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If you have type 1 diabetes and struggle with erectile dysfunction (ED), you may wonder whether there’s a link between the two conditions. Sexual health can be a taboo topic, but it shouldn’t be. Chances are, if you have a question, someone else out there does too.
Read on to get the facts about type 1 diabetes and ED.
Erectile dysfunction refers to the inability to get or maintain an erection firm enough for sexual intercourse. Low libido, on the other hand, refers to a decreased interest or desire for sexual activity. It’s possible for a person to desire sexual intercourse but be unable to get or maintain an erection.
While both conditions can affect sexual health, they have different causes and treatments. ED is often related to blood flow and nerve function, while low libido can be influenced by hormonal imbalances, psychological factors, or other health conditions.
People may notice problems getting or maintaining erections before they are even diagnosed with diabetes. In general, people are more likely to experience ED as they get older, but those with diabetes may face these problems earlier on.
You might have heard about people with type 2 diabetes experiencing ED, but there has historically been less research on type 1 diabetes and sexual dysfunction.
One study published in 2017 found that men ages 18 to 35 with type 1 diabetes who were being treated with insulin were more likely to experience ED than men of the same age who did not have diabetes. The type of insulin treatment (multiple daily injections versus continuous subcutaneous insulin infusion) did not affect a person’s chances of developing erectile dysfunction.
In addition, a 2024 meta-analysis (analysis of several studies) found that men with type 1 diabetes had an ED prevalence of 42.5 percent.
Certain risk factors and conditions associated with type 1 diabetes might explain why erectile dysfunction is more prevalent among people with the condition than the general population.
People with diabetes are much more likely to have arterial hypertension (another name for high blood pressure) than those without the condition. Having high blood pressure over a long period of time can lead to neuropathy (nerve damage) and blood vessel damage. This makes it more difficult for blood to flow to the penis so it can stay firm enough for intercourse.
Additionally, side effects from a medication meant to treat high blood pressure can make maintaining an erection more difficult.
People with diabetes often have a comorbidity (or co-occurring condition) of depression. Erectile dysfunction and depression are associated, not only for people with diabetes but for the general population as well. Mental health issues related to diabetes, such as anxiety, depression, and diabetes distress, can significantly impact sexual desire and function, leading to difficulties in achieving or maintaining an erection.
Symptoms of depression to look out for include:
In addition, according to the Centers for Disease Control and Prevention (CDC), over any given period of 18 months, between 33 percent to 50 percent of people with diabetes experience something called “diabetes distress.” This condition is similar to anxiety or depression but it requires coping mechanisms that are more specific to your diabetes treatment plan, like regularly seeing an endocrinologist and a mental health counselor who specializes in treating people with chronic health issues.
Diabetes can lead to hormonal imbalances, including hypogonadism (low testosterone levels) — though the risk is lower for people with type 1 diabetes vs. those with type 2. Testosterone plays a crucial role in sexual function, and low levels can contribute to both low libido and erectile dysfunction.
Aside from risk factors specific to type 1 diabetes, lifestyle factors, like smoking and drinking alcohol, may increase your risk of erectile dysfunction.
If you smoke regularly, you might be at an increased risk of ED, because tobacco use causes your blood vessels to constrict (narrow). That means less blood is able to reach the penis, making it more difficult to get an erection.
Smoking might also affect sexual function by reducing levels of nitric oxide in the body. This, in turn, can lessen blood flow.
Drinking alcohol can also affect erectile function. Research has shown that people with alcohol dependence commonly experience sexual dysfunction, and the risk of these sexual health issues increases proportionally with heavy drinking activity.
Health conditions other than diabetes can also contribute to erectile dysfunction, including:
Various types of medications — both for treating diabetes and other conditions — can affect a person’s libido and/or a person’s ability to achieve and maintain an erection. According to Cleveland Clinic, these include:
You may want to ask your doctor or pharmacist whether any drugs you’re taking may contribute to ED.
There are some steps you can take to lessen the effect ED can have on your quality of life.
Getting regular exercise can be helpful because it promotes blood flow and reduces stress. Maintaining a healthy weight is important, because being overweight can cause or worsen ED symptoms.
Your doctor can help you put together an exercise plan based on your goals and level of ability. This way, you can take gradual and realistic steps toward your physical activity and weight loss goals.
Eating a healthy, balanced diet is a good step to take to lessen your chances of experiencing ED. There is no one correct diet for people with type 1 diabetes, but you should generally make sure you’re getting enough fiber-rich carbohydrates, protein, and healthy fat and are staying hydrated.
There are several treatment options for erectile dysfunction. Talk to your doctor about what might be right for you.
Several oral ED medications help improve blood flow to the penis, making it easier to maintain an erection. The main treatments you might have heard of include:
Another method of treating ED is inserting a tiny suppository into the urethra. Urethral suppositories are a kind of vasodilator, or treatments that widen your blood vessels to make it easier for blood to flow.
These usually take effect within five to 10 minutes, and you should wait 10 to 30 minutes before engaging in sexual intercourse.
Vacuum-erection devices — also called penis pumps — are used by placing a plastic tube over the penis and drawing air out of the tube to create a vacuum. This brings blood into the penis and creates an erection. A rubber ring is then placed around the base of the penis to keep the blood in place for the duration of sex.
If other forms of treatment don’t work, some people use penile implants. These can be semi-rigid or inflatable, and they are generally safe and effective.
Whatever your concerns may be, the best step you can take is having an open and honest conversation with your doctor. Type 1 diabetes care doesn’t just mean monitoring glucose levels, cholesterol, and blood pressure. Holistic health care includes all the factors that affect your quality of life, and sexual health is a major one.
Mental health treatment can play a valuable role in managing erectile dysfunction — particularly when it’s linked to psychological factors such as stress, anxiety, and depression. Cognitive behavioral therapy (CBT) and other forms of counseling can help address these underlying mental health issues by teaching coping mechanisms and stress-reduction techniques, which can reduce performance anxiety and improve overall sexual function.
Moreover, mental health professionals such as sex therapists can provide support for relationship issues that might contribute to ED, fostering better communication and intimacy between partners.
On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, nearly 3,000 members come together to ask questions, give advice, and share their stories with those who understand life with type 1 diabetes.
Are you or a family member living with type 1 diabetes? Have you experienced men’s health-related complications of diabetes, and if so, how did you cope with them? Share your experience in the comments below, or start a conversation by posting on your Activities page
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Sarika Chaudhari, M.D., Ph.D.
completed her medical school and residency training in clinical physiology at Government Medical College, Nagpur, India.
Learn more about her here.
Anika Brahmbhatt
is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology.
Learn more about her here.
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