Millions of men suffer from impotence, and it is more common among men with diabetes than others. While it is estimated that 15-25% of men experience erectile dysfunction by the age of 65, it has been reported to affect 50-60% of men with diabetes over the age of 50.
The most common causes of impotence in men with diabetes are physical problems such as blood vessel disease and nerve disease. When nerves are damaged, small blood vessels don't relax, so they can't grow larger with the flow of blood that causes an erection. Medications can also cause impotence, including some used to treat high blood pressure, anxiety, depression, and peptic ulcers. Drinking too much alcohol can also contribute to impotence, and smoking slows down blood flow, which may also be a contributing factor. There is also a psychological component, when slight nerve damage causes partial impotence, creating anxiety that makes the impotence worse.
That's the bad news.
The good news is that Viagra has been tested and found effective in men with diabetes. Viagra works by helping to relax the smooth muscles in the penis during sexual stimulation, allowing increased blood flow. In an early study involving 21 patients, use of Viagra improved the quality of erections in 48% receiving the 25 mg dose and 52% of those receiving 50 mg. A larger study of 268 men with diabetes found improved erections in 56% of those receiving Viagra. These results compare to ranges of 65% to 88% percent improvement reported by men without diabetes.
The most common side effects were headache, dyspepsia, and sinus congestion or drainage. There is a potential for serious drug interactions, particularly with nitrites and calcium channel blockers.
So if you are experiencing difficulty with erections, don't hesitate to talk to your doctor. Counseling may help with the psychological aspect. For the physical causes, changing your prescribed medications may help, or a trial of Viagra may be the answer for you as it has been for millions of men since it was introduced in 1998.
- Aaron Vinik. Erectile dysfunction in diabetes: pills for penile failure. Clinical Diabetes, 1998;16(3).
- National Kidney and Urological Diseases Information Clearinghouse. Impotence. www.niddk.nih.gov
- Sildenafil Diabetes Study Group. Sildenafil for treatment of erectile dysfunction in men with diabetes: a randomized controlled trial. JAMA, 1999 (Feb. 3);281(5):465-66.