How to fix Erectile dysfunction ALTHOUGH You have diabetes!
What is the best ED drug for diabetics?
It is estimated that about 35% to 75% of men with diabetes will experience at least some degree of erectile dysfunction -- also called ED or impotence -- during their lifetime.
Men with diabetes tend to develop erectile dysfunction 10 to 15 years earlier than men without diabetes. As men with diabetes age, erectile dysfunction becomes even more common. Above the age of 50, the likelihood of having difficulty with an erection occurs in approximately 50% to 60% of men with diabetes. Above age 70, there is about a 95% likelihood of having some difficulty with erectile dysfunction.
Why Do Men With Diabetes Have Erectile Dysfunction?
The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel, and muscle function.
To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection. Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.
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What Treatments Are Available for Men With Diabetes and Erectile Dysfunction?
Men with diabetes having trouble with achieving and/or maintaining an erection can take oral medications like avanafil (Stendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca,Cialis), or vardenafil (Levitra, Staxyn).
However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and could cause dangerous interactions with some heart medicines. Talk to your doctor to determine what treatment is best.
Additional treatments men with diabetes might want to consider include intracavernous injection therapy, vacuum erection (not constriction) devices, venous constriction devices (for venous leak syndrome), intraurethral therapy, penile prostheses (inflatable and malleable), and sex therapy.
Diabetes and Erectile Dysfunction
So what treatment is best? It depends on many factors including a man's health and their ability to tolerate the treatment. Ask your doctor if you should see a specialist (a urologist) to determine the best treatment for your situation.
Erectile dysfunction is a common problem for men who have diabetes — but it's not inevitable. Consider prevention strategies, treatment options and more.
Erectile dysfunction — the inability to get or maintain an erection firm enough for sex — is common in men who have diabetes, especially those with type 2 diabetes. It can stem from damage to nerves and blood vessels caused by poor long-term blood sugar control.
Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease. Erectile dysfunction might occur earlier in men with diabetes than in men without the disease. Difficulty maintaining an erection might even precede the diabetes diagnosis.
Having erectile dysfunction can be a real challenge. It can leave you and your partner feeling frustrated and discouraged. Take steps to cope with erectile dysfunction — and get your sex life back on track.
Talk to an expert
Many men are reluctant to discuss erectile dysfunction with their doctors. But don't let embarrassment keep you from getting help. One small conversation can make a big difference. Here's what to do:
What Should Diabetic Men with Erectile Dysfunction Do?
- Tell your doctor what's going on. Your doctor will consider underlying causes of your erectile dysfunction and can give you information about medication and other erectile dysfunction treatments. Find out your options.
- Ask if there's anything you can do to better manage your diabetes. Improving your blood sugar levels can help prevent nerve and blood vessel damage that can lead to erectile dysfunction. You'll also feel better overall and improve your quality of life. Ask your doctor if you're taking the right steps to manage your diabetes.
- Ask about other health problems. It's common for men with diabetes to have other chronic conditions that can cause or worsen erectile dysfunction. Work with your doctor to make sure you're addressing any other health problems.
- Check your medications. Ask your doctor if you're taking any medications that might be worsening your erectile problems, such as drugs used to treat depression or high blood pressure. Making a change to your medications might help.
- Seek counseling. Anxiety and stress can make erectile dysfunction worse. Erectile dysfunction can also have a negative impact on your relationship with your intimate partner. A psychologist, counselor or other mental health specialist can help you and your partner find ways to cope.
Consider your treatment options
A number of erectile dysfunction treatments are available. Ask your doctor if one of these may be a good choice for you:
- Oral medications. Erectile dysfunction medications include sildenafil (Viagra), tadalafil (Cialis, Adcirca), vardenafil (Levitra, Staxyn) or avanafil (Stendra). These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see whether one of these medications is a safe choice for you.
- Other medications. If pills aren't a good option for you, your doctor might recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base or side of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.
Vacuum-constriction device. This device, also called a penis pump or a vacuum pump, is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection.
