Treating ED. There are several treatments available. In choosing a treatment, find one that is most compatible with the needs and desires of both you and your partner.

There are several drugs available for treatment, and many men with diabetes have found them to be effective. Sildenafil (Viagra)  and vardenafil (Levitra)  can help to stimulate and maintain an erection 30 to 60 minutes after taking a pill.

Tadalafil (Cialis) is similar but lasts for up to 36 hours. Ask your provider about these drugs if ED is a problem for you.

Another option is to inject a form of the drug alprostadil directly into the penis. This induces an erection that lasts about 30 minutes to 1 hour. Side effects include bruising and prolonged erection. Some men also develop scarring in the penis, which occasionally results in a permanent curvature during erection. There is a suppository form known as muse that can be inserted in the tip of the penis 5 to 10 minutes before sex.
Another option uses a vacuum pump to create an erection.

A cylinder is placed around the penis. A small vacuum pump pulls air out of the container, creating a vacuum. This causes blood to flow into the penis, triggering an erection. To maintain the erection, the container is removed and replaced with a rubber band. This provides an erection for about 30 minutes.

The rubber band can cause bruising if kept on for more than 30 minutes. Entrapment bands or external support devices are also available.

You can also have a pump device called a penile prosthesis surgically implanted into the penis to produce erections. Your best bet is to visit a urologist with experience in this type of implant. Be sure to ask about the risks, which can include infection and the need for further surgery in case the device doesn’t work correctly.

Testosterone injections or patches can be prescribed if a low hormone level is the problem. The injections are usually given every 3 to 4 weeks. Men are at risk for prostate cancer and should not take testosterone unless they have abnormally low levels and have been evaluated for prostate cancer.

It may also help for you and your partner to work with a therapist who knows how to deal with sexual issues.

All the treatments for impotence have risks or drawbacks.
You may decide to seek no treatment. Some men and their partners choose to express their sexuality in ways that do not involve intercourse. If you do want to consider treatment, you need to tell your provider even if you are not asked. Your provider can only help you if you let him or her know about your concerns.

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Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association

American Diabetes Association Complete Guide to Diabetes