Erectile dysfunction

Erectile dysfunction means not being able to have or keep an erection for long enough to have sexual intercourse. It is more common in people with diabetes, especially if their diabetes is poorly controlled.

There is a wide range of treatments available and there are many people who can give you advice and support.

What causes erectile dysfunction?

• Smoking, heavy drinking and some illegal drugs
• Some medicines used to treat high blood pressure or depression
• Operations to the bowel, bladder or prostate
• Lack of testosterone (a male hormone)
• Stress, anxiety, depression, relationship problems, guilt and fear of failure
• Diabetes, which damage the blood supply and nerves to the penis

Impotence affects both people in a relationship. Talking to your partner can help you both understand how you feel and improve the situation. You can then decide if you want to seek help for it.

Seeking help 

You should first approach your GP or diabetes care team - it often helps if you and your partner can attend together to discuss the problem. They may be able to help you themselves or may refer you to a specialist. You may be advised to try changing your diabetes medication to see if that helps the situation. Counselling and talking therapies are also available as well as medical treatment. 

Treatments

Several treatments are available. These include:

Sildenafil (Viagra)

Sildenafil, usually known as its brand name Viagra, is a tablet taken before intercourse, which can help you to have an erection if you become aroused. It is not suitable for everyone. If you take certain tablets for a heart condition, for example, you may not be able to take Viagra. Vardenafil and Tadalafil are similar alternatives.

Self-injection therapy

You can inject a drug into your penis before intercourse. This increases the blood supply to your penis to produce an erection.

Intraurethral therapy

This is a small pellet inserted into the end of the penis. It increases the blood supply to the penis to produce an erection.

Vacuum therapy

You place a rigid tube over your penis and use a pump to empty the air out of the tube. This causes blood to be drawn into the penis and then you put a type of ring at the base of your penis to maintain your erection during intercourse.

Surgery

Occasionally an operation is recommended to renew the blood supply to your penis or to implant a rod to make your penis erect enough for penetration.

Testosterone

If you are found to be lacking in the hormone testosterone, your doctor will investigate the reasons and advise appropriate treatment if needed. It is necessary to have normal testosterone levels for other impotence treatments to work effectively.