// October 25th, 2010 // No Comments » // Impotence
Diabetes mellitus is a common medical condition affecting 10 million Americans, 4 million of them men. Diabetes sets in motion events that damage the heart, eyes, and kidneys and prevent nerves from transmitting impulses efficiently. The nerve damage is called diabetic neuropathy, and it takes several different forms.
Impotence in diabetic men may be a reflection of a neuropathy affecting several different types of nerves. Some nerves carry messages of sensation, like pain and pleasure. Others transmit impulses that allow the pelvic muscles to contract during ejaculation. One other critical component of the nervous system, the autonomic nervous system, is also vital for sexual function. The autonomic nervous system works silently and effortlessly and helps us get through many daily functions.
For example, in the morning, when we first stand up, our blood pressure drops. This fall is temporary; the autonomic nervous system instigates a battery of neural responses that helps stabilize blood pressure. Diabetic patients with autonomic neuropathy cannot do this. Because diabetes has damaged their autonomic nervous system, they cannot marshal a prompt increase in blood pressure. Diabetics’blood pressure often falls to very low levels, occasionally causing fainting.
The autonomic nervous system also plays an important role in transmitting messages for erections, ejaculation, and bladder function. Diabetic men with autonomic neuropathy become impotent, are unable to ejaculate, and may even have trouble emptying their bladders completely when they urinate.
nadequate autonomic nervous system function can also occur in older nondiabetic men. Idiopathic autonomic insufficiency produces similar symptoms of inability to stand upright without feeling faint, loss of the ability to empty the bladder, impotence, and inability to ejaculate.
In terms of sexual potency, men with diabetes mellitus have to contend with two problems — altered nerve function and diminished blood flow due to diabetes-induced damage to blood vessels. In addition to causing nerve damage, diabetes attacks the blood vessels that must dilate and enlarge to pump blood into the penis for an erection to develop.
Symptoms suggesting diabetic nerve damage include loss of sensation at the tip of the penis, numbness of the lower extremities, and spasms or unexplained pain in the legs. The regularity with which impotence occurs in diabetics is striking. Young diabetics have no more sexual dysfunction than their nondiabetic contemporaries do. But they can anticipate a progressive decline in sexual function. Ten years after the onset of diabetes, 50 percent of diabetic men will be impotent. By age seventy, more than 95 percent are impotent. We do not yet know how to repair diabetic nerve damage, although there are treatments for the impotence it causes. Penile implants and penile injections and on occasion Viagra have been used to help restore potency in men suffering from diabetic neuropathy.
