Having diabetes not only affects what you eat but also all aspects of your health, including sexual life. When you have diabetes, your body cannot produce sufficient insulin or cannot utilize it properly. As insulin hormone plays an essential role in the glucose utilization by your cells, diabetes results in high blood glucose levels.

If left unattended, high blood sugar can cause complications such as heart problems and nerve damage, which may impact your sexual health. Managing diabetes can also be taxing sometimes and influence your self-esteem and mental well-being, further affecting your sexual health.

About 25% of women and 50% of men are seen to face a loss of sexual desire or some kind of sexual problem due to diabetes.

Overview

Sexual health problems are common in people with diabetes especially type 2 diabetes. Some disorders include loss of sex drive and a decrease in libido. 

This can be frustrating, especially for someone who had a satisfying sex life before diabetes.

Sexual Health Problems Affecting Both Sexes

Some common reasons for sexual health problems in people with diabetes are:

  • Lack of energy
  • Hormonal changes
  • Adverse effects of medicines for depression or high blood pressure
  • Depression
  • Anxiety and stress
  • Relationship problems

Let us have a look at some common problems.

Diabetic Neuropathy

It is a condition where high blood sugar levels damage your nerves. If nerves supplying your genital organs are affected, it may cause sexual issues.

Diabetic neuropathy may cause pain, numbness, or lack of feeling in the genitals, resulting in erectile dysfunction in men.It may also make sexual arousal difficult and inhibit orgasm, making sex unenjoyable or painful.

Relationship Concerns

Open communication between partners about sexual problems is important. Failing to do so can affect intimacy and sexual relationships.

Besides, a chronic health condition like diabetes may affect the sexual bond. For instance, the partner becomes the caregiver which may change how they view each other. It is possible to get stuck in the role of caregiver and patient, and the romance may slip away.

In some cases, it is better to avoid talking about the issues instead of seeking a solution.

Diabetes and Men’s Sexual Health

Erectile Dysfunction

The most common issue in men with diabetes is erectile dysfunction. In some cases, diabetes is diagnosed when a man consults a doctor for erectile dysfunction.

Inability to maintain or achieve an erection firm enough for ejaculation may be a result of damage to the muscles, nerves, and blood vessels. It is seen that about 50% of men with diabetes have erectile dysfunction at some point in time.

Medicines for managing diabetes may also alter testosterone levels, resulting in ED. Many other conditions associated with diabetes may also result in ED. Some of them are:

  • High blood pressure
  • Obesity
  • Not getting enough exercise or being inactive
  • Low self-esteem
  • Anxiety and depression

Retrograde ejaculation

This is the next common sexual health problem in people with diabetes. In retrograde ejaculation, semen ejaculates in the bladder instead of the penis.

The internal sphincter muscles are responsible for the contraction and relaxation of the bladder neck and urethra. In normal conditions, these muscles push semen out of the urethra and prevent its entrance into the bladder.

Abnormally high blood glucose levels may damage the nerves supplying the sphincter, resulting in retrograde ejaculation.

Diabetes and Women’s Sexual Health

The most common sexual problem a woman with diabetes may face is vaginal dryness. This can be due to reduced blood flow to the genitals or abnormal hormonal levels.

Besides, women with diabetes are at a higher risk of vaginal inflammation and infection. Both conditions can make sex uncomfortable or painful. Moreover, nerve damage to the bladder may result in urinary continence during sexual intercourse.

Women with diabetes are also at a higher risk of urinary tract infections, making sexual intercourse uncomfortable.

Diagnosis

To find out the cause for your problem, your doctor will ask certain questions, including your symptoms. They may also run a physical check for signs of physical causes such as vaginal dryness in women.

You may also be advised blood tests, such as hormonal levels and blood sugar levels, to help your doctor find the cause behind your sexual problems.

Living With Diabetes

Sexual health problems with diabetes can be irritating and may cause anxiety. Sometimes you may feel like giving up on sexual expression as it is easier than finding a solution to adjust or cope.

But the good news is that you can enjoy a healthy sex life despite diabetes. Lifestyle modifications, medications, and communication with your partner can help.

Treatment

As multiple reasons may affect your sex life if you have diabetes, management depends on the cause. For instance, if fatigue and low energy are the cause, having sex at a different time when your energy is high may help.

Most couples prefer night sex, but it may not be the best option for everyone. After a long, hectic day and fatigue due to diabetes, sex may be the last thing on your mind.

You can try sex in the afternoons or morning. You also experiment to see what works best.

Other treatment options include:

  • Lubricants: You can use lubricants to manage vaginal dryness. There are multiple options, but water-based lubricants work best.
  • Medicines to improve libido: For men, the options include sildenafil, vardenafil, tadalafil, and avanafil. Options for women include Flibanserin and Bremelanotide.
  • Hormonal replacement therapy: It can help both men and women with problems such as vaginal dryness, erectile dysfunction, and low libido. As hormonal therapy helps only if you have low hormone levels, it is best to consult your doctor before starting it. It is available in the form of patches, injectable medicines, and creams.
  • Maintain your physical and mental health: Sex utilizes energy, and thus you need to be healthy. Normal blood sugar levels are also important to manage health. If you are on medicines that enhance your insulin levels, low blood sugar levels can happen during sex. So, it is advisable to check your blood sugar levels before engaging in sex.
  • Be physically active: Regular exercise improves mood, energy level, and body damage. Besides, vaginal lubrication, erection, and sexual arousal depend on your blood flow. Being active improves your blood flow and, thus, your sex life.
  • Manage incontinence: Do not allow incontinence to come in your way of having pleasure during sex. You can discuss this with your partner, and padding the bed may help. You can also use incontinence pads or even towels to ease the situation.
  • Strengthen your relationship: It is essential to pay close attention to the relationship with your partner. Both of you can find ways to enjoy intimacy when desire is not at its peak. Some good options to express intimacy are baths, massages, and cuddling. Take out time for each other. Go on a date where you do not discuss about diabetes. You can also discuss the possible sexual problems and your feelings about them. This can bring both of you closer.
  • Counseling: You can also consider counseling or support groups to deal with emotional issues associated with diabetes or sex life.

Whatever your problem is, you will likely manage it and get back your sex life. So, it is always recommended to discuss your health and sex life problems with your doctor.

If you have diabetes, sexual problems may indicate that the disease is progressing or the medicines are not working appropriately for you. Besides, some medicines that control blood sugar levels have adverse effects on your sexual health. So, do not be afraid or embarrassed to discuss the sexual adverse effects of the medicines. You can also ask for different medications that do not have such side effects.

Final Thoughts

Having an active and healthy sex life is essential for the quality of your life. Diabetes may make your sex life difficult. But this does not mean that there is nothing you can do and completely let go of the sexual expression.

Managing diabetes often resolves your problems, and you can enjoy your sex life again. Lifestyle changes, open communication with your partner, and medicines may help you with your sex life problems. Talk to your partner and doctor about any issues you are facing. This can help you maintain a healthy sex life.

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