It's World Diabetes Day! 1...
Diabetes is a metabolic disorder that may lead to many health complications: heart disease, stroke, blindness, kidney impairment etc. However, do you know that erectile dysfunction (ED) is also one of the complications of diabetes? A study has found out that men with type 1 and type 2 diabetes were at a significant higher risk for ED than men without diabetes. Conversely, the severity of ED can even precede the diabetes diagnosis.
Image credit: Medical News Today
In Malaysia, there is inadequate epidemiological data on the prevalence of ED among male diabetics. However, a study on ED among men who frequented public primary care clinics in an urban district in Malaysia found out that the prevalence of ED among diabetics or heart disease was as high as 89.2%!
ED is defined as the consistent or recurrent inability to acquire or sustain an erection of sufficient rigidity and duration for sexual intercourse. Many studies have been conducted to identify the risk factors for ED. Besides diabetes, the following were also found to increase the risk of getting ED:
Heart disease. Interestingly, both heart disease and ED are closely linked. Heart disease and other risk factors such as high blood pressure increase the risks of getting ED later in life (e.g. decades later); on the other hand, ED may be a warning sign of future heart disease.
Use of certain medications such as antidepressants, spironolactone, thiazide diuretics, cimetidine etc.
Image credit: The Independent UK
It is important to keep in mind that ED is not merely about a male’s sexual performance and quality of life. In fact, it can be an early sign that something else is wrong with one’s body. ED is treatable if identified earlier, so the sooner one see a doctor for investigating ED, the better the outcome will be.
Causes of ED are extremely complex. In summary, the higher risk for ED among diabetic males can be explained as such:
Nerve damage. ED among male diabetics is a manifestation of a condition called diabetic genitourinary autonomic neuropathy. In this condition, the autonomic nerve fibres in the penis, which is essential for erection, have been shown to be reduced and damaged amongst male diabetics. This is because high blood sugar level can damage the nerve tissues, which include but not limited to the nerve in the penis.
Affected blood flow due to blood vessel blockage. ED is closely linked to heart disease such as atherosclerosis, i.e. deposits of fat and cholesterol on the walls of the artery. As such, the fat and cholesterol can also deposit on the arteries in the penis, leading to narrowing of blood vessels. This reduces the blood flow to the penis, which causes erectile dysfunction.
Image credit: Health & Wellness Blog India
Lack of nitric oxide. In penile erection, a substance called nitric oxide plays an important role. However, high blood sugar level can inhibit the release of nitric oxide, which makes it difficult for men with poor diabetic control to achieve an erection.
Psychosocial issue. Diabetic males who experience ED are more likely to develop depressive episodes and have a lower quality of life. Conversely, depression can further worsen ED among diabetic males.
Many men are reluctant to discuss ED with their doctors, especially in Malaysia. However, you should not let embarrassment keeping you from seeking professional help. Here are what you can do:
Tell your doctor what is going on. Your doctor will carefully investigate the underlying causes behind the ED and offer various treatment options for you.
Be proactive at managing your diabetes. Consistently attend your follow-up with the doctor, take your diabetic medications as per instructed and follow through the prescribed diet and lifestyle habits. This is because poor diabetes control is associated with worsening ED.
Seek counselling. Anxiety and depression can worsen ED and vice versa. A psychologist, counsellor or another mental health specialist can help you and your partner find ways to cope.
Stay physically active
Limit or cut your alcohol intake. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks a day for men age 65 and younger.
Image credit: Healthline
Cover image credit: The Independent UK
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