Type 1 and type 2 diabetes can affect several aspects of life, including your sexual life and health. An estimated 50% of men with diabetes and 25% of women with diabetes face some kind of sexual problem. This ranges from loss of interest and low libido to vaginal infections or erectile dysfunction. While many other diabetes-related complications are discussed widely and openly, sexual health often slips through the cracks.
Diabetics can develop sexual problems because of the damage to nerves and small blood vessels. Autonomic nerve signals that regulate blood flow to the muscles in the genitals are often affected in diabetics. The reduced blood flow (due to damaged blood vessels) can lead to sexual issues.
Sex hormones are also affected by diabetes and glucoregulation. Insulin resistance impacts hormone production in the body, leading to the loss of libido. Men and women with poorly controlled sugar levels are more likely to suffer from hormone regulation issues and the consequent sexual health issues. Fatigue due to fluctuating sugar levels also leads to a loss of interest in sex.
People with diabetes are also prone to frequent urologic problems such as urinary tract and bladder infections. Such infections often make sex painful, leading to a declining interest in intercourse.
Sexual Issues In Women With Diabetes
Research shows that around 18% of women with type 1 diabetes and 42% of women with type 2 diabetes have sexual issues. Some of the problems experienced by women include:
- Vaginal dryness due to lack of lubrication. In such cases, over-the-counter lubricants may help. Your doctor can help you find the right solution.
- Vaginal infections such as candidiasis (yeast). These can make sexual intercourse painful. Vaginal creams and antibiotics, where necessary, will help take care of these.
- Low desire for sexual activity and lack of response are again a result of fluctuating sugar and hormone levels. You can control these by keeping a strict check on sugar levels and maintaining hormone health. Your doctor will put you on hormone replacement therapy (HRT) if your hormone levels are very low.
Sexual Issues In Men With Diabetes
According to the Canadian Diabetes Association, 50–70% of men with diabetes experience impotency at some point in time. Men with type 1 diabetes are more likely to experience impotency at an earlier age while men with type 2 diabetes experience this a little later. Some of the underlying conditions leading to impotency include:
- Erectile dysfunction causes an inability to have an erection or sustain an erection. In some cases, erectile dysfunction may actually be the first marker of a diabetes diagnosis since men with diabetes are 2–3 times more likely to experience erectile dysfunction. Diabetic neuropathy is the major cause of erectile dysfunction. Talk to your doctor about the right treatment. This could range from oral medications, pellets in the urethra to injection shots in the penis or surgery.
- Retrograde ejaculation is a condition where some or all of a man’s semen enters the bladder instead of being ejaculated from the penis. This happens when the sphincter muscles do not function properly. It usually leads to fertility issues. Many men with diabetes only realize this problem when they are unable to contribute to conception. This condition can be detected through a urine analysis after ejaculation as the urine will contain traces of semen. Again, poor diabetes control and the consequent nerve damage are the main cause of this condition. Retrograde ejaculation can be treated with medications which improve muscle tone of the bladder sphincter.
The best way to avoid sexual problems due to diabetes – for both men and women – is through robust blood glucose management. High blood glucose can damage the nerves and muscles so keep a watch on this and ensure stable HbA1C levels (blood glucose levels measured over 3 months). A diabetes-friendly diet (which includes whole grain, fiber, fresh fruits and vegetables, and low-fat dairy products) and weight-bearing exercises can improve overall stamina, muscle mass, and strength. People with diabetes are also advised to work out a pelvic strengthening exercise plan after consulting a diabetologist and physical trainer.