A band placed at the base of the penis maintains the erection after the tube is removed. This hand- or battery-powered device is simple to operate and has a low risk of problems.
If a vacuum-constriction device is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it's made by a reputable manufacturer.
- Penile implants. In cases where medications or a penis pump won't work, a surgical penis implant might be an option. Semirigid or inflatable penile implants are a safe and effective option for many men with erectile dysfunction.
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Make good lifestyle choices
Don't underestimate the difference a few changes can make. Try these approaches to improve erectile dysfunction and your overall health:
Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis.
If you've tried to quit on your own but couldn't, don't give up — ask for help. There are a number of strategies to help you quit, including medications.
- Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
- Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
- Limit or cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. 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.
Traditional Chinese medicine on treating diabetic mellitus erectile dysfunction
Background:
Diabetic mellitus erectile dysfunction (DMED) refers to erectile dysfunction (ED) secondary to diabetes. As people's lifestyle changes and the population ages, the incidence of DMED continues to increase. Many clinical trials have proven that Chinese medicine has a significant effect in the treatment of DMED. In this systematic review, we aim to evaluate the effectiveness and safety of traditional Chinese medicine (TCM) for DMED.
Methods:
We will search PubMed, Cochrane Library, AMED, EMbase, WorldSciNet; Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database, and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to February, 2019.We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of DMED.
Ethics and dissemination:
This systematic review will evaluate the efficacy and safety of TCM for treating Diabetic mellitus erectile dysfunction. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.
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Keywords: diabetic mellitus erectile dysfunction, protocol, systematic review, traditional Chinese medicine
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1. Introduction
Diabetic mellitus erectile dysfunction (DMED) refers to erectile dysfunction (ED) secondary to diabetes. It is characterized by persistent or repetitive penile erection and insufficient hardness or sufficient time to be satisfied. The phenomenon of completing sexual activity.[1,2] It is a type of diabetic sexual dysfunction.[3] With the improvement of people's living standards, the incidence of diabetes, especially type 2 diabetes, has been increased, and the complications it has brought cover multiple organs of the human body.[4,5] ED is 1 of its common complications. Surveys in the United Kingdom, the United States, and other countries have shown that the incidence of erectile dysfunction in the normal population is 0.1% to 18%. However, the incidence of ED in diabetic patients has increased nearly 3-fold compared with the normal population, and tends to be in younger population.[6] Studies have shown that the number of people with ED in diabetes has reached 71% in the past 10 years. Diabetes ED patients often have severe symptoms and are a type of refractory ED, which seriously affects the quality of lives of the diabetic patients.[7]
The pathogenesis of DMED is not fully understood. At present, most scholars believe that high glucose environment leading to central nervous system and pericardial nerve damage is an important cause of the disease.[8] Some scholars believe that diabetes causes penile artery blood supply and venous closure to cause ED.[9] Apart from this, age, duration of diabetes, control of blood glucose, smoking, hypertension, atherosclerosis, adverse drug reactions, and psychological factors are all closely related to the development of DMED. DMED not only seriously deteriorates the quality of life of patients, the harmony between family and society, but also causes greater physical and mental pain to male patients.[10] The rapid development of material civilization and spiritual civilization is increasingly concerned by the society for the prevention and treatment of DMED. The current treatment methods for DMED can be roughly summarized as primary disease treatment, psychotherapy, and symptomatic treatment. These include basic treatment (eliminating risk factors such as controlling blood sugar, etc), psychotherapy, and medication (PDE-5 inhibitors, etc).[11,12] However, due to the complexity of the pathogenesis of DMED, there is still no specific treatment for DMED in modern medicine. Studies have shown that PDE-5 inhibitors have side effects such as headache, facial redness, and gastrointestinal reactions during the treatment of DMED.[13] Apart from these, in recent years, the studies have reported that some patients have prolonged drug onset time and drug resistance during the medication.[14] Diabetes belongs to the category of “Xiaoke” in traditional Chinese medicine (TCM). Male erectile dysfunction belongs to the category of “yangshuo” in TCM. TCM believes that DMED lesions are mainly in the kidney, “yin deficiency with internal heat,” and “qi stagnation and blood stasis” is its main pathogenic factor.[15,16] With the application of TCM in the treatment of DMED, a unique diagnosis and treatment system, clinical efficacy is significant. Modern research shows that the effective active ingredients in Chinese medicine can not only promote the activity of sputum-glucosidase, but also improve the blood supply of peripheral blood vessels, so as to achieve the purpose of treatment.[17,18] TCM regulates body function as a whole through multifaceted and multitarget mechanism, and has unique advantages in the treatment of DMED.[19]
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After a preliminary search and analysis of database resources, we found that randomized controlled trials (RCTs) of TCM for DMED are gradually increasing. However, due to the size and number in clinical trials, most clinical trials face problems with small sample size and evidence-based exploration. Therefore, we expect a meta-analysis of relevant studies on TCM treatment of DMED and a meta-analysis to assess its clinical efficacy and safety.
