One of the most common long-term complications from type 2 diabetes is also one of the most difficult to discuss, writes diabetes educator KASI KEEFE.

Let’s get this out of the way – erectile dysfunction is incredibly common. While men often feel uncomfortable talking openly about such an intimate issue, more than one in five men over the age of 40 will experience problems getting or maintaining an erection. Those odds go up significantly for men living with type 2 diabetes.

Erectile dysfunction (ED) is defined as a persistent or recurrent inability to attain or maintain an erection, but its effects tend to be more widespread. ED can have a profound and negative impact on the mental and physical health of men and their partners.

It’s also not just about sexual health. ED can be a common complication of a range of chronic conditions, so can function as an early warning sign that something isn’t right. The sort of blood vessel problems that can cause ED also indicate a higher risk of future stroke and heart attacks. There is good news, however. Around 95% of men can be treated successfully once the cause is identified.

These causes can include:

• diabetes, high blood pressure, high cholesterol or heart disease
• localised trauma to erectile mechanism
• medications
• tobacco smoke, alcohol and drugs
• hormonal disorders
• Peyronie’s disease
• stress – work, relationship, financial
• mental health conditions, depression and anxiety.

The first step in dealing with ED is to talk about it with your doctor. They will complete a clinical assessment, treatment plan, referrals and follow up. This will look at any chronic illness you have and investigations into other chronic health conditions.

Erectile dysfunction can have a profound and negative impact on the mental and physical health of men and their partners.

In terms of treatment, your GP will start by helping you to change any modifiable risk factors and adapt any medication to reduce side effects.

Things you can change:

• reduction in smoking and alcohol
• improving diet and exercise
• weight loss
• diabetes and cardiovascular management
• stress management.

Any treatment process for ED will vary depending on the cause. You’ll also need to consider your and your partner’s goals and weigh up any benefits against the risk and cost of the treatments. Men with diabetes are also at risk of other long-term complications including overactive bladder, incontinence, UTIs and retrograde ejaculation.

Working with your health care team to manage your diabetes is essential in reducing your risk or managing complications. Steps you can take include creating healthy habits – being active on most days, eating a balanced diet, checking your blood glucose levels and being engaged with a health care team.

Take advantage of the self-management education and support services available through the NDSS, engage with your health care team early and frequently.

For more information on male health issues: www.healthymale.org.au

How your GP can help:

• changing current medications linked to ED
• managing androgen deficiency
• addressing psychological issues
• further referral when required.