Dear Diabetes Health, Hello!  I am 60 years old and have had type one for about 24 years. It has been quite some time since I had a relationship, and now I have one coming at me.  The problem is, I am very dry. The commercially sold products don't seem to help,  and Intercourse isn't comfortable. What do you recommend that I try?  And what about a libido enhancer?  I need this relationship to work because living alone is tough, and my partner likes his intimacy.  Please!!!

Hopeful but Anxious

Dear HbA, It's exciting to have a relationship "coming at you," but it also sounds a little scary.  Fortunately, all the issues you raise can be managed.

Let's start with getting you in sexual shape. A recent study in the Journal of Sexual Medicine highlighted vaginal changes in females with diabetes. True, they were female mice, but the report confirmed what is already known about humans.

The authors wrote that in the mice, diabetes resulted in thinning of the vaginal walls, weakening of muscles, shortening of elastic fibers, and loss of nerve fibers.  Human women with diabetes often experience the same things. So naturally, intercourse doesn't feel that good!

But here's the interesting thing. Both human women and female mice with diabetes have lower than normal levels of estradiol, a female hormone (estrogen). When the mice were given estradiol in their food pellets, their vaginal structures returned to normal.

Women can take estradiol by mouth or by a vaginal tablets,  rings, or creams.  Ask your gynecologist about it - it might help your lubrication, your comfort, and your desire. You might also want to be tested for testosterone level because testosterone is necessary for sexual desire.

Physical conditioning also increases libido.  Get some exercise and achieve the best possible control over your blood sugars.  It might be good to exercise with your new love, maybe with a brisk walk (as long as your sugar doesn't go too low).  Walking or playing together might be a good form of foreplay and a chance to get closer.

Lubes Rule

You said that you're very dry and that "commercial products don't seem to help." But don't despair: it's likely that you weren't using enough or that you tried a product that is irritating to you. Susan Day, a manager at Déjà vu Love Boutique in Vista, California, advises you to keep looking because there are hundreds of "intimate lubricants," and some will surely work for you if you use enough. Some include additives that cause heat or tingling or may even increase desire.  Others taste good, or at least sort of good. You can use some on him, too, or use mineral oil - it will make all your touches more exciting. 

Some lubes can become sticky over time, but water-based lubes usually don't. With diabetes, it's best to avoid lubes containing glycerine because they can promote yeast infections (vaginitis).  Vaginitis can be a big problem for women with diabetes anyway, so if you have any vaginal itching or burning, you might want to treat yourself with an over-the-counter drug like miconazole. Or see your doctor and be tested, because vaginitis can also be caused by bacteria or allergy.

Finding Desire

We talked about exercise and hormones as ways to build desire.  There are also herbal pills and creams you can use. Two of these, damiana and dong quai, are used worldwide to increase desire. They work. They can also lower blood glucose, so be careful.  You might want to ask your doctor. A list of libido-enhancing herbs is available here.

You also might want to consider if your medications are causing your loss of libido. Blood pressure medications and antidepressants are famous libido-killers. Sometimes people take a two-day "vacation" from anti-depressants when they have a hot date coming up.

Fatigue is another desire stopper.  On days when you'll be close to your lover, try to get some rest. And be sure to get enough sleep: it's good for your diabetes, too.

If you are experiencing ongoing self-esteem problems or relationship issues that interfere with desire, you might want to see a therapist or counselor.  Nothing builds desire like love and acceptance.

Non-Intercourse Sex

Whatever is happening with your vagina, you can please a man and please yourself with sex that doesn't involve intercourse. You can use your hands and your mouth to give pleasure, and so can he. You can write us for some tips on this at love@sexandintimacy.vpweb.com 

HbA, you closed by saying,  "I need this relationship to work, because living alone is tough." We would say that is not the best reason to have sex or the best way to attract a man. Yes, living alone is tough, but desperation is not attractive. You sound like a lively woman who can certainly find potential partners, so go in with a positive attitude. Enjoy yourself; enjoy loving, and your partner will enjoy being with you.  Let us know how it goes.   

David and Aisha