The Link Between Nerve Damage and ED

Also called neuropathy, nerve damage is not uncommon in those with type 2 diabetes, especially when the disease is poorly controlled. In fact, about half of all individuals with diabetes develop some form of neuropathy.

But nerve damage can also affect individuals who have high blood pressure, high cholesterol, and  who smoke, explains Elizabeth Kavaler, MD, a urology specialist at Lenox Hill Hospital in New York City. Metabolic syndrome—in which a person has several health conditions simultaneously, such as high blood pressure, high cholesterol, and diabetes—is consistently linked with nerve damage, she says.

When a person's blood sugar is too high, the walls of microscopic blood vessels that feed the nerves are injured. And the nerves that instruct the muscles about when and how to move, stop working properly.

Unfortunately, nerve damage doesn't only affect the legs, fingers, and the toes. It can also cause erectile dysfunction (ED), or impotence, in which a man is unable to have or keep an erection.

"The causes of erectile dysfunction are two-fold," Kavaler explains. "The actual nerves in the penis can get injured from the overload of sugar in the blood, and the tiny blood vessels are also affected."

Normally, during an erection, blood flows into the penis and stays there, explains Marwan Atallah, MD, co-director of the Stone Center at SUNY Downstate/University Hospital of Brooklyn in Brooklyn, NY. "In a man with diabetes, the nerve endings are affected so that when the patient gets an erection, even if he has good circulation and the penis fills with blood, the nerve that stimulates the muscle to keep the blood in the penis can fail," Atallah explains.

Those with type 1 diabetes typically are not as often affected by neuropathy since they tend to be thin and compliant about their treatment, Kavaler says, whereas men with type 2 tend to be overweight and have other health problems.

But you can help delay the progression of neuropathy by making lifestyle changes, Kavaler says.

"Often if men lose weight and start exercising, they'll have good results and much less nerve damage resulting in ED," Kavaler says.

In addition to losing weight, Atallah advises his patients to stop smoking if they smoke. The goal is to get to a normal weight, he says.

"Men who are obese have a higher chance of having ED than men who are slim," Atallah explains.


"Living with Diabetes: Neuropathy," American Diabetes Association.

"Living with Diabetes: Erectile Dysfunction," American Diabetes Association.