The Secrets of Living and Loving with Diabetes by co-author Janis Roszler

dLifeExcerptLogo by Janis Rozler, RD, CDE, LD/N, William H. Polonsky, PHD, CDE and Steven V. Edelman, M.D.

Copyright © 2004 by Surrey Books.

Excerpted with permission of the publisher, Surrey Books.

Excerpted From Chapter 10: Sex and Other Fun Stuff

NOTE: Excerpts are provided on for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.

Erection Difficulties

Occasional erection problems happen to most men. If you can't maintain an erection long enough to have a successful intercourse in over half of your attempts, you have "erectile dysfunction" or "ED." It was formerly called impotence, which is an inaccurate and unfair term. Impotence implies that something is wrong with your masculinity, that you are a weak person and are less of a man because you can't perform sexually. Not true. ED is the most common sexual side effect of diabetes; it occurs in many men and becomes more likely as one gets older.

An erection begins when a man becomes sexually aroused from a touch, a thought, something seen, or even something heard. Nerves from the brain and skin send messages to the penis, which allows blood to enter but not exit. Like a water balloon, the penis will grow in size and stiffen. It is difficult to perform sexually if an inadequate amount of blood cannot reach and stay in the penis. This happens if circulation problems exist or if the body's nerve messages are blocked.

Dave and Laura planned the perfect evening, but everything had gone wrong again. The kids were at their grandparents', a candlelight dinner was set and soothing music was drifting in softly. Once again, Dave, who has had type 1 diabetes for over 20 years, had been unable to maintain an adequate erection for longer than a few minutes. It didn't happen every time but was becoming too frequent. He couldn't bring himself to speak to anyone about this, not even Laura. They both began to worry.

If you have ED but don't voice your concern, the issue can develop into an overwhelming problem within your relationship. You may feel it comments negatively on your masculinity, and your partner may feel that it represents your view of her attractiveness and commitment to the relationship. Although you may see it as an embarrassing issue, don't avoid it.

Have you discussed this issue with anyone yet? Have you shared it with your partner? Successful treatment starts with an important first step: you must tell someone. Ask for help and don't give up until you find the treatment that works for you. In addition to sharing details about your problem, you will need to provide a detailed medical history and take several blood tests to examine different hormone levels.

Dave finally visited his doctor and had a very productive session. His physician adjusted his medication dose, which improved his blood sugar levels. He also started taking Viagra, one of several medications now available to treat ED. This enabled him to maintain an erection much more often than before. Both he and Laura are relieved — and a lot more satisfied.

Here are suggestions to help make it easier for you and your partner to discuss ED:

1. Find a quiet, stress-free time to begin the discussion. It may be best to speak about it away from the bedroom.

2. Ask for support. Some treatments require lovemaking to be planned ahead to allow medication to take effect. Your partner's cooperation is important to the success of any treatment that you choose.

3. Don't bring up unrelated issues. This is a medical problem. There is no need to allow the discussion to deteriorate into a fault-finding session. Focus on plans for the future, not bad feelings from the past.

4. If it seems appropriate, use touch as a way to connect during your discussion. Holding and hugging can be a comforting affirmation of your commitment to each other.

Causes of Erectile Dysfunction

Diabetes is only one of the many causes of ED. Others include:

  • Blood vessel or vascular disease
  • Cancer treatments
  • Neurologic conditions
  • Medications
  • Surgery, especially for prostate problems
  • Excessive smoking and alcohol use
  • Testosterone deficiency
  • Depression
  • Emotional issues, such as lack of interest in a partner, due to weight gain, boredom, tension in the relationship, or other personal issues


    Regardless of the cause, ED usually can be treated successfully. The following are several often successful treatment options.

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Last Modified Date: April 22, 2014

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Jamis Roszler
Janis Roszler

Janis Roszler, MSFT, RD, CDE, LD/N is the American Association of Diabetes Educators' 2008-2009 Diabetes Educator of the Year.  She is a certified diabetes educator, marriage and family therapist, and registered dietitian. Her books include Sex and Diabetes (ADA) Diabetes on your OWN Terms (Marlowe & Co) and The Secrets of Living and Loving with Diabetes (Surrey books).

Donna Rice
Donna Rice

Donna Rice MBA,RN,CDE,FAADE is the 2007 Past President of the American Association of Diabetes Educators. She is a registered nurse, diabetes educator and has developed numerous educational programs on sexual health and wellness.  She is the co-author of  Sex and Diabetes (ADA) and Diabetes and Erectile Dysfunction - A Quick ‘n' Easy Handbook For the Diabetes Educator (Bella Vita).  Her newest publication is a children's book, The Magic is Me (Searchlight Press).

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