Erectile dysfunction (ED) is a common problem for people with diabetes, but several treatments can help.

ED involves trouble maintaining an erection for sexual activity. The cause may be psychological or physical.

Keep reading to learn more about how ED pills work and which are most suitable for people with diabetes.

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Medication may benefit people with diabetes who experience ED.

During arousal in males, the brain sends signals that cause more blood to flow into the penis, the blood collects and becomes pressurized, leading to an erection.

In a person with ED, something is impeding this process. Medications can help by relaxing blood vessels to increase blood flow to the penis.

ED pills are often phosphodiesterase type 5 (PDE5) inhibitors. These block the PDE5 enzyme, which helps control blood flow.

Disrupting this enzyme causes the smooth muscle in arterial blood vessels to relax, increasing blood flow. Meanwhile, the veins constrict, causing a mismatch in blood flow that leads to penile rigidity.

Most people who take ED pills do so before sexual activity. In this case, it is still necessary to be aroused for the pill to work.

Males with diabetes are three times more likely to experience ED than males without the condition. In some cases, high blood sugar levels cause nerve or blood vessel damage that leads to ED.

Other factors, such as smoking and having overweight or obesity, can also increase the risk of ED. In addition, people with diabetes are more likely to have high blood pressure or cardiovascular disease, and the treatments for these may lead to ED.

Most people with diabetes can take ED pills, but it is essential to talk with a doctor first, as these medications can affect a person’s heart rate and vision and may interact with other medications.

Learn more about the connection between ED and diabetes here.

Some ED medication options include:


Sildenafil (Viagra) is a PDE5 inhibitor. It starts working after about 30 minutes and the effects last for up to 4 hours.

It is effective for treating ED, but some side effects include:

  • hot flashes
  • a runny or stuffy nose
  • headaches
  • muscle and back pain
  • dizziness
  • nausea
  • vision problems

In rare cases, side effects can be serious. These can include chest pain and painful erections that last several hours.


Tadalafil (Cialis) is another PDE5 inhibitor for ED. Like other drugs in this class, it treats ED by relaxing blood vessels and increasing blood flow to the penis.

The effects can last for up to 36 hours, and some people take this medication daily to treat both ED and urinary problems associated with prostate enlargement. Cialis may be more convenient for people who regularly engage in sexual activity.

Cialis can cause side effects, including:

  • indigestion
  • a stuffy or runny nose
  • hot flashes
  • a cough
  • headaches
  • arm and leg pain
  • muscle pain


Levitra is the brand name of vardenafil, another PDE5 inhibitor for ED. People take Levitra about 60 minutes before sexual activity.

Side effects of Levitra include:

  • hot flashes
  • a stuffy or runny nose
  • headaches
  • stomach problems
  • muscle and back pain
  • vision problems


Avanafil (Stendra) works more quickly than most other PDE5 inhibitors, taking effect within 15–30 minutes. It is not available in generic form and can be more expensive than the other PDE5 inhibitors.

Stendra can cause side effects, including:

  • a stuffy or runny nose
  • hot flashes
  • headaches
  • back and muscle pain
  • nausea
  • vision problems

Each ED medication can cause side effects, and people with diabetes may face additional risks.

For example, PDE5 inhibitors can interact with several other drugs, including nitrate-based medications. These are commonly used to treat high blood pressure, which frequently affects people with diabetes.

Anyone with diabetes should speak with a doctor before taking medication for ED.

Beyond medication, a person may be able to reduce or eliminate ED with the following approaches:

  • Making lifestyle changes: It can help to quit smoking, engage in regular exercise, and lose weight, if necessary.
  • Improving blood sugar control: This can help in the long term.
  • Going to counseling: ED can have emotional or psychological causes that counseling can address.
  • Changing medications: ED can be a side effect of medication, in which case a doctor may change the dosage or the type of drug.
  • Trying devices: Vacuum devices use suction to draw blood into the penis.
  • Having injection therapy: Medications, either singly or in combination, can be injected into the penis to cause an erection.
  • Undergoing surgery: If all other treatments are ineffective, a doctor may recommend a surgically implanted prosthesis, which can reliably generate an erection.

A person with diabetes and ED may benefit from taking standard ED medication. However, these pills can cause side effects and there are additional risks for people who take certain medications for high blood pressure.

It is essential to speak with a doctor before taking ED medication.