Sex and Diabetes

Diabetes doesn’t have to squelch your sex life. Several treatments and tools are available to combat this common diabetes complication and help improve intimacy. 

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Illustrated by Michael Mullan

A Common Concern

Of all the challenges diabetes presents, sexual problems are among the most common. “Research shows about 50 percent of women with diabetes have some form of diabetes-related sexual complications,” says Janis Roszler, RD, CDE, a marriage and family therapist and coauthor of Sex and Diabetes: For Him and For Her (American Diabetes Association, 2007). For men with diabetes, erectile dysfunction—the inability to achieve and maintain an erection—is common. Prevalence increases from about 9 percent among men in their 20s to 55 percent in men age 60 and older.

Why Diabetes Affects Sex

Diabetes can cause erection difficulties in men because nerve and artery damage from many years of uncontrolled blood glucose levels can disrupt the flow of blood into the penis and diminish sensation.

“In order for a man to become aroused and have and maintain an erection, he needs good blood flow into the pelvic area,” Roszler says. Consistent high blood glucose also can affect the production of testosterone, the hormone responsible for sex drive in men, she adds.

The problems are murkier for women, but they also may suffer from nerve and artery damage, Roszler says. Sex-related hormones can be disrupted, too. The consequences: inadequate lubrication leading to painful intercourse, and low arousal or loss of sensation that makes it difficult or even impossible to reach orgasm. 

Off-target blood glucose can simply make you feel too out of whack for intimacy. And then there’s a potential for hypoglycemia if you take a blood glucose-lowering medication that can cause it. 

Adding insult to injury, conditions that often accompany diabetes—heart problems, high blood pressure, and depression, and the medications used to treat these problems—can interfere with sexual function. And dealing with diabetes, as with any chronic condition, can put an emotional strain on a couple. “Diabetes is like the third person in a relationship,” Roszler says.

Luckily, medical experts can provide the tools to tackle the culprits behind sexual troubles. “There are physical and psychological causes, and they interact with each other,” says Irwin Goldstein, M.D., director of San Diego Sexual Medicine. “But we can tell if something is, say, an exclusively neurological or hormonal problem.”

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