Male Sexual Dysfunction in Diabetes Mellitus

Male sexual dysfunction can be classified in the following categories: erectile dysfunction (ED); orgasmic and ejaculatory dysfunction; priapism; and decreased libido. Of these various dysfunctions, more patients with ED are likely to seek medical attention. ED, or impotence, is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual function1. In recent years, there has been an escalated awareness of ED, partly attributed to the advent of ViagraTM and its associated promotion. The impact of ED can be appreciated by the estimation that its prevalence in men 40 to 70 years old is 52%, based on the Massachusetts Male Aging Study.2 Based on these data and United States population projections for the year 2005 of more than 50 million men 40 to 70 years old, ED will affect more than 25 million men, and millions more over the age of 70. The projected worldwide prevalence of ED for year 2025 will be staggering at 322 million men. Certain patients are found to have a significantly higher prevalence of ED; for example, diabetic men command a more than threefold increase in risk of ED than their nondiabetic counterparts. Indeed, diabetes mellitus is the single most common cause of ED.2 More than 50% of diabetic patients are afflicted with some degree of ED, and approximately 50% of the patients evaluated at our Center for Male Sexual Dysfunction are diabetic.