Being your own advocate is imperative for women with diabetes, especially when it comes to gynecologic care. As soon as a young woman is ready to become sexually active, she needs to talk with her doctor about contraceptive options. This conversation should continue through the time when she is ready to stop taking contraceptives and prepare for a family.
Dear David and Aisha, I am a 39-year-old married man who has had type 1 diabetes for 22 years. My A1C levels run around 7.5%. About six years ago, I started having trouble with erections. Now they are very rare, even with ED pills. I know you say that there is more to sex than intercourse, and my wife and I still enjoy ourselves however we can. But we both miss the erections.
Talk about a win-win situation! It seems that many aphrodisiacs--herbs that boost sexual energy and function--can also bring down blood sugar, cholesterol, and/or blood pressure. At least four herbs have shown these double benefits in scientific studies.
Dear Diabetes Health, I am 62 years old. I was diagnosed with type 2 diabetes in 1997, and I am doing OK on metformin. My last A1c was 7.2 %. About a year ago, they put me on medicine for my blood pressure (which was 142/90) and for cholesterol. I started having less interest in sex, which I had really liked before.
Dear Diabetes Health, I am a 60 year old married woman who was diagnosed with type 2 diabetes eight years ago. In the last two years, I have lost interest in sex. I just don't feel like it, although I still like hugs.
Dear Diabetes Health, I am a 55-year-old man who was diagnosed with type 2 diabetes two years ago, and I think it made me depressed. The depression eventually got so bad that I didn't want to get out of bed in the morning. My doctor referred me to the psych clinic, where they put me on Paxil (paroxetine). The medication is helping my depression, but ruining my sex life. Basically, I can't get an erection, but I don't really care because I'm not interested anyway. I have no desire. My wife is still interested, however, and she is really upset about my lack of desire for sex. I don't like hurting her, and I don't want us to break up over this, but the depression was awful. I don't want to go back to that. What can I do?
Dear Diabetes Health, I'm 26 years old and engaged to a woman I've known since college. We live together, love each other, and have good sex, but now I'm having doubts. A year ago, she was diagnosed with type 1 diabetes. She started taking insulin, and it has been rough. Four times now she has started sweating and shaking and saying strange things. Twice this happened during sex.
Dear Diabetes Health, I hope you can help me. I am 49 years old and was diagnosed with type 2 five years ago. My husband still wants sex. I don't even want him to touch me. He is very mean to me. He yells at me and calls me names.
The first time that my fiancé Richard and I got, um, "intimate," I had some explaining to do. "Er, that's for my diabetes. So's that. And this thing. Oh, and this too." Richard was a bit overwhelmed. I think his exact words were, "Are you bionic or something?"
Dear Diabetes Health, I am 57 years old. About five years ago, I saw my doctor because I was feeling tired. My waist size was up, and I was not interested in sex. I almost never got an erection. The doctor diagnosed type 2 diabetes and put me on metformin. He also prescribed Viagra, which helped sometimes, but not all the time.
Dear Diabetes Health, Hello! I am 60 years old and have had type one for about 24 years. It has been quite some time since I had a relationship, and now I have one coming at me. The problem is, I am very dry. The commercially sold products don't seem to help, and Intercourse isn't comfortable. What do you recommend that I try? And what about a libido enhancer? I need this relationship to work because living alone is tough, and my partner likes his intimacy. Please!!!
Dear Aisha and David - I am a 22-year-old woman with type 1, on a pump. I've only had one real boyfriend, and we broke up two months ago. He said that my diabetes didn't have anything to do with it, but I'm not sure. I think that the lows scared him. Sex with him was good, but I don't have much to compare it with.
Dear Aisha and David: I am a 66-year-old woman who has had diabetes for over 64 years. My husband is 52. He wants sex two or more times day. I hate it. I have no sexual drive, and most of the time it is painful. It was not always like this, but he has always wanted more sex than any man I know! We talk about things, but he basically ignores a lot of what I say when it comes to sex. He is actually a very caring person and has put up with a lot considering all the complications I have after 64 years of diabetes. We have been together for 18 years (married for nine). He waits on me hand and foot. I have to tell him to let me do things myself!
A ten-year study that tracked 652 women with type 1 diabetes found that 35 percent of them reported some sort of sexual problem, including loss of desire (57 percent of those reporting problems), problems experiencing orgasm (51 percent), pain during intercourse (21 percent), reduced arousal (38 percent), or decreased vaginal lubrication (47 percent).
Dear Sex & Diabetes, I have had type 1 diabetes since the age of ten. When my husband and I were first married, I had no trouble with my sex drive. After the births of our three children, however, I noticed a big decrease in desire. I have also had a hysterectomy and have gained 50 pounds since we were first married. Do you think my weight has something to do with it? I really don't feel it is fair to put my husband through my lack of desire. He still seems to want me.
Many people with diabetes who have ditched multiple daily injections in exchange for an insulin pump regret not doing so sooner. Ask them why they didn't, and arguably the most common answer has something to do with vanity. Still, while many might feel overjoyed by their optimum blood sugar control, they're not in love with their new appendage and may struggle with self-image as a result.
Welcome to Diabetes Health's new column on sex and diabetes, by David Spero RN and Aisha Kassahoun. Once a month, we'll publish questions submitted by our readers, along with David and Aisha's responses. Send your questions to firstname.lastname@example.org and watch for their answers to appear in this column.
