Diabetes and Erectile Dysfunction: How to Proceed

Written by
The Manual Team
Medically approved by
Dr Earim Chaudry
Last updated
2nd June 2021

In 30 seconds…

Diabetes is a chronic condition that affects hundreds of millions of people worldwide. Unfortunately, although a completely separate issue, it can go hand-in-hand with erectile dysfunction (ED).

Bad news: diabetes has a negative impact on blood flow, and can cause damage to the nervous system – both of which can impact on a man’s ability to get, and maintain, an erection.

Good news: erectile dysfunction medications including Sildenafil, branded Viagra, and Tadalafil (Cialis) are usually safe to take alongside your diabetes medications, allowing you to enjoy a healthy sex life.

Leading a healthy lifestyle by quitting smoking, losing weight if you’re obese, reducing stress and eating healthly can help support in preventing the progression and development of diabetes and ED. And they’ll probably make you feel a whole heap better about yourself too.

Diabetes, however well you’re managing it, is a chronic condition and can come with a whole host of problematic signs and symptoms. Unfortunately, for millions of men, one of those is erectile dysfunction.

It is estimated that 35-75% of men with diabetes will suffer from erectile dysfunction, as opposed to just 26% of the non-diabetic population, and you’re three times more likely to suffer with erectile dysfunction (ED) if you’re diabetic. The onset of ED may occur 10-15 years earlier in diabetics than their non-diabetic counterparts.

In some cases, erectile dysfunction can actually present itself as a symptom of diabetes before getting a confirmed diagnosis. So, despite how difficult ED can be to talk about, it’s definitely not something to ignore. It may be a sign of something more serious. More serious than not being able to get a hard-on, you ask? Yep. Diabetes is not to be messed with.

But, never fear, it doesn’t all need to be doom and gloom. While the prognosis doesn’t sound great, there are things you can do as a diabetic to combat your erectile dysfunction. There is no reason why you shouldn’t be able to lead a normal sex life, thanks to ED drugs and a few healthy lifestyle changes.

And while using the term “therapy” can sound like a biggie, it really does sometimes help to talk to someone who knows what you’re going through. Our clinicians can help, or if you’d rather, we can just deliver your ED treatments discreetly to your door. No drama.

How Does Diabetes Affect Erectile Function?

First up, just what is diabetes? Well, Europe’s biggest diabetes community defines diabetes as “a metabolic condition of having higher than normal blood sugar levels.” In itself, it doesn’t sound too scary, but it is a serious condition which can be hard to manage and can have a major impact on some pretty major bodily functions. 

There are two types of diabetes, but both revolve around the hormone, insulin, which is produced in the pancreas and regulates blood glucose (sugar) levels.

Type 1 diabetes is an auto-immune disease which can present in people of any age and affects the pancreas, meaning no insulin can be produced, resulting in high blood sugar.

Type 2 diabetes is a condition that is more common in those over 45 years of age, typically characterised by insulin resistance or metabolic syndrome. It is often caused by lifestyle choices that mean not enough insulin can be produced, resulting in high blood sugar levels. The vast majority of diabetics suffer with Type 2 diabetes, however, younger Type 1 diabetics can also suffer with erectile dysfunction.

Having too-high blood sugar levels can lead to long-term damage to two main systems in your body. Firstly, your blood vessels; meaning healthy blood flow can be restricted and reduced. Secondly, the nervous system; resulting in loss of sensation and response. You don’t have to be a scientist to see how these negative impacts of diabetes could affect your ability to get and maintain an erection, no matter how turned on you are. Which sucks.

On a molecular level, when it comes to getting an erection, a chemical called nitric oxide is basically like a trigger switch. It tells your body to send more blood to where you need it – your penis. Chronically raised blood sugar levels damage the nervous tissues innervated by nitric oxide, learning to less nitric oxide mediated vasodilation of the blood vessels supplying the penis.

Furthermore, additional serious conditions, such as high blood pressure and heart disease – which are common amongst diabetics – can also cause erectile dysfunction by increasing the buildup of “plaque” known as atherosclerosis within the blood vessel network. And medications to treat high blood pressure can even sometimes cause ED as a side effect.

Unhealthy lifestyle choices that cause Type 2 diabetes can also provoke ED. Being overweight, stressed, sleep deprived and a smoker increase your chances of suffering from ED, whatever age you are. Drinking too much alcohol, smoking, eating unhealthily and living a sedentary life are further negative life choices that can result in both diabetes and erectile dysfunction.

These lifestyle choices are also linked with low testosterone levels and although low testosterone may not cause diabetes and erectile dysfunction – or vice versa – they do go hand in hand. Another reason to brush off the trainers, go for a run and ditch the daily booze and takeaways.

Many men with diabetes struggle with their diagnosis, which we think is fair enough. Finding out you have a condition to manage for the rest of your life can be overwhelming, and it is important to acknowledge your mental health. Anxiety, depression, and stress are common amongst chronic disease sufferers and shouldn’t be dismissed or taken lightly. The additional stress of ED can be difficult to cope with, but you are not alone and we can help. Here’s how…

Which Erectile Dysfunction Drug Works Best with Diabetes?

The good news is that many ED drugs can be taken alongside diabetes medications such as insulin, so there is no need to despair. It is possible to control your diabetes and erectile dysfunction at the same time! However, ED medications may not interact well with some heart disease meds, so make sure you run that one past one of our clinicians at Manual before taking the pill.

Erectile dysfunction drugs like Sildenafil and Tadalafil are the most popular ED treatments and may be able to help you. They are both PDE5 inhibitors, which mean they help relax vessels to boost blood flow in your penis, so it’s easier to get, and keep, an erection. These approved ED medications are easy to use, and can be delivered directly to you.

It’s also suggested in a 2017 study, that supplements of amino acid L-arginine can help diabetic sufferers of ED. The study found men with ED often had low levels of this substance in their body naturally, and this deficiency was more likely in those suffering from ED. This amino acid naturally boosts nitric oxide levels, which can make getting an erection easier. While not necessarily “proven”, supplements may improve your ED symptoms when taken alongside approved medicinal ED treatments.

Cialis (Tadalafil)

The weekend pill

Known as the “weekend pill” because it is effective for up to 36 hours, Tadalafil is the generic, unbranded version of Cialis. Clinically proven to help you get an erection when you need it.

Best for
Weekend use
Effective in
Effective in 8 out of 10 men
2.5mg, 10mg, 20mg

Healthy Habits

Changing up your bad habits can also make a marked improvement on both your diabetes and erectile dysfunction. If you’re overweight, sleep-deprived, eating unhealthily and/or drinking too much booze, it’s only fair that your body’s going to have something to say about it. Stopping smoking, getting better sleep, reducing stress (as much as you can) and getting more exercise will all improve your condition.

Adopting a healthy diet, specifically one designed for diabetics can also make a marked improvement in both your diabetes and erectile dysfunction symptoms. A diabetes-friendly diet will likely include plenty of unsaturated fats, such as avocado and oily fish, and plenty of fresh fruit and veg. Low carb and raw food diets are also commonly adopted by diabetics.

Lots more resources for meal plans are available at Diabetes UK: more information via this link.

Erections aren’t always easy for millions of men in the UK. It’s no big deal. Choose from highly effective, clinically proven solutions.

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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Erections aren’t always easy for millions of men in the UK. It’s no big deal. Choose from highly effective, clinically proven solutions.