Diabetes and Erectile Dysfunction
Most men with diabetes of 1 or 2 type have problems with potency. Researchers suggest that diabetes increases erectile dysfunction risk 3-fold compared to men of the same age who have normal blood sugar level. In this article, My Canadian Pharmacy will tell about effective measures for impotence treatment at men with diabetes.
Reasons for problems with potency at diabetes can be numerous, and doctor determines them together with the patient. This list includes:
- violation of vascular permeability supplying penis with blood;
- diabetic neuropathy – nerve damage that control erection;
- decreased sex hormones production;
- some medications (neuroleptics, antidepressants, non-selective beta-blockers);
- psychological impotence.
Why does Diabetes Affect Potency?
To achieve erection, you need to fill penis with about 100 – 150 ml of blood and then block its outflow until sexual intercourse is over. This requires good function of blood vessels and nerves that control the process. If diabetes is poorly compensated, i. e. blood sugar level is chronically increased, it affects nervous system and blood vessels, and thus decreases male potency.
Glycation is a reaction of binding glucose with proteins. The higher glucose concentration in blood as a result of diabetes, the more proteins undergo this reaction. Unfortunately, a large number of proteins glycation leads to disruption of their functioning. This includes also proteins that form nervous system and blood vessel walls. There produced « glycation final products» – poisons to human body.
FYI, erection is controlled by autonomic nervous system. Autonomic – means that it works without conscious participation. This system regulates breathing, digestion, cardiac rhythm, blood vessels tone, hormones production and many other vital body’s functions.
Why are we writing about it? Because if potency problems arise due to diabetic neuropathy, this can be an early sign that serious life-threatening violations will soon appear. For example, heart rhythm violations. The same thing happens with erectile dysfunction due to blood vessels occlusion. It is an indirect sign of problems with blood vessels that feed heart, brain and lower limbs. Due to blood vessels blockage, heart attacks and blood strokes appear.
30-35% of diabetic men who address doctor about sexual problems, observe decrease in sex hormones production, particularly testosterone. In such a situation usually not only potency disappear, but also libido. Fortunately, this problem is curable. And sex hormones normal levels in the body restoration will not only return «man’s strength», but also improve overall well-being.
Diagnosing Erectile Dysfunction Cause
The main method of male impotence caused by diabetes diagnosis is to gather information by asking questions and carry out tests and examinations. Most likely, the doctor will ask to fill a questionnaire or ask some questions.
Doctor will be interested in what blood sugar level is normal for the patient, i. e. how well diabetes is compensated. If you have already obtained diabetes complications on kidneys, vision disorders, patient complains on cardiac discomfort, diabetic nervous system damage, problems with potency are likely to have «physical» cause. If diabetes «experience» and is not large, general health condition is good, it is possible to suspect psychological impotence.
Watch the video which discusses the diagnosing Erectile Dysfunction cause:
Examinations in Erectile Dysfunction Treatment
To find out vessels condition supplying penis with blood, patients undergo ultrasonography (what is it?). This is called cavernous bodies blood vessels Doppler sonography. Doctor may also appoint intracavernous pharmacodiagnostic examination. Its essence is that penis is injected with drug that relaxes blood vessels, and monitor whether erection will appear.
If you were appointed intracavernous pharmacodiagnostic examination, make sure that it is conducted with prostaglandin E1. Earlier for these purposes papaverine was used or its combinations with phentolamine. But papaverine content too often caused complications, so now it is recommended to be replace with prostaglandin E1.
After intracavernous pharmacodiagnostic examination patient should stay under medical supervision, until erection disappears. Because there is a chance of priapism – too long and painful erection. In this case, another ingestion is made with drug that narrows blood vessels.
Sometimes there also carried out pulse conduction through nerve fibers that control penis examination. If surgical treatment of potency problems is planned, doctor may appoint penile vessels angiography. This means that contrast agent will be entered into bloodstream and then X-ray picture will be taken.
Blood Tests, Prescribed by Doctor
If a man goes to doctor with complaints on potency problems, he can be assigned the following tests:
- blood testosterone;
- luteinizing hormone;
- follicle-stimulating hormone;
- cardiovascular risk factors( «good» and «bad» cholesterol, triglycerides, lipoprotein A, homocysteine, fibrinogen, C-reactive protein);
- creatinine, urea and uric acid in blood – for kidneys examination;
- thyroid function (first of all, free T3);
- glycated hemoglobin – to determine diabetes treatment quality.
If there is a clinical picture of sex hormones insufficiency (it is called hypogonadism), but tests showed normal testosterone level, then doctors additionally define globulin level that binds sex steroids. It is necessary to calculate free testosterone level in blood.
Psychological Erectile Dysfunction
First of all, it is necessary to determine is potency problems have psychological or physiological causes. In case of psychological impotence erection is spontaneous, especially in the morning. Sometimes problems appear in bed with a concrete partner. And as soon as another one appears – all normally again.
Psychological erectile dysfunction at diabetes usually occurs during first years of disease cause, untile diabetic nerve and blood vessels damage developed. Young men erection failures are caused by difficulties in relationships with partner or fears. In addition, diabetic men bear psychological burden associated with their disease treatment.
Erectile Dysfunction, Caused by Medications
Doctor must find out which drugs patient takes, if he complains on potency decrease. Remember that impotence is often caused by:
- non-selective beta-blockers (of older generation).
Erectile Dysfunction, Caused by Blood Vessels Occlusion
If you have cardiovascular risk factors (elderly age, hypertension, smoking, cholesterol in blood bad parameters), it is possible to suspect vascular nature of erectile dysfunction. This, by the way, is the most likely option.
