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Diabetes Complications: Erectile dymsfuntion (ED)

ED may be behavioural or psychological or physical or mixed origin. Among the bodily diseases, diabetes ranks high as a cause of ED. Here, too, ED may be the result of various factors. Temporary ED can occur when diabetes is in poor control and is due to general weakness. . Anxiety due to diagnosis of diabetes or balanitis and phimosis may give rise to ED. Husbands of diabetic women with pruritus vulvae may develop ED due to anxiety. ED in long-standing diabetes may be due to involvement of autonomic nervous system or of blood vessels. Many drugs given for high blood pressure, allergy, and psychological problems can give rise to ED. Tobacco, by narrowing the blood vessels, can contribute to the problem.

The prevalence of ED in diabetic males increases with age. ED in long standing diabetes is due to involvement of the autonomic nervous system and blood vessels. ED itself is a cardiovascular risk factor. Alcohol can contribute to ED.

Most diabetic mates feel shy to discuss this problem with their doctors. This problem should be discussed frankly with the doctor and counseling of the couple is important. Many subjects are married for several years and simple explanation and advice suffice for them. Diabetes should be controlled property and alcohol and smoking should be stopped. A change in blood pressure lowering drugs may help.

Sildenafil citrate is an advance in treatment of erectile dysfunction. It relaxes the smooth muscle of the penis allowing an increased "flow of blood in presence of sexual stimulation. It is taken as a tablet, about an hour before sexual activity. Maximum frequency of dose is once a day. The side effects of this drug are headache, indigestion, flushing and visual disturbances. Tadalafil, a similar drug, can be taken any time of the day. Persons taking organic nitrates should not take these

drugs. Erection can be induced by self injection into the penis of a drug that relaxes the smooth muscle; the dose of the drug is titrated to produce the desired degree of erection. Persistent unwanted erection, clotting of blood and infection of the penis are the hazards of this method.

In vacuum therapy, the penis is put in a plastic cylinder and partial vacuum is created by means of a hand-operated pump. Erection of the penis is induced by the partial vacuum. A rubber ring is slid on the base of the penis to maintain the erection. Inconvenience of the rubber ring, cold penis and bruising are the main disadvantages of this method. Both methods work when ED is due to involvement of the autonomic nerves with a reasonable blood supply.

Erection of the penis can be effected by instilling a drug into the urethra. This may cause irritation of the urethra.

A penile prosthesis, either rigid or inflatable may be tried if both these methods fail. The prosthesis is introduced under a general anesthetic. Infection, the main hazard, necessitates removal of the prosthesis.

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Diabetes Complications: Erectile dymsfuntion (ED)