A large number of men in Anguilla have been diagnosed with diabetes mellitus, and it is believed many more have the disorder and are not aware of it as they fail to get tested for this very common chronic disorder. If diabetes is not adequately controlled a number of complications, including sexual problems, can develop.
Sexual issues in male diabetics
Diabetes is a leading cause of sexual issues in men. While some of the problems are nothing more than a chronic nuisance some, such as erectile dysfunction (ED) — not being able to get or keep an erection — are easy to notice and can have severe consequences.
Decreased libido is also more common in men who have diabetes but this is slower to recognise, and you may not notice it until your partner brings it to your attention.
What causes sexual problems in men with diabetes?
If you have poor blood sugar control, you are more likely to have sexual issues. High blood sugar levels over a long time can damage nerves and blood vessels, including those in the penis. This disrupts blood flow and makes it hard to get an erection. You can also have sexual issues if you have good diabetes control, but they may be milder and easier to treat.
About half of men who have had diabetes for more than 10 years have trouble with erections. Men with diabetes tend to develop this trouble 10 to 15 years before other men. Most doctors define erectile dysfunction as a consistent inability to sustain an erection sufficient for sexual intercourse, or the inability to get or keep an erection more than half the time.
Depression or emotional problems, and some drugs, can also cause ED. None of the diabetes drugs used to lower blood sugar is known to cause sexual problems in men or women. However, high blood pressure is common in people with diabetes, and some blood pressure medications — such as beta blockers, clonidine, and diuretics — are more likely to cause ED than others.
Erectile dysfunction and heart disease
Men with erectile dysfunction are also more likely to have heart disease, another condition linked to diabetes, because the same problems that block blood flow in your penis block it in your heart. For men with type 2 diabetes, erection problems are usually just the tip of the iceberg. The ED might lead the doctor to diagnose other problems like kidney disease and eye problems.
At what age does ED develop?
Erectile dysfunction can develop at any age in men with diabetes. In men with type 1 diabetes this can occur at an early age, but in men with type 2 diabetes (the most common type in Anguilla) it tends to be more common after the age of 45.
Treating erectile dysfunction
Many men have erectile problems and are too embarrassed to see a doctor, but I encourage all men, especially those with diabetes, to see an experienced doctor if they have trouble getting or keeping erections. Your doctor will ask you questions and do a physical exam to see if there are other causes. No matter what your age, you can get treatment for erectile dysfunction.
Treatment depends on your overall health and the cause of the problem, and will vary from one man to another. Treatment will include counselling, medications and a variety of other options. Treatment includes:
Oral drugs – Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra, Staxyn) and avanafil (Stendra) are approved for treating ED. How long they help you get an erection with stimulation varies. They can cause some side effects so discuss this with your doctor if you are a good candidate for these medications. It is estimated that for up to 60% of men with diabetes, they work well for ED. You should not take them if you take nitroglycerin or nitroglycerin-like drugs for chest pain, or if you have heart problems.
Other treatments are available such as suppositories, various devices such as vacuum pumps and various surgical procedures.
Other things that my help ED
A number of lifestyle changes have been shown to help men with ED. These include:
Regular physical activity – The more you exercise, the less likely you are to have erectile dysfunction.
Get help for depression. Emotional issues — such as stress, depression, anxiety, and conflict with your partner — can affect any couple’s sex life and relationship. If you have been feeling depressed for 2 weeks or more, talk to your doctor. Counseling or drugs can help depression and other emotional issues.
Eat right – Some research shows that erectile dysfunction is less common in men with type 2 diabetes who follow a Mediterranean diet. Other research has shown that the Mediterranean diet can make people less likely to have metabolic syndrome — the grouping of obesity, insulin resistance, blood pressure, and abnormal lipids that raise your chance of getting heart disease, diabetes, and stroke. The diet focuses on fruits, vegetables, fish, beans, and whole grains. You eat fish and poultry at least twice a week, limit red meat, and use healthy fats like olive oil, instead of unhealthy fats like butter. Ask your doctor if the diet is right for you.
Do not smoke – Smoking is bad for your health. It not only causes cancer, heart disease, and lung disease. Smoking can also help cause ED. In fact, men who smoke are about twice as likely to develop ED as those who do not smoke. So if you smoke, it is one more good reason to quit. For the youngsters, it is not cool to start smoking, so do not be tempted to start – quitting can be difficult.
Limit alcohol – Drinking a lot can also affect ED. Alcohol curbs blood flow to the penis and can affect how much testosterone your body makes. Both these things can affect your sex drive and erections.
Conclusion
Diabetes mellitus is very common in Anguilla. You will know if you have diabetes if you do a blood test. Men with this chronic disorder, and have poorly controlled blood sugar, are more likely to develop complications, one of which is erectile dysfunction. Sexual problems can be very difficult for the man to accept and can result in many emotional, physical and other problems. Early diagnosis and good management of diabetes can help prevent sexual issues from developing, but if they do develop various treatment options are available. Talk to your doctor today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
