Are you a male diabetic? then you are at risk of developing erectile dysfunction. Erectile dysfunction can be described as the inability to attain and maintain penile erection sufficient for sexual intercourse. Diabetes is one of the major causes although it can be caused by some other conditions.
Other causes of erectile dysfunction
1}-Drugs: use of certain drugs can lead to erectile dysfunction as a side effect for example anti hypertensives{methyldopa,reserpine,thiazides}, antidepressants{trycyclic antidepressants},anti psychotics{phenothiazine},anti androgen's{cimetidine,ketoconazole}.
CNS depressants{Barbitone, morphine},substance abuse{cocaine,amphetamine}
2}-Vascular diseases like hypertension, arteritis etcarteritis etc
3}-Endocrine diseases like hypothyroidism, hyperthyroidism etc
4}-Genitourinary causes like priaprism{abnormal, over sustained hyper turgid erection}, prostatitis{infection of the prostate},perineal prostactectomy{operation that involves the removal of the prostate gland}.
5}-Neurological diseases like spinal cord injury, spinal cord tumor, transverse myelitis.
Erectile dysfunction caused by diabetes in men is usually associated with increasing age, long duration of disease, poor glucose control, and appearance of other complications of diabetes like neuropathy and retinopathy.
Erectile dysfunction in diabetes progresses slowly and other symptoms of diabetes may be present. There is often a poor quality of erection at the beginning of the disease which often results later into total failure of erection ,there is however no loss of libido.
There is loss of morning , nocturnal{night}and reflex erections in diabetes
Treatment of erectile dysfunction
Treatment includes
A} Psycho sexual counseling
Counseling is necessary in the management of erectile dysfunction as psycho sexual factors are often present in cases of erectile dysfunction.
Counseling often involves discussion of the quality and stability of your sexual relationships, it will also explore the expectations of the man and his partner. It will also help to deal with anxiety and relationship problems associated with erectile dysfunction. Sometimes drug treatment may be required for the treatment of severe depression.
B} Drugs
Certain drugs can be used to treat erection problems, these include:
a}Phosphodiesterase inhibitors-these group of drugs are often considered as first line therapy for erectile dysfunction, for example sidenafil{Viagra}, vardenafil, tadafil. Their use results in a higher frequency of successful attempts at sexual intercourse and a higher mean number of successful attempts at intercourse each month.
C} Self injection therapy
Intracavernosal injection:the cavernosum is the tissue of the penis and certain drugs can be injected directly into the penis tissue by the male diabetic. The problem with this is that the pain it causes at the injection site.
D} Intraurethral alprostadil this drug is inserted into the tip of the penis and pushed into the urethra with aid of a syringe, alprostadil is a prostaglandin E1 analogue.
E} Use of vacuum devices
External vacuum constrictive devices are cylinder like chambers that create a vacuum around the penis and this increases blood flow to the penis leading to erection.
Erection is then maintained by restricting outflow by placing a constricting band at the base of the penis.
F}Surgery
Surgical treatment is reserved for men who can not use or who have tried other forms of treatment that did not work for them. Surgical options include the implantation of devices in the penis and micro surgical re vascularisation{new blood vessels are surgically created in the penis}
Although erectile dysfunction is a common complication of diabetes, there are other genito-urinary complications that you need to be aware of.
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