Diabetes and Sex

Here is some more uplifting statistics.  Women who have had gestational diabetes or have given birth to a baby weighing more than 9 pounds are at an increased risk for developing type 2 diabetes later in life.  The prevalence of diabetes is at least 2 – 4 times higher among African American, Hispanic/Latino, American Indian, and Asian/Pacific Islander women than among white women. The risk for diabetes also increases with ag e. Because of the increasing lifespan of women and the rapid growth of minority populations, the number of women in the United States at high risk for diabetes and its complications is increasing.

     And to top all this off, when glucose isn’t under good control, a woman’s sex life can suffer.  If your sugar is up, your libido may be down!  Most of us associate diabetes and sexual problems with hubby, and indeed it is (hence all the TV commercials), yet women are effected, albeit somewhat indirectly also.  Diabetes educator Ann Albright, PhD, RD says, “It’s not diabetes per se that harms your intimate life. It’s the complications of uncontrolled blood sugar levels that cause problems for both men and women — the only difference is that many women simply aren’t as aware of this complication as men are.”

This problem was not widely recognized until a landmark study in 1971 showed, “35% of women with diabetes reported being unable to have an orgasm during intercourse, compared to just 6% of the women who didn’t have diabetes.”  The mechanism was thought to be a decreased lubrication that may arise from elevated blood sugars.  This dryness may mimic what is commonly seen in menopause where lubrication also declines which results in decreased sensitivity and even pain with intercourse. Let’s face it, if it hurts it’s hard to find pleasure.

Another area affected is the tiny blood vessels that supply the vaginal and vulvar area, especially in the region of the clitoris.  These vessels can become damaged by high sugars and limit the sensitivity and response from these areas.  This results in both a decline in response but a definite decrease in desire.  Prolonged elevation in blood glucose can also lead to nerve damage called neuropathy and this can also affect the pleasure sensation.

Women with diabetes are also prone to two types of medical problems that also can interfere with intimacy: Yeast infections and urinary tract infections.  Whenever I see a patient with recurring infections, I always check for diabetes.  Frequent infections can make sex uncomfortable and unfortunately the longer you go without, the more painful it may be to resume.

Dr Albright also reminds women that “The demands of the diabetes itself can affect you emotionally and if you’re a woman the stress of those demands is simply more likely to play out in the bedroom.”

So what is a woman to do?  If you think this may be an issue with you, talk about it.  Not to just anybody of course, but mainly your husband and especially your doctor, both your internist/endocrinologist and your gynecologist.  Many of the problems can be reversed by better sugar control.  There are both over the counter and prescription medicines that can enhance lubrication and increase tissue sensitivity.  If you are having problems between the sheets, don’t pull the covers over your eyes!  Remember, sexual functioning and libido are complex and multifactorial so focus on the big picture, get it out in the open, and ask about solutions