Diabetes and Sex Issues

Diabetes can lead to difficulty with sexual performance or enjoyment for men and women. Most often, these problems are caused by blood vessel or nerve damage. But diabetes and sexual complications don't have to mean the end of your sex life. Many issues can be addressed by your healthcare team-if you talk to them.

Issues Affecting Men

Diabetes can cause nerve and artery damage, disrupting the blood flow needed for an erection.¹ Known as impotence or erectile dysfunction, it's estimated to affect up to 75% of men with diabetes at one time or another.² If you experience erectile dysfunction, it's nothing to be ashamed of. You're in good company.

In addition to erectile dysfunction, some men experience a decrease in the amount of semen they produce, or a diminished interest in sex.

Causes of Sexual Dysfunction
The following factors, which can result from ongoing high blood sugar, can cause these problems:

• Nerve damage, or neuropathy
  
  
• Circulation problems

•  A decrease in testosterone¹

In addition, some medications such as blood pressure drugs, antidepressants, and stomach ulcer medications may have side effects that cause sexual dysfunction. Be sure to check with your doctor to see if any medications you're taking could cause problems.

Prevention and Treatment
Several types of treatment are available for sexual dysfunction. The type of treatment will depend on your specific situation.

• Oral medications, such as Viagra, help stimulate and maintain erections
• Injection drugs can be delivered directly into the penis
• MUSE suppositories can be inserted painlessly into the opening at the end of the penis
• Physical devices , such as a penis ring (an elastic band that is placed at the base of the erect penis to keep blood in it), vacuum devices, and surgical implants are all options your doctor may consider

•  Counseling may also be called for, if impotence is the result of emotional causes

To minimize the effects of sexual dysfunction, avoid circulation and nerve damage by maintaining good blood sugar and blood pressure control and by keeping healthy cholesterol levels. Stop smoking, exercise and don't drink alcohol.

If you notice any erectile dysfunction, talk with your doctor right away. The sooner you address the problem, the better your chance of finding effective treatment.

Issues Affecting Women

Sexual dysfunction doesn't only affect men. It can affect women, too. If you have any of the following symptoms, there's a good chance you're suffering from some form of diabetes-related sexual dysfunction. Talk to your doctor about treatments right away.

• Decreased sexual desire
• Vaginal dryness or tightness
• Pain or discomfort during or after intercourse

•  More difficulty reaching orgasm than in the past

Contributing Factors
A variety of factors may contribute to sexual problems for women:

• Neuropathy-damage to the nerves that affect circulation and sensation-can affect what you feel and how you respond
• High blood sugar can sap your energy, making you feel too worn out for sex; it can also dehydrate tissues, lessening lubrication
• Certain medications can decrease desire or cause vaginal dryness

•  Urinary tract and yeast infections, relatively common in women with diabetes, can cause discomfort¹

Prevention and Treatment
Start by talking with your doctor. They'll help you determine the best course of action. A simple solution may work, such as using special lubricants or learning muscle relaxation techniques.

Many women never seek help for their sexual problems because they're too embarrassed, or they feel it's a trivial matter. But it does matter, and it's not trivial. Your doctor deals with this sort of issue regularly, so don't hesitate to talk about it. It's worth it.

¹ Joslin Diabetes Center "Sexual Dysfunction-Causes and Symptoms"
² MayoClinic.com "Erectile dysfunction in diabetes: Keys to prevention"