Impotence worries up to 50% of all diabetic men. Because of false modesty with a doctor, this problem is rarely discussed, and not every doctor can go straight ahead with a solution. Impotence, or scientifically, erectile dysfunction in diabetes mellitus is treated by a urologist , although diabetes itself refers to endocrine diseases. At present, there is enough knowledge about the work of the male reproductive system, and there are several options for helping a man with impotence.
Physiology of sexual intercourse in men
But first you need to figure out how the erection is physiologically, and that in this process violates diabetes. When a man has sexual desire, blood rushes to the cavernous bodies of the penis. The source of this blood is ileal artery. A rush of blood is normal enough to strain the penis, which allows you to penetrate the vagina of the partner. Then, through the urethra, there is a release of sperm, secretions of the prostate gland and seminal fluid, and a feeling of pleasure arises. For normal sexual function requires the coordinated work of the vascular, nervous, endocrine systems and the corresponding mood. If any stage of this process is impaired, impotence may occur.
Artery and Nerve Damage in Diabetes
Micro- and macrovascular complications of diabetes mellitus can lead to stenosis (narrowing) and blockage of arteries, which prevents the passage of blood into the cavernous bodies. Filling them with blood does not occur completely, and the erection is weak. Most often the stenosis of the internal artery is susceptible. In this case, the desire persists. However, with insufficient blood supply to the brain, it may disappear. Such complications, like diabetic neuropathy, develop with long-term diabetes. The very same diabetic neuropathy affects both the somatic and vegetative nervous system. It is the latter that is responsible for the erection – it arises spontaneously without control from the side of consciousness, like other processes in the body, such as breathing, heart contraction, food digestion. It is possible to check the filling of the cavernous bodies with blood using the ultrasound option – Doppler method.
Hormonal component
On the background of diabetes mellitus, the production of the male sex hormone testosterone can be reduced. This problem is faced by up to 30% of diabetics. In this case, not only the erection itself disappears, but also the desire to have sex. High levels of sugar in the blood affect the amount of testosterone, therefore, to combat this cause of impotence, you need, first of all, careful sugar control. For this, a low-carb diet is prescribed for diabetic patients, especially as sugar diabetes Type 2 often develops on the background of obesity, which in itself can lead to a violation of potency.In addition, it is important to take hypoglycemic drugs prescribed by a doctor on time or to inject insulin and regularly check glucose levels with a glucometer. Testosterone levels can be determined by laboratory.
Neurogenic impotence and drugs
Impotence in a patient with diabetes may not be associated with diabetes, but may result from the fear of failure when a man has not had sexual intercourse once or twice. In addition, some drugs may reduce erections, such as antidepressants, antipsychotics. And patients with diabetes may experience depression, being aware of the burden of problems that falls on them in connection with the treatment and control of glucose levels. This also includes drugs for lowering blood pressure, sedatives and some other drugs. If the examination does not reveal other causes of impotence, the patient has a morning erection, and diabetes does not last very long, you can think of neurogenic impotence. This kind of impotence is treated by a sex therapist. By the way, impotence can be discussed if 75% of attempts fail.
What are the treatments for impotence?
As already mentioned, the correction and control of carbohydrate metabolism, as well as weight loss, come to the fore. If the diagnosis revealed vascular and nervous complications of diabetes, the treatment regimen will be different. With a decrease in testosterone levels in men, you can use androgens. And the pills do not work well with them, so these drugs are injected in injections or in the form of a patch. The latter is stuck on the skin of the scrotum (1 patch) or in any other place of the body (2 patches).
Yohimbine and vacuum devices
Yohimbine is a medicine that people almost attribute to magical properties. However, the drug is not so effective and works, rather, with psychogenic impotence. Thus, in a study involving 101 men, yohimbin managed to restore potency only in 37% of cases. In addition, the drug has enough side effects – agitation, trembling, headache, anxiety, increased pressure, and others. Therefore, it can be used only in patients without arterial hypertension.
There are vacuum devices that increase the flow of blood from the arteries to the cavernous bodies, and the so-called occlusive rings that prevent blood flow through the veins. The use of such devices requires skill, but once learned, a man can quite easily cause an erection. The disadvantage of occlusal rings is that the ejection of the seed is impossible, since the urethra is also clamped by a ring.
Alprostadil
This drug belongs to drugs, dilates blood vessels, and is injected directly into the corpus cavernosum of the penis. In response, the smooth muscles of the penis relax, which causes blood to flow to it. It is necessary to inject the drug right before sexual intercourse, therefore men under the guidance of a doctor are trained in intrapenis injection. But alprostadil can be used only once a day. A side effect can be pain and prolonged erection – priapism. In these cases, injected drugs reverse action. In order to avoid priapism, the doctor carefully checks the dose of alprostadil. It should be sufficient for an hour erection, not more.
In recent years, other alprostadil dosage forms have become available, in particular, a suppository, which is placed in the urethra. In a study of 1511 men, 996 had an erection. Priapism and other complications are less common with this route of administration. Occasionally there are cases of irritation of the vagina. Alprostadil is also available as an ointment.
Viagra and operations
If the treatment of these methods is ineffective, you can try Viagra and other similar drugs (Cialis, Levitra). They allow you to get rid of impotence in diabetes in 70 patients out of a hundred. Moreover, Cialis and Levitra are designed to receive at high blood glucose levels. These drugs also work by relaxing the smooth muscles of the penis. You can take them no more than three times a week for 6 months. There are contraindications – it is angina, hypertension, heart failure, previous stroke or heart attack. To restore the patency of the arteries associated with filling the blood of the penis, and can be surgically. In addition, you can install an implant (prosthesis) that will simulate and maintain an erection.
Impotence is a serious problem for many men. However, as we see, there are many medicines and devices that allow it to cope. But the main thing in the fight against erectile dysfunction is maintaining a healthy lifestyle: sufficient physical activity, reduction and maintenance of normal weight, control of blood sugar and timely taking of all medicines prescribed by a doctor. The methods and preparations described here are also best used only after consulting a doctor, even if they are sold without a prescription.