Erectile Dysfunction (ED) and Diabetes             

The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel and muscle function.

To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection.

Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.

What Treatments Are Available for Men With Diabetes and Erectile Dysfunction?

Men with diabetes having trouble with achieving and/or maintaining an erection can take oral medicine like Viagra, Cialis or Levitra.

However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and cause dangerous interactions with your heart medicine. Talk to your doctor to determine what treatment is best.

Additional treatments men with diabetes might want to consider include intracavernous injection therapy, vacuum constriction devices, intraurethral therapy, and sex therapy.

So what treatment is best? It depends on many factors including a man's health and their ability to tolerate the treatment. Have your doctor refer you to a specialist (a urologist) to work with you and determine the best treatment for your situation.

How High Blood Pressure Leads to Erectile Dysfunction

To understand how high blood pressure can lead to erectile dysfunction, you first have to understand how erections work. Getting an erection is really a complicated process.

Anatomy of an Erection
In the shaft of the penis there are two side-by-side chambers of spongy tissue called the corpora cavernosa. They're mainly responsible for erections. Just below them is another chamber called the corpus spongiosum. The urethra, which carries semen and urine, runs through the center of it.

The corpora cavernosa are made of small arteries and veins, smooth muscle fiber, and empty spaces. The chambers are wrapped in a sheath of thin tissue.

When you get an erection, nerve signals from your brain or from the nerve endings in your penis cause the smooth muscle of the chambers to relax and arteries to dilate, or open wider. This allows a rush of blood to fill the empty spaces.

The pressure of blood flow causes the sheath of tissue around the chambers to press on veins that normally drain blood out of the penis. That traps blood in the penis. As more blood flows in, the penis expands and stiffens, and you have an erection.

When the excitement ends, the smooth muscle contracts again, taking pressure off the veins and allowing blood to flow back out of the penis. Then the penis returns to a flaccid state.

High Blood Pressure and Other Causes of Erectile Dysfunction

High blood pressure is a major cause of erection problems. A study in the Journal of the American Geriatrics Society found that about 49% of men ages 40 to 79 with high blood pressure had erectile dysfunction.

A more recent study of men with high blood pressure, published in the Journal of Urology in 2000, found that 68% of them had some degree of erectile dysfunction. For 45% of the men, it was considered severe.

High blood pressure keeps the arteries that carry blood into the penis from dilating the way they're supposed to. It also makes the smooth muscle in the penis lose its ability to relax. As a result, not enough blood flows into the penis to make it erect.

Men with high blood pressure may also have a low testosterone level. Testosterone is the male hormone that plays a big role in sexual arousal.

High blood pressure by itself can lead to erectile dysfunction. But some drugs for treating high blood pressure can actually be the cause as well.

Diuretics -- or water pills -- and beta-blockers are the high blood pressure drugs most commonly linked to erectile dysfunction.

Diuretics may cause erectile dysfunction by decreasing the force of blood flow into the penis. They may also decrease the amount of zinc in the body. Your body needs zinc to make testosterone.

Beta-blockers dampen the response to nerve impulses that lead to an erection. They also make it more difficult for the arteries in the penis to widen and let in blood. What's more, they can make you feel sedated and depressed -- and the mind always plays some part in sexual arousal.

Sometimes, the choices that some men with high blood pressure make can add to the problem. Smoking, especially, is one of those. Smoking increases blood pressure, and damages blood vessels and reduces blood flow all around the body.

The power to take control of your blood pressure and your sexual health is in your hands. By living a healthy lifestyle and working with your doctor, there's a chance you'll once again be able to have normal sexual function.

The best way to improve ED is to make some simple lifestyle changes. For some men, adopting a healthier lifestyle, such as eating healthier, quitting smoking, exercising regularly, and reducing stress, may be all that is needed to find relief. For those who require more intensive treatment, adopting these lifestyle changes in addition to other treatments can further help.

Eating Healthier

Eating healthier is not that difficult -- it is more of a mindset change to stop eating the processed foods and junk foods that clog up your arteries and cause circulatory issues that lead to ED.

