Diabetes and erectile dysfunction: What is the connection?

Erectile dysfunction, also called impotence, is not being able to get and maintain an erection for long enough to have sexual intercourse.

There are many causes of erectile dysfunction (ED) which can be physical, psychological, or both. One of the most common causes of ED is diabetes.

Studies suggest that 35-75 percent of men with diabetes will go on to develop ED. They will also tend to develop ED some 10-15 years earlier than men without diabetes.
Medical News Today Newsletter
Stay in the know. Get our free daily newsletter

Expect in-depth, science-backed toplines of our best stories every day. Tap in and keep your curiosity satisfied.

Your privacy is important to us
Diabetes and erectile dysfunction

Diabetes can cause ED because it can damage the blood supply to the penis and the nerves that control an erection.
Poorly managed diabetes can lead to erectile dysfunction due to its effects on the bloodstream.

When a man becomes sexually aroused, a chemical called nitric oxide is released into his bloodstream. This nitric oxide tells the arteries and the muscles in the penis to relax, which allows more blood to flow into the penis. This gives the man an erection.

Men with diabetes struggle with blood sugar level swings, especially if their condition isn’t managed poorly.

When their blood sugar levels get too high, less nitric oxide is produced. This can mean that there is not enough blood flowing into the penis to get or keep an erection. Low levels of nitric oxide are often found in those with diabetes.
Other causes of erectile dysfunction

Listed below are some other reasons for ED:

obesity, high blood pressure, and high cholesterol
hormonal problems such as low testosterone
psychological problems including stress, anxiety, and depression
nervous system problems including damage to spinal cord or brain
smoking, drinking too much alcohol, and using some illegal drugs
some medications such as those taken for high blood pressure and depression

Pelvic injury or surgery on the prostate, bowel or bladder may cause damage to nerves connected to the penis. This nerve damage can also lead to ED.

Tests and diagnosis

A doctor will often perform some of the following tests to diagnose ED:

Blood tests to check for a raised blood sugar level, which may indicate diabetes.
Hormone tests to measure the levels of testosterone and other hormones.
Nervous system tests, such as blood pressure and sweat tests, which can rule out nerve damage to the heart, blood vessels, and sweat glands.
Urinalysis to test for sugar in urine, which might indicate diabetes.
Physical examination to assess the genitals and nerve reflexes in the legs and penis.
Patient history to help determine why someone is having problems with erections and under what circumstances.