by Melinda D. Maryniuk, MEd, RD, CDE
High blood glucose over time can affect many different parts of the body, including sexual health and feelings of intimacy. About half of all adults with diabetes have some kind of sexual concern or problem.
Sexual health and diabetes: What’s the link?
When blood glucose and A1C levels are high for a long period of time, it can lead to damage of both blood vessels and nerves. In men, nerve damage affects the ability to turn sexual stimulation into an erection and poor blood circulation reduces blood flow to the penis. Both of these contribute to the difficulty many men experience having or keeping an erection, also known as erectile dysfunction or ED. Ejaculating too early or having low testosterone levels (which leads to low sexual interest) are also common. Sometimes this damage occurs before diabetes is recognized, and erectile dysfunction is what eventually leads to the diagnosis of diabetes.
This is not only a concern for men. Women with diabetes may have vaginal dryness, discomfort during intercourse, more frequent vaginal infections, as well as low sexual interest. For both men and women, this can be frustrating and stressful, impacting one’s confidence, as well as being harmful to relationships.
What can be done?
Just as diabetes requires learning new skills like glucose checking or carb counting, it may also mean finding new ways to be intimate. It means understanding that there are different ways to enjoy physical contact that can bring pleasure, excitement and connection. An important first step is to ensure there is frequent, honest, and loving communication between partners. Be open to new ways to both offer and receive physical contact that can show love and bring pleasure.
There are several things both men and women can do to reduce their risk of sexual problems as well as to have more pleasure including:
- Make time for each other. A healthy sex life includes making time to do enjoyable things with your partner– taking time to talk, laugh, cuddle, share, listen and communicate.
- Keep your diabetes and blood pressure numbers in target range. For most people that means having an A1C at or below 7%, and blood pressure below 140/90.
- Don’t smoke. Smoking can damage blood vessels which is why quitting can improve ED symptoms.
- A therapist or counselor may be helpful in facilitating a discussion that ensures the needs and desires of both individuals are heard.
- If you’re worried about low blood glucose during sex, make sure you keep quick treatments (like glucose tablets) close by. If possible, check your glucose before sex if you’re afraid of being low.
If you are a man, it is normal to have trouble with an erection once in a while. If this happens more often than you would like, talk to your healthcare provider about:
- ED medicines. There are several pills that may help, including Viagra, Levitra or Cialis. However, know that these don’t work for many men with diabetes and other options may be needed.
- Review your other medications. Some medicines, such as antidepressants or blood pressure medicines may interfere with sexual function or desire.
- ED aids. There are many options that can help men have and maintain an erection if medicines do not work including a penile vacuum pump, a penile sleeve, penile shots, a constriction ring as well as a penile implant.
If you are a woman, a few things to consider are:
- Vaginal creams or gels can help reduce dryness and pain.
- Let your partner know if you need a little longer to get in the mood. Set aside some extra time for romance.
- Explore the parts of your body that respond well to touch and share what you discover with your partner.
While diabetes can interfere with sex and intimacy, it’s still possible to have loving and close relationships. The key is to communicate honestly and openly with your partner, and to continue to prioritize diabetes management and your health overall.
For more information:
Sex and Diabetes: For Him and For Her. Janis Rozler and Donna Rice