Q. I am 54 and have been diagnosed with type II diabetes for seven years. I have been experiencing erectile dysfunction for the past two years. I initially thought it was due to a circumcision I had performed five years ago, but I now understand that it may be due to the lack of blood sugar control I had during the early stages of my diabetes. I have been in control for the past two years, and lately I have began to experience some slight erections during the mornings and sometimes during the day. Would you please tell me if this means there is hope?
A. I hope you are not keeping your blood sugars under control simply in hopes of regaining erections. Instead, keep your sugars under control to prevent further complications of diabetes, such as heart disease, peripheral vascular disease, neuropathies and strokes. This way, you will live a long healthy life without false expectations. But if you keep your sugars under control hoping you will get better erections and it doesn’t happen, you may be angry and disappointed.
In patients with diabetes, blood flow to the penis diminishes because the small blood vessels in the penis harden and partially clog. When the blood flow is depressed, the penis doesn’t get hard enough for penetration. Also, high blood sugars can damage the nerves to the penis. These changes are not reversible, but the resulting erectile dysfunction is often treatable.
In my practice, once a man with diabetes starts to notice a change in his erectile strength, I treat him with Viagra. This pill increases the blood flow to the penis and helps provide a better, longer-lasting erection. If the patient doesn’t respond to Viagra, then I offer other treatments. One such treatment is the vacuum erection device. This fits around the penis; when activated it sucks blood into the penis, creating an erection. If that doesn’t the patient, we may try prostaglandin injections into the penis. Overall, the patient will have satisfying erections.