There are so many things to manage when you have a long term condition like diabetes that for some people, sex gets relegated to the back burner. For others, sex and being intimate is at the top of their list.
Diabetes and sex
Issues with sex can happen to anyone and can be embarrassing and frustrating. Having diabetes can sometimes seem to make it more difficult to maintain intimacy and your sex life. If this sounds familiar, don’t give up yet - there are things you can try to help ease the problems.
Men and sexual dysfunction
For men, diabetes can cause damage to the nervous system over time, this is known as neuropathy. This damage can affect the erectile tissue in the penis making it difficult to achieve or maintain an erection until ejaculation. Erectile dysfunction (ED) is a widely reported problem for men with diabetes. ED can be a presenting symptom of diabetes and in some cases diabetes is diagnosed when the man seeks treatment for ED.
There are different treatments for ED so with support and management of glucose levels through diet, physical activity and medication, minor sexual problems usually recede and it is possible for the man to achieve and maintain an erection.
Women and sexual dysfunction
For women, a common sexual problem is vaginal dryness caused by hormonal changes or from blood flow problems to the genitals. Use lubricant liberally to deal with vaginal dryness. Water-based ones are best and there are lots of different brands available. It doesn’t matter how much you use - sexual activity can often require large amounts.
For some women with diabetes, vaginitis (inflammation of the vagina) can be recurrent. Bacterial vaginitis occurs due to yeast infections and thrush is the most common of the conditions. This can make sex painful, and is heralded by itching or burning sensations. Cystitis can also be a recurrent problem for women with diabetes. There is some evidence that shows, in a similar way to men being unable to maintain an erection, the woman’s clitoris may fail to respond to stimulation.1
Many women find that their glucose levels can be more difficult to manage just before or during their periods. Women with diabetes can take the contraceptive pill to regulate their cycle and it is an effective form of birth control.
Sex and hypos
Sex, like other physical activities, can cause hypos (low glucose) during sex or afterwards. So although it sounds a little unromantic or lacking in spontaneity, test your glucose level before and after sex to help prevent hypos happening during an intimate time. If you are worried about night hypos try to avoid having sex just before you go to sleep. You may have more energy at a different time of the day too! Sharing you concerns with an understanding partner should help. If you have a new partner, try not to hide your diabetes - be as open as possible.
1 Fundamentals in diabetes. Part 4: Sexual dysfunction http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/1518/files/pdf/jdn15-10-387-90.pdf