A review of 145 studies, involving 88,577 men, discovered that more than half of guys with diabetes struggle with impotence.
Off the back of the findings, Dr Damiano Pizzol, co-author of the analysis, called for clinicians to routinely screen for erectile dysfunction in men with diabetes, as “both conditions are linked with increased cardiovascular risks”.
With one in 10 men estimated to suffer erectile dysfunction, and an increasing number of the population being diagnosed with diabetes, we spoke to experts about the causes and treatment options for ED that are currently available.
What is erectile dysfunction?
Erectile dysfunction (or ED), or impotence, is where a man cannot get and maintain an erection. The condition is common and is often prevalent among older men aged 40 and over.
What causes it?
The causes of ED can be both physical and psychological. In some cases, men might experience blood flow issues, where the blood vessels leading to the penis become narrow.
“This would be common in men with high cholesterol or high blood pressure,” Holland and Barrett’s resident health expert Emily Rollason told HuffPost UK.
“Diabetes may also affect blood supply and could be a possible cause of ED.”
ED can also occur as a result of penis injury, surgery and even hormonal changes, such as hypogonadism (a condition in which the body doesn’t produce enough testosterone) or thyroid conditions.
It can also occur as a side effect of certain medication. “Anti-depressant medication such as fluoxetine or sertraline (SSRIs), antipsychotics, diuretic medication and even anti-histamines may cause it in some men”, added Rollason.
In cases where it’s not as a result of a physical health problem, it could be down to stress, anxiety, depression and relationship troubles.
How is erectile dysfunction treated?
According to the NHS, narrowing of the arteries in the penis is one of the most common causes of ED. As such, doctors may recommend lifestyle changes such as losing weight, which can also reduce the risk of heart disease.
Medication is also a common treatment option. Stuart Gale, chief pharmacist for Oxford Online Pharmacy, told HuffPost UK: “Sometimes, simply knowing that you are physically able to respond to your partner can greatly improve any negative feelings you may have towards sex, which is why medication that helps to achieve and maintain an erection is so effective – and so popular.”
There are many different types of medication available, from Viagra to the generic, and much cheaper, versions like Sildenafil, Cialis (Tadalafil), Levitra (Vardenafil) and Spedra (Avanafil). These work by opening up the arteries and increasing blood flow to the penis.
Discussing how long it takes for them to take effect, Gale said: “Viagra and Levitra typically take 60 minutes before they work, and the effects may last up to eight hours. Cialis usually takes 30 minutes to work and can last up to 36 hours. Spedra is fast acting and takes 15 minutes to work. The effects last up to 5 hours.
“You should only take one pill in any 24-hour period and you should always ensure you access medication via a reputable source.”
Creams, pellets and injections
There are also other options including a cream, called Vitaros, which can be applied directly to the penis hole. Additionally little pellets, called Muse, can be inserted into the hole.
Meanwhile injections, such as Caverject or Viridal, can be administered directly to the penis.
“These options may sound less appealing but they actually work very well,” said Gale. “Often men suffering with erectile dysfunction lose their nerve and get stuck in a spiral of fear of failure. But these treatments can provide the necessary kick-start they need to get everything going again.”
Vacuum pumps are successful in 90% of cases, according to the NHS.
The noninvasive treatment involves placing a cylindrical device over the penis. The pump then slowly creates negative pressure, or a vacuum, inside the cylinder, which draws blood to the penis, producing an erection.
If the problem is psychological, cognitive behaviour therapy (CBT) and sex therapy may help.
So, which is best?
Gale concluded: “It’s difficult to say which is the most effective form of treatment as the response is very individual. This is why a thorough assessment for each patient is essential.”