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2. Methods
This is a systematic review and ethical approval was not necessary.
2.1. Study registration
This systematic review protocol has been registered on PROSPERO as CRD42019117444 (hops://www.crd.york.cord.php?RecordlD=17444).
2.2. Eligibility criteria
2.2.1. Type of study
Take TCM or Chinese medicine combined with other effective interventions as main treatment, including RCTs of the control group (effective methods other than TCM). Language is limited in Chinese and English. Non-RCTs, quasi-RCTs, case series, case reports, and crossover studies will be excluded.
2.2.2. Participants
Men with a history of diabetes who match the Diagnostic Criteria for Diabetes: refer to the American Diabetes Association Diabetes Care Guidelines. The diagnosis is ED after diabetes, and the International Index of Erectile Function 5 (IIEF-5) score is <21. The course of ED is ≥3 months. The patient must be at least 18 years of age. The sexual partners of the patients are fixed. The group is well balanced when enrolled.
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2.2.3. Types of interventions
2.2.3.1. Experimental interventions
The drug composition, the dose-specific Chinese medicine preparation or the combined western medicine, is used as experimental interventions. Both prescription and Chinese patent medicines will be included. Other TCM treatments such as intravenous medication, acupuncture, and massage will be limited.
2.2.3.2. Control interventions
As for the control interventions, those who accepted simple western medicine can be used as a control intervention or those who did not get any treatment as a blank control would be adopted. However, once they had accepted the therapy of TCM, the trials will be rejected.
2.2.4. Outcomes
The primary outcome measurement will be assessed using the International Erectile Function Index.
Healing: IIEF-5 score ≥22 points after treatment; significant effect: IIEF-5 score <22 points after treatment, score improvement ≥60%; effective: IIEF-5 score <22 points after treatment, points improved <60%, but ≥30%; invalid: IIEF-5 score <22 points after treatment, score improvement <30%.
The secondary outcome measurement will be assessed according to the TCM syndrome scoring criteria.
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Healing: The clinical symptoms and signs of TCM disappear or disappear, and the syndrome score is reduced by ≥90%; markedly effective: the clinical symptoms and signs of TCM are obviously improved, the syndrome score is reduced by ≥60%; effective: TCM clinical symptoms signs and signs have improved, syndrome points reduced by <60%, but ≥30%; invalid: Chinese clinical symptoms and signs have not improved, or even worse, syndrome scores reduced by <30%. Integral variation formula (Nimodipine method [{pretreatment score − post-treatment score} ÷ pretreatment score] × 100%).
