Diabetes and Sexual Health: What Women Should Know

In a recent study, 30 to 40 percent of women with diabetes said that they have sexual problems. These women said that they choose not to have sex and are not satisfied with sex. But it’s not A1C levels or problems with diabetes that have a direct effect on sexual function. Instead, the problem for women with diabetes is caused by lack of arousal or feeling “in the mood” for sex. If a woman does not feel in the mood, then her body does not work the way it needs to for her to enjoy sex. While studies are under way to learn more, what we know now is that diabetes can affect a woman’s sex life in different ways, at different times in her life.

Menstrual cycle

Some women find that their menstrual cycles are irregular when their blood glucose levels are high. Others find that their blood glucose levels are higher just before and during their periods. This is because of normal changes in hormones that occur during the course of a women’s menstrual cycle. Many women find that when their blood glucose levels are going up and down, they have less energy. This may lead to less interest in sex. Some women find that changing their insulin dose just before their period can help keep their blood glucose on target.

Fear of pregnancy

Many women with diabetes know the importance of having near normal blood glucose levels before getting pregnant. They also know that taking care of diabetes during pregnancy is demanding. They want to make sure that the time is right for them before they get pregnant. A reliable method of birth control can help women feel more relaxed and in the mood for sex.

Infections

Vaginal infections, such as yeast infections or vaginitis, and bladder or urinary tract infections, are more common among women with diabetes. This is because the glucose in the blood gives the bacteria an excellent setting in which to grow. These infections do not have anything to do with how clean a woman is, her age, or her sexual activity. While vaginal infections do not directly affect sexual function, they can cause discomfort and affect how sexy and desirable a woman feels. For more detailed information, see the next page.

Signs of a bladder or urinary tract infection include feeling like you need to go to the bathroom more often, having painful urination, having painful sexual intercourse, or blood in the urine. Some women find that cranberry juice helps to prevent bladder infections. Keep in mind that most cranberry juice is sweetened: about 1/3 cup has 15 grams of carbohydrates, equal to one carb serving. Cranberry juice sweetened with Splenda has about 15 grams of carbohydrate in one cup. Cranberry pills, which are available over-the-counter, may be an alternative that will not affect your blood glucose levels. If you believe you have a bladder infection, be sure to contact your health care provider as you many need testing and/or treatment.

Menopause

During menopause, hormone levels change, and some women with diabetes find that their blood glucose levels go up and down more than usual. Mood changes and hot flashes are common. Menopause can also cause vaginal dryness. This can make having sex painful or uncomfortable. You can buy lubricating gels, such as water-soluble jelly—these usually solve the problem. If this doesn’t fix things, ask your health care provider about estrogen creams that are available by prescription only.

Lack of sexual desire

Some women find that they are just too tired. They are coping with busy lives, caring for children and grandchildren, or working and trying to find some time for themselves. Diabetes adds more stress and work to their lives. High blood glucose levels add to feeling tired and run down.

Depression is more common among people with diabetes. Depression usually causes people to feel less interested in sex. In addition, some of the medicines used to treat depression can affect sexual desire.

For anyone with diabetes, thinking about low or high blood glucose levels during sex can get in the way. Women may feel less desirable or think that their bodies are less attractive as they get older and perhaps heavier. Complications from diabetes also can cause women to feel less desire emotionally and physically.

putting the spark back in your sex life

The first step is to figure out the cause for the decrease in your desire for sex.

– If you have dryness, infections or are worried about getting pregnant, talk with your health care provider or your gynecologist.

– If you are worried about your blood glucose levels, do a quick check before you have sex. Knowing that you are not likely to have a concern with your blood glucose levels can help you relax and enjoy yourself. You also may want to keep something to treat low glucose by your bedside so that if your levels do go low, you won’t have to get up.

– If you feel sad and blue, or if your sadness is affecting your desire for sex, talk with your health care provider, as there are medicines that may be able to help.

Because there is a link between the mind and body for women with diabetes, these steps can make a difference in getting back that spark!

Reviewed by Robert Ehrman, MD