Sex & Diabetes: Not Wanting It

NOT saying what you feel CAN hurt you and damage your relationship.

| Jul 10, 2009

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! 

I am blind from the diabetes, in stage 4 renal failure. I recently had a mild myocardial infarction. A month ago, I had to have an exploratory surgery for rectal bleeding. I do a lot of walking and other exercise, and my A1c is usually under 6%, thanks to an insulin pump.

Any suggestions?

Not Wanting Sex

Dear NWS,

Our first thought was that your husband is breaking some kind of record for insensitivity.  Even without renal failure and heart attacks, nobody should have to engage in sexual behavior that is painful and unwanted just to make someone else happy.  That view of women's role has been over for 40 years!  Your husband has a right to get his needs met, but there are other ways that might work for both of you. 

On second thought, though, we feel for both of you. Your husband is probably very scared and sad about what is happening to you. (The phrase "freaked out" comes to mind.) He may be trying to treat his anxiety with sex. He may also be using sex as a form of denial. "You can't be that sick if I can still do this to you." 

You both have a tremendous amount of pain to deal with around your complications. We know, because David's MS complications cause similar problems for us. You need to talk about your feelings honestly.

Remember, words can never hurt you if they're said with love. But NOT saying what you feel CAN hurt you and damage your relationship. You two have a lot to communicate about, and you might consider professional help. Most therapists don't deal well with chronic illness OR sex, however, so finding good help might be challenging.

You told us how well you are self-managing, and it's remarkable. You should be proud of what you have accomplished. Could it be, though, that you are not showing your own pain and fear, so much so that your husband has to be afraid for both of you? 

There are things you can do to maintain intimacy and meet your husband's needs. Could you say, "Look, I'm not [having intercourse] with you. That's not going to happen. But I can do some hot things to you with my hands (or mouth, or toys), and a lot of kissing and stroking."

Are you interested in that? Because you might be able to have a sex life that works for both of you that way. If even non-intercourse sex seems too much, could you just hold him or talk sexy to him while he masturbates? There are a lot of other possibilities we could share with you if kinky things don't bother you. 

I know we'll get angry comments about this next suggestion, but when one partner can't be sexual, some couples stay together and thrive by allowing the sexual partner to get needs met in other ways.  We're not talking about sneaking around to have an affair. But we know many couples who have broadened their relationship to include a sex partner, paid or unpaid.  It takes a lot of communication and love to make this work, and there are risks. But it can be done, and it can be healing to your marriage.

So our firm advice is that your husband does have a right to have his needs met, but not at your expense.  Be creative, but stand firm on the no intercourse rule unless you are really ready for it.

Please let us know how it goes. You might want to share this letter with him-it might be a start for communication.

Healthcare Reform

We all know there's more to life than sex and love. Healthcare has major effects on us, too. Right now, there's a serious struggle going on over how to change our dysfunctional healthcare system.  Read David's article on how the system mistreats people with diabetes and what can be done to fix it.

David Spero RN 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 online at or check out their coaching and counseling services. You can also read David's blog.

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Posted by Anonymous on 16 July 2009

I think she should talk more openly to her husband. If he is the man she says he is, he wouldn't intentionally hurt her, no matter how much of a horndog he is. If sex hurts, she also needs to talk to a doctor to find out if there isn't something physical that can be remedied easily. I'm thinking about something as simple as a lubricant like KY jelly. If it didn't hurt, she might enjoy it.
She may be better off than she thinks. I am a 62 year old man with a healthy libido, but unable to perform due to my diabetic neuropathy. My wife left me kids seventeen years ago for a man who could give her game. I got the kids only because Prince Charming didn't want them around. Predictably that little spree didn't last very long, but our marraige was ruined. The children are adults now and I'm as alone now as she is. No relief in sight.
Signed, Frustrated Celibate

Posted by enjoyinglife on 16 July 2009

I totally agree with you that this woman should not be forced into having sex with her husband and that it is very plausible that her husband is attempting to assuage his anxieties about her illness through sex.

My deeper concern is for this woman's diabetic condition/complications. I would urge her to go to her library or book store and pick up a copy of Dr. Richard Bernstein's book, "Diabetes Solutions" I have absolutely no affiliation with Dr. Bernstein except that he saved my husband's life when he wrote that book.

No one should suffer the unbearable consequences of Diabetes whether they are Type 1 or Type 2 diabetics. Dr. Bernstein is a Type 1 diabetic. His story as well as the testimonial stories in is book alone are worth the price. They give you hope. Then the book tells you how to overcome the terrible complications of this dreaded disease.

My husband is a Type 2 diabetic. After reading Dr. B's book over 7 years ago, I realized that my husband needed to be in charge of his life and his diabetes. Following Dr. B's advice with a little of my own research and study, my husband was able to lose 80 pounds within 9 months, come off of 43 units of insulin a night, significantly reduce the neuropathy in both his feet to the point that he has not take any pain medication in over 4 years. I could go on and on -- Please for your sake - get this book, read it and follow Dr. B's advice. It will have life changing effects.
God Bless.

Posted by Green Lantern on 16 July 2009

I was pretty impressed with the advice in this article. At 52, it's pretty amazing that the husband has the stamina to have sex twice a day! He's unlikely to be able and willing to do without, so the possibility of allowing him the freedom to get those needs met elsewhere was courageous to mention. But if he's caring for her to the extent that it sounds like, there's real love there, and he may not be interested in going elsewhere.

