Diabetes and ED (Erectile Dysfunction): What’s the Link?

The CDC reports about 34.2 million people have diabetes, accounting for 10.5% of the entire US population. 

Diabetes mellitus is a lifelong condition that may increase the risk of many other health problems. 

Erectile dysfunction (ED) is one of them. 

What’s the connection between diabetes and erectile dysfunction? 

Scroll down to find out.

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The connection between Diabetes and ED

Diabetes is a risk factor for erectile problems. 

In fact, men with diabetes are three times more likely to develop ED than their non-diabetic counterparts, according to CDC. 

When men younger than age 45 develop ED, it could be a sign of the presence of type 2 diabetes

The likelihood of getting ED often depends on a patient’s age and duration of diabetes.

The relationship between diabetes and erectile dysfunction persists, regardless of the type of diabetes you have.

A report from Boston University Medical Center revealed about half of the men with type 2 diabetes diagnosis will develop ED within five to 10 years of their diagnosis. 

What’s more, men who also have cardiovascular diseases such as coronary heart disease or heart disease are even more likely to develop impotence.

The good news is that men with diabetes who focus on a healthy lifestyle can reduce symptoms of their condition and improve sexual performance. 

Learn more about lifestyle changes further in this post. 

Besides ED, diabetes can also cause retrograde ejaculation.

What causes erectile dysfunction in diabetics?

As you can see, the link between diabetes and erectile dysfunction is evident. 

It is impossible not to wonder why it happens. 

The relationship between the two conditions is related to the nervous system and blood circulation. 

Diabetes is, after all, the most common cause of autonomic neuropathy (nerve damage that affects basic functions) and a factor for venous outflow.

Inadequately managed diabetes, i.e., high blood sugar levels, induces damage on nerves and small blood vessels. 

So, when diabetes damages nerves that regulate sexual stimulation and response, your ability to achieve or maintain a penile erection is impaired too. 

Diabetic men may have ED because damaged blood vessels decrease blood flow. 

Remember, erection happens when blood fills out chambers in your penis.

Endothelial dysfunction is a common finding in men with diabetes. 

Moreover, men with this problem also tend to have low nitric oxide levels, which is necessary for a strong erection. 

Additionally, men with diabetes have difficulties relaxing smooth muscles, which also affects their erectile function.

Risk Factors

Various factors can increase the risk of erectile dysfunction in men with diabetes. 

These include:

  • High blood pressure
  • Obesity
  • High cholesterol
  • Stress, anxiety, and depression 
  • Some medications e.g., for depression and antihypertensive medications
  • Smoking
  • Illegal drugs
  • Alcohol intake
  • Problems with the nervous system, including those affecting brain and spinal cord

Additionally, diabetic vascular disease can also happen in men with this condition and contribute to ED. 

Vascular disease is the hardening of arteries throughout the body.

Testosterone deficiency is yet another factor brought on by this lifelong condition and other problems that may lead to ED.

It’s also useful to keep in mind erectile dysfunction may develop due to nerve damage caused by surgery of the prostate, pelvic injury, and surgery of bowel and bladder. 

These injuries and surgeries can damage nerves, which can be a major complication in men with diabetes. 

Are there treatments for men with diabetes and erectile dysfunction?

Erectile problems are not to be ignored, especially if you experience them frequently. 

You may want to see a healthcare professional who will diagnose the problem.

Generally speaking, ED treatment in men with diabetes is the same as in guys who don’t have it. 

Oral medication such as PDE5 inhibitor tadalafil (Cialis), sildenafil (Viagra), or vardenafil (Levitra) is the main treatment route. 

Keep in mind these medications are available with a prescription only.

Erectile dysfunction medications generally don’t interact with diabetes therapies such as insulin or metformin (Glucophage).

While penile implants and pumps are also available, you may want to try oral medications first. 

They are less invasive and more effective without causing additional (and unnecessary) complications. 

Lifestyle changes

Erectile dysfunction is one of those manageable problems that you can relieve with lifestyle changes. 

