I am 41 years old, have had type 1 diabetes since age 10, and have experienced problems gaining and maintaining an erection. We have only recently got married, and my wife is very understanding. We still enjoy being intimate, but is there any treatment to improve this situation or is it something we will both have to live with?

Your question is a common one. The short answer is no, you do not have to just settle for the problem. Although diabetes is associated with both vascular and neurologic problems, the most likely problem causing the erectile dysfunction is diabetic neuropathy. I would suggest you see a urologist or someone familiar with treating erectile dysfunction.

Medications such as Viagra have been very helpful in patients with diabetes. However, there are important safety issues which need to be discussed with your doctor. Other therapies include a vacuum pump, intercavernous injections, or penile prostheses. The benefits and risks of these treatments need to be discussed with your physician.

JTL