People with diabetes are at increased risk of developing erectile dysfunction (ED). It is estimated that about half of men who have diabetes also have ED. This occurs when nerves and blood vessels in the penis are damaged and a person cannot have an erection or maintain one.

Although it can be an embarrassing topic, the sooner you discuss it with your healthcare provider, the quicker you will be able to treat it and improve your quality of life.

Learn more about erectile dysfunction, how diabetes affects it, prevention, and treatment.

What Is Erectile Dysfunction?

Erectile dysfunction (ED) occurs when you are consistently unable to get or keep an erection firm enough for satisfactory intercourse. It is more common with age, and the occurrence of ED can occur around 10–15 years earlier in men with diabetes. But, age is not the cause, and oftentimes there is a vascular, endocrine, or neurological contributor to ED.

ED can present differently in different scenarios. For example, you may not be able to have an erection when you want to have intercourse. This can be common from time to time but problematic if it occurs often. Or you can have an erection but not for long enough to satisfy intercourse. Some people are unable to have an erection altogether.

Diabetes and ED 

The development of ED in people with diabetes is complicated and has many contributing physical and mental factors. Many people with diabetes and ED also have underlying conditions, such as obesity, high blood pressure, and atherosclerosis (hardening of the arteries due to a buildup of plaque in the inner lining of the arteries), all of which can contribute to ED.

For a person to have and sustain an erection they need adequate blood flow to the penis. Diabetes can disrupt blood flow because of hyperglycemia (high blood sugar). Over time, elevated blood sugars can reduce the amount of nitric oxide (NO) that is produced. NO helps to relax the muscles in the penis and increases blood flow.

Low levels of NO are common in people who have diabetes and also are overweight or obese. Endothelial dysfunction, a narrowing of blood vessels instead of dilating or opening, is another complication of low NO levels from high blood sugar.

Chronically high blood sugar causes neuropathy (nerve damage). Autonomic neuropathy increases the risk of ED by disrupting nerve impulses to the penis, as well as reducing the body’s ability to allow the penis muscles to relax.

People with diabetes are at increased risk of having hormonal imbalances (such as low testosterone), another contributing factor of ED.

Can ED Be Reversed?

Due to its complexity and multiple contributing factors, ED treatment can be involved. However, prevention or delay of ED is possible if a person with diabetes can keep their blood glucose levels at goal. This isn’t always simple, as diabetes self-management is also complex and multilayered.

Getting your blood sugar under control and maintaining it is an ongoing process. But you can find support, resources, and education to get you to your goals. Below are some simple steps to get you on your way.

Meet With a Specialist

Whether you have just been diagnosed with diabetes or have had it for many years, meeting with a certified diabetes care and education specialist (CDCES) is an important step in your diabetes journey. CDCES’s specialize in all things related to diabetes. They can tailor a plan to meet your individual needs and educate you on topics such as meal planning, blood glucose management, diabetes medications, insulin injections, and more.

Studies have shown that meeting with a CDCES and receiving diabetes self-management education (DSME) can help people improve their glycemic control, as well as reduce healthcare costs, lower weight, and improve quality of life. Good glycemic control is associated with prevention and improvement of ED, and a reduced risk of diabetes complications.

Healthy Eating

There is no-one-size-fits-all eating plan with diabetes. In fact, the American Diabetes Association (ADA) believes that meal plans should be customized to the individual. People with diabetes should also be able to maintain the pleasure of eating.

Well-balanced and nutritious diets include eating a variety of fruits, vegetables, whole grains, legumes, nuts, seeds, and lean protein such as poultry, fish, lean beef, eggs, and low-fat dairy. The ADA supports a high-fiber diet that is dense in whole food and limits processed ones.

Understandably we all have different preferences. Perhaps you want to try a Mediterranean, flexitarian, or a low-carbohydrate eating plan. Regardless of what method you choose, it’s important to understand that carbohydrates, such as grains, bread, fruit, starchy vegetables, snack foods, and desserts, impact your blood sugars the most.

If your weight is impacting your blood sugar control, losing about 5% of your body weight can help you to improve your glycemic control. In some instances, weight loss has been shown to actually put diabetes in remission. Changing your eating habits can help you achieve and maintain your weight loss goals.

Daily Movement

Exercise helps to improve circulation and glucose control by improving insulin sensitivity. People with diabetes are encouraged to exercise daily. The type and intensity of physical activity will depend on your overall physical health, abilities, and interests.

All types of physical activity, including aerobic exercise, resistance training, stretching, and reducing sedentary behaviors have shown to be beneficial and is one step to help raise testosterone naturally (which can run low in diabetics).

