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Erectile Dysfunction and Heart Disease

Men with erectile dysfunction are also more likely to have heart disease, another condition linked to diabetes, because the same problems that block blood flow in your penis block it in your heart. So any practice that is bad for your heart -- such as smoking, not being active, and being overweight -- is also bad for erections.

"For men with type 2 diabetes, erection problems are usually just the tip of the iceberg," says Irwin Goldstein, MD, director of San Diego Sexual Medicine at Alvarado Hospital.

Diabetes and Sex: Treating Erectile Dysfunction

See your doctor if you have trouble getting or keeping erections. Your doctor will ask you questions and do a physical exam to see if there are other causes. No matter what your age, you can get treatment for erectile dysfunction.

Treatment depends on your overall health and the cause of the problem:

  • Oral drugs. Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra, Staxyn) and avanafil (Stendra) are FDA-approved for treating ED. How long they help you get an erection with stimulation varies. They can cause side effects -- like erections that may last more than 4 hours. But for up to 60% of men with diabetes, they work well for ED. You should not take them if you take nitroglycerin or nitroglycerin-like drugs, though.
  • Shots. If pills don't work, alprostadil (Caverject, Edex) shots may help. This drug also widens blood vessels in the penis, helping blood flow. You inject it into the base of your penis. "It sounds painful, but men who use it love it," Campbell says. Erections happen fast and may last a couple of hours. You can only use the shot three times a week, and it can cause scarring or make erections linger. But it works in up to 90% of men with diabetes.
  • Suppositories. You place these tiny pellets -- the size of a grain of rice -- into the tip of the penis. Like other drugs, they relax the muscles and widen the blood vessels. They are easy to use, and you can use them twice a day. But they have downsides. They are costly and can cause pain and burning in your testicles, and sometimes dizziness. They can also cause burning in your partner. They work in about 35% of men.
  • Devices. Vacuum pumps, constriction bands, and penile support sleeves are other options. Constriction bands keep the blood in your penis once it's erect, so they may be most useful if you can get an erection but have trouble keeping it. Vacuum pumps are not costly, and you can buy them over the counter at a drugstore. They work to some degree on just about all men. But they are more work to use than constriction bands. "They require a lot of lubrication, a lot of stimulation, and your partner's participation," Campbell says. Penile sleeves can be a good choice if you can't get an erection.
  • Surgery. A device called a penile prosthesis is another option if you can't get an erection. The simplest type of prosthesis is a pair of flexible rods that a surgeon places within the erection chambers of the penis. With this implant, the penis is always semirigid. You only need to lift or adjust it so it is erect and ready for sex.