Q. I am 26 and was recently diagnosed with diabetes. I am having a hard time maintaining an erection or reaching orgasm. Can anything be done to correct this problem?

A. Diabetes is not just a sugar problem. Unfortunately, while researchers and doctors can develop effective medicines to control blood sugar, other manifestations of the disease can still occur.

For instance, long after the original diagnosis — typically 10-20 years — some of the body’s autonomic nerves (which control the bladder, bowel and erectile function) may start to fail. This is called diabetic neuropathy. Symptoms could be the inability to urinate, severe constipation and loss of erections. This can happen even in patients with good sugar control, and researchers still aren’t sure why. We do know that neuropathies occur much more quickly in people who do not control their sugar levels, so please keep your blood sugar under control.

Also, diabetes can destroy small arteries in the body; this leads to poor tissue blood supply. This also takes years, and it usually occurs in the feet. The same poor circulation can affect the penis, and you can lose your erection. But again, this usually happens to older men, around age 50.

So, at this point, you are at risk of developing these problems because of your diabetes. But I am not sure the diabetes is responsible for your difficulty in erections now — at least not physically.

However, dealing with your new condition may be having an effect on your mood as a whole, which can in turn affect your sexual response. Someone who is diagnosed with a severe medical condition typically goes through several stages. Usually there is some degree of denial, followed by anger. Eventually the person must learn to accept the problem and go on with life. Once there is acceptance, the person then begins to deal with major lifestyle changes. Your doctor will tell you what to eat and how much to weigh, and every time you go to the doctor there is often more bad news. With this much stress, it is not uncommon for a person, no matter how strong, to get a little depressed.

I am very pleased you are willing to take get help for your erections, because there are several options. First, your urologist can offer support — and Viagra. The Viagra can increase blood flow to the penis and strengthen your erection. Second, look up a diabetic support group — in your community or online — where you can talk to others living with your problem who share common stresses. There you can vent and get reinforcement and encouragement. I believe that a healthy mind leads to a healthy erection.

Don’t forget, also, that there are other causes of erectile difficulty you may wish to explore with your doctor. For more information on erection problems, see my earlier column, Can’t Get Full, Lasting Erection.

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