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Sexual Wellness

by Laura Hieronymus, MSEd, APRN, BC-ADM, CDE, and Lawrence Maguire, MD

In addition, when blood glucose levels are high, you may feel irritable or cranky. Other symptoms of high blood glucose such as frequent urination, feeling thirsty, and having blurry vision can be annoying and preoccupying, keeping you from any preferred behavior, including spending time with your partner.

Persistent high blood glucose levels can increase the likelihood of infections in the urinary tract, vagina, and penis, which can obviously put a damper on intimate moments.

Over the long term, blood glucose levels that remain high and uncontrolled contribute to neuropathy (nerve damage) and blood vessel damage leading to impaired blood circulation. Both of these can affect the body’s response to sexual stimulation, leading to erectile dysfunction in more than one in three men with diabetes as well as lubrication problems related to sexual function in up to 60% of women with diabetes.

Impaired circulation. High blood glucose, high blood pressure, and high cholesterol all raise the risk of developing atherosclerosis, or an accumulation of fatty material under the inner lining of the arteries. Atherosclerosis raises the risk of having a heart attack or stroke, and it can also lead to impotence and problems with arousal and orgasm (in men and women) if it impedes blood flow to the genital region.

Neuropathy. As many as 50% of people with diabetes eventually develop some type of nerve damage. While damage to the peripheral nerves is associated with burning, tingling, or numbness in the feet, damage to the nerves that regulate involuntary functions, such as those that relate to response or excitement from sexual stimulation, can contribute to sexual problems. The function of nerve fibers plays a vital role in one’s ability to experience sexual pleasure.

Preventing diabetes complications, including sexual complications, involves controlling your blood glucose, blood pressure, and blood lipid levels. If your glycosylated hemoglobin (HbA1c) level is currently higher than 7% (or higher than the HbA1c goal recommended by your diabetes care provider), your blood pressure higher than 140/80 mm Hg, your low-density lipoprotein (LDL) cholesterol 100 mg/dl or above, or your triglyceride level 150 mg/dl or above, speak to your provider about bringing these levels into the recommended ranges.

Take a proactive role in your diabetes health by monitoring your blood glucose levels, taking action when they are too high (based on medical advice), and communicating regularly with your diabetes care team. Maintaining excellent health takes hard work, but the payoffs are many, including feeling better mentally and physically.

Getting help
If you’re experiencing persistent sexual difficulties, speak to your diabetes care provider about it. Based on your description of the difficulties you’re having as well as your previous medical history, including any drugs you may be taking, your provider may be able to rule out some possible causes or identify some likely ones. He may choose to treat you himself or may refer you to a specialist such as a urologist for care. If your diabetes control appears to be a contributing factor, your provider may recommend changes in your treatment plan or refer you to an endocrinologist or possibly to a diabetes educator for education and skills training. If your sexual problem appears to be primarily psychological in nature or your provider believes you may be experiencing depression, he may refer you to a mental health care provider such as a psychiatrist or psychologist for therapy and, if needed, antidepressant drug therapy.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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