2.2.5. Data source
2.2.5.1. Electronic searches
The electronic search database includes PubMed, Cochrane Library, AMED, EMbase, WorldSciNet, Nature, Science online and China Journal Full-text Database, China Biomedical Studies CD-ROM Database (CBM), and China Resources Database. The clinical research studies on the treatment of Diabetic mellitus erectile dysfunction with Chinese medicine published in domestic and foreign biomedical journals from the establishment of the library to February, 2019 was searched. Based on the standards of the Cochrane Collaboration Workbook of the International Evidence-Based Medicine Center, a manual and computer-based method is used to conduct related studies. The search terms include: Chinese medicine, traditional Chinese medicine, proprietary Chinese medicine, Chinese herbal medicine, Diabetic mellitus erectile dysfunction, impotence. According to the characteristics of different databases, comprehensive search using keyword was conducted. All search results are determined after multiple searches. We will follow the references included in the studies to incorporate relevant studies as much as possible to avoid missed detection. The search term in the Chinese database is the translation of the above word. The complete PubMed search strategy is summarized in Table Table11.
Table 1
Search strategy used in PubMed database.
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2.2.5.2. Searching other resources
The manual search mainly is used for searching relevant studies such as “Chinese Journal of Endocrinology and Metabolism,” “National Journal of Andrology,” and “Chinese Journal of Urology” before the database creation.
2.2.6. Data collection and analysis
The data collection and analysis was conducted as follows:
1.
Applying the EndnoteX7 software to manage the included references. Two qualified evaluators independently screened the titles and abstracts of the selected studies, excluding duplicates and documents that did not significantly conform to the study.
2.
The second screening of the studies: Screening out unqualified studies such as case report, theoretical discussion, and nonconformance of interventions was done. After preliminary evaluation, the remaining studies to further screen out the unqualified studies such as ordinary control study, no control group, no random grouping, no outcome index, and data mine equivalent were carefully read.
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3.
For the studies that could not be determined whether to be included or not, it was decided by 2 researchers. If the opinions were not uniform, third-party expert was asked. A clinical RCT was finally included in the study.
4.
Information and data extraction for the final included documents: The extracted data and information included the test methods of the study, the basic information of the included cases, the observation period, the intervention methods of the treatment group and the control group, the observation indicators, and the test results (Fig. (Fig.11).
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Figure 1
The PRISMA flow chart.
2.2.7. Risk of bias
The studies quality assessment applies the bias risk assessment tool recommended by Cochrane to evaluate the quality of all included studies and the risk of bias. The assessment will include sequence generation, allocation concealment, blinding of participants, personnel and outcome assessors, incomplete outcome data, selective outcome reporting, and other sources of bias. The risk of high and low bias is expressed as “high risk” and “low risk,” respectively. The information provided in the study is inaccurate or does not provide sufficient information for the bias assessment to be expressed as “unclear risk.” The above content evaluation is independently evaluated by 2 researchers. If there are different opinions, the discussion will be conducted. If there are still differences, a third appraiser will be consulted. Otherwise, the Cochrane Professional Group will be consulted.
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2.2.8. Statistical analysis
The meta-analysis in this study will use Rev Man5.3 and Stata13.0 statistical software. Heterogeneity tests will be used for the included experimental studies. The numerical variable will be expressed as the normalized mean difference with a confidence interval (CI) of 95%. The heterogeneity of each pair-wise comparison will be tested by chi-square test (test level α = 0.1). If there is no heterogeneity, a fixed-effect model will be used. If there is significant heterogeneity between a set of studies, we will use a random-effects model (REM) for meta-analysis. We will explore the reasons for the existence of heterogeneity from various aspects such as the characteristics of the subjects and the degree of variation of the interventions. The source of heterogeneity is further determined by means of sensitivity analysis.
2.2.9. Publication bias
If a result of a meta-analysis contains more than 10 articles and above, we will use a funnel plot to test the risk of publication bias. Quantitative methods such as Begg testing and Egger testing will be used to help assess publication bias in the application.
2.2.9.1. Quality of evidence
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method will be used to assess the quality of evidence for key outcomes. This assessment will be conducted through a Guideline Development Tool (GRADEpro GDT, https://gradepro.org/).
