: Dyslipidaemia; High blood pressure; Smoking; Alcohol consumption; Depression; Hormonal dysfunction. The patient medication should be reviewed , as some drugs can interfere with erectile function. The assessment should normally include specific lab tests and image exams , in addition to the general ones. How is erectile dysfunction treated in diabetics? Proper control of blood sugar levels and other risk factors, such as high blood pressure and dyslipidaemia, is essential in diabetic patients. The aim of this control is to reduce the risk of erectile dysfunction and improve the efficacy of erectile dysfunction treatments. There are currently vasodilator drugs ( eg Viagra ® , Cialis ® , Spedra ® ) that are quite effective in treating erectile dysfunction in patients with diabetes. These drugs must only be used under medical supervision so that they are safe from a cardiovascular point of view. There are also drugs that are administered via the urethra or injection into the penis, as alprostadil, with an efficiency of up to 70%. As a rule they are used as a second-line treatment. Promising new forms of treatment for erectile dysfunction in men with diabetes have emerged, such as shockwaves, which are quite effective and safe. Surgery to insert penile prostheses may also be an option. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
