How to treat erectile dysfunction in men with diabetes: from pathophysiology to treatment
Abstract
Erectile dysfunction (ED) is highly prevalent affecting at least 50 % of men with diabetes mellitus (DM). DM may cause ED through a number of pathophysiological pathways. These include neuropathy, endothelial dysfunction, cavernosal smooth muscle structural/functional changes, and hormonal changes. Lifestyle changes, diabetes control, and treatment of hypogonadism are important as the first step in ED management since there is no curative treatment for ED. Phosphodiesterase type 5 inhibitors (PDE5i) are the first-line treatment option. Intracavernous administration of vasoactive drugs is commonly used as a second-line medical treatment when PDE5i have failed. Alprostadil is the most widely used drug in this second-line setting. The combination of papaverine, phentolamine, and alprostadil represents the most efficacious intracavernous pharmacologic treatment option that may save non-responders to alprostadil. Penile prosthesis implantation can be considered in treatment refractory cases, with excellent functional and safety results in the properly informed patients.
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Men with diabetes face a threefold higher risk of erectile dysfunction than men without diabetes.
“Less research is available regarding sexual health for males, particularly in youth; however, males with diabetes have a threefold increased risk of erectile dysfunction compared with men who do not have diabetes (106,107).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [107]
In one study of people with type 1 diabetes, sexual dysfunction was reported in up to 50% of male participants.
“In one study of individuals with type 1 diabetes, sexual dysfunction was reported in as many as 50% of male patients (107).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [107]
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Young-Hyman, D., de Groot, M., Hill-Briggs, F., Gonzalez, J. S., Hood, K., & Peyrot, M. (2016) · Diabetes Care · doi:10.2337/dc16-2053 · Cited by 1,072 · see citing works
- Authors
- Hatzimouratidis, K., & Hatzichristou, D.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- Corresponding author
- Hatzichristou, Dimitrios
- Venue
- Current Diabetes Reports
- Published
- 2014-09-06
- Volume
- 14
- Issue
- 11
- Pages
- 545-545
- ISSN
- 1534-4827 (ISSN-L)
- 1539-0829
- OpenAlex
- W1978459563
- Cited by
- 68
- References
- 92
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 5 · 2020: 5 · 2019: 9 · 2018: 5 · 2017: 4 · 2016: 9 · 2015: 4 · 2014: 1
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Diabetes Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- erectile dysfunction, diabetes mellitus, pathophysiology, diabetic neuropathy, endothelial dysfunction, corpus cavernosum smooth muscle, hypogonadism, phosphodiesterase-5 inhibitors, intracavernous injection, prostaglandin E1, penile prosthesis implantation
- MeSH terms
- Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Hypogonadism, Erectile Dysfunction, Male, Patient Education as Topic, Risk Factors, Vasodilator Agents, Penile Prosthesis, Smoking Cessation, Treatment Outcome, Penile Implantation, Risk Reduction Behavior, Diabetes Complications, Phosphodiesterase 5 Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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