Erectile dysfunction and diabetes: causes and treatment

How diabetes affects erections

Erections need healthy blood vessels and working nerves. Years of high blood sugar can damage both.

Damaged vessels let less blood flow in. Damaged nerves (neuropathy) weaken the signals between the brain and the penis. Mayo Clinic lists diabetes among the common physical causes of ED. Low testosterone can also play a part, and it is worth asking your clinician whether it should be checked. We do not give prevalence figures here, because the numbers vary by study.

Blood sugar control and ED

Better blood sugar control can slow the damage and may improve erections for some men. It works best as part of a wider plan.

Your A1C is a useful talking point with whoever manages your diabetes. Exercise and weight loss help both blood sugar and erections. Nobody can promise that damage will reverse, so treat ED as something to manage alongside your diabetes care. Some people with diabetes use GLP-1 medicines under their diabetes clinician's care. Our guide to compounded semaglutide explains what that term means.

Do ED pills work if you have diabetes?

PDE5 inhibitors such as sildenafil and tadalafil are often used in men with diabetes. Some men respond less strongly, so the clinician may adjust the plan.

A Cochrane review of trials in men with diabetes found PDE5 inhibitors performed better than placebo on sexual function scores, with more headache and flushing. Daily low-dose tadalafil is one option a clinician may consider, and our sildenafil vs tadalafil guide explains the difference. Response varies and nothing is guaranteed. If pills are not enough, a urologist can talk through specialist options. Source: Cochrane review CD002187.

Medications and conditions to mention

Tell the clinician about every diabetes, heart and blood pressure medication you take. Some combinations with ED medication are unsafe.

Never use a PDE5 inhibitor with nitrates. Blood pressure medicines and alpha-blockers also need review, because the combination can drop your blood pressure. Mention heart disease, kidney disease and eye disease (retinopathy), and list your supplements too.

ED as a heart warning in diabetes

In men with diabetes, ED can be an early sign of heart and blood vessel disease. It is a reason for a cardiovascular check, not just an ED prescription.

The American Urological Association (AUA) guideline on erectile dysfunction says ED is a risk marker for underlying cardiovascular disease and may come before a cardiac event. Chest pain or breathlessness with exertion means in-person care first. Our erectile dysfunction treatment guide covers the wider picture.

Getting reviewed online

Many men with well-managed diabetes can be evaluated for ED online. The clinician decides whether it is safe or whether you need in-person care.

The intake asks about your symptoms, health history, diabetes and heart conditions, and every medication you take. A prescription is never automatic. Mendoxa serves 49 states (not California), licensed LocumTele clinicians review every intake, and Rush Pharmacy prepares the medication when one is prescribed. See getting an ED prescription online for how the process works.