Erection problems, also called erectile dysfunction or ED, are common in men with diabetes. Especially those with type 2 diabetes. High blood sugar over a long period of time can damage the nerves and blood vessels. This damage causes problems with getting or keeping an erection firm enough for sex.

Erectile dysfunction also can be caused by high blood pressure and heart disease. These conditions are common in men with diabetes. Although age can contribute to ED, erectile dysfunction often occurs earlier in men with diabetes. Men might notice problems with erections before getting diagnosed with diabetes or heart disease.

Living with erectile dysfunction can be a real challenge. You and your partner might feel upset or let down. But you can cope with ED. Take steps to get your sex life back on track.

Many men don't want to talk about erectile dysfunction. Even to a health care provider. But don't be embarrassed. Get help. One small conversation can make a big difference. Here's what to do:

• Tell your health care provider what's going on. Your provider will look at your whole health picture. You might get insight on health conditions, testosterone levels or medications that cause your erectile dysfunction. A provider will give you information and ideas for treatment. Find out your options.
• Ask how you can better manage your diabetes. Better blood sugar levels can help protect your nerves and blood vessels. When damaged, these cause erectile dysfunction. You'll feel better overall and improve your quality of life. Ask your provider if you're taking the right steps to manage your diabetes.
• Ask about other health issues. It's common for men with diabetes to have other chronic conditions. Some might cause or worsen erectile dysfunction. Work with your provider to stay on top of other health issues.
• Check your medicines. Ask your doctor about your medicines. They could be causing your erectile problems. Some drugs, such as those to treat depression or high blood pressure, are known to cause ED. Changing your medicines might help.
• Seek counseling. Anxiety and stress can make erectile dysfunction worse. Erectile dysfunction can put strain on both you and your partner. A psychologist, counselor or other mental health provider can help you and your partner cope.

There are many ways to treat erectile dysfunction. Ask your provider if one of these options might work for you:

• Oral medicines. Erectile dysfunction medicines include sildenafil (Viagra), tadalafil (Cialis, Adcirca), vardenafil or avanafil (Stendra). Oral medicines are pills that you take by mouth. These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see if one of these medicines is a safe choice for you.
• Other medicines. If pills aren't a good option for you, your health care provider might recommend a tiny suppository. You insert this into the tip of your penis before sex. Another possibility is medicine you inject into the base or side of your penis. Like oral medicines, these drugs increase blood flow that helps you get and keep an erection.

• Vacuum-erection device. Also called a penis pump or a vacuum pump, this device is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection.

  Then, a band is placed at the base of the penis to keep the erection after the tube is removed. This hand- or battery-powered device is simple to use and low risk.

  If a penis pump is a good choice for you, your provider might prescribe a certain model. That way, you can be sure it suits your needs and is well made.

• Penile implants. If medicines or a penis pump won't work, a surgical implant might be an option. Semirigid or inflatable penile implants are a safe and effective option for many men with erectile dysfunction.

When it comes to your health, a few changes can make a big difference. Try these tips to improve your overall health and your ED:

• Stop smoking. Smoking and other tobacco use narrows your blood vessels. So, less blood can reach your penis. Also, smoking lowers your body's levels of nitric oxide. Nitric oxide signals your body to let blood flow to your penis. Less nitric oxide means less blood flow. Less blood flow can cause or worsen erectile dysfunction.

  If you've tried to quit on your own but can't, don't give up. Ask for help. There are lots of ways to help you quit, including taking medication.

• Think about what you eat. There's no one-size-fits-all diet plan for a person with diabetes. But a provider can offer the right blend of carbs, protein and fat for your health. And they can tell you which kinds of foods are the best match for you.
• Lose excess pounds. Being overweight can cause or worsen erectile dysfunction.
• Get moving. Exercise helps other conditions that can cause erectile dysfunction. It boosts blood flow while helping lower stress and weight. Start where you are. A provider can help create a plan that works with your abilities.
• Stop drinking or cut back. Alcohol can impact erectile dysfunction. If you choose to drink alcohol, balance is key. For healthy adults, that means up to one drink a day for men older than age 65. Or, up to two drinks a day for men age 65 and younger.