Diabetes is a common cause of erectile dysfunction (ED). Erections depend on blood supply, and diabetes affects the blood vessels and blood supply to all organs -- heart, brain, kidneys, and penis. In fact, a man with ED is at risk for heart disease. Clinical experience and numerous studies suggest that at least half of all male diabetes patients will experience difficulties with erections. Men with diabetes are up to three times more likely to have ED and appear to get it earlier in life. The significance...
"What I see as a problem is the public has been educated to
believe that good sex requires an erect penis that stays hard through the
entire sexual encounter," Shaw tells WebMD. "This definition of good
sex changes the basic nature of an encounter from intimacy and pleasure to
achievement and performance."
This focus on performance, Shaw says, robs men and their
partners of the opportunity to deepen their relationships -- and their
sexuality. The sexual needs of adolescents, she says, are different that those
of adults. Yet by making erections the be-all and end-all of sex, grown men are
retreating to adolescent sexual values.
"Having an erection does not mean you are being sexual.
Being sexual comes from inside your sense of yourself," Shaw says. "You
can be sexual, you can feel sexual, you can behave sexually without an
erection. A penis is not the only part of a man's body that can be used
Shaw makes a distinction between genital behavior and sexual behavior.
Mistaking one for the other, she says, leads to dishonesty and
"You can behave genitally whether you feel sexual or
not," Shaw notes. "Women and men can fake it. Lots of men get an
erection, penetrate, and lose the erection and pretend they have had an orgasm
because they want to be perfect. They don't say, 'Hey, I didn't have an orgasm
but maybe next time. Being near you is enough.'"
In her practice, Shaw finds that physical problems don't lie at
the heart of most men's sexual problems.
"Actually, it is psychological distress associated with not
measuring up rather than physiological problems that causes most sexual
dissatisfaction," Shaw says. "For many, many men -- maybe most --
problems with sex are due to ignorance, anxiety, and inability to communicate
with their partners. I think sexual dysfunction is the inevitable result of the
effort to attain perfection."
SOURCES: Gerald Brock, MD, associate professor, St. Joseph's
Health Center, London, Ontario, Canada. Chad Ritenour, MD, professor of
urology, Emory University, Atlanta. Jeanne Shaw, PhD, clinical psychologist;
certified sex therapist, private practice, Atlanta.