Erectile dysfunction

Definition

Erectile dysfunction (ED) is the inability to develop and maintain an erection sufficient for satisfactory sexual intercourse or sexual activity.

Background

Erection difficulties are common in diabetes and there are a number of causes including blood vessel or nerve damage caused by diabetes itself, tiredness, stress, excess alcohol, poor blood sugar control, certain medications, and deficiency of the male sex hormone testosterone.

35-75% of all men with diabetes have difficulty with their erections, the incidence increasing with age. Men with diabetes can have any of the difficulties that affect other individuals but diabetes itself can cause nerve damage (neuropathy) or arterial dysfunction that interferes with the erectile mechanism.

Whilst symptoms may be worrying for individuals it is important to remember that the majority of patients respond to treatment (depending on the treatment chosen).

Assessment

All patients with erectile dysfunction should undergo a formal evaluation. This evaluation is used to assess the severity of the problem, to determine the likely cause or precipitating factors and to take account of other co-morbid conditions eg. ischaemic heart disease. An appropirate treatment can then be recommended.

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