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If you have had type 2 diabetes for several years, or type 1 for a decade or more, your ability to enjoy sex may not be what you want it to be. It’s estimated that almost half of all women with diabetes experience sexual problems, which can include pain, lack of arousal and trouble reaching orgasm.
“In addition to physical issues, for both men and women, emotions play a big part in sexual problems,” says Janis Roszler, R.D., a certified diabetes educator and author of Sex & Diabetes and The Secrets of Living and Loving with Diabetes. “If a woman has gained a lot of weight or if she has bruises from injections, the last thing she may want is to be seen naked. And dealing with a chronic disease such as diabetes is stressful and can trigger depression, which in turn can suppress sexual feelings.” If you’re having these feelings, you may find that you also have a hard time getting aroused or that you’re just not interested in sex.
Some women living with diabetes experience problems with lubrication and pain. They may also find it harder to climax. Physical changes and emotional upset can combine to cause these difficulties. In a survey of 800 women with diabetes conducted in 2010 by the healthcare marketing company MicroMass Communications, almost half of the respondents said the disease had a negative effect on their sex lives. Along with diminished libido, 22 percent said they found it increasingly difficult to reach orgasm.
If your man has diabetes, you may be dealing with his sexual issues. According to a recent study in Diabetes Care, a journal of the American Diabetes Association, almost 40 percent of men with the disease have difficulty achieving or maintaining an erection; 29 percent report that they climax too quickly; and 21 percent say they can’t have an orgasm. But there’s some good news: The same study found that around 69 percent of men and 62 percent of women with diabetes who had partners engaged in some sexual activity two or three times a month. Among their age group—57 to 85—that’s about the same frequency as folks without diabetes.
Fortunately, there’s a lot you can do to keep your sex life on track while you deal with your condition. “The single most important step to take in preventing or solving diabetes-related sexual problems is to talk to your doctor about them,” says Michael Dansinger, M.D., director of the Diabetes Reversal Program at Tufts Medical Center and a nutrition doctor for the Biggest Loser. You’ll probably have to bring the subject up yourself, though. “The medical profession is guilty of overlooking the issue,” Dansinger says.
Here are more ways to prevent, reverse or control sexual problems if you’re living with diabetes:
Control glucose levels. This reduces the risk of cardiovascular and nerve damage, which can make lubrication, arousal, erection and orgasm more difficult to achieve.
Maintain healthy cholesterol levels to reduce cardiovascular damage, which can impair blood flow and interfere with erections and orgasms.
Watch your blood pressure. Try to keep it at the recommended levels—less than 130/80 mmHg. If you have high blood pressure, the arteries that supply blood to the penis cannot dilate properly and the smooth muscles in the penis aren’t able to relax. Those two problems prevent sufficient blood from flowing into the penis to make it erect. High blood pressure medications can also interfere with erections.
Stop smoking. Smoking is far more damaging for people with diabetes, who are already at increased risk of heart disease and all of the sexual problems that go along with it, including lack of lubrication, troubling climaxing and, for men, erectile dysfunction.
Exercise regularly. Exercise improves glucose control, reduces body weight, helps fight depression, changes body image and improves muscle tone and function.
Check the side effects of medications you are taking. Certain antidepressants and even some high blood pressure medications, for example, can interfere with a man’s ability to have an erection and may dampen a woman’s arousal. Ask you doctor to help you find alternatives if necessary.
Get help if you think you are depressed. People with uncontrolled diabetes are at increased risk for depression, which is associated with lack of interest in sex, as well as erectile problems in men.
Ask your doctor about medications and devices that can help you overcome physical obstacles to enjoying sexual relations. “But most important, communicate with your partner and work together to find solutions,” Roszler advises. “Experiment, enjoy each other and enjoy yourself.”
