Sexual Health is of equal importance to persons suffering from Type 2 Diabetes as they are concerned of the diabetes itself. As a healthy sexual life brings happiness and better environment and circumstances for diabetes management.
Many people assume that when someone has a chronic illness, they have so many things going on managing the illness that sex automatically gets relegated to the back burner. However, research shows that sexuality and sexual expression rises to the top of the list when it comes to quality of life issues, no matter what other problems a person may be facing. People with type 2 diabetes are no different. That’s why it is important to recognize and attempt to address the known sexuality issues that often accompany type 2
diabetes
In some aspects, the effects of type 2 diabetes on sexuality are gender less, meaning both genders suffer the same problems. In other aspects sexuality and sexual problems are gender specific.
Sexuality Issues for Both Men and Women
One of the most common sexuality issues in patients with type 2 diabetes is decrease in libido, or loss of sex drive. This can be particularly frustrating if, prior to onset, the patient reports having had a thriving libido and satisfying sex life. Causes of low libido associated with type 2 diabetes include:
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- sexual side effects of medication, such as those for high blood pressure or depression
- extreme fatigue
- lack of energy
- depression
- hormonal changes
- emotional health issues including stress, anxiety and relationship issues
Diabetic neuropathy can also be a problem as it can result in numbness, pain, or lack of feeling in the genitals. This can inhibit orgasm, make sex painful or unenjoyable as response to sexual stimulation can be lacking or absent.
Lack of communication between partners about sexual issues can impact the sexual and intimate side of a relationship. Sometimes couples just “check out” of the relationship sexually because avoiding discussion of the issues is easier than confronting them and seeking solutions. Instances when one partner becomes the primary care giver of the other can lead to a change in how each view the other. Often they get so caught up in the roles of “patient” and “caregiver” that romance slips away.
Sexuality Issues for Men
The most widely reported problem men face is erectile dysfunction. In fact, in some cases diabetes is diagnosed when the man seeks treatment for erection dysfunction—erectile dysfunction is a presenting symptom of diabetes, particularly for those under 45 years of age.
Failure to achieve or maintain an erection until ejaculation can be caused from nerve, muscle, or vascular damage. It is estimated that between 20 and 75% of men will have a problem with erectile dysfunction. Changes in testosterone level can also affect erection, as can sexual side effects of medication. Co-morbid conditions that often accompany diabetes also contribute to erectile dysfunction. For example:
- obesity
- high blood pressure
- emotional and psychological issues such as depression, low self esteem, and anxiety
- too little exercise Retrograde ejaculation is also a possible sexual problem men may experience as a complication of type 2 diabetes. Retrograde ejaculation, which is when all or part of the semen is ejaculated back into the bladder instead of out of the penis, is caused when there is a problem with internal sphincter muscles. Sphincter muscles are responsible for opening and closing passages in the body. Abnormally high glucose levels can result in nerve damage to the sphincter muscles and the result is retrograde ejaculation.
Sexuality Issues for Women
For women, the most common sexual problem that comes with type 2 diabetes is vaginal dryness. This can be caused by hormonal changes or from blood flow problems to the
genitals.
Women who have diabetes have increased rates of vaginal infections and inflammation, both of which can make sex painful. Another issue is that nerve damage to the bladder can cause incontinence making sex embarrassing. Women with diabetes are also more likely to have frequent urinary tract infections, which can also make sex painful and uncomfortable.
For some women with diabetes, vaginitis (inflammation of the vagina) can be recurrent. Vaginitis can be brought on by a number of different ways including bacterial imbalance of the vagina (bacterial vaginitis) yeast infections (thrush) or from chemical irritation, such as from soaps or fabric conditioners. This can make sex painful, and is heralded by itching or burning sensations. Cystitis can also be a recurrent problem for women with diabetes. Furthermore, some evidence indicates that, in a similar way to men being unable to maintain an erection, the woman’s clitoris may fail to respond to stimulation.
Hypoglycemia and sex
Hypoglycemia can occur during sex. You may also suffer from a night time hypo as the physical exertions of sex mean that in some ways it makes sense to treat intercourse in a similar way to exercise. However, testing before and after ‘getting it on’ may not help in setting the right mood(!). How you handle blood sugars around sex will come down to personal preference. If you have an understanding partner it certainly helps, but how you handle things yourself is also key.
If you’re in a new relationship, it may be tempting not to tell your partner about your diabetes and you may find yourself taking great pains to hide your diabetes. However, your diabetes will emerge sooner or later so it’s best to be open where possible. If your partner is reassuring, you may have found yourself a great life partner.
Tips and Tricks to Help Stop Type 2 Diabetes from Hijacking Your Sex Life
Sexual problems that occur with type 2 diabetes can be frustrating, embarrassing, and cause anxiety. Patients may feel that throwing in the towel and giving up on sexual expression is easier that finding ways to cope and that things can never be the way they once were. However, there are things you can try to help ease the problems and make maintaining the sexual and intimate part of your life easier.
Fighting Low Energy and Fatigue
If low energy and fatigue are a problem, try having sex at a different time of day when energy is at its peak. Nighttime may not always be the right time. After a long day—and with the added fatigue that goes along with diabetes—the last thing someone may have energy for is sex. Try sex in the mornings or afternoons. Experiment to see what works
best for you.
Overcoming Dryness
Use lubricant liberally to deal with vaginal dryness. Water-based lubes are best and there is a plethora of brands available. Do not be afraid to stop during sex to add more lube—sexual activity can often require a greater amount.
Improving Libido
Hormonal replacement can also help both men and women with libido, vaginal dryness, and erection issues. Ask your doctor if this is a possibility for you. Hormone replacement can come in the form of pills, patches, creams, or injectable medications.
Staying Healthy Enough for Sex
Maintain optimal health overall for a healthy sex life. This includes maintaining proper blood sugar levels. Remember, sex is like exercise in the sense that is uses up energy, so be aware of your glucose levels. Hypoglycemia can occur during sex, as it does with exercise if you are on medications that increase the amount of insulin in the body. If you are, consider checking your blood sugar levels before engaging in sexual activity. Also keep in mind that what is good for the heart is good for the genitals. Sexual arousal, vaginal lubrication, and erection all have a lot to do physically with blood flow. Engage in a lifestyle that promotes good heart health and circulation.
Vibrators to Overcome Neuropathy
Did you know sometimes using a vibrator could help with neuropathy and increase stimulation? This is true for both men and women, although it can take several uses before a change is noticed. Consider getting a small vibrator and applying it to areas where you experience neuropathy for a few minutes each day.
Discussing sexuality issues
Make discussing sexuality issues a priority with your health care provider. Sexual dysfunctions can be an indicator of the progression of a disease or a sign that a disease is not under control. Also, don’t be afraid to discuss sexual side effects of medication with health care providers. Ask if there is a different medication to help the problem that does not have the same side effects. Also, feel free to ask about erectile dysfunction drugs. Some men are candidates for ED drugs and some are not. Penile pumps may also be an option for men who have problems with erections.
Pay close attention to your relationship. Find other ways to express intimacy when desire is not at its peak. Massage, baths, and cuddling are just three examples of ways to does not involve intercourse. Make time for each other to be a couple away from care giving. Get respite care if needed. Have a date night where the topic of diabetes is off limits. Communicate with your partner about your feelings and possible sexual issues that may occur. Consider support groups or counseling to help with the emotional issues associated with illness or sexual problems.
Padding the bed can go a long way to help in case of urine leakage. Lay out a couple towels or ask your medical supply company for some pink pads. Embarrassed? Don’t be. Everyone urinates and if you are comfortable sharing your body with someone sexually, these are things you should feel free to talk about.
Type 2 diabetes may make sexual activity more challenging but it does not mean you must forgo the sexual side of life completely. Many times if the disease is brought under control, sexual dysfunctions resolve themselves. The most important thing is not to give up on what is an important quality of life issue.
Studies Shows Diabetes Is Linked to Loss of Libido
Middle aged and older adults are interested in sexual activity, but diabetes impairs libido and can result in erectile dysfunction, a new study shows. Researchers in Chicago say men diagnosed with diabetes are more likely to express a lack of interest in sex, but also to experience erectile dysfunction. Scientists at the University of Chicago Medical Center conducted a study of nearly 2,000 people between the ages of 57 and 85.
The study found that about 70% of men and 62% of women with diabetes and sexual partners were found to engage in sexual activity two or three times a month — comparable to people without diabetes.
The study also found that:
- Men were more likely to express a lack of interest in sex if they had diabetes.
- Men also were more likely to suffer erectile dysfunction if they had diabetes.
- Women as well as men with diabetes reported a higher rate of orgasm difficulty, including climaxing too quickly for men, or not at all, which was reported by both men and
women. - Only 19% of women compared to 47% of men, all with diabetes, had discussed sexual problems with a doctor, and men were more likely to talk about it than women.
Men in the study regardless of age or diabetes status were more likely than women to be married or living with a partner, and more men than women said they were sexually active.
The research was done as part of the National Social Life, Health and Aging Project, which involves in-home interviews, self-administered questionnaires, blood tests to assess diabetes status, and medication audits of 1,993 participants.
“Patients and doctors need to know that most middle age and older adults with partners are still sexually active despite their diabetes,” says study researcher Stacy Lindau, MD, associate professor obstetrics and gynecology at the University of Chicago, in a news release. “However, many people with diabetes have sexual problems that are not being addressed.”
She says almost half the women in the age group studied do not have sexual partners, and that women with diabetes are much less likely than women without diabetes to have a partner. “Those who have partners were more likely than men to avoid sex because of a problem and were less far less likely than men to discuss a sexual problem with their doctors.”
The study found, based on blood tests, that:
- 47% of men had diabetes.
- 22% had the disease but hadn’t been previously diagnosed.
- Almost 40% of the women had diabetes, including 20.5% who had been diagnosed and 19% not previously diagnosed.
- Researchers say those findings are comparable to previous studies of people over age 60 and consistent with the estimate of 12 million people with diabetes in the U.S. over the
age of 60.
The researchers report that very little has been known up until now about sexuality among people with undiagnosed diabetes, who typically are earlier in their stage of the disease and who don’t know that they have the condition. “Ignorance of the diagnosis protects individuals from the psychological burden and stigma associated with having diabetes,”
Lindau says. “The elevated prevalence of orgasm difficulties in people unaware of their diabetes suggests that these are predominantly physical.” She says erectile dysfunction, as well as loss of interest in sex among men with a diagnosis, may in part be due to the “psychological burden” associated with the disease. The study found that 60% of men without diabetes had masturbated in the past 12 months, but the rate was only 47% for men who had been diagnosed, or had diabetes and didn’t know it.
The researchers say only 22.5% of women reported masturbating in the past year. About 29% of women without diabetes did so, compared to only 15% who had the disease whether it had been diagnosed or not. Women, like en with diabetes — diagnosed or not diagnosed — had a higher prevalence of difficulties with having orgasms.
Importance of Addressing Sexual Problems
“Failure to recognize and address sexual issues among middle age and older adults with diabetes may impair quality of life and adaptation to the disease,” says Marshall Chin, MD, one of the researchers and a professor of medicine at the University of Chicago. “Sexual problems are common in patients with diabetes and many patients are not discussing these issues with their physicians.”
The researchers write that the rate of erectile dysfunction was not “markedly elevated” in men with undiagnosed diabetes (36%), compared to men without diabetes (32%).
However, the inability to experience orgasm was high in men without diabetes, and comparable to men who had been diagnosed with the disease.
The study findings suggest “that loss of orgasmic function may not only occur as a consequence of erectile dysfunction … but also may actually precede erectile dysfunction, at least as perceived by some men with diabetes.” “Attention to potentially treatable sexual problems in middle-aged and older adults with diabetes should improve quality of life and enhance overall diabetes management,” the authors write. The study is published online in advance of print publication in the October issue of Diabetes Care.
In women, even as late as 1989, it was thought that there was no greater incidence of sexual disorders in diabetics than in the general population. By 1994, however, researchers noted that problems with libido, arousal, and orgasm are common in both men and women with diabetes.
Common answers about sexual dysfunction in women
It is true that some women with diabetes experience decreased sex drive or the inability to achieve orgasm. Like other complications of the disease, this is a slow and progressive pattern. It is thought to be a result of diabetic neuropathy and/or vascular disease.
Also, the fact that uncontrolled diabetes can sap strength and therefore sexual desire, may play a role in the problem. Diabetic women have a predisposition to chronic vaginal infections, which may also interfere with normal sexual pleasure. Add to this the effects of medications taken for other medical problems such as heart disease, and the fears that many of us carry concerning the complications of pregnancy, the effect of our disease on our marriages and work, and you can begin to appreciate the complexity of trying to ferret out the causes of sexual dysfunction.
More research has been done on type 1 diabetic women than women with type 2 diabetes. However, research completed does show that type 2 diabetic women are more likely to experience some sort of dysfunction. Participants reported less sexual desire, less satisfaction, more avoidance of sex, difficulty with lubrication, and fewer orgasms.
Researchers postulated that these type 2 diabetic women had more neurovascular problems which would account for lubrication difficulties. These researchers also examined psychological aspects of older type 2 diabetic women who reported that they felt their bodies were less sexually attractive than non-diabetic women. Now the good news. More than 60% of women in the study did not report any dysfunction.
Researchers point out that if you are experiencing difficulties, a candid talk with your physician about the side effects of medications you take which may impact your sex life is
very important. For example, certain medications for hypertension may affect orgasm.
As important is to monitor food intake and exercise. Controlling weight and diabetes will enhance self esteem and body image. Also, knowing that as we age we may need more time for arousal, it is important to share your needs with your partner, and if necessary, to ask for help from the appropriate professional.
Researchers theorize that inflammation may also dampen desire. “Sexual desire is a brain-driven event,” says Stacy Tessler Lindau, MD, MAPP, director of the Program in Integrative Sexual Medicine at the University of Chicago. “If inflammatory molecules cross the blood-brain barrier and circulate in the area where there is sexual desire, then it’s plausible the desire for sex may be affected.” Another possible culprit: low testosterone, which often affects men and women with diabetes.
Treating women isn’t quite as simple. Some studies suggest that taking testosterone can increase sexual desire in women—a 2008 article in the New England Journal of Medicine found that post-menopausal women had a greater sexual appetite after taking testosterone for almost six months—but the treatment is still understudied, particularly its long-term effects on women’s health. Not only that, but it’s hard for researchers to determine whether a particular woman’s low libido is a result of diabetes, emotional issues, or something else because low libido is common in women regardless of the presence of diabetes.
A small study in the August issue of The Journal of Sexual Medicine found that women with type 1 diabetes who took 5 mg of tadalafil (Cialis) for 12 weeks reported an improved quality of life, greater arousal and orgasm, more enjoyment and satisfaction from sex, and more frequent sex. This doesn’t mean you should start sneaking your partner’s pills—please don’t: The treatment is unapproved in women, dangerous in some people with heart problems, and generally unsafe until proved otherwise. But it does show promise for female treatments of the future. As for the present, Lindau says some women use clitoral pumps to aid blood flow but notes that the device isn’t for everyone.
An orgasm is a sought-after sexual reward, but for people with diabetes it can feel like an unattainable goal. And, yes, we’re talking about women and men here. Both can struggle with the elusive O, and the first thing they and their doctors should check are the medications they take, such as antidepressants.
Though women in general report more difficulty having an orgasm than men, those with diabetes have even greater difficulty. Sure, a woman’s inability to climax often has to do with her mental or emotional state (more on that later), but diabetes may be in play, too. According to a study published this August in the journal Obstetrics & Gynecology, middle-aged women whose diabetes requires insulin are 80 percent more likely to report trouble reaching an orgasm than women without diabetes.
“To the best of what we know now, the neurovascular system is necessary for arousal and orgasm,” says Lindau. “If the small nerves are not working properly, then you can have sensation problems. In order for the clitoris to have the engorgement it needs to orgasm, it needs to have the blood flow and sensation.”
A hormone imbalance may be to blame, Roszler says. Some scientists studying women’s ovulation cycles hypothesize that off-balance hormones, and not just testosterone, may be behind women’s decreased arousal and orgasm, but the research is in its infancy.
Essential Sex Tips For Diabetics
What’s going on with your blood sugar can have a huge impact on how you feel between the sheets—and not in a good way. “Medical conditions such as diabetes can cause your sex life to take a plunge,” says Lauren Streicher, MD, an assistant clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and author of Slip Sliding Away: A Gynecologist’s Guide to Turning Back the Clock on Your Sex Life. “As a diabetic, you have multiple obstacles for achieving a satisfying sex life that other people don’t have.” The good news is that once you understand how to deal with the symptoms that may be putting a damper on your sex life, you can boost your sexual satisfaction big time.
1. Find some new toys
If sex feels a little (or a lot) less intense lately, diabetes may be to blame. “Diabetics often have decreased blood flow to the vagina because of blood vessel changes, which leads to less arousal and sensation,” says Streicher. “Studies show that diabetics don’t orgasm as easily as others due to vascular changes and nerve damage.” In short: What used to work for you in terms of reaching orgasm may not be working any more, so it’s time to try something new. The quickest way to get the stimulation you need is with a vibrator.
