Erectile Dysfunction
EDP column by Dr Ketan Dhatariya

“I have recently experienced some problems in getting an erection. My GP tells me this is because I am a smoker and am overweight with diabetes. Why is this?”

The ability to get an erection is dependent on several different things. It depends on a working nerves to pick up the sensations as well as to control the blood flow to the specialised tissue that expand when blood enters the penis. An erection also depends on an adequate blood supply.

In people who are smokers, then the build up of cholesterol and other fatty materials along the lining of the blood vessels makes the diameter of the blood vessels smaller and so less blood can get to the places it is needed. In people who have diabetes, this build up of fatty material lining the blood vessels happens much more quickly and at a younger age, so people with poorly controlled diabetes also can experience problems getting an erection. In addition, in people with poorly controlled diabetes, the nerves can die off, so the area can lose sensation, as well as a loss of the ability to increase the blood supply to the area.

Finally, the other important part of being able to achieve an erection is the hormone testosterone. This hormone is found in men and women and is responsible for sex drive – libido in both sexes. In people who are overweight, the blood chemistry changes to lower the amount of testosterone in the blood so lowering libido and the ability to get an erection. 

There are several treatments available that may help. The single most important thing you can do to help your heath is to stop smoking. This can be done using nictotine replacement, such as patches or gum, or your GP may start you on some tablets that you need to take for a few weeks that reduce the craving.

Next, it is important to lose weight. This is hard work, but is a combination of eating a little bit less with each meal and doing a little bit more between meals.

Next, is to make sure your diabetes is kept as good as it can be, your GP and practice nurse can help you to get things better.

Finally, your GP may try you on a number of different medications to help you get an erection. These drugs work by increasing the blood supply to the penis. They only work if there are good blood vessels to allow the blood to flow. As I have mentioned, they may not work for the other reasons mentioned.

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