How to keep sex alive and well when you have diabetes

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A chronic illness has a way of throwing a wrench into many aspects of our lives including sex.  Type 2 diabetes is one such disease in which sexuality is commonly affected and experienced by both men and women with this condition. Not only can this disease cause sexual complications for both genders but it can also cause gender-specific issues.

Sexuality issues affecting both men and women

There are several common sexuality problems shared by both men and women with type 2 diabetes.  One is a decrease in libido, or loss of sex drive.  If before a diabetes diagnosis their sex life was thriving and fulfilling but now is almost nonexistent, this can be extremely frustrating.  Low libido in type 2 diabetes can be a result of:

· Side effects of medications for high blood pressure or depression

· Extreme fatigue

· Lack of energy

· Depression

· Hormonal changes

· Stress, anxiety, and relationship issues

Diabetic neuropathy, a type of nerve damage associated with diabetes, can cause numbness, pain, or lack of feeling in the genitals.  This may also inhibit the ability to have an orgasm or to feel sexual stimulation.  The side effects of diabetic neuropathy may make sex painful or unenjoyable.

To combat this issue of type 2 diabetes negatively affecting a couple’s sex life, communication is important.  Couples need to open up and feel free to talk about the issue and to seek out a solution to the problem by discussing this with their primary care physician. 

Sexuality issues affecting men with type 2 diabetes

The most widely reported sexuality issue by men is erectile dysfunction (ED).  Occasionally, a man may first be diagnosed with type 2 diabetes when he seeks out treatment for ED.  ED is a condition commonly found in men with diabetes as they are two to three times more likely to develop it and about half of all men diagnosed with type 2 diabetes will have ED within 10 years of their diagnosis

The reason for increased ED is due to damage caused to the nerves, muscles and vascular structures.  Other reasons may include side effects of certain medications altering testosterone levels that can also cause ED.  Other conditions associated with diabetes contributing to ED include obesity, high blood pressure, depression, anxiety, and not enough exercise.

Men who are experiencing abnormally high blood glucose levels may have a condition called retrograde ejaculation.  This is when semen is ejaculated into the bladder instead of out of the penis which can happen when the internal sphincter muscles are not working properly by opening and closing passages in the body.

Sexuality issues for women with type 2 diabetes

The most common sexual issue for women with type 2 diabetes is vaginal dryness.  This is usually caused by hormonal changes or from reduced blood flow to the genitals.

Another factor affecting a woman’s sex life with type 2 diabetes are increased rates of vaginal infections and inflammation making sex painful.  Damage to the nerves leading to the bladder can cause incontinence which can make sex embarrassing.  Women with type 2 diabetes are also prone to urinary tract infections which also can make sex painful and uncomfortable.

How to maintain an active sex life with type 2 diabetes

Even though type 2 diabetes may cause some disruptions of a couple’s sex life, there are ways to still have active and satisfying sexual encounters by following certain tips:

Have sex when energy is high and fatigue low – When a person has low energy and fatigue, try having sex during the time of day when energy levels are at its peak.  No one said the only time to have sex is at night.  Often by the time night rolls around and it’s been a long day, all a person wants to do is go to sleep.  But sex in the morning or afternoons may be the time to have a romantic rendezvous when energy levels are higher.

Use lubrication for vaginal dryness – To deal with vaginal dryness, use lubricant liberally.  The best to use are water-based lubricants.  It’s okay to add more lubricant during sex if need be.

Consider hormonal replacement therapy – Whether a man or woman is having sexual issues such as reduced libido, vaginal dryness or ED, hormonal replacement therapy may be the answer.  Hormone replacement can come in the form of pills, patches, creams, or injectable medications.  Discuss this with a doctor to get their opinion.

Maintain good blood glucose control – To have a healthy sex life, keeping blood glucose levels within a normal range is critical.  Be sure to follow a healthy diet plan for diabetes, take all diabetes medications prescribed and engage in a regular exercise routine. 

Have a regular exercise routine – By participating in regular exercise, it has added benefits of improving energy levels, mood, and body image.  In addition, exercise promotes good heart health and proper blood circulation.  Keep in mind what’s good for the heart is good for the genitals.  To become sexually aroused, to have vaginal lubrication and the ability to achieve an erection, all require good blood flow.

 

Take home message

 A healthy, active sex life is important for all couples, including those with type 2 diabetes.  Diabetes may make sexual activity more challenging but that doesn’t mean an end to sex.  By keeping diabetes under control, sexual issues tend to resolve themselves.  To maintain a healthy sex life, good communication is a must between couples and to always discuss with their doctor on any issues pertaining to sexuality.