Diabetes and erectile dysfunction: are they linked?

Erectile dysfunction (ED) is extremely common among people with penises–in fact, ED currently affects 30 million people in the US. However, if you have diabetes, you may be even more likely to experience ED. What exactly is the connection between diabetes and erectile dysfunction? 

Diabetes means that the body has an issue making or responding to the hormone insulin, which helps drive blood sugar into cells. As a result, sugar stays in the blood. Over time, this can damage nerves and blood vessels, raising your risk for a range of health problems—including erectile dysfunction. Continue reading to learn more about the connection between diabetes and ED, and what you can do to treat it.

Men with diabetes are more likely to experience erectile dysfunction than those without. More specifically, a recent study of men with diabetes and sexual dysfunction found that biological men are 3.5 times more likely than those without diabetes to experience erectile dysfunction. The likelihood of ED is correlated to the type of diabetes present–an older study showed that 26% of men with type 1 diabetes and 37% of men with type 2 diabetes experience ED.

Erectile dysfunction is common among the general population, but certain risk factors and health conditions associated with diabetes increase a person’s likelihood of struggling with ED.

1. Cardiovascular disease

Cardiovascular disease and cardiovascular events like heart attack or stroke are the leading cause of death among people with diabetes. Research also shows a direct correlation between erectile dysfunction and cardiovascular disease or events. Because ED can be an early warning sign of heart disease, it’s important to speak to your healthcare provider about your ED symptoms, whether or not you have diabetes. 

Over time, diabetes can damage the blood vessels. Along with high blood pressure, this can cause damage to all blood vessels, including those that supply blood to the heart, but also the penis. Low blood flow to the penis means you may struggle to get or maintain an erection firm enough for penetration. Speaking to a provider about your ED may increase your chance of an early diagnosis of silent CAD (coronary artery disease) and stroke, especially in people under the age of 60.

2. Nerve damage

High blood sugar levels caused by diabetes may cause damage to the nerves, or diabetic neuropathy. Stimulating the nerve endings in the penis plays a critical role in getting and maintaining an erection strong enough for satisfying intercourse (if that intercourse involves penetration), so nerve damage may lead to ED.

3. Low testosterone

Low testosterone levels are common among people with type 2 diabetes, in particular. In fact, studies have shown that up to 40% of men with type 2 diabetes have low testosterone, and many experience erectile dysfunction.

4. Depression

People with diabetes are twice as likely to suffer from depression than those without diabetes. In men, sexual complications linked to diabetes such as ED can potentially make it worse, resulting in lower quality of life, frustration and even depression. At the same time, erectile dysfunction can lead to more severe depression, and some antidepressants can cause ED, creating a vicious cycle.

Erectile dysfunction is treatable. With the help of your healthcare provider, you are likely to find a treatment plan that results in a satisfying sex life for you and your partner(s). Here are some options for treating erectile dysfunction with diabetes.

1. ED medication

PDE5 inhibitors, including Viagra, Levitra, Cialis, and Stendra, are the most common and effective treatment for erectile dysfunction. However, PDE5 inhibitors can also interact with certain heart and blood pressure medications. Speak to your healthcare provider about ED medication to find out if it’s safe for you. 

2. Penile implants

There are two types of penile implants: malleable and inflatable. Malleable implants are two semi-rigid rods that are inserted into the penis and can be positioned for sex. Inflatable implants are two cylinders inserted into the penis and a pump which fills the cylinders with fluid, causing an erection. 

3. Penis pumps

To use a penis pump, also known as a vacuum pump, you insert your penis into a plastic chamber. Suction is created using a hand pump or battery device, which draws more blood into the penis, resulting in a firmer erection.

4. Intraurethral alprostadil 

Intraurethral alprostadil is a suppository inserted into the urethra with an applicator. With a success rate of up to 65% in patients with diabetes, it’s a fairly effective treatment alternative to PDE5 inhibitors. However, the treatment is known to cause penile pain and burning in 10% of users.

5. Lifestyle changes

Your erection will be healthiest when you’re at your healthiest. Certain lifestyle changes may have a big impact on the quality of your erections. Follow these tips to increase your odds of satisfying penetrative sex:

• Stop smoking

• Eat a healthy balanced diet

• Increase your exercise

• Reduce or stop drinking alcohol

If you have diabetes and struggle with erectile dysfunction, there’s no shame in speaking to your healthcare provider about your symptoms. ED is extremely common in general, and especially among those with diabetes. With so many ED treatment options available, your healthcare provider will help you develop a safe treatment plan that works for you.

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Current version

August 21, 2023

Written by

Abbi Havens

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.