Vol.8: Diabetes and ED (erectile dysfunction)
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【Diabetes and ED (erectile dysfunction)】
Why does diabetes (DM) cause ED (erectile dysfunction)?
There is a very close relationship between diabetes (DM) and ED (erectile dysfunction).
Diabetes is reported as the highest in frequency as the primary cause of ED and it occurs with moderate and serious ED in 30% and 60% of diabetic patients, respectively. Also if we include mild degree ED, it’s reported with the figures 80% to 90%. Diabetes is different from the other primary causes of ED as it causes damage to the vessels and nerves which relate to the erection at the same time due to the long-range hyperglycaemia condition, and in addition to this, it’s thought that the whole body’s organization gets damaged by the oxidation stress.
In particular, because the blood vessels and nerves which relate to ejaculation and erection are more sensitive and narrower than those in the brain and heart, when the penis receives damage from diabetes, the symptom appears at an earlier stage than the brain and heart.
The mechanism of erection and ejaculation are complicated and these occur in conjunction with a number of nerves and blood vessels. Specifically, the physical stimulation to the penis is passed into the brain and spinal cord via the sensory portion of the dorsal nerve of the penis, and it stimulates a parasympathetic nerve along with sexual excitement in the cerebrum. The parasympathetic nerve works on both the penile artery and vein to increases the blood flow of the arteria-profunda-penis (the profound artery of the penis), and to decrease the blood which goes out from the penile-vein. Eventually, the cavernous-sinus in two of the corpus cavernosum penis and one corpus cavernosum urethrae gets filled with blood. This is the mechanism of erection. Moreover, when sexual arousal is added, the spinal ejaculation nucleus responds and ejaculation occurs through the function of the sympathetic nerve.
In this way, a lot of blood vessels and nerves are connected with sexual intercourse, but as for the patients with diabetes, all of these are to some extent blocked. In particular, the autonomic nerve (sympathetic nerve and parasympathetic nerve) are the ones which get easily affected in diabetes patients (DM). Impairment of the autonomic nerves cause various symptoms such as poor circulation, flush, abnormal sweating, constipation, diarrhea, lightheadedness, dysuria, malfunction of the heartbeat, and also ED (erectile dysfunction) .
However, you shouldn’t be pessimistic when you have diabetes. It is proved in a study in recent years that it is possible to prevent worsening the symptom of ED by continuing with appropriate blood sugar control measures. The first priority is to be careful not to become diabetic, however if you do, it is essential to make an effort not to let it worse by everyday management so that you can maintain your quality of life.
【Supervisor of this article】
Ken Takemori, MD. An anesthesiologist and Director of Shibuya 3rd Block Clinic.