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Review
. 2022 Feb;38(2):e3494.
doi: 10.1002/dmrr.3494. Epub 2021 Sep 21.

Erectile dysfunction and diabetes: A melting pot of circumstances and treatments

Giuseppe Defeudis  1 , Rossella Mazzilli  2 , Marta Tenuta  3 , Giovanni Rossini  1 , Virginia Zamponi  2 , Soraya Olana  2 , Antongiulio Faggiano  2 , Paolo Pozzilli  1 , Andrea M Isidori  3 , Daniele Gianfrilli  3
Affiliations
Review

Erectile dysfunction and diabetes: A melting pot of circumstances and treatments

Giuseppe Defeudis et al. Diabetes Metab Res Rev. 2022 Feb.

Abstract

Diabetes mellitus (DM), a chronic metabolic disease characterised by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aims to review the definition and prevalence of ED in DM, the impact of DM complications and DM treatment on ED and, finally, the current and emerging therapies for ED in patients with DM.

Keywords: PDE5 inhibitors; diabetes; diabetes complications; diabetes treatment; erectile dysfunction; hypogonadism.

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Conflict of interest statement

All authors declare no conflict interests.

Figures

FIGURE 1
FIGURE 1
Diabetes and erectile dysfunction: a complicated connection. The major complications and comorbidities related to diabetes (DM) that contribute to erectile dysfunction (ED) are shown in the figure. The graphic representation shows the major diabetes (DM) complications and comorbidities that contribute to ED. DM complications are associated with endothelial impairment and can be distinguished in macrovascular (cardiovascular events) and microvascular (nephropathy and neuropathy). The major diabetes comorbidities which lead to ED are hypogonadism, metabolic syndrome (obesity, hypertension and dyslipidemia), obstructive sleep apnoea and depression. The picture shows how the single pathologies are strictly interconnected: thus, increasing the incidence of ED with the number and severity of comorbidities as indicated by arrows, each individual disease can worsen DM complications and increase the incidence and number of comorbidities, thus increasing the incidence and severity of ED. Abbreviations: CV: Cardio Vascular; MetS: Metabolic Syndrome; OSAS: Obstructive Sleep Apnoea Syndrome; UTI: Urinary Tract Infection
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