In general, avoid the processed foods, fast foods, alcohol, tobacco, and drugs. Drink raw vegetable juices, and eat more green and bright-colored vegetables such as spinach, kale,  broccoli, red peppers, and Brussels sprouts for the Vitamin C, chlorophyll, folate, and  other nutrients. Also, eat wild salmon and sardines for the Omega-3 EFAs. Foods and nutrients such as filtered water, celery, CoQ10, onions, and garlic help the ciculatory system, which helps to prevent erectile dysfunction. Refer to the wellness protocol section in Chapter 15  of the Death to Diabetes  book and the Power of Juicing ebook for more details about good circulation.

Also, refer to Chapters 6, 7, 8, and 14 of the Death to Diabetes book for more details about a sound nutritional program

Quit Smoking

Quitting smoking can be very difficult and there is no single best way to quit that works for all people. Some approaches to try that might help you kick the habit include:

• Pick a quitting date one to three weeks in the future. Prepare for the date by cutting down on smoking, staying away from your favorite places to smoke, and making a plan for how you will deal with stressful events without smoking.
• On your quitting date, get rid of all cigarettes, keep busy, and stay in smoke-free places.
• Talk to your doctor to see if you should try nicotine replacement therapy. The nicotine patch, nicotine gum, or other medication can be helpful but they will not take away your cravings to smoke.
• Make a clean break. Do not allow yourself to smoke "now and then." An addiction to nicotine can be reactivated anytime, even years after quitting.
• Take it one moment, one hour, one day at time. Cravings to smoke are usually short-lived and will go away whether or not you have a cigarette.
• Get help with quitting if you need it. Choose a comprehensive smoking cessation program that does not rely on a single technique (such as hypnosis). Your doctor can point you in the right direction.

Exercise Regularly

Regular exercise can improve your health in many ways. Along with improving erectile function, exercise can:

• Strengthen the heart.
• Improve the flow of oxygen in the blood.
• Build energy levels.
• Lower blood pressure.
• Improve muscle tone and strength.
• Strengthen and build bones.
• Help reduce body fat.
• Help reduce stress, tension, anxiety and depression.
• Boost self-image and self-esteem.
• Improve sleep.
• Make you feel more relaxed and rested.
• Make you look fit and healthy.

To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes.

When starting out, you should plan a routine that is easy to follow and stick with. As the program becomes more routine, you can vary your exercise times and activities. Here are some tips to get you started.

• Choose an activity you enjoy. Exercising should be fun not a chore.
• Schedule regular exercise into your daily routine. Add a variety of exercises so that you do not get bored. Look into scheduled exercise classes at your local community center.
• Exercise does not have to put a strain on your wallet. Avoid buying expensive equipment or health club memberships unless you are certain you will use them regularly.
• Stick with it. If you exercise regularly, it will soon become part of your lifestyle.
• If you feel you need supervision or medical advice to begin an exercise program, ask your doctor to refer you to physical therapy. A physical therapist can evaluate your needs and start you on a safe and effective exercise program.

Reduce Stress

Stress is common to everyone. Our bodies are designed to feel stress and react to it. It keeps us alert and ready to avoid danger. But it is not always possible to avoid or change events that may cause stress and it is easy to feel trapped and unable to cope. When stress persists, the body begins to break down and illnesses can occur. The key to coping with stress is to identify stressors in your life and learn ways to direct and reduce stress.

Learning an effective means of relaxation and using it regularly is a good first step. Allow yourself some "quiet time," even if it's just a few minutes. Examine and modify your thinking, particularly unrealistic expectations. Talking problems out with a friend or family member can help put things in proper perspective. Seeking professional assistance can help you gain a new perspective on how to manage some of the more difficult forms of stress. Other approaches to reducing stress include:

• Keep a positive attitude. Believe in yourself.
• Accept that there are events you cannot control.
• Be assertive instead of aggressive. "Assert" your feelings, opinions or beliefs instead of becoming angry, combative or passive.
• Learn to relax.
• Exercise regularly. Your body can fight stress better when it is fit.
• Eat well-balanced meals.
• Stop smoking.
• Limit or avoid use of alcohol and caffeine.
• Set realistic goals and expectations.
• Get enough rest and sleep. Your body needs time to recover from stressful events.
• Don't rely on alcohol or drugs to reduce stress.
• Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.