When impotence is caused by vascular occlusion, usually, there also present some or all complications at once from the following list:
- ischemic heart disease;
- arterial hypertension;
- diabetic foot syndrome due to impaired blood circulation in legs.
Erectile Dysfunction Treatment Methods during Diabetics
The main way to treat erectile dysfunction at diabetes – lower blood sugar level and keep it close to normal. The doctor will insist that patients underwent intensive diabetes treatment, taking their time and efforts. If normalize blood sugar, it is often enough for male potency to fully recover.
To maintain normal blood glucose level is the best way to treat not only problems with potency, but all other diabetes complications. Sexual function improves, because blood vessels damage is slowed down and diabetic neuropathy symptoms are weakened.
At the same time, most diabetics complain that it is almost impossible lower blood sugar level to normal. Because cases of hypoglycemia appear more and more often. But there is a real way to do it – just eat less carbohydrates. Focus on foods rich in proteins and natural useful fats.
Male Sex Hormones Substitution Therapy
If a man’s body lacks sex hormones, he may be prescribed androgen drugs replacement therapy. The doctor strictly individually chooses medicine, its dosage and dosage regimen. Preparation may be in the form of injections, pills or gel that is applied to skin.
During therapy testosterone blood level should be monitored. Besides, every six months it is necessary to take blood test for «liver values», as well as «good» and «bad» cholesterol. It is believed that androgen therapy improves cholesterol indicators. Potency should restore within 1 – 2 months after treatment beginning.
All men older 40 years should undergo digital rectal examination once every 6 – 12 months, and also determine prostate-specific antigen content in blood serum. This is done to determine prostate disease. Androgen therapy is strictly contraindicated if there is prostate cancer or its benign tumors with pronounced infravesicular obstruction.
If a man’s sexual function is violated because of diabetic neuropathy, he is prescribed alpha-lipoic (thioctic) acid in 600 – 1800 mg a day. It is harmless natural substance that helps at neuropathy. But if alpha-lipoic acid treatment was started at late diabetes stage and patient does not try to normalize his blood sugar level, high treatment efficiency can not be expected.
Now the good news. If you learn to maintain normal blood sugar level, diabetic neuropathy development will not only stop, but it will disappear at all. Nerve fibers have ability to recover when they are no longer poisoned by high blood glucose. But it may take several years.
This means that if male sexual dysfunction arose due to diabetic neuropathy, there is hope for its full recovery. Unfortunately, if nerve damage is accompanied with blood vessels occlusion, then such a magical effect of sugar level normalization can not be expected. It may turn out that surgical treatment is mandatory.
Viagra, Levitra and Cialis
Doctor is likely to offer first androgen therapy – male sex hormones replacement therapy. Because it not only improves potency, but also strengthens health in general. If this method does not help, then some of phosphodiesterase type 5 (PDE-5) inhibitors are appointed. The list is headed by famous Canadian Pharmacy Viagra (silendafil citrate).
Viagra helps approximately 70% of men with diabetes. It does not raise blood sugar level, but sometimes there are the following side effects:
- digestive disorders;
- blurred vision, increased sensitivity to light (rare).
After a man has used Viagra for several times, the body gets used to it, and unpleasant side effects possibility decreases significantly.
The standard initial dosage is 50 mg but at diabetes Canadian Viagra dosage may be increased to 100 mg. It is taken approximately 40 – 60 minutes before planned sexual intercourse. After taking a pill erection occurs only under sexual excitement influence, «combat readiness» can last up to 4 – 6 hours.
Canadian Pharmacy Levitra – Viagra analogue, professionally known as vardenafil. These pills are released by competing pharmaceutical company. Standard dosage – 10 mg, at diabetes can also be increased to 20 mg.
Canadian Pharmacy Cialis is another drug of the same group, officially called tadalafil. It begins to act quickly, within 20 minutes after administration. Its effect is maintained for 36 hours. Canadian Cialis was nicknamed «the weekend pill» because, having taken one pill, you can perform sexual activity from Friday until Sunday. Standard dosage – 20 mg, at diabetes — twice as much.
All these preparations are allowed to be taken not more than 3 times a week, if necessary. Reduce PDE-5 inhibitors dosage if you are taking any medications from the following list:
- HIV protease inhibitors;
Contraindications to Viagra and its «Relatives»
Canadian Viagra, Levitra, Cialis and similar drugs are contraindicated to people who, for health reasons, have to limit their sexual activity. In what situations is it dangerous to take phosphodiesterase type 5 inhibitors:
- after acute myocardial infarction – 90 days;
- unstable cardiac angina;
- heart insufficiency of II or higher class;
- uncontrolled heart rhythm disorders;
- hypotension (blood pressure < 90/50 mm Hg);
- after blood stroke – 6 months;
- diabetic retinopathy with hemorrhages (possible blindness!);
- there have been cases of cardiac angina attack during sexual intercourse.
Prolonged Viagra, Cialis or Levitra use usually does not reduce effectiveness of potency disorders treatment. This means that dosage increase with time is hardly required.
Erectile Dysfunction Treatment – Two More Methods
If phosphodiesterase type 5 inhibitors do not resolve the problem, vasodilators injections into penis are used – prostaglandin E1. In another way it is called alprostadil. The drug is injected 5 – 20 minutes before sexual intercourse, not more than 1 time a day. Discuss this erectile dysfunction treatment option with your doctor. Extreme option – surgery, i. e. penile implantation.
My Canadian Pharmacy hopes this article about potency problems at diabetes was helpful for you. Once again we want to offer you low-carbohydrate diet to effectively lower blood sugar level. Before taking Canadian Pharmacy Viagra, Cialis or Levitra it is desirable to discuss it with your doctor. Remember contraindications list for drugs of this group and be reasonable.