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Sex and Diabetes


Apr 14, 2009

Diabetes Health’s new column on love and diabetes is written by David Spero RN and Aisha Kassahoun (pictured here).

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 love@diabeteshealth.com and watch for their answers to appear in this column. 

Dear Sex & Diabetes,

My husband was diagnosed with type 2 diabetes seven years ago and put on oral medication. We've had some sexual problems since then, and lately there has been no sex at all. He says that he doesn't want it or need it. We had a very good sex life before this.  What can I do? I think we all need intimacy in our lives. At least I do. I don't feel that it is fair to me to be left high and dry, and I want to do something to help him.

High and Dry in Tennessee

Dear H and D,

Yours is a sad and very common story. Diabetes can impact our sex and love lives physically and emotionally.  But there are ways of maintaining and even improving sex and intimacy with diabetes. 

Here are some possibilities to consider:

  • How good is your husband's diabetes control? High sugars can drag a person down so he doesn't feel like doing anything physical, including sex. If his glucose is up, he probably won't be down for loving. 
  • How physically active is he otherwise? Maybe he needs to get his body moving. Exercise can make him feel more positive, improve his blood sugar control, and increase his sexual desire. 
  • He might be depressed. Is he being treated for that, and if so, how? Depression kills desire, and sometimes antidepressant medicines (especially the SSRIs) can knock out sex drive. Blood pressure medicines can also have sexual side effects.
  • Quite possibly he is reacting to erection problems by withdrawing, without admitting that's the reason. Diabetes can make erections (and lubrication in women) more difficult. Some men will say "I don't want to" when they really mean "I'm afraid I can't."
  • His testosterone level may be low. Many men and women with diabetes are low in testosterone and consequently have low sex drive.  
  • Other relationship issues and other emotions might be involved.  There may be anger, grief, fear, or disagreements in your lives that interfere with his wanting you. These feelings could be his, yours, or both of yours.     

Talk about it

Your husband seems to be hurting, but he is not being fair to you. You two really need to talk about how you feel. You may want to start by saying something like, "I really love you honey, and I hear you when you say that you don't want or need intimacy, but I do. What are we going to do?"  You may want to seek help with this conversation or follow-up conversations from a counselor or diabetes educator. 

Your doctor might be able to help with a testosterone level check and maybe a change of antidepressant or blood pressure medicine. Perhaps your husband could benefit from one of the erection drugs. These drugs (sildenafil, or Viagra, tadalafil, or Cialis, and vardenafil, or Levitra) work well for most men and some women (although they are not approved for women). They're worth a try at least. Unfortunately, some doctors are not comfortable talking about sex. If you sense that yours isn't, ask him firmly to refer you to someone who is. 

Try something new

If you're willing, you can enjoy non-intercourse ways to have sexual pleasure. Hopefully, you and your husband are open to trying new approaches. There are things you and he can do with your hands, mouths, other parts of your body, and with toys that don't require erections and can give both of you a lot of pleasure, closeness, and orgasms. Here's a good starter article on sexual touch.  All these things work best if you explore, talk about them ("I really like this." "I really want to try that."), and treat it as play. 

But how do you get him interested in the first place? It's important to set aside time both for pleasure and for talking about issues in your relationship. If you try to jump into bed after a hard day, with tense feelings and with all your concerns unmentioned, you are not going to have good sex. Even healthy twenty-five-year olds can't do that. 

Try making a date. Set aside some time for loving but honest talk. Maybe put on some music. Dancing is a good way to get him moving and in the mood. (And it's great exercise!) Take a shower together. Use your imagination. 

Bottom line: Don't give up. Sex problems are just like all the other problems that diabetes and life throw at us. We can manage them with some creativity, courage, and communication.  Keep trying, keep talking, and see what happens.

We encourage you to send questions pertaining to love and diabetes to love@diabeteshealth.com. And by the way, this column isn't just for couples. Single people with diabetes have love and sex issues too. 

David Spero is a nurse who has lived for 30 years with multiple sclerosis.  A leading expert on self-care, he has written two books, Diabetes: Sugar-coated Crisis, and The Art of Getting Well. He has learned to maintain and even improve sex and love despite disability and illness. 