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3. Discussion
In recent years, with the changes in people's lifestyles and the aging of the population, the incidence of diabetes has increased. Diabetes has a variety of chronic complications, including heart disease, high blood pressure, stroke, and ED. Among them, diabetes is most closely related to ED and is the leading cause of organic ED.[20,21] About half of the diabetic patients have ED. TCM believes that the etiology and pathogenesis of ED is related to spleen and kidney deficiency, and qi and blood block. TCM can play the role of strengthening the spleen and kidney, promoting blood circulation and collaterals, and at the same time, can improve the mood and achieve the purpose of treatment.[22–24] Modern research shows that the effective active ingredients in Chinese medicine can not only promote the activity of sputum-glucosidase, but also improve the blood supply of peripheral blood vessels, so as to play a corresponding therapeutic role.[25,26]
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With the deepening of understanding of diabetes and its complications, the trials and clinical reports of TCM treatment of DMED have gradually increased. Whether it is syndrome differentiation or special disease, Chinese medicine has achieved good results in the treatment of diabetes ED. To the best of our knowledge, there has been no comparison of the efficacy and safety of TCM for the treatment of DMED in recent years. Therefore, we will compare the effectiveness and safety of TCM in the treatment of DMED by applying systematic evaluation and meta-analysis. The results of this study can provide a possible ranking for Chinese medicine treatment of DMED. We hope that the results will provide clinicians with the best options for treating DMED and provide them with research directions. Although we will conduct a comprehensive search in this study, languages other than Chinese and English will be restricted, which will lead to some bias. In addition, the relevant studies on TCM treatment of DMED are small and the overall quality is low, which may affect the authenticity of this study. Therefore, we hope that in the future, we will have a more rigorous and reasonable multicenter RCT to explore the clinical efficacy of TCM in the treatment of DMED, so that the conclusion is more objective and reasonable.
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Author contributions
Conceptualization: Jianwei Shang.
Formal analysis: Xudong D. Yu, Jisheng S. Wang, Songli Wu.
Funding acquisition: Xudong D. Yu, Jisheng S. Wang, Jianwei Shang.
Investigation: Jisheng S. Wang.
Project administration: Jisheng S. Wang.
Supervision: Xudong D. Yu, Jisheng S. Wang, Yaosheng Zhang.
Validation: Xudong D. Yu, Jisheng S. Wang, Jingyang Lim.
Writing – original draft: Xudong D. Yu, Jisheng S. Wang, Guang Zuo, Fuxing Ge.
Writing – review & editing: Xudong D. Yu, Jisheng S. Wang, Xin Wang, Fuxing Ge.
Erectile dysfunction (ED) occurs when someone who has a penis can’t have or maintain an erection. The condition affects around 30 million men in the U.S., and is more common in people who:
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are older
have health conditions like diabetes or high blood pressure
have had an injury to the spinal cord, penis, or pelvis
take medication like antidepressants or blood pressure medications
have anxiety or stress
are overweight
smoke
The treatment for ED depends on its cause. It may include certain prescription medications, a vacuum device, or even surgery. But lifestyle changes and other natural treatments can also help improve ED.
What are some natural remedies for treating erectile dysfunction?
There are many natural treatments for ED. They range from lifestyle changes like modifying your diet and exercise to getting mental health or relationship counseling.
It’s best to talk with your doctor before trying a new treatment on your own. They can help identify the cause of your ED and recommend effective ED treatment options, whether conventional, natural, or a combination.
Diet
Eating a balanced diet may help maintain sexual function and decrease your risk of ED.
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A 2020 studyTrusted Source found that men who more strictly followed a Mediterranean diet or Alternative Healthy Eating Index 2010 diet had a lower chance of developing ED. In particular, they consumed less red or processed meat and primarily ate:
fruits
vegetables
legumes
nuts
fish
Research from 2017 similarly found that eating more fruits, vegetables, and flavonoids (compounds found in produce, coffee, and other foods) lowered the risk of ED in men ages 18 to 40.
These foods are important for your overall health, so helping maintain or improve your sexual function as well is a win-win.
Exercise
Research indicates that physical activity may help protect against and improve ED. It may be particularly effective if your ED is caused by obesity, inactivity, or cardiovascular disease, among other conditions.
