Can Metformin cause erectile dysfunction?

Can Metformin cause erectile dysfunction?
Published : Feb 03, 2024
Last Updated : Feb 28, 2024

Erectile dysfunction is a common sexual problem among males, and 18% of men over age 20 in the united states face Ed. Many factors can contribute to causing male impotence.

Physical and psychological factors and using certain medications may develop the risk of Ed.

In this article, we will discuss such medications that may affect your sexual responses. Medication like Metformin, a diabetic drug, can affect penile blood flow. Also, Metformin may have an impact on the testosterone levels of a person. Read on to know more about Metformin and does it cause erectile dysfunction in males.

What is Metformin?

Metformin is a diabetic medication that helps to lower blood glucose levels. It increases insulin sensitivity within the body, allowing its natural occurrence and its proper use in our body. The administering of Metformin during treatment therapy efficiently controls blood sugar levels. 

Uses of Metformin

Metformin is commonly prescribed for a person who has type 2 diabetes. Patients who have Type 2 diabetes face the problem of being insulin-resistant. It means insulin doesn't work effectively in their bodies, and blood glucose levels keep increasing. Insulin is a hormone the pancreas produces to control blood sugar levels after you eat. In this patient, the insulin is still released but is ineffective at removing blood glucose. 

 Thus, using Metformin can help increase the body's insulin sensitivity. It improves glucose absorption into cells without affecting insulin production in the body. 

 But other medications, such as Sulfonylureas, can cause hypoglycemia which means low blood sugar. It happens because Sulfonylureas may have an impact on the production of insulin. 

 So Metformin is one of the safer choices for diabetic patients, and a doctor may suggest it with a combination of other drugs.

 In addition, Metformin is also used off-label to treat gestational Diabetes. Even this diabetic drug has shown potential as an anti-oncogenic (anti-caner) therapy. 

 Diabetes and erectile dysfunction

Diabetes is a metabolic disease affecting the production and function of insulin in our bodies. When our body does not produce enough insulin or efficiently uses the created insulin, then the levels of blood glucose are difficult to control. 

 It often leads to excess blood glucose(Hyperglycemia), and over time, Hyperglycemia may cause serious damage to the body. It can cause damage to the heart, eyes, nerves, and blood vessels. A person having Diabetes faces multiple complications. It includes cardiovascular risk, obesity, and hypertension problems. 

 Among certain complications led by Diabetes, a lesser-known side effect of Diabetes involves erectile dysfunction(Ed). According to the studies, Ed is 3.5 times more common in men with Diabetes than men without it. And more than half of men who are suffering from Diabetes get affected by erectile dysfunction.

 In diabetic patients, the causes of Erectile dysfunction can vary. It can range from physical, hormonal, and psychological complications impacting your sexual response and functioning.

 Physical complications often linked with Diabetes are damage to the blood vessels and nerves that supply the penis. Hyperglycemia is the prime cause of macrovascular and microvascular problems in diabetic patients. It may include the large blood vessels supplying the heart and smaller vessels like those in the penile region. By affecting these blood vessels, Diabetes may cause a risk of Erectile dysfunction. 

 Hyperglycemia may affect penile blood vessels in the following ways-

  •  It can damage endothelial cells and may inhibit the product of nitrous oxide. Nitric oxide is generally released during sexual stimulation, as a single to cause the vascular smooth muscle of the corpora cavernous to relax. Thus, the increased blood flow into the penis enables and causes an erection. Damage caused due to Hyperglycemia can affect this part of erectile function. 
  • Plaque buildup in the penile blood vessels (atherosclerotic luminal narrowing) may reduce the blood flow into the penis. 

 There can be peripheral neuropathy(nerve damage) due to advanced Diabetes in individuals. It can affect sensory impulses from the penis and reduce the contractile force of the penile muscles. Thus, it can make it harder for the muscles to hold the blood in the penis to cause an erection. As a result, a person would struggle to maintain an erection and suffer from impotence. 

Can Metformin cause erectile dysfunction(ED)?

Metformin is commonly used to increase insulin sensitivity in type 2 diabetic patients. However, insulin isn't the only hormone Metformin affects the body. 

 During use of Metformin, it can inhibit a key enzyme that helps in testosterone synthesis. As a result, it may reduce circulating testosterone. 

 Lower testosterone levels can affect sex drive and penile blood flow, and it may develop complications of Ed. But other diabetic drugs, like Sulfonylureas, which are not commonly prescribed, are not found to have the same effects on testosterone. 

How does Metformin help erectile dysfunction?

In contrast with the above-given information, some studies also found Metformin helpful for Ed in diabetic patients. Metformin can alleviate erectile dysfunction by helping diabetic patients. 

 Metformin improves insulin sensitivity and helps reduce insulin levels by properly using it. As a result, it relieves Hyperglycemia which can stop further damage to the blood vessels and nerve cells in the penile tissue. 

 Treatment with Metformin can help with erectile dysfunction by

 Increasing the blood flow to the penis by protecting the endothelium-dependent vasodilation.

Improving sympathetic nerve activity regulation improves erectile dysfunction in diabetic patients.

 Is Metformin safe to use to treat erectile dysfunction?

As you know now, it's generally a safe medication for people with Diabetes. It can effectively control blood glucose levels and may increase insulin sensitivity. And helps prevent Hyperglycemia, which can damage the penile tissue over time and cause Ed.

 However, it is not recommended to use Metformin to treat nonvascular or neuropathic Ed. And recent studies have found that Metformin can reduce testosterone levels. So it is inappropriate to use such during the treatment of Ed.

Several medications are well-tolerated by diabetic patients and can help treat Ed. It includes Ed Drugs such as Viagra(Sildenafil) and Cialis(Tadalafil), Levitra(Vardenafil), etc.

 Along with medication, a healthy lifestyle is essential to reduce the progression of Diabetes and Ed. Anyone who takes Metformin for Diabetes and notices worsening erectile dysfunction should consult a doctor soon. You can also seek other treatment options if Metformin affects your erectile function.

Some FaQs

Can I take Viagra while taking Metformin?

In a clinical study, researchers observed that men with Insulin-resistant had significant improvement in erectile function when Metformin was added to Sildenafil(Viagra). The use of Metformin can increase the activity of Sildenafil, and one must consult a doctor before using them together.

What is the safest drug for erectile dysfunction for Diabetes?

Cialis is generally found to be a safe drug for erectile dysfunction as it does not alter blood sugar levels in diabetic people. Cialis containing Tadalafil can also be used by people who are taking insulin.

Is Metformin good for erectile dysfunction?

Metformin can improve Ed by managing some side effects of Diabetes that can lead to Ed. It reduces the amount of blood glucose by improving the body's response to the sugar-regulating hormone(Insulin).

Final Lines

Metformin is a medicine widely prescribed in people to manage type 2 diabetes. The impact of this diabetic medicine on erectile dysfunction (ED) is complex. According to some studies, Metformin may contribute to ED by inhibiting testosterone synthesis. However, others indicate its potential benefits in improving insulin sensitivity. It also reduces hyperglycemia-related damage to the blood vessels and nerves in the penile tissue. So, by looking over the potential risks and benefits of Metformin on ED, the importance of individual treatment approaches.
Diabetic patients who experience a worsening of Ed while taking Metformin should consult with a doctor. They must explore alternative medications or combination therapies to reduce the potential risk of this drug. Additionally, maintaining a healthy lifestyle and considering well-tolerated ED drugs can be an effective way. It may help in the overall management of both diabetes and erectile dysfunction at the same time. Moreover, expert guidance and supervision are necessary.


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