Can Taking Insulin Cause Erectile Dysfunction?

The more you learn about how erections work, the more you realize it's not just one function but an interdependent series of functions. In fact, so many systems have to work together to ensure proper erections that it's easy to get lost in the sauce trying to isolate a single cause of erectile dysfunction (ED).

For starters, you need proper circulation, nerve function, hormonal function and psychological function. Issues such as smoking, obesity, diabetes, medications, drug and alcohol use, anxiety, depression, relationship issues and poor sleep can all affect erectile function.

With so many potential causes of ED, it's little wonder guys run to the internet with all kinds of search questions, including whether taking insulin can cause erectile dysfunction. And you can't really fault their logic: If cigarettes, antidepressants, opioids, alcohol, depression and fighting with my boss might cause it, why not insulin?

We'll look at whether insulin and erectile dysfunction might be linked, some other potential issues that might be factored into the equation and how guys can help themselves get better erections.

Connecting insulin and erectile dysfunction

Insulin is a hormone your pancreas makes that helps your body process glucose (sugar) by "unlocking" your body's cells and allowing them to convert glucose into energy. People whose bodies can't produce enough insulin have trouble performing this unlocking step, leaving the sugar to accumulate in their bloodstream, a condition called hyperglycemia.

Over time, high blood sugar can develop into diabetes. As the disease progresses, many patients need outside insulin, taken by injection or another method, to control their glucose levels.

Let's cut to the chase: Can insulin cause problems with erectile function?

"Quite simply, the answer is no, insulin doesn't cause erectile dysfunction," said Justin Dubin, M.D., a urologist and men's health specialist with Memorial Healthcare System in South Florida. "But I can definitely see why people may think that."

To highlight why there is an assumed link between insulin and ED, we can look at a large 2023 meta-study on the side effects of taking insulin. Researchers found that a tiny percentage of men reported erectile dysfunction as a side effect; out of 49,604 people reporting insulin side effects, 74 reported ED, representing 0.15 percent of the whole.

BuEven that number, though, is probably overstated. That's because diabetes—the reason for taking insulin in the first place—is a well-known cause of ED. If your blood sugar control issues have reached the point where insulin is necessary, it's likely you already have issues with ED due to diabetes, not insulin.

"Diabetes is a common cause of ED, and people taking insulin for their diabetes tend to have more significant diabetes," said Amy Pearlman, M.D., a men's health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida.

More significant diabetes probably means your baseline blood sugar levels are elevated, which is another risk factor for ED.

"Hemoglobin A1C is a test used to measure blood sugar levels over the past two to three months," Dubin said. "Typically, with people with diabetes, you want to keep them at 7 percent or lower for their hemoglobin A1C. For people without diabetes, you want it to be much lower than that. The point being that if you have poorly-controlled diabetes, your A1C is higher, and there are studies showing that a higher A1C is also associated with worse erections."

Why does diabetes cause ED?

There are three main side effects of diabetes that can have an impact on a man's erections: nerve damage, blood vessel damage and hormonal disruption.

Nerve damage, aka neuropathy, is critical because you need well-functioning nerves in your penis to get good erections. If you can't feel sensations in your penis as well as you could before you developed diabetes, that process isn't going to be as straightforward.

"High blood sugar levels can damage your nerves," Dubin said. "When we think about nerves and diabetes, usually we think about people's hands, feet and eyes, but guess what? The nerves in your penis are much smaller, so those are often the first ones to go when it comes to diabetic neuropathy."

Similarly, the tiny blood vessels that are critical for carrying blood to the penis when it's time to get an erection may not work as well due to diabetes.

"ED is the canary in the coal mine for heart disease, heart attacks, things like that, because the vessels in your heart are much bigger than the vessels in your penis," Dubin said. "And often, the first thing to go with blood vessel damage is the penis. Having diabetes contributes to that."

Finally, diabetes affects your hormones. Diabetes is a major risk factor for low testosterone, which is an important component of any healthy sexual function in men.

The takeaways with insulin and erectile dysfunction

It makes sense that a person taking insulin might wonder if it's responsible for his ED.

If your analysis stops there, though, you're missing perhaps the most critical factor: the diabetes for which you're taking the insulin. If guys want to ensure they keep their erectile function tip-top, they should keep a close eye on their diet, get plenty of exercise, keep their body weight under control and get tested regularly if there are any signs of potential high blood sugar.

Remember: Diabetes doesn't mean the end of your sexual health.

"Having diabetes is one thing—having poorly controlled diabetes is another," Dubin said. "The best thing you can do to protect your erections and protect your sexual health is to see that it's under control."