Men's Sexual Function and Diabetes

It’s a very embarrassing topic, but I’m curious what has worked for other men as it pertains to erectile issues and diabetes. I’m fairly young (40) and recently put onto injections by a urologist because PDE-5 pills were not working. He believes this is due to diabetic neuropathy. I’m wondering if there is any good information out there or people having similar experiences? I’d love to believe this is a temporary issue and blood sugar control could reverse it, but the urologist didn’t give me much hope.

Hearing about other experiences out there would be appreciated.

I’m sorry you’re faced with this. I don’t have any advice or experience to offer you except the more general findings of the landmark Diabetes Complications and Control Trial (DCCT). This study basically found that better control of blood glucose mattered. It showed that better overall blood glucose control often led to stopping the progression and sometimes even reversing diabetes complications.

How long have you lived with diabetes? What is your regimen to keep blood glucose in check? Do you use a continuous glucose monitor (CGM)?

I completely renewed my effort to rein in my glucose control five years ago when I was diagnosed with gastroparesis, a result of impairment of the vagus nerve, the central nerve system that connects the brain with major organs. My blood sugar control improved a lot. My symptoms have not improved but they’ve also not gotten any worse, something I count as a victory.

I encourage you to consider getting a lot more aggressive with your diabetes habits. I would consider checking your BGs more frequently with fingersticks and/or a CGM. Many people find that cutting down on carbohydrate consumption makes blood sugar control easier. Lots has been written here about this.

You’re at a juncture where you need to decide to defend your quality of life or resign yourself accepting the new status quo or some choice in between. I think sexual health is worth fighting for. Please let us know if we can help.

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I do believe that that kind of neuropathy CAN be reversed; however, it can take a long time. I recommend reading Dr. Richard K. Bernstein’s book “The Diabetes Solution.” (Note to self: You bought the dang thing, now READ IT! :wink:).
Dr. Bernstein mentions frequently that he had various forms of neuropathy himself before he started aggressively managing his diabetes, but that after years of good blood glucose control, his neuropathy reversed and he regained most, if not all, nerve function that he’d lost.

I have not specifically been diagnosed with the sort of neuropathy that you mention; however, I have noticed improved sexual performance since managing my diabetes with fairly tight control. I was diagnosed at 50, five years ago.

Garlic and toothpaste.

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Control your blood sugar as close to normal as you can safely do. That’s it. Other than making sure that you have an appropriate level of free testosterone (have your doctor run the test) tight control is your only real weapon. I speak from experience.

We all are different and your results may vary, but I had quite severe neuropathy. Both peripheral and autonomic. I forced myself to maintain my blood sugar in a normal range and have had an average A1c below 5.5 since early 2011. All of my neuropathies (and other complication related issues) are vastly improved. None of them are completely gone, but all of them are at a very low level compared to the beginning.

The problem with treating ED in diabetics is exactly what your doctor says. The nerve damage (and also damage to the small blood vessels) makes typical ED drugs ineffective. Not only that they can pose a greater danger to your eyesight than a nondiabetic.

This condition can improve over time. But Thas is quite right that it can take a very long time to see any results. It took almost 5 years of tight control to get back to a point where I felt that I was anything even close to normal again. I am still healing and it is going on seven years. You just need to hang in there.

Which goes where?

Thanks for the advice. I’m trying — it’s been very tough even with significant exercise. I haven’t tested for anti-bodies but the endo thinks I may be LADA given how insulin dependent I am and in relatively decent shape. It’s a frustrating disease for sure!

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Thanks for the recomendation – I will check it out

The problem with trying to prevent or cure diabetic neuropathy is that there is now increasing evidence that it may all be genetically pre-determined, so there is no way to escape it as it builds up over time. The latest research is reviewed in: V. Spallone, “Might Genetics Play a Role in Understanding and Treating Diabetic Polyneuropathy?” Diabetes/Metabolism Research and Reviews, vol. 33, no. 4, May, 2017.

The toothpaste is for his partner.