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Erectile Dysfunction (ED) Pre-diabetes 29 year old

Hi All

   I started masturbating when 20 yrs (porn and imagination in shower) and now I just turned 30 (5'10.5, 197 pounds, BMI 28%). Also, I have had happy ending massages since 24 yrs old (1 or 2 per month) but have never been able to ejaculate when the lady strokes. I have had some sexual encounters but I cannot ejaculate during penetration sex or BJJ .. I finish myself. I snore loudly for past 5 years and its sleep apnea and was prediabetic in 2012 but with diet and exercise I was ok in Jan 2013 (160lbs) but then tried to get big and now am 197 lbs with pre-diabetic range blood sugars.
            I used to never think about erections at all until Feb2013 -  during sex ... my penis was just semi hard ... and her BJJ .. HJ and penetration did not get it hard ... Ever since I have tried to have sex but even if I am hard initially, I will go semi hard in 5-10 minutes. So I tried to use the liquor store male enhancement pill (Zen) this gives me the hard erection for about 3-4 days but also gives me unusual headaches, tingling at fingers tips and lower back pain which is not at all pleasant. Are these pills at liquor stores safe for use?  Anyway, now during porn I might get erections (not very hard like before) which last for sometime (5-10 mins) and then go soft, but with girl I will be semi hard then go soft soon or nothing at all. I cannot anymore get hard by grinding, or just making out with a girl.

my question ..I think My ED is mostly due to pre-diabetic and/or Sleep Apnea .. so if I reverse my pre-diabetic will I be able to achieve normal erections again?  or is the damage to my arteries irreversible?  Also, is there any exercises diet that will help my ED condition now?   Also if you can suggest any tests to confirm my ED with pre-diabetes I will get it done.

Please advice Thanks much
6 Responses
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563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Thanks for posting your query.

I can understand your concern for the erection problems that you are having at a young age.

It is true that diabetes can cause erectile dysfunction but even people with prediabetes may experience erectile dysfunction (ED). This is because nerve damage can occur even before a type 2 diabetes diagnosis, when a person has prediabetes. Poorly managed blood sugar control can damage the blood vessels and nerves, including the blood vessels and nerves in the penis. This type of nerve damage can prevent a man from getting and sustaining an erection.

But good news is that both Insulin Resistance and Pre-Diabetes can be reversed, thereby often removing underlying causes of ED. Try to lose some weight. Also moderate exercise for 30 minutes a day, such as cycling, swimming, or brisk walking, helps prevent diabetes. Lastly healthy meals that mix a balance of low-fat protein, vegetables, and whole grains can help prevent prediabetes from becoming diabetes. Calorie control, portion sizes (no super-sizing), and low-sugar, low-carbohydrate diet should be eaten.

Then erectile dysfunction is also common in patients with obstructive sleep apnea. Sleep apnea induces hormonal alterations, deviations in neural regulation, endothelial dysfunction, and changes in microvascular perfusion that can cause or contribute to the development of erection problems.
Now you are having two contributing factors for erectile dysfunction but luckily these are both reversible or treatable. The most common treatment and arguably the most consistently effective treatment for sleep apnea is the use of a continuous positive airway pressure (CPAP) device. In addition to CPAP, a dentist specializing in sleep disorders can prescribe Oral Appliance Therapy (OAT).

So please contact your doctor if you have not done it before so that treatment can be started.

There are no exercises for the penis which can help in erectile dysfunction but doing moderate exercises may help in regularizing blood sugar levels which can reverse erectile dysfunction. Also do not take any over the counter drugs as it may be having potential more dangerous side effects which you are already having due to the drug.

Lastly, at your age and with your previous sexual history, it can be psychological as performance based anxiety. If your morning erections are good then the cause is psychological.

The psychological causes can be due to unrealistic sexual expectations, which make sex a task rather than a pleasure, negative feelings about non performance, smoking, alcohol and sometimes illicit drugs. Talk to your partner openly about any fears or apprehensions, eat nutritious healthy food,exercise regularly and cut down on smoking or alcohol if you are taking it.

Hope that this information helps and hope that you will get better soon.

Wishing you good health.


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Avatar universal
Snoring prolly 8 years now NOT 5 yrs ... Thx
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Avatar universal

  Hi Doctor Kaur

   My morning erections were not very good for past one year and the last time I experienced a morning erction is prolly 2-3 months ago. Would you change your opinion of it prolly being psychological  (performance anxiety). Please let me know. Thanks much

    I am working hard to reverse pre-diabetes with good food and 20 mins cardio and 40 mins weight training.
I am using an Over the counter MAD (madibular advancement device) which helps only little with snoring .. I will look into custom device from dentist. Thx much for ur suggestion.
Helpful - 0
Avatar universal
Lastly Doctor Kaur

    Can I see doctor and try Viagra (if its safer than OTC pills) .. I just need to use for couple months cause I have a new GF ... thanks much
Helpful - 0
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,

Thanks for writing back with the additional information.

If your morning erections are also affected then chances of erection symptoms being due to psychological reasons are less. In your case, prediabetes seems to be the main culprit with sleep apnea being another cause. But we also need to rule out certain medical conditions. These include high blood pressure, heart or thyroid conditions, poor circulation, low testosterone, metabolic syndrome, enlarged prostate and neurological causes.

In that case, you should consult a urologist and get blood tests, urine analysis, ultrasound penis and overnight erection test done.
The commonly prescribed drug by the doctors is sildenafil or Vardenafil (Levitra), which causes erections to be stronger and long lasting. However it may not be effective if you have uncontrolled diabetes, very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension), heart disease or heart failure, stroke or you are taking any nitrate drugs for angina, blood-thinning (anticoagulant) medications, antihypertensives or alpha blockers for enlarged prostate. So you can take Viagra but take it under a medical supervision.

I sincerely hope that helps. Take care and please do keep me posted on how you are doing.



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Avatar universal
Thx doctor kaur ... I'll come back with my tests .. Thx
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