Women, Sex, and Diabetes

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By: Linda von Wartburg

Although most research about the effect of diabetes on sex hasfocused on men, some studies report that women are at higher riskfor sexual dysfunction than diabetic men. It’s high time thatthe woman’s side of the story was given the attention that itdeserves.

Women are complicated sexual beings who need to be comfortable bothphysically and psychologically in order to enjoy sexual health.Diabetes can erode a woman’s sexual well-being from bothdirections, and it’s important to know the ways in which youcan keep yourself up and running sexually in the face of thesepotential problems.

Just Relax: It’s the Best Medicine

First, let’s examine the psychological ways in which diabetescan steal the sense of ease that you need to feel sexually alive.Fear of rejection based on your diabetes is the most obvious one,and is best handled by being upfront from the beginning with yourpartner about your condition and your regimen. It is also importantto let your partner share in your care, so that he or shedoesn’t feel excluded. A partner usually doesn’t reactwell to being shut out. Letting your partner in might help you relaxa little too, which is no easy task when you’re used to being“on” all the time, watching your own body like a hawk.It’s hard to let go of that constant scrutiny long enough forsex. Sometimes directed relaxation exercises can help, or perhapsfrequent massages, which can teach you to focus on your body in asensual way.

The Hardware Can Be Hard to Wear

Anyone with a pump knows the hardware of diabetes can be a distraction. An infusion setstuck to one of your erogenous zones, with tubing just waiting to be yanked off during atender moment, can really kill the mood. Each couple needs to work through thisindividually, but there is a DVD out there in which a former Miss America with diabetes,Nicole Johnson Baker, reveals how she and her husband eroticized her pump and discussesother issues surrounding sex and diabetes.

The DVD, which is produced by dLife and is called Sex, Intimacy, and Diabetes, alsodiscusses such potentially awkward subjects as how to talk to your doctor about sexualproblems. Its a good resource if you find yourself kind of shy about the subject at hand andneed a little boost to get you going. (You can order it on the Web from dLife or from the Public Health Foundations Learning Resource Center.)

Complications Make It Complicated

Complications of diabetes can also throw a wrench into the sexualworks. Diabetic neuropathy, for one, can lead to poor bladdercontrol, an inconvenient condition that certainly doesn’tincrease one’s libido. In such cases, it’s a good ideato urinate before intercourse (and 30 minutes afterward, if you canbring yourself to get up, because it’ll help prevent urinarytract infections).

Neuropathy can also damage the nerves that stimulate the genitalia,so lubrication fluids aren’t released and intercourse becomespainful. This is easily rectified by the use of KY Jelly, orAstroglide, a water-soluble lubricant by Biofilm, Inc., which hasworked for many women. Sometimes it’s not neuropathy, buthormone levels that cause the dryness. If that’s the case,there are new low-dose estrogen therapies on the market which haveno negative effects for women with diabetes. Of course, you mustwork with your doctor when beginning estrogen because hormonetherapy research is coming up with new recommendations all the time.

Another really unpleasant complication of diabetes is frequentvaginal yeast and urinary tract infections, because bacteria justlove the sweet environment that’s present in your urine andvagina if your sugar’s a little elevated. There’snothing like a yeast infection to make you not want sex. Luckily,there’s Monistat and Gynelotrimin and, if necessary,prescription Diflucan, an oral medication for recurrent yeastinfections. Once you enter menopause, you might have even morevaginal infections, so eat yogurt, bathe a lot, and discuss hormonereplacement therapy with doctor.

Many diabetic women are taking medications that have the side-effectof dampening sexual response. Among these are compounds to achievebetter blood glucose control, to promote cardiac or kidney health,and to alleviate the depression that sometimes afflicts women whoare struggling with diabetes on top of everything else. If you losesexual feeling or interest for reasons you cannot pinpoint, be sureto talk to your doctor and learn if perhaps your medications can bealtered and your sexual life restored.

Prescriptions for Good Sex

When neuropathy has reached the point of numbness, or circulatorydamage has begun to impair blood flow to the sexual organs, there isno need to despair. All those pills and devices to restore sexualfunctioning aren’t just for men anymore. In fact, Viagra(although not yet approved by the FDA for women) is being prescribedfor some women because it increases blood flow to the vagina,enhances sensation, and increases vaginal lubrication. Andthere’s actually a device for women now, called the Eros-CDT(clitoral therapy device), which in 2000 became the first treatmentfor female sexual dysfunction approved by the FDA. It’s asmall pump with a tiny plastic cup that uses suction to stimulateblood flow to the clitoral area. It can help women reach orgasm, andit may prevent fibrosis from building up in arteries leading to theclitoris. Talk to your doctor about Viagra and the Eros-CDT if youthink either one might help you regain your pleasure in sex.

Feeling Fine Without Going Low

And what about the $64,000 question: how does hypoglycemia affectsex? Not positively. For one thing, you don’t want to have ahypo and mistake it for an orgasm—and you sure don’twant to have an orgasm and mistake it for a hypo. Check your bloodsugar right before sex just to be certain. But if you don’treally want to do that, it might be wise to adjust your insulindownward before you have sex, or compensate by eating somethingbeforehand.

Diabetes is a complicated disease, women are a complicated sex, andsex is just plain complicated. But with care and knowledge, womenwith diabetes can enjoy a long and happy sex life. Wouldn’t itbe nice if they’d study us as much as they study the men,though?

How Was It For You?

Diabetes Health would like your helpin addressing the lack of informationabout women, sex, and diabetes. Tothat end, we’ve set up a survey on ourwebsite, packed with questions abouthow having diabetes affects your sexlife and how you overcome the hurdlesthat diabetes raises.

Please fill it out,because we will use the results fora future article about how diabetesimpacts our readers when it comes tosex. And be sure to write us if you haveany thoughts or experiences to sharethat might help our readers with thisdeeply human problem, or comment on this article, below. After all, youare the ones who know how it is.

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