• Diabetes can cause nerve and artery damage in the genital area, disrupting the blood flow necessary for an erection. This is more common in older men who have had diabetes for a long time. High cholesterol, high blood pressure and obesity - all common among men with diabetes - as well as smoking, can contribute to the problem.
• Some men with diabetes experience retrograde ejaculation, which means that the ejaculate goes backward into the bladder instead of being discharged during climax. This condition does not affect orgasm, but it can make it difficult to father a child.

• People with diabetes (particularly men whose disease is poorly controlled) may have too little or too much of certain hormones, such as prolactin, testosterone or thyroid hormone. Generally these conditions can be treated with pills.
• Certain drugs for heart problems, high blood pressure, anxiety, depression, pain, allergies and weight control sometimes cause impotence. Switching medications may solve the problem.
• Stress and other mental health problems can cause or worsen sexual dysfunction, as can smoking and alcohol use.
• Physical problems not caused by diabetes, such as accidents that injure nerves, prostate surgery, and spinal cord injuries, can cause impotence.

Vacuum erection device. The man puts a plastic tube over his penis and creates a vacuum by pumping the air out. The vacuum draws blood to his penis. This makes it erect. He then places an elastic band around the base of his penis to maintain blood in the penis and keep it firm.

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