A 2018 research reviewTrusted Source found that moderate-to-intense aerobic exercise for 40 minutes a day, four times per week for 6 months helped reduce ED. This includes exercises like:
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running
brisk walking
bicycling
swimming
skiing
Physical activity helps improve blood vessel health, lower stress, and raise testosterone levels, which can all help with ED.
WERBUNG
Sleep
It’s important for your overall health to get enough sleep each night. Sleeping regularly may also improve your ED.
A study from 2017 found that men working night shifts who reported worse sleep quality were at higher risk for ED.
A large 2015 studyTrusted Source also indicated that people with a sleep disorder had a greater risk of developing ED. Other researchTrusted Source has linked obstructive sleep apnea to an increased chance of ED.
Not getting enough sleep can lower your testosterone levels, which may contribute to ED. Sustained lack of sleep is also associated with conditions that are related to ED, like diabetes and high blood pressure.
Weight loss
Your weight may be another factor in ED.
According to a research review from 2020, ED was significantly more common in men who were overweight, or had obesity or a larger waist circumferences.
A small 2014 study indicated that gastric bypass surgery improved blood vessel health and ED among extremely obese men. A 2017 research review similarly found an improvement in ED after bariatric (weight loss) surgery.
If your weight is contributing to your ED, exercise and a balanced diet can help you lose weight and improve your ED.
Psychotherapy
In some cases, ED results from a combination of physical and psychological issues. These may include fear of failure, religious beliefs, and sexual trauma, among others.
In turn, ED can lead to additional mental health issues, including emotional distress and lower self-esteem, which then can further worsen ED. Therapy may help address these issues to improve ED.
According to a 2021 research review, psychological interventions like cognitive behavioral therapy were especially effective when paired with ED medications. Mental health interventions may also be effective on their own, but more research is needed.
A small 2018 study involving 4 weeks of mindfulness-focused group therapy indicated that this type of therapy may be helpful for improving ED and sexual satisfaction, too.
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More research should be done to determine the most effective types of psychotherapy for ED.
Sex therapy or couples counseling
Around 10 to 25 percentTrusted Source of men with ED have no known risk factors. This condition, known as non-organic ED, may be caused by mental health issues like depression or by experiencing anxiety when having sex.
A small 2020 study found that cognitive behavior sex therapy (CBST) and medication were each effective on their own at reducing non-organic ED. In addition, CBST was more effective at lowering anxiety among study participants.
It may also be helpful to attend counseling with your partner to help them understand your condition and discuss ways to support you.
Research from 2016Trusted Source labeled ED as a shared health issue for sexual partners and recommended that couples engage in education, counseling, and therapy together.
Stress reduction
Mental health issues like stress and anxiety are often linked to ED.
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A 2019 studyTrusted Source found that stress was one of the main predictors of ED, with anxiety and depression also associated with the condition. The study suggested that chronic stress may affect testosterone or cause sleep deprivation, which may contribute to ED.
Still, other research indicates that the effect of stress on ED is still unclear. A 2020 study found no association between stress and ED.
Another small study from 2014Trusted Source found that an 8-week stress management program alongside ED medication was similarly effective for improving ED, compared with the medication alone.
Until more is understood about stress and ED, it’s still beneficial to reduce stress in your everyday life to improve your overall health.
Alcohol reduction
Studies have shown mixed results for the effects of alcohol on ED.
A research review from 2018Trusted Source found that drinking light-to-moderate amounts of alcohol (less than 21 drinks per week) was actually associated with a lowered risk of ED. On the other hand, regular and high consumption did not significantly affect ED.
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Still, other research has linked alcohol use with ED. A 2018 studyTrusted Source found that sexual dysfunction, particularly ED, was common in people with alcohol dependence syndrome. A 2020 research review also identified alcohol as a risk factor for ED.
More research is needed on the role of alcohol in ED. In general, the Centers for Disease Control and PreventionTrusted Source recommend that men consume two or less alcoholic drinks per day.
