» Erectile dysfunction is a widely spread medical problem especially among patients suffering from diabetes of both types. We will figure out the interconnection of diabetes and ED symptoms as well as the methods of ED treatment under the condition of diabetes.
Erectile Dysfunction and Diabetes
ED is a typical complication of diabetes which deteriorates the patient’s life significantly as it initiates and maintains the depressive state. The ED frequency in patients with diabetes reaches 50%. Plus, ED occurs and develops at the younger age. The frequency of ED directly depends upon the age of the patient as well as upon the duration of disease. That is why ED cases are met in patients with II type diabetes very frequently.
ED may even become the first sign of the diabetes. According to the statistical data patients applying for the medical consultation regarding ED as the only health disorder are diagnosed diabetes in 10% cases.
Why Erectile Dysfunction Occurs In Patients With Diabetes
The process of reaching and maintaining erection is greatly dependent on the state of vegetative nervous system as well as blood vessels and their elasticity and vascular permeability. So, among the factors of diabetes that lead to the erectile dysfunction one can name nerve disorders (diabetic neuropathy) and vascular disorders (diabetic micro- and macroangiopathy).
Patients suffering from type II diabetes experience the decreased level of testosterone which adds to the development of ED. Decreased level of testosterone shows in the form of low libido and leads to the reduction of NO synthesis. It is known that erectile dysfunction in patients with diabetes correlates to the man’s age, level of glycated hemoglobin, peripheral and vegetative neuropathy, retinopathy as well as the duration of diabetes.
ED in patients with diabetes can be triggered by several medications that are prescribed for the treatment of the co-existing diseases and complications. The given medications may include beta – blockers, thiazide diuretics, psychoactive drugs and others.
ED can also be caused by psychogenic factors as often patients are aware of the possible sexual problems and are expecting them. Any sexual failure possible in the life of any man is connected to the diabetes. Thus the so-called fear of failure occurs and buttons up.
» Depending upon the reason Ed can be divided into psychogenic (based on psychological problem), organic (based on the somatic diseases) and mixed erectile dysfunction. Psychogenic ED is possible in patients who has been suffering from diabetes for less than 1 year and don’t have any typical diabetic complications. Organic ED is mainly typical in cases when the following complications occur: polyneuropathy, micro- and macroangiopathy.
Full Medical Check Is Of Great Importance
Patients suffering from ED and diabetes should understand the importance of the complete medical examination. It helps reveal the other conditions as ED can be a harbinger of other health disorders.
It is necessary that the screening of sexual function violations should be conducted for all the patients. The doctor should initiate the conversation about the sexual problems in any case whether patient is ready to answer these questions or not. The doctor should find out all the possible health damages that is why such conversation is of vital importance. International Index of Erectile Function (IIEF) can make the process much easier as it contains 15 questions the answers to which should be graded by the man. The higher the scores are, the better the sexual function is.
In clinical investigations other questionnaires like Sexual Encounter Profile are applied. The profile includes assessment of each sexual intercourse and erection quality. Global Assessment Question is applied at the end of the treatment.
The first step in treating ED in patients with diabetes is a maximal compensation of diabetes. In case of diabetic polyneuropathy corresponding treatment (alphalipoic acid) should be applied.
Patients with diabetes should make the following investigations:
- Physical examination of external sex organs in order to exclude hypogonadism, acute or chronic inflammation (balanitis, balanoposthitis), cicatrization of foreskin (phymosis);
- Examination of vibration and tactile sensitivity;
- Checking of the LH, FSH, testosterone, estradiol, prolactin, thyreotropine. If there are any changes the corresponding treatment is required;
- Examination of lipid profile. In case of hypercholesterolemia or dyslipidemia special diet is needed as well as hypolipidemic medications are prescribed.
Viagra (Sildenafil) Efficiency In Patients With Diabetes
Methods of ED treatment in patients with diabetes should be applied very carefully due to the fact that the given group of patients suffers from typical diabetic complications including polyneuropathy, angiopathy and damages of joints etc. In any case the preference should be given to oral drugs.
Viagra is one of the most popular oral drugs used for the treatment of ED and applied for the treatment of ED in patients with diabetes. It refers to the group of PDE5 inhibitors which are highly effective medications. They are erection modulators and do not cause the erection directly. Viagra intensifies the relaxation effect that results in the increased blood flow to the cavernous body of the penis and stable erection. It is very important to know that if there is no sexual stimulation Viagra will not work.
