WebMD Medical Reference

Reviewed by Brunilda Nazario, MD, November 2005

If you have diabetes and are having problems with erectile dysfunction (ED), the first step toward a solution is to see your doctor. You may be a bit hesitant to discuss your sex life with a doctor, but rest assured. Your doctor has heard it all before and will know how to help you.

Given how common erection problems are in men with diabetes, your doctor may have been expecting you to raise the issue at some point. It's estimated that 35% to 75% of men with diabetes develop some degree of erectile dysfunction.

Your doctor will need a lot of information from you before suggesting any treatment. If this doctor has been involved in your diabetes care previously, you will talk about how well you've been controlling your blood sugar and how you are doing with the medications you're taking. If you are meeting with a new doctor, you will share all that, plus information about other health problems you may have, like high blood pressure or high cholesterol.

Telling a doctor that you have difficulty with your erection may not be the easiest thing to do. But to get the right care you have to tell your doctor everything, including the truth about things like drinking a lot of alcohol, doing drugs, or smoking cigarettes. It's in your best interest to be totally honest.

You may also feel uncomfortable if the doctor asks a lot of questions about your sex life and your emotions. You may be asked things like:

• What's your sexual orientation?
• Do you have a steady partner? Multiple partners?
• How is sex with your partner? Has anything changed recently?
• Has anything upsetting happened to you lately?
• In general, are you under a lot of stress?
• Do you feel depressed a lot?

Again, it's best to answer honestly, even though these things are very personal.

A doctor you are seeing for the first time may also need to examine your penis, testicles, and prostate gland. Some men have their testosterone level tested.

There is another test that is done sometimes to see whether you get erections while you are asleep. The doctor may send you home with a special tape that you wrap around your penis before you go to bed. If the tape is broken in the morning, you've had an erection during the night. That means the cause of your erection problems may not be physical.

In many cases erectile dysfunction does have a physical cause.

The first treatment doctors usually recommend is one of the pills for erectile dysfunction: Cialis, Levitra, or Viagra.

Typically you will see the doctor again for follow-up around the time that your prescription runs out. You can talk then about any issues you may be having with the medication. Maybe it's not working as well as you'd like. If not, you can make sure you're using it correctly. The doctor might switch you to a different drug or a different type of treatment if thing's aren't improving.

It's a good idea to stay in touch with your doctor about your erection problems. Changes in your health over time may affect your treatment. But you don't need to be in the doctor's office more often. Since you will already have regular checkups for your diabetes care, bring up your treatment for erection problems at those appointments.

Remember, there's no such thing as a bad question. Your doctor asks you lots of questions. Feel free to ask as many of your own, until you're confident that you understand all the risks and benefits of your treatment. Also, it's important to show your doctor all the other medications that you take. And, if the doctor doesn't know the answer to a question you ask, you can have them get back to you with it.

If you ever feel like your concerns are being ignored, don't accept it. Find another doctor who will talk to you.

But most doctors genuinely want to work together with you to solve your health problems. You can help them help you by taking an active role in your care.

SOURCES: American Urological Association, "Management of Erectile Dysfunction." Miller, T.A., "Diagnostic Evaluation of Erectile Dysfunction," American Family Physician, Jan. 1, 2000. Vinick, A., et al, "Diabetic Autonomic Neuropathy," Seminars in Neurology, 2003; 23(4):365-372.