Before starting any exercise program, get medical clearance from your physician. Once you do, find something you love to do and get started. Start slowly and increase gradually to prevent fatigue and burnout.

Smoking Cessation

Cigarette smoking can lead to vascular dysfunction, a risk factor for ED. By quitting smoking, you may see improvements in blood flow. However, more research is needed. Current literature suggests that improvement is limited to younger men with a more minor smoking history and a lack of comorbidities (other, co-occurring illnesses).On the other hand, smoking cessation proves to be beneficial for overall health, including cardiovascular health.

Treatment of ED

Whether ED can be fully reversed depends on a variety of factors. A person’s overall health, as well as the frequency, duration, and severity of the ED are influencing factors. Some research suggests that nearly 95% of men with ED can be treated successfully. And while ED can be more difficult to treat in men with diabetes, there are a variety of treatment methods to choose from.

Treatment of ED includes the same strategies that are needed to prevent it. Making lifestyle changes, such as the ones mentioned above, can improve blood flow and glycemic control. In addition, there are several medical and surgical options that are available to people with ED with diabetes.

Talk to Your Healthcare Provider

Since ED presents differently in everyone, discuss your personal symptoms with your healthcare provider and make sure you alert them as to what medications you are taking. Certain medications, such as blood pressure medication and medication used to treat depression, can contribute to ED. Sometimes simply changing a medication can improve ED.

Medicine

Certain medications can help to increase blood flow. These may be contraindicated in people with diabetes, based on their prescription medications and if they have any comorbidities. Discuss your options with your healthcare provider.

Hormones

Hormonal imbalances, such as low testosterone can contribute to ED. If you have diabetes, you are at increased risk of having low testosterone, therefore, hormonal therapy maybe indicated.

Other options may include:

  • Vacuum device
  • Injections or suppository
  • Penile implant
  • Acupuncture

Coping

ED can be stressful on you and your partner. Stress, anxiety, and worry also can make ED worse. Therefore, it is important to seek out help when you need it. In fact, research has demonstrated that in conjunction with treating the medical condition, psychological counseling can improve ED symptoms and sexual satisfaction. A licensed mental health professional can assist you in finding ways to cope.

A Word From Verywell 

Erectile dysfunction may be more common in people with diabetes, especially if you are older and have a history of high blood sugars, or vascular disease. But ED is preventable and treatable. If you suspect you have ED, have a conversation with your medical team right away. Although it might be a difficult conversation, discussing your concerns will help you identify and treat the problem. Your medical team can assist you in making lifestyle changes, as well as introduce you to potential treatment options. Having a healthy sex life can improve quality of life and longevity.

Frequently Asked Questions

  • How can a diabetic overcome erectile dysfunction?
  • Making lifestyle changes that can improve your glycemic control, such as eating a healthy diet, exercising, and stopping smoking, are important steps in preventing and treating ED. If these changes don’t work, talk to your healthcare provider about medications and other treatment options. Seek out the help of a mental health professional for emotional support.
  • Can diabetes stop you from ejaculating?
  • No. Erectile dysfunction occurs when you cannot achieve or maintain an erection for an extended period of time. It has nothing to do with ejaculating.
  • What is the fastest way to cure ED?
  • There is no fast-track approach to curing ED. However, achieving glycemic control and improving circulation and vascular health are important steps in treating ED. Discuss your specific issues with your healthcare provider so they can curate the best plan for you.
  • Can Metformin help with erectile dysfunction?
  • Glucophage (metformin) is an oral medication that is used along with a healthy diet and exercise as a first-line therapy for type 2 diabetes treatment. It may help improve ED by improving glycemic control. However, other studies suggest it can reduce sex drive, which contributes to ED. More research is needed.

Making lifestyle changes that can improve your glycemic control, such as eating a healthy diet, exercising, and stopping smoking, are important steps in preventing and treating ED. If these changes don’t work, talk to your healthcare provider about medications and other treatment options. Seek out the help of a mental health professional for emotional support.

No. Erectile dysfunction occurs when you cannot achieve or maintain an erection for an extended period of time. It has nothing to do with ejaculating.

There is no fast-track approach to curing ED. However, achieving glycemic control and improving circulation and vascular health are important steps in treating ED. Discuss your specific issues with your healthcare provider so they can curate the best plan for you.

Glucophage (metformin) is an oral medication that is used along with a healthy diet and exercise as a first-line therapy for type 2 diabetes treatment. It may help improve ED by improving glycemic control. However, other studies suggest it can reduce sex drive, which contributes to ED. More research is needed.