Long-standing diabetes often leads to sexual problems. By age 43, about 45 percent of men with type 1 (childhood-onset) diabetes experienced impotence (also known as erectile dysfunction). Men with type 2 (adult-onset) diabetes develop impotence at a similar rate. Some women also report diminished sexual responsiveness, probably due to decreased sensation.
Achieving and maintaining an erection is a complex action in which blood circulation, nerves and hormones all play a role. Psychological and emotional factors are also important. Diabetes can affect any or all of these systems. Nerve damage or vascular problems are the usual causes of sexual-performance problems for men. The likelihood of impotence increases when diabetes has been present for a long time, the blood sugar has been poorly controlled, and other types of nerve damage are present. Psychological factors such as anxiety and depression can also cause or contribute to erectile dysfunction, which may be temporary or more long-lasting.
The good news is that a number of devices and medications can improve sexual function. Penile implants are one option. Some men with diabetes can get relief for their sexual problems from the drug sildenafil (Viagra), which helps to improve blood flow in the penis.
Nerve damage that causes impotence can be prevented, or at least delayed, with good blood glucose control. Smoking also contributes to neuropathies, so smokers should stop. Maintaining normal blood pressure also may be protective.