Aisha Kassahoun is trained in marriage and family therapy. Aisha and David present sex and intimacy programs for people with diabetes, people with multiple sclerosis, and  health professionals.  

Visit David and Aisha on-line at http://www.davidsperorn.com or  http://sexandintimacy.vpweb.com. You can read David's blog at http://www.diabetesselfmanagement.com/blog/David_Spero


Categories: Beginners, Blood Sugar, Diabetes, Diabetes, Living with Diabetes, Losing weight, Love and Diabetes, Sexual Issues, Type 2 Issues



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Comments

Posted by AnnetteUK on 20 April 2009

I have had Juv/Diabetes for 51 years and by following 'the' advise, being very active.. an avid walker and dancer .. you know... the oldie but goodie CD's .. Meatloaf, Roy Orbison etc... my sex-life is still enjoyable and a regular part of my life!!

I am in the harvard/joslin 50 year diabetes study and when I go there for numerous tests next week I will certainly let them know that 'it' and laughter have been/are my best free non toxic drugs!!
50% of it is in our heads... :)
AnnetteUK

Posted by Anonymous on 20 April 2009

I love the article, it explains a lot. I am a women with diabetes and I have a low sex drive.

Posted by Anonymous on 20 April 2009

WHY DO WOMEN WITH DIABETES HAVE TROUBLE STAYING MOIST DURING INTERCOURSE

Posted by Anonymous on 21 April 2009

Just saying im dibetic and have absolutly no problem staying "moist" (hahaha well i am 16) during sex but i am kind of curious if cum has any carbs because i allways swallow (well for oral)and someone told me it has suger in it but im not sure if their confused and its just protin that will eventully be broken down into suger

Posted by Anonymous on 22 April 2009

I have had diabities for 8 years. There are times of depression that I just give up. If not for the love and understanding of my life mate, I surly wouldn't have come this far. The care and understanding of her heart has made the differance. d.Morgan San Diego ,Ca

Posted by Anonymous on 25 April 2009

I definitely have no problem staying "moist" but the reason SOME diabetic women might have trouble remaining that way is due to vascular damage in the vagina caused by poor blood sugar control and/or having diabetes for a long time. It could also be poor circulation and lack of blood flow to the fun spots. I believe that if you change a few of these words, the above statements apply to men with diabetes, as well.

Not all diabetic women have low sex drives, either... ;-)

Posted by Anonymous on 26 April 2009

This is a fairly interesting advice but touch and all intimacy fades over time when intercourse is no longer possible for him.........silence, resentment and detachment replace what was a warm intimate marriage. He has given up. He has no interest. I want more than he can can or will give .......there are no answers for men who withdraw. After 2 years of no intimacy I am ready to walk. There is no hope as there are no medical fixes for him...Sadly I could have coninuted the marriage without the sex but not the cold lack of intimacy......Sadly for many men intercourse is the only route to intimacy. I do not want to share his cold detached world any longer......of course he could get treatment for depression which would mean adding drugs that also kill erections but I guess you can not kill something dead like out marriage more than once.

Posted by volleyball on 27 April 2009

A lot of the problems are going to happen whether diabetes is part of your life directly or indirectly or not.
The people who have been making poor health choices will find it catches up with them.
Once people face the reality that what they could do at 18 is no longer possible, then they can move onto different things.
After decades of exciting their man with just an ok I will, they need to think more like a man and learn seduction techniques. And be willing to face some rejection.
If there is willing, there is ALWAYS a way. It may not be movie scene perfect but there is no reason it should be.

Posted by Anonymous on 12 December 2009

I have had ED to some degree or the other during most of our 16 yr. of marriage. It is not impossible -- I'm just not the 20 yr. old stud I once was now that I'm 60. We still have a pretty neat sex life, though, through understanding & desire to please each other. There are those as components and, frankly, there is a very heavy duty, commercial vibrator that helps in the most difficult of times. Hopefully, My situation will be better as I get my diabetes under control, too.


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