For many men, a diagnosis of diabetes can be overwhelming enough in itself. From learning about treatments to discovering how to manage the condition, it can feel like a lot.
With all the new learning, one thing that can sometimes be overlooked is the link between diabetes and erectile dysfunction (ED). But it’s important to understand the connection and what you can do about it, so that a diabetes diagnosis doesn’t affect your sex life.
What is diabetes?
Diabetes is a condition where your blood glucose level (blood sugar level) is too high. There are two types of diabetes, which develop in different ways and affect the body differently.
Type 1 diabetes
Type 1 diabetes accounts for around 8% of diabetes cases in the UK (1). It’s an autoimmune disease where the body mistakenly attacks the cells of the pancreas that produce insulin, stopping them from making it. Insulin is the hormone that lowers blood sugar levels. Without it, they stay elevated.
Most people with Type 1 diabetes are diagnosed in childhood, and symptoms appear quickly. They need to use insulin and must monitor carbohydrate intake to keep blood sugar levels stable.
Type 2 diabetes
Type 2 diabetes is more common, accounting for 90% of cases (1). It develops when the pancreas does not produce enough insulin, or when the body becomes resistant to it. It typically develops later in life and progresses more gradually.
Lifestyle factors, genetics, ethnicity and obesity can all influence the risk. Management may involve lifestyle changes alone, oral medication, injectable treatments, or insulin, depending on severity.
How are erectile dysfunction and diabetes connected?
Erectile dysfunction is common, but especially so for men with diabetes. Diabetes UK reports that men with diabetes experience erectile dysfunction (ED) up to three times more than those without (2). There isn’t usually one single cause. Instead, several factors linked to diabetes can affect erectile function:
It can damage blood vessels: Over time, persistently high blood sugar levels can damage blood vessels throughout the body, including those involved in erections. If blood vessels are damaged, they may not dilate properly, reducing blood flow and making erections more difficult to achieve or maintain (2).
It can cause nerve damage: Nerve damage (known as diabetic neuropathy) is another common contributor. As erections depend on signals travelling between the brain and the penis, disruption to those pathways can make it difficult to get an erection. Neuropathy-related ED is significantly more common in men with diabetes compared to those without (3).
It can lower your testosterone levels: Some men with diabetes, particularly type 2, may also experience lower testosterone levels (4). Reduced testosterone can lower your sex drive, energy levels and overall sexual function. While low testosterone isn’t the sole cause of ED, it can make it harder to get an erection.
It can impact your mental health: Living with a long-term condition like diabetes can be exhausting and overwhelming, affecting your mental health. This is more likely to cause sexual problems in women with diabetes, but poor mental health can contribute to ED in men (2). This is known as psychological erectile dysfunction.
For many men with diabetes, ED is caused by a combination of physical and psychological factors.
The psychological impact of diabetes and ED
We’ve mentioned that living with diabetes can take its toll emotionally. Managing blood sugar levels, worrying about long-term complications, and navigating daily lifestyle adjustments can be stressful. Over time, this stress can affect confidence, mood and overall well-being.
When erectile dysfunction enters the picture, it can add another layer of strain. Many men with ED describe feelings of embarrassment, frustration, loss of confidence, and performance anxiety. These negative feelings can put a strain on their relationship as both partners try to navigate the knock-on consequences to their sex life, intimacy, and connection.
This can make a cycle, with anxiety making erections harder to achieve, even if the original cause was primarily physical. For men with diabetes, the relationship can work both ways:
Diabetes can increase the risk of ED physically and mentally
ED can impact mental health, even if diabetes didn’t
Poor mental health can worsen erectile difficulties
Breaking that cycle often requires addressing both the physical and emotional aspects. This might involve medication, better diabetes management, counselling, or a combination of approaches.
If you feel stress or low mood may be playing a role, speaking to your GP is an important step.
Treatment options for diabetes-related erectile dysfunction
The good news is that ED linked to diabetes is treatable. It can often be improved by managing diabetes well and keeping blood sugar levels within a healthy range, be that with insulin, lifestyle modifications, or both. If needed, erectile dysfunction medicines can also help (5).
