Erectile Dysfunction Treatments for Men With Diabetes

Diabetes is a very common cause of erectile dysfunction (ED). Clinical experience and numerous studies suggest that at least 50% of diabetic patients will experience difficulties with erections. When compared to nondiabetic men, men with diabetes are up to 3 times more likely to have ED and appear to get it earlier in life. The significance of ED increases with the severity and duration of diabetes as well as with advanced age.

There is evidence that controlling blood sugars and cholesterol as well as participating in a consistent exercise program may help in preventing the development of ED and, in some cases, may even improve symptoms in those with ED. If you are one of the many men with diabetes and ED, you have many treatment options to consider, including:

Oral Drugs for Erectile Dysfunction

The three oral medications available -- Viagra, Cialis, and Levitra -- to treat erectile dysfunction have been used successfully in people with diabetes. In general, however, the success rate of these medications is less than the reported success rates in people without diabetes. These medications may help 50% to 60% of men with diabetes.

Injection Treatment for Erectile Dysfunction

When oral medications are ineffective for erectile dysfunction, intracavernous injection therapy (the injection of medication directly into the erection chamber of the penis) may be helpful in facilitating intercourse. Among diabetic men, the success rates with this method ranges from 60% to 80%. The medications used include:

• Alprostadil (brand names Caverject Impulse, Edex, and Prostin VR)
• Papaverine hydrochloride
• Phentolamine mesylate

In many cases, it may take a mixture of the three medications to produce an adequate response. Although injections may be reasonably effective in diabetic patients, about 50% of users stop after several years.

Vacuum Constriction Devices (VCD) for Erectile Dysfunction

VCDs have been helpful in facilitating intercourse among diabetic patients with erectile dysfunction. They work in up to 80% of users; however, like injection therapy, many people discontinue treatment after several years.

This device consists of an acrylic cylinder that is placed over the penis. A lubricant is used to create a good seal between the body and the cylinder. A pump mechanism is used to create a vacuum inside the cylinder, allowing a patient to achieve an adequate erection. If an adequate erection can be achieved, a band or ring is then placed over the base of the penis (the part of the penis closest to the body) and is used to help maintain the erection.

Learn more about vacuum constriction devices.

Intraurethral Therapy for Erectile Dysfunction

This erectile dysfunction treatment involves using an applicator to place a suppository or pellet containing medicine into the urethra (canal in the penis that carries urine).

Learn more about intraurethral therapy.

Penile Implants for Erectile Dysfunction

Clinical studies have shown a high degree of patient satisfaction with penile implants when other therapies have not worked for their erectile dysfunction. Patients need to be suitable surgical candidates and it is preferable that patients have reasonably good diabetic control before surgery.

Learn more about penile implants.

Get the facts about diabetes and ED.

View the full table of contents for the ED guide.

Reviewed by the doctors at the Glickman Urological Institute at The Cleveland Clinic.