Type 1 Diabetes: Sex and Diabetes: From Her Point of View

Dear Sex & Diabetes, I have had type 1 diabetes since the age of ten.  When my husband and I were first married, I had no trouble with my sex drive. After the births of our three children, however, I noticed a big decrease in desire.  I have also had a hysterectomy and have gained 50 pounds since we were first married.  Do you think my weight has something to do with it?  I really don’t feel it is fair to put my husband through my lack of desire. He still seems to want me.

It seems to me that diabetes and sex with regard to men is an open book, but diabetes and sex with regard to women is still very much in the closet.  Why does it have to be this way, and can we bring it out in the open?


Dear CJ,

You are right that women’s sexuality is “very much in the closet,” and not just with regard to diabetes.  For centuries, we’ve been told that women shouldn’t enjoy sex or want sex at all.  Male sexuality is praised and promoted (“he’s a stud”), while female sexuality is insulted (“she’s a whore”).  One example: some countries, states, and companies will pay for Viagra or the other erection drugs for men, but won’t cover birth control pills.

Let’s bring diabetes and women’s sexuality out in the open, shall we? Men, this is for you, too.

Normally, diabetes (type 1 or 2) does not directly decrease sexual desire (also called “libido”). Indirectly, however, it can lower libido in several ways. If your sugars aren’t well controlled, you will feel too tired for sex.  If your circulation or nerve function is damaged by diabetes, sex won’t feel as good. You may have lubrication problems and possibly pain with intercourse, which are obviously turnoffs.

Women with diabetes are more likely to get vaginal infections (vaginitis), which makes sex uncomfortable.

Depression often goes along with diabetes, and depression discourages sex. (Sometimes, though, sex is good medicine for depression, once you get started.)  The medicines used to treat depression can also dampen libido.

But in your case, CJ, we can think of several other explanations.  You have three children, and I’m sure they take up much of your energy and attention. You had a hysterectomy, and low sex drive is common after a hysterectomy.

Fifty pounds of extra weight could cause desire problems. Perhaps you don’t see yourself as attractive, or perhaps your husband doesn’t. The weight, like the kids, could also be making you tired.

You don’t say how old you are, but your hormone levels may be low. This is normal with aging. Low estrogen and/or low testosterone levels lead to low libido.

Relationship issues may be interfering with sex. There might be issues that you and your man need to deal with, or there may be life issues (money, kids, parents, or health) that are stressing you both too much to think about loving.

Finally, you and your husband have been together a long time. If you think of sex only as intercourse and do pretty much the same thing year after year, do you think you could be a little bored with sex?  Maybe you could try something different, perhaps using hands, mouths, toys, or at least different positions. 

So What Should You Do?

The first thing is to make sure that your glucose is well controlled, because good control has many benefits, including good sex.  Second, you can ask your doctor to check your hormone levels and possibly evaluate your meds to see if they might be weakening your desire.  If your hormones are low, hormone replacement is quite easy.  A gynecology exam might be a good idea.

If you haven’t been evaluated for depression, you might want to do that, too. Depression can be self-managed or treated with therapy and/or medications.

You and your man need to talk about this. Try to identify things that might turn you (and him) on, as well as things that might be getting in the way. Is your weight or your diabetes a problem for him? Or for you? Are there fears or resentments that weigh you down?  Be honest. Remember, words can never hurt anyone if they are said with love. But not saying what you feel CAN hurt both you and your relationship.

You need to take some time for pleasure. Don’t expect that you can go right into sex without getting into the mood. Take a break from childcare, housework, your job, or stressing about finances. Put on some wine, music, a sexy video. 

Good luck and let us know how it goes.


Dear Sex & Diabetes,

I have had type 2 diabetes for five to six years. I can’t believe I’m asking this, but I can’t seem to reach an orgasm, no matter what my husband and I do.

– Anonymous Please

Hi AP,

We’re going to do a column on orgasms soon. For now, here are two words and links that might help: Vibrator and G-spot. Check them out.   


Dear Sex & Diabetes,

Does diabetes make it hard for women to stay “moist” for sex?

-Too Dry

Hi Dry,

Yes, diabetes can block vaginal lubrication. It does this by clogging circulation and/or damaging nerve function, the same ways that diabetes can cause erection problems in men.  You might be able to fix this by achieving better glucose control, but you don’t have to wait!  You can treat the problem now with lubricants. We’ll need another column just to talk about lubes, but the best ones for vaginal use are water-based or silicone-based. Use a lot: there’s no such thing as too much.

Be aware that your dryness might also be due to low hormone levels. In that case, there are estrogen rings, vaginal tablets, and creams available by prescription that will help you get wet. Unlike estrogen pills, fortunately, vaginal estrogen has not been linked to cancer. (Note that estrogen may also have health benefits for your heart and blood sugars, as this article in DH reports.)


Confidential to Anonymous who asked about semen – there are not enough calories or carbs in semen to have any measurable effect on blood sugar. Go for it.  You don’t need to adjust your insulin. 

David Spero is a nurse who has lived for 30 years with multiple sclerosis.  A leading expert on self-care, he has written two books: Diabetes: Sugar-coated Crisis, and The Art of Getting Well. He has learned to maintain and even improve sex and love despite disability and illness. 

Aisha Kassahoun is trained in marriage and family therapy.

Aisha and David present sex and intimacy programs for people with diabetes, people with multiple sclerosis, and health professionals. Visit David and Aisha on-line at  http://sexandintimacy.vpweb.com. You can read David’s blog athttp://www.diabetesselfmanagement.com/blog/David_Spero

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