Good Vibrations Magazine

Many people aren’t aware of the impact that diabetes can have on their sex life. Like anyone else, people with diabetes may find it difficult to talk to their physician about their sex life.

Much of the information that has been available about sex and diabetes has focused on erectile dysfunction in diabetic men. And, in fact, it is estimated that half of all diabetic men over age 50 do have erectile dysfunction — it’s one of the leading causes of ED in men. But women also experience many sexual symptoms of diabetes, including decrease in sexual desire, vaginal dryness or tightness resulting in pain during penetration, difficulty reaching orgasm, menstrual problems and a greater tendency toward yeast and urinary tract infections.

Still, don’t think that all these problems have to add up to a diminished sex life. The sexual difficulties associated with diabetes can often be dealt with by taking relatively simple measures. That includes erectile dysfunction, which men sometimes think will spell an end to their sex life. But there are many, many ways to be sexual, and with a little exploration, you can keep your sex life as exciting as ever.

Sexual Concerns for Diabetic Men and Women

The most important thing that you can do to maintain your sex life, whatever your gender, is to maintain good glucose levels. Like other forms of exercise, sexual activity can cause blood glucose fluctuations, so be aware of that possibility and be sure to let your partner know that you’re diabetic. Keep a supply of glucose tablets or appropriate snack foods near the bed. And, if you fear you’re having a hypoglycemic reaction, however uncomfortable it may be to check your blood glucose while you’re in the middle of having sex, it’s better to be sure. You can always pick up where you left off — with renewed confidence.

Aiming for good long-term glucose control, however, is much easier than trying to take action to control it while you’re making love. Long-term control will do the most toward keeping you healthy and sexually active.

Sexual Concerns Specific to Diabetic Women

One of the most common sexual concerns women with diabetes have is difficulty in reaching orgasm. While this can sometimes be related to diabetic neuropathy in the genital region, it is often the culmination of other symptoms.

First, vaginal dryness and tightness can lead to discomfort during penetration and rubbing, not to mention difficulty reaching orgasm. If you enjoy focusing on penetration during sex, water-based lubricant should help. If you do focus on penetration, now might be a great time to explore other forms of touch, including clitoral or vulva stimulation, not to mention incorporating sensation all over your body: breasts, nipples, back, buttocks, anus, arms, legs, face. You might want to try a vibrator or some sensation toys, with a partner or alone. Even if you prefer clitoral or vulva stimulation, lubricant can greatly decrease any discomfort you’re feeling. And if you do choose to have intercourse or other forms of penetration, try experimenting with different positions; being on top of your partner may make it easier to relax your vaginal muscles and may decrease tightness.

However, if you find that you can’t reach orgasm through direct clitoral stimulation that could be a sign of diabetic neuropathy, a problem with the nerves of the clitoris. Mention it to your doctor right away.

Second, a greater tendency toward urinary tract infections and vaginal yeast infections can cause plenty of sexual discomfort. If you’re experiencing UTIs, try urinating before and after sex; it helps flush any bacteria out of the urethra. Even if you don’t experience UTIs, urinating before and after is a good idea because it may help prevent them. If you have cloudy or bloody urine or feel like you constantly have to urinate, you should contact your doctor immediately; any of these may be signs of a serious infection.

Yeast infections are an overgrowth of the body’s natural organisms. Since the growth of those organisms is tied to sugar, the best thing you can do to prevent and control yeast infections is to maintain good long-term control of your blood glucose — see above.

Thirdly, you may note an increase in blood glucose levels immediately prior to your monthly cycle. As mentioned above, this may cause yeast infections or other problems related to high blood glucose. If you experience this, your doctor may indicate that you should plan to increase your insulin during these days (if you have insulin-dependent diabetes). Similarly, menopause can affect your blood glucose control. If you’re starting to go through menopause, make sure that you talk to your doctor about your diabetes and how menopause may affect it.

Sexual Concerns Specific to Diabetic Men

Again, the most common sexual side effect mentioned in the diabetic literature is erectile dysfunction in men. While there are many sexual options open to a man regardless of whether he can get an erection, many times men with erectile concerns don’t feel empowered to explore them. But now might be the time for you to explore other ways of being sexual with your partner or alone, including stimulating erogenous zones other than your penis.

But even so, erectile difficulties do present a great concern for many diabetic men; if you’re worried about difficulty attaining or maintaining an erection, it may be hard to enjoy other forms of sex. Erectile dysfunction in diabetic men comes from either circulatory (blood) or neurological complications. One notable fact is that high blood sugar levels can interfere with the transmission of sensory messages through the nerves. What that means is that even if you’re aroused, your penis might not be getting hard — not because of a circulatory problem, but because it’s not getting the message that you’re turned on. High blood sugar also interferes with circulation, making it more difficult for the blood to flow properly into the penis.

All of these problems may contribute to a performance anxiety that makes erectile dysfunction worse. For that reason, my earlier recommendation to focus on other kinds of stimulation is doubly important, because enjoying your body may help lessen that anxiety.

For Further Help

If you find that simple techniques such as those mentioned in this article aren’t helping with your sexual concerns around diabetes, ask your doctor to refer you to a qualified sex therapist. Many sex therapists have specific training in diabetic concerns, and may be able to help you more than your primary care physician or endocrinologist would.

The most important recommendation, however, is to maintain ownership of your sexuality. Often when we have health problems, we get the sense that sex should be the last thing on our minds. This view may be exacerbated by the discomfort many health care professionals feel about discussing sexual concerns. Try to remember that it’s your sexuality, and you have as much right to a vibrant sex life as anyone. In fact, maintaining your sex life and enjoying yourself is one of the best things you can do for your health.