One word I didn't see in the article was LUBE. Most postmenopausal women have lubrication issues. If sex is painful, slicking up could help make it less so. Perhaps the husband would be able to scale back to several times per week if she could enthusiastically take part during those interludes?

Posted by Anonymous on 17 July 2009

i have had diabetes for 58 years and have erectile dysfunction. In our marriage we have solved the problem of sexual intercourse by engaging in mutual masturbation. This may not sound like much of a substitute but believe me it can be very erotic and mutually satisfying.

Posted by Anonymous on 17 July 2009

Having read the comment from the lady who doesnt want sex, I think her husband is being rather selfish.There are not many woman at 66 that do want sex 2-3times a day, without the added health issues. He may be caring and wait on her hand and foot but isnt that what a marriage is about? ,in sickness and in health' How would he feel if he was the one who had to deal with the diabetes? Could he deal with the same demands.I would suggest that he see a sex therapist to help him deal with his 'health issues'and appreciate that love and support is what is important in a marriage.Im sure his wife would feel more inclined to want to 'make love' as if she was cared for and not just there for 'his needs'.This lady states 'he has put up with alot' with her diabetes, shows what a totally unselfish woman this is and has been made to feel guilty about her low sex drive!! I think this lady needs to concentrate on staying as healthy as she can and leave her husband to deal with his own 'health issue' Im sure he is a lovely man but perhaps a bit thoughtless!!!!

Posted by Anonymous on 19 July 2009

Neither men nor women are merely sex objects meant to gratify others...but I do believe that we take on a committment to meet the needs of our mate within reason. I am in my sixties with type 2 diabetes. As an aside,for some time I took antidepressants and they can adversely affect one's sexual functioning. At any rate, in the present, I have little desire for sex, but I do use a lubricant and this has helped sex not to be painful. I enjoy being touched and my back gets rubbed pretty routinely, which improves the experience. My husband is not very able to verbalize his emotions, and I believe that sex reassures him and helps him to feel loved. However, I am not willing to be on call day or night and can say "no" when I really don't want to. As far as your suggestion as I understood it about third parties...I think that is horrible and immoral...God gave us "rules" for a reason. There are painful consequences that far exceed doing without. The deterioration of the family in our society and a host of other ills have much to do with each man going his own way and doing as he pleases.

Posted by David Spero RN on 20 July 2009

Thank you for these valuable comments. The people who mentioned lube are really right. It helps, but it might not be enough to make intercourse enjoyable in this case. The man who does mutual masturbation with his wife is also on a good track. You can do really hot and satisfying things with your hands.

To the man whose marriage broke up partly due to ED, our hearts go out to you. But you are NOT too old to find love and romance. You might start with a diabetes support group or a senior center. We're sure you are attractive and have a lot to give, and as we've been writing for months, you can have great sex without erections.

Posted by David Spero RN on 21 July 2009

To Anonymous who wrote: "As far as your suggestion about third parties...I think that is horrible and immoral...God gave us "rules" for a reason."

Men wrote those "rules" and said they were God's. In Saudi Arabia they have a strict set of "God's rules". But those rules allow a man to have four wives! (Not the other way around though.)

Please live according to your beliefs and let other people live according to theirs. Ours are that people finding love and comfort and support with each other is the way we are meant to live.

But you are right that there are risks. Adding someone to a relationship requires a lot of communication and trust. And hiring a sex worker could involve legal risks. We're not pushing anyone to do these things, but they can and do work for a lot of people. They have kept many relationships together, especially when there is chronic illness.

Posted by Anonymous on 3 August 2009

I am a man with type 2 diabetes my wife gets infections when we have sex with or without protection she has tried,but now it's non existing she refuses to go through the pain and agony.Someone told her she's allergic to my sperm.I need answers.

Posted by David Spero RN on 11 August 2009

To Anonymous whose wife gets infections - it has nothing to do with your diabetes. "Allergic to your sperm" sounds crazy, and anyway, using condoms hasn't helped, so that's not it.
Have you seen a gynecologist about this? What did the doctor say? That's the first step.

Posted by David Spero RN on 11 August 2009

Actually, there is such a thing as semen allergy. But it's not an infection - it comes on within 5 - 30 minutes after ejaculation and causes fairly severe pain. Condoms will prevent it, if you put them on before intercourse starts. There are other treatments also. Read more here -

Posted by Anonymous on 7 October 2009

This advice is a bit more radical than we normally read, and I'm glad you are willing to be risky in your suggestions!

Posted by Anonymous on 2 January 2012


Posted by Anonymous on 6 February 2012

I am 42, been in a relationship for 7 months. When we first met he was all over me, and not i can't get him to touch me.
I notice a change in his sleeping and eating, when I try to talk about he claims it's my attitude . I am so turn off by His lack of communicate about sex. I try to touch him, and it's nothing, it won't do anything. I've even got into with nothing on and he go to sleep. It's been one month since weve had sex,and I really am ready to move on. I'm young beaUtiful, my kids are in college, I have nothing holding me back from moving on. I love him but he's being selfish toward me in my needs. Can you help me.

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