Male impotence

Erectile dysfunction (ED) is defined as the persistent inability to achieve and/or maintain a penile erection sufficient to permit satisfactory sexual performance (1)

• although a benign condition, ED may have a significant impact on the quality of life of the sufferers as well as their partners
• ED is also considered as an early warning sign of potential cardiovascular disease (1)

Erection requires an intact parasympathetic reflex at S2 and S3. Ejaculation requires an intact sympathetic L1 root.

Diabetes and erectile dysfunction

• diabetes has been associated with sexual dysfunction in men including increased risk of erectile dysfunction
  • a study found a prevalence of almost 60% for ED in a hospital-based cross-sectional observational study conducted at a tertiary care centre including 357 diabetic men recruited over one and half years (2)
    • note that study evidence has also reported a higher prevalence of female sexual dysfunction in diabetic women than non-diabetic women (3)

Reference:

• (1) European Association of Urology (2014). Guidelines on Male Sexual Dysfunction: Erectile dysfunction and  premature ejaculation
• (2) Parmar R et al. Prevalence of erectile dysfunction in Type 2 diabetes mellitus (T2DM) and its predictors among diabetic men. Journal of Family Medicine and Primary Care 11(7):p 3875-3879, July 2022. | DOI: 10.4103/jfmpc.jfmpc_1130_21
• (3) Enzlin P, Rosen R, Wiegel M, Brown J, Wessells H, Gatcomb P, et al. DCCT/EDIC Research Group Sexual dysfunction in women with type 1 diabetes:Long-term findings from the DCCT/EDIC study cohort Diabetes Care 2009 32 780 5