Could you explain what is meant by erectile dysfunction to me and what causes it?

Erectile dysfunction is the medical term for impotence. It is the persistent inability to get or keep an erection that is hard enough to achieve the quality of sex desired by you and your partner. Most men will have had problems in getting or maintaining an erection at some point in their lives. Erection problems can be caused by stress, tiredness or too much alcohol. These reasons are nothing to worry about and many men will experience them, but they can lead to fear of failure. This is when you become so preoccupied with previous failure that you are no longer able to enjoy sexual stimulation to get an erection.

However, in the majority of men, erectile dysfunction is caused by physical (of the body) and psychological (of the mind) reasons. If erectile dysfunction is due to physical problems, the man may have noticed that his erections were getting worse as time went on.

Possible causes may include:

• poor blood flow to the penis because of blocked arteries (atherosclerosis)
• too much blood draining from the penis (venous leak)
• damage to the nerves in the penis
• side-effects from certain drugs
• alcohol and drug abuse
• diabetes – poor control increases the risk
• heavy smoking
• high cholesterol
• nervous system problems such as multiple sclerosis or after a stroke
• prostectomy (surgical removal of the prostrate gland)

Men with psychological reasons for erectile dysfunction may still experience “morning erections”. This means that the physical workings behind the erection are fine. Psychological reasons for erectile dysfunction include: stress, worry about performance, emotional trauma, relationship difficulties or confusion over sexual orientation.

Does type 2 diabetes affect sexual drive in men? If so, how can I improve my sexual drive?

High blood sugar levels effects all your body and may result in tiredness or dehyration and resultant dryness. In addition, poor diabetes control can result in physical problems. Therefore, keeping good control of your diabetes, sugar, cholesterol and blood pressure can help. If you are on other medications, check with your pharmacist if there is any association. Talk to your doctor, as they may be many other causes and the doctor may be able to help.

Reduced sexual drive should not be considered a complication of diabetes until other causes are outruled. This matter should be discussed with any healthcare professional as there are many options available.

There appears to be a lot of information on diabetes and men’s sexual drive and ability, is there any information on women and diabetes. Is there a loss in sex drive, with the use of insulin?

The impact of diabetes on sexual health and enjoyment is not well researched. This is particularly the case for women’s sexual health.

Common sexual difficulties encountered by women, both those with diabetes and those who do not have diabetes are:

• poor vaginal lubrication
• a decrease in sexual desire
• pain during sex
• trouble having an orgasm.

The sexual problems encountered by pre-menopausal women who have Type I diabetes are similar to the problems non-diabetic women have. In addition, they may have decreased vaginal lubrication and more frequent yeast infections, especially if their diabetes is not well controlled

Women with type 2 diabetes are more likely to have difficulties, as they are older, and are usually taking medications. Ongoing strict control of blood glucose levels may help prevent these and other problems in later life.

What to do:

First, recognize the problem and decide to deal with it. Ignoring sexual difficulties will not make them go away.

See your doctor. Describe the problem clearly in plain language. If you feel you cannot discuss your problem with your primary care physician, ask for a referral to another doctor, perhaps a specialist.

You may also get help from your practice or diabetes nurse. They may help you overcome shyness in discussing private matters and help you put your concerns into words.

If your blood glucose levels are up and down, you will not feel well.

This will affect your interest in sex. Sexuality is complex. While many of the factors affecting sexual pleasure are physical, sex also has a psychological dimension. For many people sexual problems are a combination of the physical and the mental and emotional parts of life.