At least that’s possible for most cases of ED. 

Diabetic patients can reduce the risk of ED by managing their condition and controlling blood sugar levels

You can also prevent problems linked with low testosterone if you manage your condition correctly.

Lifestyle plays an important role in the management of both diabetes and erectile dysfunction. 

They can also prevent both problems in men with metabolic syndrome. 

Some useful lifestyle changes to make include:

Lose weight 

If you’re overweight/obese, you can improve erectile function (and overall health) through weight loss. 

Evidence shows even a slight weight loss can improve sexual desire and erectile function in men with diabetes. 

Weight loss can also help manage blood glucose levels.

Exercise and eat a healthy diet 

Studies confirm even moderate physical activity and a healthy diet low in saturated fat but high in fiber can improve ED without prescription medications. 

Both diet and exercise are vital for glycemic control too.

how to start exercising

Read our Beginner’s Guide to Working Out.

Manage stress 

Stress can impair erectile function, but ED can also cause stress. 

So make sure to manage stress more effectively, resolve relationship problems, and look after your mental health. 

It can help manage ED.

stress and anxiety

Find out 15 Simple Ways To Relieve Stress And Anxiety.

Use supplements 

Some supplements such as amino acids l-arginine and l-citrulline can improve erectile function by increasing nitric oxide production, a vasodilator. 

This is particularly important if you bear in mind men with diabetes tend to have low nitric oxide levels.

nitric oxide booster

Find out 5 Ways to Increase Nitric Oxide Naturally

Quit smoking and reduce/avoid alcohol intake 

Both smoking and alcohol can constrict or narrow blood vessels, thus contributing to erectile problems.

how to quit smoking

Read our guide on How To Quit Smoking.

Lifestyle modifications can also help diabetic women improve their quality of life.


Diabetes, both type 1 diabetes and type 2, is a lifelong but controllable condition. 

Doctor-recommended treatment can help you manage blood glucose levels and live a healthier life. 

Lifestyle modifications are necessary for the form of regular exercise and proper diet. 

Erectile dysfunction can be a permanent problem for some men, but not for most of them. 

This is especially the case for men who experience erectile difficulties occasionally. 

Men with diabetes are more likely to have ED, but they can still overcome this sexual dysfunction. 

To do so, you need to make lifestyle changes (see above). 

If lifestyle changes aren’t enough, you may want to see your doctor. You’ll get a prescription for ED medication. 

These drugs are well-tolerated and can help men improve their erectile function.


Both diabetes and erectile dysfunction are common problems. 

Men with diabetes are more likely to have erectile dysfunction due to potential damage to the nerves and blood vessels. 

Fortunately, lifestyle changes and doctor-recommended treatment (if necessary) can help improve erectile function and overall sexual health, including testosterone level.

Explore More


Find out 10 Natural Remedies To Improve Erectile Dysfunction In Men.


  1. Nisahan B, Kumanan T, Rajeshkannan N, Peranantharajah T, Aravinthan M. Erectile dysfunction and associated factors among men with diabetes mellitus from a tertiary diabetic center in Northern Sri Lanka. BMC Res Notes. 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451292/
  2. Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95-105. Published 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949699/ 
  3. Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, Worthley MI, Lange K, Wittert GA. Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med. 2011. https://pubmed.ncbi.nlm.nih.gov/21819545/
  4. Esposito K, Ciotola M, Giugliano F, Maiorino MI, Autorino R, De Sio M, Giugliano G, Nicoletti G, D’Andrea F, Giugliano D. Effects of intensive lifestyle changes on erectile dysfunction in men. J Sex Med. 2009. https://pubmed.ncbi.nlm.nih.gov/19170853/
  5. Barassi A, Corsi Romanelli MM, Pezzilli R, Damele CA, Vaccalluzzo L, Goi G, Papini N, Colpi GM, Massaccesi L, Melzi d’Eril GV. Levels of l-arginine and l-citrulline in patients with erectile dysfunction of different etiology. Andrology. 2017. https://pubmed.ncbi.nlm.nih.gov/28178400/

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