The most popular and effective treatments for erectile dysfunction are sildenafil and tadalafil. These two medications can support your sex life without affecting your blood sugar levels. They also don’t interact with standard diabetes medicines, making them a safe option for many men with diabetes.
Both these ED pills belong to a group of medicines called PDE5 inhibitors, are taken shortly before you plan to have sex, and work by temporarily improving blood flow to the penis. The main difference between these medicines is how long they help you get an erection:
Sildenafil typically works within 30 to 60 minutes after taking it and lasts up to four hours.
Tadalafil can last up to 36 hours, giving it a longer window of opportunity.
Importantly, sexual stimulation is still required for these medicines to work. They support the physical response but don’t create desire on their own. While slightly less effective in men with diabetes, working best when the nerves and blood vessels are healthy, they can help many men with diabetes improve their erections.
Is daily tadalafil an option if you have diabetes?
Instead of taking a tablet before you have sex, some men with ED prefer to take a small dose of tadalafil once daily. The idea is that there is always a steady level of the medicine in the body, allowing for less planning and more spontaneous sex.
For men with diabetes and erectile dysfunction, daily tadalafil is known to generally be safe and effective, and may even help with blood sugar control (6). It might be particularly helpful if:
You suffer from erectile dysfunction regularly
You prefer not to plan sex around medication timing
You want a more consistent effect
However, suitability depends on your overall health, current medications, and risk for cardiovascular problems. You’re always required to have a clinical assessment before prescribing.
Taking the next step
Understanding the link between diabetes and erectile dysfunction is the first step. The next is speaking to a healthcare professional about treatment.
You can consult your GP or use a private service such as Oxford Online Pharmacy to explore your options discreetly. Over 32,000 customers trust our UK-registered doctors and pharmacists. Patient safety and confidentiality are at the centre of everything we do.
👉 Explore our erectile dysfunction treatments or complete an online consultation today.
FAQs
How does diabetes affect a man sexually?
Diabetes can affect sexual function by damaging blood vessels and nerves, lowering testosterone levels, or contributing to psychological stress, all of which may impact erections. Speaking with us or with your GP will help you pinpoint exactly how your diabetes is affecting you sexually.
Can a diabetic man be sexually active?
Of course, there is no reason why a man with diabetes cannot or should not have a healthy sex life. With proper diabetes management and appropriate treatment for ED if needed, you can get back your erections and confidence in the bedroom.
Does sildenafil work for diabetic erectile dysfunction?
Yes, sildenafil is one of the most popular treatments for diabetic erectile dysfunction, along with tadalafil. Both of these medicines can be taken shortly before sex and increase blood flow to the penis when sexually aroused. Alternatively, you can try taking a low dose of tadalafil daily.
References
Diabetes UK. How Many People in the UK Have Diabetes? [Internet]. Diabetes UK. 2023.
Diabetes UK. Diabetes and Sexual Problems – in Men [Internet]. Diabetes UK. 2018.
Zamponi V, Mazzilli R, Balducci S, Faggiano A, Haxhi J. Diabetic Neuropathy and Erectile Dysfunction: Unveiling the Neural Pathways Behind a Vascular Symptom. Journal of Clinical Medicine [Internet]. 2026 Feb 20 [cited 2026 Mar 1];15(4):1621.
Testosterone and Diabetes. [Internet]. Diabetes.co.uk. 2019 [cited 2026 Mar 1].
Diabetes and Erectile Dysfunction. [Internet]. Diabetes.co.uk. 2019. [cites 2026 Mar 1].
Lee MK, Lee JH, Sohn SY, Lee SY, Jeong TY, Kim SC. Effect of low-dose Tadalafil Once Daily on Glycemic Control in Patients with Type 2 Diabetes and Erectile dysfunction: a randomized, double-blind, placebo-controlled Pilot Study. Diabetology & Metabolic Syndrome. 2022 Apr 21;14(1).