You can find all information about Viagra in this guide by My Canadian Pharmacy: mycanadianpharmacypro.com/generic-viagra.
Viagra (Sildenafil) is a prescription drug that should be taken according to the individually defined dosage. The dosage is taken once a day 40-60 minutes before the sexual intercourse. The duration of Viagra’s action is 4-5 hours. According to the investigation the therapy with Sildenafil in patients with type II diabetes increases the quantity of successful sexual intercourses from 6% to 49%. Evident improvements of erectile function were noticed by 46% of patients. So, one can say that Viagra show quite high effectiveness in patients suffering from type II diabetes even despite the unsatisfactory control of glucose level in blood and serious diabetes complications.
However, Viagra is also very effective while being used for the treatment of patients with type I diabetes. Nearly 36% of patients told that they were able to reach erection and 68% told they could maintain it. Improvement of erectile function was noticed by 66% of patients; the increased quantity of successful erections was proved by 63% of men.
Being a medication Viagra also has its side effects. The investigation says that the most frequent side effects involve headache, flushes and dyspepsia. They occur in 20%, 18% and 8% cases correspondingly.
Viagra is not for patients with excessive sensitivity to any ingredient of the drug. Patients taking medications containing organic nitrates and young people under 18 are not prescribed Viagra either. Doctors recommend Sildenafil with care for patients suffering from sickle cell anemia, multiple myeloma or leukemia which increase the risk of priapism. Anatomic deformations of penis (angulation, cavernosal fibrosis or Peyronie’s disease) are also reasons to take Viagra with care. ED therapy with PDE5 inhibitors should be postponed or canceled if the patient is not recommended to have sexual activity. This refers to patients suffering from cardio – vascular diseases including acute myocardial infarction (less than 90 days), unstable angina, angina occurring during coitus, cardiac failure, uncontrolled deviations of heart rhythm, arterial hypotension, uncontrolled arterial hypertension, heart stroke (less than 6 months). The complete list of contraindication is provided in the medical insert. Moreover, it is better to consult health care professional before starting Viagra therapy.
» It should be noted here that diabetes influences all the processes inside the human body. That is why Viagra’s effectiveness in patients with diabetes is affected by the disease so that it is a little bit lower than it is in patients without diabetes.
Other Erectile Dysfunction Treatment Methods
Other ED treatment methods include oral medications, psychotherapy, intracavernous and intraurethral therapy, mechanic and surgical methods.
We have already described peculiarities and effectiveness of PDE5 inhibitors and Viagra, in particular, being applied in patients with diabetes. Other medications referring to the group of PDE5 inhibitors – Cialis (Tadalafil) and Levitra (Vardenafil) has the same therapeutic parameters and are as effective as Viagra is.
The other group of medications used for the treatment of ED includes oral blockers of adrenoreceptors, general tonics and homeopathic medicines. There are no sufficient clinical research regarding homeopathic drugs; the effectiveness of the other mentioned medications are equal to placebo.
Psychotherapy is very effective method of ED treatment especially when both partners are involved. It can cure erectile dysfunctions of psychogenic character completely; ED of organic origin requires additional treatment. The disadvantage of psychotherapy lies in high time expenditure.
Intracavernous therapy with alprostadil is a very effective method of ED treatment as it has good results and quite rare side effects. However this method is not applied in patients suffering from diabetes due to the high risk of microbleeding and further development of penis fibrosis.
Intraurethral therapy with alprostadil is rather effective method with rare side effects. Its disadvantages include the necessity of special training, itching in urethra, and risk of traumatic injuries of urethra in patients with polyneuropathy and reduced sensitivity threshold.
Mechanic method is the cheapest one however it does not facilitate natural erection and may cause microbleeding, edema and deterioration of ejaculation. Besides applied mechanic devices such as vacuum devices, constrictor rings etc. are noticeable for the partner which is not very comfortable.
Surgery is a very effective method which is not recommended for the patients with diabetes due to the high rick of post-surgery infections and perforation.
» To sum it up, we would like to underline the importance of ED diagnosis in patients suffering from diabetes. It is good to remember that there are no uncured forms of ED; the matter is the proper method of treatment.
