• Impotence is when a man has problems getting or keeping an erection.

  • Although it is very common in men with diabetes, it’s one of the least talked-about complications.

  • The good news is that it's often possible to treat.

  • It’s really important to talk about it, especially with one’s partner.

  • There are a range of treatments available for this condition.

  • There are clinics and health professionals that specialise in impotence.



What’s impotence?

Impotence is a side effect of diabetes for many men. Impotence is when a man isn’t able to have an erection firm enough, nor can he maintain it for long enough, to have satisfying sexual intercourse. There are two types of impotence.

Physical impotence

This may result from damage to the nerves or blood vessels that control blood flow to the penis. Hormone problems also can cause physical impotence. Occasionally, impotence is a side effect of medication, particularly medication for high blood pressure or depression.

Psychological impotence

This can be caused by fear, stress, worry, anger or frustration. Often this type of impotence develops from “performance anxiety” – a man’s fear that he won't perform well during sexual intercourse. Stress caused by problems at work, by strains in a marriage or relationship, by loss or bereavement or by financial difficulties also can lead to this type of impotence.

Things are made more complicated because the two types of impotence can happen in the same person at the same time (in fact, it’s quite common).

Is impotence common in men with diabetes?

Yes, very. According to the Canadian Diabetes Association between 50 to 70 percent of men with diabetes develop this problem. The longer a man has diabetes, the greater his chances are of developing the condition.

Men with Type 1 diabetes are more likely to experience impotence at an earlier age (this is because they have usually had diabetes for a longer period of time). Men who have Type 2 diabetes (which usually develops in adulthood) may not experience the problem until later in life. If your diabetes is out of control, this can lead to temporary impotence.

What causes impotence?

Understanding what causes impotence is the first step in knowing how to deal with it. An erection occurs when sexual stimulation or excitement causes nerves to release signals. These signals allow more blood to flow into the penis, causing it to stiffen and enlarge.

When the function of nerves or blood vessels is damaged or impaired (usually by disease or drugs) the flow of blood to the penis may be reduced. This can prevent an erection from developing. Diabetes can result in damage to either nerves, blood vessels or both.

Aside from diabetes there are many other causes of physical impotence. Things that damage nerves and blood vessels include prostate cancer surgery, heart disease and multiple sclerosis. Spinal cord injury and depression can also cause impotence. So can alcohol consumption, smoking and various medications.


Managing impotence


Talk about it

Many men find it extremely hard to talk about erection problems with their partner, either out of embarrassment or because they’re absorbed in other issues. Yet it’s vital that you do talk about it. Not talking about it can lead to other problems:

  • Your self esteem may suffer
  • Your work productivity may suffer
  • Your partner may be confused or think it is because you have lost interest in them. This can cause problems within your relationship and with your partner’s self esteem

The first step

The first step in dealing with impotence is talking about it with your partner and health care professional. Some men prefer to see a male doctor or nurse. There are also specialist impotence clinics, nurses and doctors available. Check with your GP to see what is available.

You may wish to visit your health care provider alone, or you and your partner may wish to visit them together. If you want to learn about managing or treating impotence, several options are available. It is best to include your partner in these choices.

What are the options?

There are a number of ways to treat erection problems. If the cause of the impotence is treated it will often improve or come right. Treating the causes may involve:

  • Reviewing or altering the medications you are taking (this should be planned with your doctor)
  • Improving your blood glucose or blood pressure levels
  • Getting treatment for any drug or alcohol issues
  • Exploring any psychological issues

If the cause can't be treated there are still a number of treatments available that will result in your being able to get a satisfactory erection. These treatments include:

  • Medications (either taken by mouth, injected or applied to the penis)
  • Vacuum devices that are applied to the penis to cause and keep an erection
  • Surgery that can implant devices that enable you to get and maintain an erection

As impotence can result from a number of different causes it is best to see a doctor or nurse who specialises in impotence to get advice and help. They can help you choose the best treatment for your particular impotence.