Ask the Doctors: Diabetes and Erections

I am a male, 72 years young, and I am concerned about my diminishing sex drive. I have diabetes which was diagnosed 4 months ago, my sugar remains with lower ranges. I do not have to take Insulin, and I am reasonably healthy. I have difficulty getting and keeping an erection. I am bombarded with  literature and late night Television Ads, trying to sell me on the idea that if I take certain pills or capsules, that can not only make my penis harder, but can make it last longer. I am moderately overweight. Is sex over for me, or can you recommend something to bring me sexually alive, again? I await with keen anticipation your answer.  Thank you for any help or advice you may give me.

There are a few different things here that I’d like to unpack because it’s a lot easier to get a handle on this if we take it one step at a time.

First, diabetes can cause erection difficulties in several ways. The most common one is neuropathy, which is damage to the nerves in the extremities. Other possibilities include damage to the walls of the blood vessels, and a decrease in nitric oxide (a chemical that helps blood vessels relax, bringing blood into the penis).

Personally, I don’t recommend the products you’ll see on late night TV because there’s no guarantee of their safety or effectiveness. I also don’t think it’s a good idea to get Viagra or other medications from anywhere other than a reputable pharmacy. According to an article in International Journal of Clinical Practice, millions of counterfeit erection pills are seized yearly and account for the bulk of all counterfeit pharmaceutical product seizures. These pills may contain very low doses of the active ingredient, or they may contain more than twice as much as the labeled dose. In their research, only about 10% of the seized pills were within 10% of the advertised strength. That means that users can be taking too little to be effective or much more than is safe. Plus, counterfeit pills are often made with unsafe ingredients, including printer ink.

If you are interested in trying erection medications, talk with your doctor. You’ll know that you’re getting a safe and effective amount from a safe source. Plus, if there are other health conditions that would make these meds unsafe, your doctor can tell you about that.

Having said all that, it’s possible that the changes you’re experiencing may not be due to diabetes. For example, some men find that as they get older, the pelvic muscles lose tone, making erections less easy than they used to be. Fortunately, you can strengthen the pelvic floor and it often results in easier erections. This article on our website explains how to do that.

Moderate exercise can also help a lot. Most experts suggest walking for 30 minutes per day, although you can break that into 2 or 3 smaller sessions as long as you get 30 minutes total. Exercise improves the blood flow, helps tone muscles, reduces stress and burns some of the extra sugar you have in your system. All of those can improve sexual response.

I think it’s also worth talking about the difference between having an erection and having a sex life. There are a lot of other ways to have sex, such as oral sex and sexual massage, that don’t require an erection. Unless you’ve experienced neuropathy, your nerve endings are still just as sensitive as they were before. So rather than focusing on penetrative sex, you might try exploring your other options and see if you and your partner enjoy them.

Another benefit of that is that it can help reduce performance anxiety. When we get stressed out, our bodies go into  the fight-or-flight response. It makes sense that this turns off the erection response- when you’re in danger, you don’t need to have an erection. Unfortunately, our bodies can’t tell the difference between real danger and things like performance anxiety, so stressing about having an erection can cause the penis to get softer. It’s easy to see how that reinforces the situation.

If you change your focus from penetrative sex to experiencing pleasure, you may find that your erections return, at least part of the time. It’s one of the many ironies of sex that letting go of a goal can make it easier to achieve it. At the very least, if you’re enjoying yourself, then whether you have an erection or not becomes less of a deal-breaker.

I hope that this helps. Whatever you decide to do, I wish you all the best!


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Dr. Charlie Glickman

Charlie Glickman is the Education Program Manager at Good Vibrations. He also writes, blogs, teaches workshops and university courses, presents at conferences, and trains sexuality educators. He’s certified by the American Association of Sexuality Educators, Counselors, and Therapists, and loves geeking out about sex, relationships, sex-positivity, love and shame, communities of erotic affiliation, and sexual practices and techniques of all varieties. Follow him online, on Twitter at @charlieglickman, or on Facebook.

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