Featuring Dr. Richard Bebb, MD, ABIM, FRCPC

Duration: 2 minutes, 50 seconds

Diabetes damages the body very slowly over years, and in a simplistic form you can look at damage to large blood vessels, small blood vessels, and the nerves.

The large blood vessel damage is heart attacks, strokes, damage to your circulation to your legs, peripheral vascular disease we call that. Damage to the small vessels includes damage to the eyes, the kidneys, the nerves, and also to erectile function, damage to the penis, the small blood vessels are very, very exquisitely sensitive to blood sugars. And the third issue is damages to nerves directly, the toxic effect of high blood sugars.

Erectile dysfunction as an issue in diabetes is a major one and if you look at the population at large, by the age of 40 about 5 percent of men, one out of 20, have complete erectile dysfunction, which is defined as being the inability to have sexual relations for a period of three months or more.

If you’ve had diabetes since your teenage years, that number is closer to 40 or 50 percent of individuals if your blood sugars have not been well controlled and you get to the age of 40 or 50, so it’s a huge issue. So in terms of preservation of erectile function, the first thing is to control your blood sugars. It helps prevent the damage to the small blood vessels in the penis.

The next issue is smoking. And smoking is always a problem, and if you have diabetes consider smoking as being the biggest threat to erections that can occur. In any population of men, whether it's a high blood pressure, diabetes, high cholesterol, men after prostate surgery, smoking is always the key critical issue. So stop smoking if you want to preserve what erection function you still have and if you want to prevent losing your erections in the future.

Other risk factors for erectile dysfunction include not just diabetes and smoking but high blood pressure, high cholesterol, being obese, and then there are certain medications that unfortunately will have erection dysfunction as a complication and generally that falls into the category of certain antidepressants or certain antihypertensive drugs will tend to have that as a side effect.

In addition to those risk factors for erectile dysfunction, includes other things such as depression can be an issue, and again medication and side effects, so it's important to review your particular case with your primary health practitioner.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist