Mike’s doctor looked and sounded concerned. “Your sugars are up, your blood pressure is up, and you’ve gained 10 pounds since I last saw you, ” she said. “You were doing so well. What happened? ”
“I don’t know,” said Mike. “I’m just down. Exercising and checking my blood glucose don’t seem worth the effort now. My neuropathy is burning holes in my feet. It’s been a hard year.”
“Sounds to me like you’re depressed,” said the doctor. She then wrote out a prescription for a selective serotonin reuptake inhibitor (SSRI) for Mike’s depression and another for a refill of Mike’s usual blood pressure medicine, but this time with a higher dose.
The doctor didn’t ask about Mike’s sex life, and Mike didn’t volunteer that what was really bothering him was that he and his wife Barbara had stopped having sex about 10 months before. He couldn’t count on getting erections or keeping them, and without them, he withdrew, both physically and emotionally. He and Barbara were miserable. Unfortunately, both of the medicines his doctor had just prescribed can have the side effects of decreasing sex drive and making it harder for men to have erections. So the new treatments were potentially going to make Mike’s problem worse.
Mike hadn’t mentioned his sexual problems to his doctor because he felt embarrassed about them, and his doctor apparently didn’t think to ask about sexual issues. Had she known about Mike’s erection difficulties, she might have prescribed a drug for erectile dysfunction rather than an antidepressant. But Mike had already bought some Viagra on the Internet. It had helped a little with the erections, but not much, and it did nothing for his energy level or low mood.
Barbara was at her wit’s end. She thought Mike’s withdrawal meant he didn’t love her anymore. True, there were problems in the relationship besides the cessation of their sex life. But Mike and Barbara did not talk about those or about sex, either, so they drifted farther apart.
Problems like Mike and Barbara’s happen all the time: A medical condition such as diabetes causes sexual difficulties that don’t get talked about, either at home or in the doctor’s office, and pretty soon an individual’s or couple’s sex life is a distant memory. This can have major impact on a relationship and on a person’s mental and physical health. Sex with a caring partner can help people feel more connected and supported. It can be a form of relaxation, a pain reliever, and a sleep aid. It can be a source of physical pleasure, even for people whose bodies more frequently give them pain and frustration.
Having a satisfying sex life can raise a person’s perceived quality of life, make him feel less stressed, and serve as a motivator to care for himself and his diabetes. If sexual activity stops for any reason, it can reduce the motivation to carry out self-care tasks. Fortunately, there are always ways to restore and improve your sex and love lives, whether or not you have a partner, no matter what physical or emotional challenges diabetes throws your way.
Diabetes’s effect on sex
Diabetes can interfere with sexual function in numerous ways. Chronic high blood glucose can contribute to both neuropathy (nerve damage) and impaired blood circulation, both of which can lead to decreased or delayed erections, lubrication, genital sensation, and orgasm. In women, high blood glucose can lead to frequent vaginal yeast infections and urinary tract infections. Neuropathy can make bladder control more difficult. And high blood pressure can also damage blood circulation, leading to the same arousal and orgasm problems as high blood glucose.
