We might be embarrassed to talk about it, but it’s true: Sex is an important part of life and relationships. In fact, it’s so important that September is appointed Sexual Health Month, making this a great time to talk about it.
There’s a lot of buzz about eye, nerve, kidney and heart damage when it comes to diabetes complications, so it may surprise you that diabetes can also affect a man or woman’s sexual health.
It’s normal to feel uncomfortable discussing sexual difficulties with your health care provider, but it’s important to do so if you think something is wrong—especially if you live with with diabetes, as this could hint at other health issues.
That being said, chronic high blood glucose is behind many sexual problems for people with diabetes, so any solutions should begin with improving glucose control.
Here are common sexual health problems people with diabetes may face, as well as suggestions for addressing them.
One of the biggest sexual problems men with diabetes face is the inability to have an erection, also called erectile dysfunction (ED). ED occurs when blood vessels and nerves in the penis become damaged over time, but it can also be caused by other conditions like prostate or bladder surgery.
Certain medicines, such as some pills for high blood pressure, heartburn or depression, may also cause ED. Ask your health care provider if ED is a side effect of any of your medicines. There may be other pills you can take.
Nerves can play a role in erection inability as well. If your brain isn’t properly communicating with the nerves in your sexual organs, your body might not be able to transport blood there, blocking the ability for an erection. This can also affect your capability to keep an erection, as there must also be communication to hold blood in the penis.
Low libido, or sexual desire, can be a problem in relationships, and it’s one that affects people with diabetes more than those without. This too can be a result of poorly controlled blood glucose. Studies have shown that men with diabetes, especially those who have type 2 or are overweight, are twice as likely to suffer from low testosterone as a man without diabetes, which can affect a man’s desire for sex.
Fortunately, there are plenty of treatment options, including PDE5 inhibitors to improve blood flow, such as Viagra and Cialis, or testosterone injections or gels for raising low testosterone levels. Losing weight may also help men renew their desire for sex.
Nerve damage may cause vaginal dryness, which is twice as common in women with diabetes as it is in women without diabetes. It’s also a result of aging and is common among women who are menopausal or post-menopausal. Lack of estrogen is the reason for dryness in this age group and can be treated with prescription estrogen.
As with men, women with diabetes may also experience blood-flow issues because of nerve or blood vessel damage. Diabetes complications may make it difficult for blood to move to the vagina and clitoris. Researchers note that even women with great A1Cs who don’t have blood vessel issues or neuropathy can still have sexual problems. So more study that needs to be done when it comes to women with diabetes and sex.
Urinary tract infections (UTIs) and vaginal yeast infections are also common issues for women with diabetes, which can lead to painful sex. You can lower your chances of getting a UTI or yeast infection by keeping your blood glucose under good control. Be sure to contact your doctor at the first sign of discomfort.
For both men and women, emotional factors can interfere with sexual feelings. often leading to or worsening sexual dysfunction. These include depression, anxiety, stress and fatigue. You may feel distant or withdraw because you don’t feel enjoyment, or you may have a fear of failure when it comes to performing sexually. A counselor could help you and your partner work out any strain your sexual dysfunction may have caused.
It’s okay to feel embarrassed discussing such an intimate and personal issue, but your health care provider is there to help you, not judge you. And hey, you’ve already fought half the battle just by beginning the conversation with your doctor!
Depending on the scope of your sexual dysfunction, you may be able to see improvement by getting your blood glucose in control. Even if the complications are too severe to reverse with better diabetes control alone, keeping your blood glucose levels in line can help prevent further damage.
Lifestyle changes can also make a difference. Eating healthfully, exercising regularly and reducing stress will benefit your whole body, not just your lower regions.