Women, Sex, and Diabetes

The content of this column might not be suitable for younger readers.

| Feb 1, 2007

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 deserves.

Women are complicated sexual beings who need to be comfortable both physically and psychologically in order to enjoy sexual health. Diabetes can erode a woman’s sexual well-being from both directions, and it’s important to know the ways in which you can keep yourself up and running sexually in the face of these potential problems.

Just Relax: It’s the Best Medicine

First, let’s examine the psychological ways in which diabetes can steal the sense of ease that you need to feel sexually alive. Fear of rejection based on your diabetes is the most obvious one, and is best handled by being upfront from the beginning with your partner about your condition and your regimen. It is also important to let your partner share in your care, so that he or she doesn’t feel excluded. A partner usually doesn’t react well to being shut out. Letting your partner in might help you relax a little too, which is no easy task when you’re used to being “on” all the time, watching your own body like a hawk. It’s hard to let go of that constant scrutiny long enough for sex. Sometimes directed relaxation exercises can help, or perhaps frequent massages, which can teach you to focus on your body in a sensual way.

The Hardware Can Be Hard to Wear

Anyone with a pump knows the hardware of diabetes can be a distraction. An infusion set stuck to one of your erogenous zones, with tubing just waiting to be yanked off during a tender moment, can really kill the mood. Each couple needs to work through this individually, but there is a DVD out there in which a former Miss America with diabetes, Nicole Johnson Baker, reveals how she and her husband eroticized her pump and discusses other issues surrounding sex and diabetes.

The DVD, which is produced by dLife and is called Sex, Intimacy, and Diabetes, also discusses such potentially awkward subjects as how to talk to your doctor about sexual problems. Its a good resource if you find yourself kind of shy about the subject at hand and need a little boost to get you going. (You can order it on the Web from dLife or from the Public Health Foundations Learning Resource Center.)

Complications Make It Complicated

Complications of diabetes can also throw a wrench into the sexual works. Diabetic neuropathy, for one, can lead to poor bladder control, an inconvenient condition that certainly doesn’t increase one’s libido. In such cases, it’s a good idea to urinate before intercourse (and 30 minutes afterward, if you can bring yourself to get up, because it’ll help prevent urinary tract infections).

Neuropathy can also damage the nerves that stimulate the genitalia, so lubrication fluids aren’t released and intercourse becomes painful. This is easily rectified by the use of KY Jelly, or Astroglide, a water-soluble lubricant by Biofilm, Inc., which has worked for many women. Sometimes it’s not neuropathy, but hormone levels that cause the dryness. If that’s the case, there are new low-dose estrogen therapies on the market which have no negative effects for women with diabetes. Of course, you must work with your doctor when beginning estrogen because hormone therapy research is coming up with new recommendations all the time.

Another really unpleasant complication of diabetes is frequent vaginal yeast and urinary tract infections, because bacteria just love the sweet environment that’s present in your urine and vagina if your sugar’s a little elevated. There’s nothing like a yeast infection to make you not want sex. Luckily, there’s Monistat and Gynelotrimin and, if necessary, prescription Diflucan, an oral medication for recurrent yeast infections. Once you enter menopause, you might have even more vaginal infections, so eat yogurt, bathe a lot, and discuss hormone replacement therapy with doctor.

Many diabetic women are taking medications that have the side-effect of dampening sexual response. Among these are compounds to achieve better blood glucose control, to promote cardiac or kidney health, and to alleviate the depression that sometimes afflicts women who are struggling with diabetes on top of everything else. If you lose sexual feeling or interest for reasons you cannot pinpoint, be sure to talk to your doctor and learn if perhaps your medications can be altered and your sexual life restored.

Prescriptions for Good Sex

When neuropathy has reached the point of numbness, or circulatory damage has begun to impair blood flow to the sexual organs, there is no need to despair. All those pills and devices to restore sexual functioning aren’t just for men anymore. In fact, Viagra (although not yet approved by the FDA for women) is being prescribed for some women because it increases blood flow to the vagina, enhances sensation, and increases vaginal lubrication. And there’s actually a device for women now, called the Eros-CDT (clitoral therapy device), which in 2000 became the first treatment for female sexual dysfunction approved by the FDA. It’s a small pump with a tiny plastic cup that uses suction to stimulate blood flow to the clitoral area. It can help women reach orgasm, and it may prevent fibrosis from building up in arteries leading to the clitoris. Talk to your doctor about Viagra and the Eros-CDT if you think either one might help you regain your pleasure in sex.

Feeling Fine Without Going Low

And what about the $64,000 question: how does hypoglycemia affect sex? Not positively. For one thing, you don’t want to have a hypo and mistake it for an orgasm—and you sure don’t want to have an orgasm and mistake it for a hypo. Check your blood sugar right before sex just to be certain. But if you don’t really want to do that, it might be wise to adjust your insulin downward before you have sex, or compensate by eating something beforehand.

Diabetes is a complicated disease, women are a complicated sex, and sex is just plain complicated. But with care and knowledge, women with diabetes can enjoy a long and happy sex life. Wouldn’t it be nice if they’d study us as much as they study the men, though?

How Was It For You?

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.

Please fill it out, because we will use the results for a future article about how diabetes impacts our readers when it comes to sex. And be sure to write us if you have any thoughts or experiences to share that might help our readers with this deeply human problem, or comment on this article, below. After all, you are the ones who know how it is.

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Categories: Blood Glucose, Diabetes, Diabetes, Insulin, Low Blood Sugar, Nerve Care (Neuropathy), Sexual Issues

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Feb 1, 2007

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