Smoking cessation
Smoking is another behavior that likely contributes to ED. This may be caused in part by smoking damaging blood vessels, preventing enough blood from reaching the penis for an erection.
Smoking may also reduce the availability of nitric oxide in the body, which is needed to cause the involuntary muscle relaxation and increased blood flow that play a role in erections.
According to a research review from 2015Trusted Source, more-frequent smoking was associated with an increased risk of developing ED, as well as more-severe ED.
Some damage from smoking may not be reversible. Still, the review concluded that quitting smoking, especially for men under age 50, may help improve ED.
It’s challenging to quit smoking, but there are many resources available to help. Stopping smoking has the potential not only to help your ED, but to benefit many other areas of your health.
Are there drawbacks to using natural remedies?
Lifestyle changes may be an effective natural remedy for ED and improve your overall health. But many changes — like losing weight, quitting smoking, or eating a balanced diet — may be difficult to achieve.
It may also take time for natural treatments to have an effect. Some people, depending on the cause of their ED, may not show improvements without medications or other treatments. It’s helpful to work with your doctor to find a treatment that works for you.
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Risks of ED supplements
There are many supplements advertised online as a treatment for ED, but none have been proven to be effective and safe. Some may also contain dangerous combinations of ingredients or overly high doses.
More research in people needs to be done on herbal remedies and other supplements for ED. If you do decide to try one, be sure to talk with your doctor first. They can help you determine whether the treatment may be safe and if it’ll react with any medications you’re taking.
Frequently asked questions about erectile dysfunction
What is the most effective treatment for erectile dysfunction?
The most effective treatment for you depends on the underlying cause of your ED. While lifestyle changes tend to be safe while improving ED, they can be difficult to achieve. Oral medications are another primary treatment for ED, but they also don’t work for everyone.
The American Urological Association’s 2018 guidelines for ED state that men may choose any option — medication, lifestyle changes, assistive devices, or surgery — to begin treatment. They suggest talking with your doctor about the risks and benefits of each treatment.
Can erectile dysfunction be cured?
If your ED is caused by a lifestyle factor, health condition, or a medication you’re taking, it may be possible to reverse it by addressing the underlying cause. Surgery may also cure ED in some cases.
On the other hand, medications treat ED symptoms and can improve ED, but do not cure the condition that’s causing it.
How can I help my partner with erectile dysfunction?
ED is a common condition that affects both sexual partners. ResearchTrusted Source suggests that partners engaging in the diagnosis, education, and therapy together may be more effective for improving ED and achieving more satisfaction from sex.
What if natural ED treatments don’t work?
Depending on the cause of your ED, natural remedies may not be effective. If this is the case, your doctor may prescribe medications for ED, like:
Diabetes and Sexual dysfunction
sildenafil (Viagra)
tadalafil (Cialis)
avanafil (Stendra)
vardenafil (Levitra)
Side effects of these medications may include headaches, indigestion, and dizziness. You shouldn’t use them if you’re also taking nitrates (chest pain medications).
Takeaway
ED is a common condition that can affect men’s confidence, relationships, and quality of life. The most effective treatment depends on the cause of your ED. Still, natural remedies may help improve your ED and your overall health.
It’s best to talk with your doctor about your ED to identify treatments that are most likely to be helpful. It can also be beneficial to approach your condition together with your partner.
Remember that treatment, particularly lifestyle changes like losing weight or getting more exercise, may take time. Work with your doctor to find the treatment or combination of remedies that work best for you.
What to know about ED pills and diabetes
Erectile dysfunction (ED) is a common problem for people with diabetes, but several treatments can help.
ED involves trouble maintaining an erection for sexual activity. The cause may be psychological or physical.
Keep reading to learn more about how ED pills work and which are most suitable for people with diabetes.
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How do ED pills work?
Medication may benefit people with diabetes who experience ED.
During arousal in males, the brain sends signals that cause more blood to flow into the penis, the blood collects and becomes pressurized, leading to an erection.
In a person with ED, something is impeding this process. Medications can help by relaxing blood vessels to increase blood flow to the penis.
