Purpose: Erectile dysfunction occurs earlier in men with diabetes than in the general population, affecting over 50% of male patients by age 60. This article summarizes the etiologies and presents methods of patient assessment and treatment options for erectile dysfunction.
Methods: Assessments of neurologic and vascular complications related to diabetes should be included in a sexual function history. The assessment must be holistic and focus on organic as well as psychogenic causes. Diabetes educators must be prepared to discuss the various pharmacologic treatment options.
Results: Sildenafil currently is the only oral medication available for erectile dysfunction. Injectable treatments have proven successful but with limited long-term use and poor patient acceptance. Implantable devices carry surgical risk and increased rates of infection.
Conclusions: All men with diabetes should be screened for erectile dysfunction. The availability of a new oral medication provides a patient-acceptable treatment option.