Erectile Dysfunction (ED) and Diabetes: What's The Link?

Erectile dysfunction, or ED, is a common sexual health issue that affects around 30 million men in the United States alone. Often, ED is caused by physical health problems, such as atherosclerosis, obesity, nerve damage or high blood pressure. Unfortunately, issues associated with diabetes mellitus can also cause or contribute to ED.

Erectile dysfunction or ED is common in men with diabetes, including type 2 diabetes. Damaged blood vessels and nerves — which occur with diabetes — can make both getting and keeping an erection more challenging.

Diabetes can also affect the age at which you first start to develop ED symptoms, often by a decade or more. The good news is that it can be treated.

Below, we’ve looked into the link between diabetes and erectile dysfunction. We’ve also covered what you can do to treat ED and improve your sexual performance if you’re affected by type 1 diabetes or type 2 diabetes.

Can diabetes cause ED? Sort of. Diabetes can either cause or contribute to erectile dysfunction in three main ways — by affecting blood flow to tissues inside your penis, by affecting the function of your nervous system and by potentially contributing to depression. 

These three issues mean that men with diabetes have a significantly higher risk of dealing with ED than their peers.

Because erections depend on proper nerve function and blood flow, any condition that affects your nerves or vascular system can also potentially affect your ability to get an erection.

For example, diseases and conditions such as atherosclerosis (clogged arteries), hypertension (high blood pressure) and heart and blood vessel disease can contribute to ED by affecting the ability of blood to flow to the tissues inside your penis.

This is where diabetes comes into the picture. Diabetes is closely linked to two issues that can cause erectile dysfunction: cardiovascular disease and nerve damage.

Diabetes can contribute to cardiovascular disease through blood vessel damage. Over time, high blood sugar levels can damage your blood vessels and contribute to cardiovascular disease, affecting the flow of blood throughout your body. 

Diabetes can also cause a type of nerve damage called diabetic neuropathy. One form of nerve damage caused by diabetes, called autonomic neuropathy, affects the sex organs. For men, this type of nerve damage can cause ED; in women, it can cause vaginal dryness.

Even the non-physical effects of diabetes can affect your erections and sexual performance. For example, if you have diabetes, your risk of developing major depressive disorder is two to three times higher than a person without diabetes.

Depression can affect your sex drive, including by contributing to ED. In fact, depression is one of the most common factors in psychological erectile dysfunction. 

Does diabetes cause ED for every man who has it? Not exactly, but it definitely increases your risk — and the prevalence is quite high.

In research published in the journal Clinical Diabetes, researchers found that men with diabetes have a 35 to 75 percent risk of also developing ED, versus just 26 percent of men in the general population.

They were also more likely to develop erectile dysfunction early in life, with the average onset of ED occurring 10 to 15 years earlier in men with diabetes.

Research also suggests that erectile dysfunction is more common in men who’ve been affected by diabetes for a long period of time. Put simply, in older men, the longer you’ve had diabetes, the greater your risk of potentially developing ED. 

Read here to learn more about the sexual side effects of diabetes.

Treating diabetes and ED simultaneously will require the guidance of a healthcare professional. 

A urologist or other health professional can answer questions. They’ll help you navigate treatment, prioritize what could be many changes in behavior and habits. They’ll also help you understand which risk factors men with diabetes can address to rule out other causes of ED like mental health concerns or low testosterone. 

Erectile dysfunction can be frustrating to deal with — something that’s true for men with and without diabetes. The good news is that ED is almost always treatable, typically with medication. 

Today, a variety of ED medications are available for men with diabetes, many of which are very effective at improving erections and sexual function.

The most widely used ED treatments are oral medications called PDE5 inhibitors. These work by inhibiting the PDE5 enzyme, which is responsible for regulating blood flow to the soft tissues inside your penis.

The most widely used PDE5 inhibitors are sildenafil (the active ingredient in Viagra^®), tadalafil (Cialis^®), vardenafil (Levitra^®) and avanafil (sold as Stendra^®). 

A standard dose of ED medication such as sildenafil can increase blood flow to your penile tissues, making it easier to develop and maintain an erection if you have diabetes. 

ED medications vary in their onset and duration of action. Some medications, such as sildenafil and vardenafil, are ideal for a single night of relief from ED. Others, such as tadalafil, last for up to 36 hours per dose.

Your healthcare provider may prescribe a certain medication based on the severity of your ED, your general health, personal needs and more. Our guide to what you should expect from ED medication goes into more detail on these medications and how they work.

Because ED medications can also have effects on the cardiovascular system, it’s important to speak to your doctor before using any of these drugs to treat diabetes-related ED. 

ED medications can also interact with some medications used to treat high blood pressure — a common issue for people with diabetes — making it important not to take any ED drugs without first consulting your healthcare provider. 

In addition to traditional ED medications, there are alternative treatments available for people with diabetes, such as injections and vacuum erection devices (VEDs).

These treatment options are often effective, but are less convenient than oral medications. Your healthcare provider may suggest using a device or prescribe an injectable ED medication if you fail to respond to other treatments.

In addition to medication to address ED, it’s also important to work with your healthcare provider to manage your diabetes. This is typically accomplished through lifestyle changes and medication.

Diabetes care and the complications of diabetes are both very serious responsibilities and while we know that erectile function is an important part of quality of life, obviously you need to have your priorities in order.

That means that if you think or know that you have diabetes, you can’t ignore that aspect of your health to prioritize treating sexual dysfunction.

If you're noticing a link between your diabetes and erectile dysfunction, it’s always best to talk to your healthcare provider about lifestyle changes you can make to address your erectile function and your blood glucose. 

You can also access ED medication online through our platform after a private, online consultation with a licensed healthcare provider. 

Interested in learning more about successfully dealing with ED? Our guide to the most common treatments for ED goes into more detail about how you can improve your erections and enjoy a healthy sex life even if you’re prone to severe or persistent erectile dysfunction.