:: HOW DIABETES CAUSES IMPOTENCE

:: QUESTION: I'm a man with diabetes,
and I'd like to know how the disease
causes impotence. This is getting to
be a problem for me and my wife.

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ANSWER: Consulting Editor sex educator Sharon Goldsmith, R.N. (GO
HSXCONSULT), answers as follows:

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Diabetes (diabetes mellitus) is a disease characterized by abnormalities in
sugar metabolism and insulin secretion from the pancreas. Approximately 11
million people in the United States have it, and of those, 10 to 15 percent
must rely on insulin injections.
Diabetes is a complex illness affecting many organs. It can cause damage to
nerves and blood vessels, especially when it is severe, poorly controlled, or
occurs over a long period of time.

:: Artery Hardening, Nerve Damage

Erection occurs when the penis fills with blood, and this process is
controlled by nerves and blood vessels in the pelvis. Hardening of the
arteries (arteriosclerosis) or nerve damage caused by diabetes can interfere
with erectile and ejaculatory ability.
A reversible "impotence" can be caused by temporary nerve damage resulting
from poorly controlled diabetes. It is essential that the diabetic man be
carefully monitored so that this type of damage can be prevented or immediately
corrected.

:: Home Glucose Monitoring

An important change has taken place in diabetic care. It is known as home
glucose monitoring and it has replaced the much less accurate method of urine
testing.
Frequent measuring of the blood sugar and adjustment of insulin based on
this information can result in normal blood glucose levels most of the time.
Although some people must inject themselves with insulin several times a day,
careful glucose monitoring not only improves a person's overall condition. It
probably improves nerve function.
You did not mention whether you are an insulin-dependent diabetic, but if
you are you should be using this form of monitoring.

:: Other Medical Problems

Erectile problems in a diabetic man also can be due to physical processes
other than diabetes. A number of medical conditions can interfere with
erection. Drugs can be at fault, especially those used to treat hypertension
and heart disease as well as narcotics, sedatives, antispasmodics and alcohol.
Diabetes can cause both erectile and ejaculatory problems, but many male
diabetics function well sexually throughout life. It's important to bear this
in mind, since anxiety is a major cause of erectile difficulties.
In other words, if you worry about what diabetes can do to you, the worry
itself may interfere with your erections.

:: Emotional Factors

Other emotional factors also must be considered. Diabetic men are just as
capable of developing sexual problems of psychological origin as any other
group of men. In fact, individuals coping with long-term illness are even more
at risk.
Be sure to discuss your problem candidly with your doctor, so he or she can
evaluate the possible physical causes or suggest a counselor if appropriate.