Avanafil, a pill that may permit diabetic men who are experiencing erectile dysfunction to engage in intercourse without the restrictions on food or alcoholic intake associated with other ED treatments, is entering a second phase 3 study-the crucial step before a drug manufacturer seeks FDA or European approval to market.
Until fairly recently, low testosterone in men (I call it "low T") was treated only in patients with severe and obvious T deficiencies, such as men with congenital hormonal conditions that affected their pituitary gland or those who had lost both testicles to trauma, tumors, or infections. However, as the medical community has learned more about the benefits of T therapy for men with less obvious causes of low T (e.g., improved sexual desire and function, energy, and body composition), there has been concomitant interest in how T relates to other medical conditions, including diabetes. It turns out that the relationship between low T and diabetes is quite involved, although the final chapter on the ultimate nature of the relationship is still to be written.
Do men with diabetes have special problems when it comes to sex? If so, are there special solutions as well? Bernie Zilbergeld, PhD, renowned sex psychologist and author of “Male Sexuality,” shares with us his extensive knowledge on the subject of male sexuality.
Among the many possible complications of diabetes is sexual dysfunction. It's
not talked about as much as something like neuropathy, so people (especially
women) often don't connect their sexual problems to their diabetes. And even if
they do, they often can't raise the topic with their healthcare team.
Diabetes Health would like your help in addressing the lack of information about women, sex, and diabetes. To that end, we've set up a survey on our website, packed with questions about how having diabetes affects your sex life and how you overcome the hurdles that diabetes raises.
When it comes to sex and diabetes, it’s sometimes hard not to
get discouraged. Estimates of the number of diabetic men who
experience sexual dysfunction range from 20 percent to a stunning 80
percent. And men with diabetes are three times more likely to
experience sexual problems than men without diabetes.
Although most research about the effect of diabetes on sex has
focused on men, some studies report that women are at higher risk
for sexual dysfunction than diabetic men. It’s high time that
the woman’s side of the story was given the attention that it
Jan and Kevin were starting to “get romantic” when Jan noticed that Kevin was, uncharacteristically, losing interest. His skin had become moist and clammy and his movements slowed. Jan ran for his monitor. Kevin checked his blood glucose—it was in the low 50s. Fortunately, he had some glucose tablets at the bedside and quickly treated his low.
Having a chronic disease like diabetes can put a great deal of pressure on a relationship. In fact the divorce rate for people with chronic diseases is known to be higher than that of the general population.
Despite the widespread publicity their condition has received, a high percentage of men suffering from erectile dysfunction (ED) have failed to seek treatment with prescription therapies. This failure to seek treatment is primarily attributed to the great difficulty men have discussing ED with their doctors.
The topic of sexual problems among women with diabetes has been highly underreported, says Lois Jovanovic, MD, from the Sansum Medical Research Institute in Santa Barbara, California. While nearly 2,000 studies addressing sexual dysfunction among men with diabetes have been published in the past five years, Jovanovic observes that a "paltry" 13 articles about sexual dysfunction among women with diabetes appeared during that same period.
Erectile dysfunction is a complication that affects 35 to 75 percent of men with diabetes. It is most often associated with diabetic neuropathy and peripheral vascular disease. According to the February 3 issue of the Journal of the American Medical Association (JAMA), erectile dysfunction occurs at a younger age in men with diabetes than in men without the disease.
Viagra, the first oral medication for impotence, was approved by the U.S. Food and Drug Administration (FDA) in March. In clinical studies, 64 to 72 percent of the patients successfully completed intercourse after taking Viagra.
During the expensive and highly coveted Super Bowl commercial air-time viewers saw everything from Jerry Seinfeld hanging with Superman to chameleons hawking Budweiser beer. One thing viewers didn't see, however, was a commercial on impotence.
Now impotence sufferers have another valuable ally. VIVUS Inc. has received clearance from the U.S. Food and Drug Administration (FDA) to market its new product MUSE (Alprostadil), a urethral suppository for the treatment of impotence.
Hope may be in store for men who experience one of the most common side-effects of diabetes: impotence. In the past, men have relied on mechanical devices and injections to boost their sex lives, but a new drug called sildenfil may offer aid without the need for pumps or sharp needles. Pfizer Inc. from Sandwich, England, was testing a drug for angina, the chest pain preceding a heart attack, when the subjects of the study reported an unexpected bonus: improved erections.
The Pos-T-Vac is a simple device intended to help men overcome erectile dysfunction. According to its manufacturer, Pos-T-Vac, Inc., it is "easy to use, non-invasive... even those with severe arthritis can have a return of normal sexual activity with a very user-friendly system along with the most comfortable constriction band available."
A recent study reported in the September 1995 issue of Diabetes Care by David S.H. Bell, MB, at the University of Alabama, may have answered a question long debated by diabetes researchers. It has been known for some time that long-term diabetes complications rarely occur before puberty. Whether this is a result of the short duration of diabetes before puberty or because pre-puberty diabetes simply does not cause complications has remained a controversial question.
Female hormones are both a blessing and a curse. They make us feminine and fertile, but they upset our diabetes control. With each monthly cycle, insulin needs are influenced heavily by changing hormone levels.
Few studies have looked closely at female sexuality and diabetes. What are the special issues that arise? In this interview, Eileen Walko, MD, and Daryn Stier, MSW, LCSW, poignantly discuss what all women with diabetes should know.
Do men with diabetes have special problems when it comes to sex? If so, are there special solutions as well? Bernie Zilbergeld, PhD, renowned sex psychologist and author of Male Sexuality, shares with us his extensive knowledge on the subject of male sexuality.
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