ED pills are often phosphodiesterase type 5 (PDE5) inhibitors. These block the PDE5 enzymeTrusted Source, which helps control blood flow.
Disrupting this enzyme causes the smooth muscle in arterial blood vessels to relax, increasing blood flow. Meanwhile, the veins constrict, causing a mismatch in blood flow that leads to penile rigidity.
Most people who take ED pills do so before sexual activity. In this case, it is still necessary to be aroused for the pill to work.
ED pills for people with diabetes
Males with diabetes are three timesTrusted Source more likely to experience ED than males without the condition. In some cases, high blood sugar levels cause nerve or blood vessel damage that leads to ED.
Doctor Explains: Do Male enhancement pills WORK?! | Erectile Dysfunction
Other factors, such as smoking and having overweight or obesity, can also increase the risk of ED. In addition, people with diabetes are more likely to have high blood pressure or cardiovascular disease, and the treatments for these may lead to ED.
Most people with diabetes can take ED pills, but it is essential to talk with a doctor first, as these medications can affect a person’s heart rate and vision and may interact with other medications.
Learn more about the connection between ED and diabetes here.
Some ED medication options include:
Sildenafil
Sildenafil (Viagra) is a PDE5 inhibitor. It starts working after about 30 minutes and the effects last for up to 4 hours.
It is effective for treating ED, but some side effects include:
hot flashes
a runny or stuffy nose
headaches
muscle and back pain
dizziness
nausea
vision problems
In rare cases, side effects can be serious. These can include chest pain and painful erections that last several hours.
Tadalafil
Tadalafil (Cialis) is another PDE5 inhibitor for ED. Like other drugs in this class, it treats ED by relaxing blood vessels and increasing blood flow to the penis.
The effects can last for up to 36 hours, and some people take this medication daily to treat both ED and urinary problems associated with prostate enlargement. Cialis may be more convenient for people who regularly engage in sexual activity.
Cialis can cause side effects, including:
indigestion
a stuffy or runny nose
hot flashes
a cough
headaches
arm and leg pain
muscle pain
Vardenafil
Levitra is the brand name of vardenafil, another PDE5 inhibitor for ED. People take Levitra about 60 minutes before sexual activity.
Side effects of Levitra include:
hot flashes
a stuffy or runny nose
headaches
stomach problems
muscle and back pain
vision problems
Avanafil
Avanafil (Stendra) works more quickly than most other PDE5 inhibitors, taking effect within 15–30 minutes. It is not available in generic form and can be more expensive than the other PDE5 inhibitors.
Stendra can cause side effects, including:
a stuffy or runny nose
hot flashes
headaches
back and muscle pain
nausea
vision problems
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Risks
Each ED medication can cause side effects, and people with diabetes may face additional risks.
For example, PDE5 inhibitors can interact with several other drugs, including nitrate-based medications. These are commonly used to treat high blood pressure, which frequently affects people with diabetes.
Anyone with diabetes should speak with a doctor before taking medication for ED.
ED | Can Diabetes Cause Erectile Dysfunction? | StreamingWell.com
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Alternatives
Beyond medication, a person may be able to reduce or eliminate ED with the following approaches:
Making lifestyle changes: It can help to quit smoking, engage in regular exercise, and lose weight, if necessary.
Improving blood sugar control: This can help in the long term.
Going to counseling: ED can have emotional or psychological causes that counseling can address.
Changing medications: ED can be a side effect of medication, in which case a doctor may change the dosage or the type of drug.
Trying devices: Vacuum devices use suction to draw blood into the penis.
Having injection therapy: Medications, either singly or in combination, can be injected into the penis to cause an erection.
Undergoing surgery: If all other treatments are ineffective, a doctor may recommend a surgically implanted prosthesis, which can reliably generate an erection.
Summary
A person with diabetes and ED may benefit from taking standard ED medication. However, these pills can cause side effects and there are additional risks for people who take certain medications for high blood pressure.
It is essential to speak with a doctor before taking ED medication.