“Make sure the model you use offers clitoral stimulation, because it won’t help much to have something hard or overly powerful inside your vagina,” Streicher says. Here are 18 sex toys experts use—and love.
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2. Pay attention to pH
Increased blood sugar levels can throw the pH balance of your vagina out of whack, upping your odds of chronic vaginal infections. “When pH goes up, the healthy lactobacilli in your vagina can no longer survive, and you get bad bacteria growth like bacterial vaginosis and yeast infections,” says Streicher. One way to keep your bacteria in balance is with an OTC vaginal gel twice a week. Try RepHresh, which is FDA-approved to help restore normal vaginal pH and it also acts as a moisturizer for more comfort during intercourse.
3. Eat to get in the mood
Aphrodisiacs aren’t just something your hippie cousin told you about—there’s some science to back up the popular notion that eating certain foods can have a positive effect on your sex drive. The mineral zinc may work as a libido-enhancer by helping with testosterone production, and oysters hold more zinc than any other food. Other good sources of zinc include red meat (which is healthy in moderation, especially if you go grass-fed), crab, and cashews.
4. Control your glucose levels
Obviously you need to do this for your overall health, but your vagina will thank you for it, too. “Maintaining blood sugar in the normal range helps protect blood vessels, prevent nerve damage, and makes it easier for your vagina to fight off infections,” Streicher says. That means ditching high-glycemic carbs in favor of whole grains, protein, and fruits and veggies. Paying attention to calories is also essential. “Taking in less food puts less demand on the insulin-producing cells so they’re more efficient, as well as eliminating extra fat in the pancreas that inhibits insulin production,” says David Kendall, MD, chief scientific and medical officer at the American Diabetes Association.
5. Get moving
Research shows exercise plays a role in reversing diabetes symptoms—and it also works wonders for your sex life by strengthening your heart, improving flexibility and stamina, and increasing blood flow to those all-important areas. No need to sign up for a marathon; low-impact workouts like yoga can increase circulation, even awakening sensation in areas where you may have experienced nerve damage, like your fingers and toes. Get started with these 9 yoga poses for better sex.
6. Use a sugar-free lubricant
Lubricant should be a part of everyone’s sexual arsenal, but diabetics need to watch which lubes they choose. “Some lubricants actually contain forms of sugar, such as glycerin and propylene glycol, which will throw off your vaginal pH and possibly trigger yeast infections,” says Streicher. “The last thing you want if you already have higher levels of sugar in your vagina is to add more sugar to it.” Check the ingredients list and choose a silicone-based lube.
7. Learn to love your body
If you’re like many people with diabetes, you’ve been advised by your doctor to lose weight—which can lead to some awfully critical feelings about your body. Not that you need to be diabetic to have those concerns: A recent study found that both men and women in long-term relationships reported feeling distracted by negative thoughts about their bodies during sex, and women in particular said they were worried about what their partner thought. To help quiet that nasty voice in your head, try these 5 ways to love lights-on sex.
8. Get some sleep
Most Americans don’t get enough sleep, and for diabetics, getting your zzz’s is especially important. Sleep has been found to play a role in controlling blood sugar—one study found that regularly getting less than 6 hours of sleep a night made people three times more likely to have elevated blood sugar levels. If you have trouble sleeping, these simple tips can help.
9. Don’t have sex
If you’re not feeling up to sex on a given night, there are other ways to maintain the bond with your partner. “Spicing up your sex life doesn’t necessarily mean that you have to try a bunch of unusual positions,” says Justin R. Garcia, MS, PhD, an evolutionary biologist at The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University. “You can be erotic and sexual without engaging in sex.” Doing something intimate that doesn’t involve intercourse—whether it’s cuddling during a movie, reading erotic literature, or splurging on a treat like a couples massage—can strengthen your bond.
10. Find a sexpert
No one should have to live with less-than-stellar sex. There’s help out there for you, but if you’re diabetic it might just take a little extra searching. “The sexual side effects of having diabetes are real, but you may have a doctor who’s not an expert in that area,” says Streicher. “If your doctor is unable to address your concerns, start by checking out a university-based sexual clinic.” If you don’t have one in your area, the International Society for the Study of Women’s Sexual Health (ISSWSH) can help you find a qualified expert.
Women Fitness wish this resource of information way assist the diabetic patients to have more fulfilling and happy sex life.