Erectile dysfunction
Male: When you face a serious problem like erectile dysfunction, that comes with diabetes.
Male: Do talk to your doctor about problems with erections if they are occurring. There are varieties of reasons as to why this may occur if you have Type II Diabetes.
Male: One of the things that I would really like to encourage you to do if you are facing erectile dysfunction is to realize that there is help available. That there is a lot of possibilities to deal with the physiological aspect, but there is also some real help available to address the kind of mind games that started happening when one is facing this kind of problem. The emotional impact that it has, the impact that it has on your relationship—all of these things can be just devastating for a person who is facing this, and often, there is a temptation to want to just face this is in silence, to not speak of it and not seek that help. And it is just really important to access the supports that are available like a urologist, psychologist, whoever you are comfortable talking to about this. Finding what your options are.
Female: We know that diabetes causes blood vessel disease and that may be a big part of the problem. It is also quite common that some of the medications we put people on, in particular, some of our blood pressure medications, will also lead to the problem. It is very important that you feel comfortable talking to your physician about that. Certainly, it can be uncomfortable for men to talk to female physicians and I do think it is important that female physicians ask patients whether they are having this problem. These problems can often be dealt with quite easily, either with medication or even surgical or injection techniques that a urologist can offer.
Male: Nowadays, the modern era of medicine, majority of men can re-establish normal erectile function but it can require patient’s motivation to achieve those results. Many patients will often start off with a trial of caplet medications such as the PD5 class inhibitors. Common side effects would include red, rosy cheeks, changes in vision, a blue-green color tint to your vision which is temporary, more rare would be headaches. PD5 class inhibitors as a class were initially developed as cardiac medications to improve the blood supply to the heart. Ultimately, of course, there were shown not to be effective for the heart but were found to be effective for the treatment of erectile dysfunction. PD5 inhibitors are not a universal treatment for all men who suffer from erectile dysfunction. Some of them may be taking medications that preclude the uses of these drugs because of drug-drug interactions.
The next treatment most commonly used would be a prostaglandin gel which is injected down the urethra. This is clearly more potent than the PD5 inhibitors, but as not as potent as penile injection therapy, which would be the next treatment option in the step-wise progression.
Penile injection therapy involves injecting a small amount of medication in the base of the penis, on the side. The needle is very small and the amount of medication injected is very small. It is very easy to learn how to give the injection. Injection is typically given by the patient or the patient’s partner. Typically, one or sometimes a mixture of medication is injected.
Next treatment in line would probably be the “vacuum pump device”. The vacuum pump device is effective for some patients. Some patients however, find it uncomfortable.
The last treatment option is surgical insertion of a prosthetic device. There are two different types of prosthetic device. The first prosthetic device is a malleable device. There are no moving parts, there is no pump, and it cannot fail. The device is inserted in the spongy tubes of the penis and it is there permanently. The second type of prosthetic device requires the insertion of a mechanical pumping system that allows the penis to have an artificial erection by basically pressing a button that is hidden on the body, typically in the scrotum.
Female: If erectile dysfunction occurs, it is important to realize it occurs within a relationship. It does not just happen to the man. So, this is obviously going to have effect on their partner, as well. They need to have a relationship that they feel comfortable talking about this problem, but I think the bigger point is that the spouse generally needs to be involved in the diabetes diagnosis as well, and they probably should be coming to the physician’s office with the patient, and being comfortable bringing up issues such as this.
Male: I think it is very important not only to seek someone that you trust to discuss with, whether this is a professional or a peer, but it is not something that one should suffer in silence with because it is such a fundamental part of our human being—of our experience as a human being. And there are lots of options today to deal with. I think that is the hopeful part of it, is that by suffering in silence, one really denies themselves the opportunity to trust in very effective treatments today.
Male: One of the things that I really want to encourage is for men to take courage, to speak out with confidence that they are facing this issue, because there is real help available, both on the physiological side, speaking to your urologist or to your psychologist, someone you feel comfortable with that you trust, and not being afraid to talk about this issue.”
