For two years, I have had periods when I felt sexually weak. I don’t get a proper erection. This goes on for a few months and then the problem suddenly disappears. For few months, it works normally and then, again, it reappears. I’m afraid of having sex now. What is really going on?

Although I’m not getting A1c tests regularly, these are the results of the few A1cs: February 2003 – 13; March 2004 – 7; October 2006 – 11; and March 2008 – 9.

The problem of erectile dysfunction is a complex one. It is well known that diabetes, especially if the blood sugars are elevated for a long time, can involve the nerves that control male erections. However, since having an erection is a complex physiologic process, other factors may enter into your difficulty with having an erection. For instance, patients with diabetes have an increased rate of depression. This can cause your ability to be interested in sex to diminish. Your libido, or sex drive, is also controlled by other hormones. You could potentially have a deficiency of testosterone that makes this worse. You may be on medications that do not diminish your sex drive, but they affect the ability to have an erection. Many of these are blood pressure medications used to lower blood pressure. This problem is not easily solved with a simple answer. I would suggest you see your physician for a more detailed review of your particular situation. There is a good chance you may get some benefit, whatever the cause for the problem might be.

JTL