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When Diabetes Affects Your Sex Life

by David Spero, RN

Sex involves more than just genitals, though. Pain in any part of the body can make it hard to relax and enjoy sexual activity, and some diabetes complications can cause pain. Fatigue can make sex seem like more trouble than it’s worth, and diabetes can be related to fatigue in numerous ways, from interfering with a person’s sleep to causing a person to feel constantly drained from the effort of coping. Both high and low blood glucose can affect a person’s mood, energy level, and, hence, interest in sex.

Then there are the psychological effects of having diabetes. While many people with diabetes have a strong sense of self-worth, some feel that having diabetes or its complications makes them unattractive to others. These people may think of themselves as “damaged goods” and fear that nobody will want them as a partner. If people feel bad about themselves, they may lose sexual desire or withdraw socially.

A number of medicines that are commonly prescribed for people with diabetes are known to dampen sex drive and/or sexual function as a side effect. This is often true of antidepressants and blood pressure medicines. Pain medicines, especially narcotics but also some medicines commonly taken for neuropathy pain, can cause sexual problems. Alcohol and street drugs such as cocaine or marijuana can interfere with sexual functioning. And smoking tobacco impairs circulation and nerve function and lowers libido.

Medical approaches
What can you do if you’re having sexual difficulties? You might start by talking with your doctor. Let him know what’s going on, and ask if your symptoms could be the result of a medical condition or a side effect of any drugs you are taking. Since high blood glucose can interfere with sexual functioning, ask how you can “tighten” your blood glucose control if it is not currently optimal. Ask about any signs of peripheral neuropathy in your feet, such as loss of sensation; this can easily be tested in a doctor’s office. Evidence of neuropathy in your feet may mean that nerves in other parts of your body are affected as well, possibly affecting your sexual functioning.

What about your blood pressure? While high blood pressure can have negative effects on sexual functioning, so can some of the medicines used to treat it. Your doctor may be able to change your prescription to a blood pressure drug that is less likely to cause sexual side effects. In addition, lifestyle changes such as increased exercise, less sodium in your diet, and increased consumption of fruits and vegetables can help to lower blood pressure and do not have negative sexual side effects. Your doctor can tell you whether your blood pressure is at the recommended level (below 130/80 mm Hg for people with diabetes), point you toward safe and effective lifestyle changes, and/or refer you to a dietitian or exercise specialist for help in these areas.

Losing weight if you are overweight can also improve sexual functioning, and a dietitian can help you work out a plan for weight loss.

If an antidepressant you are taking is a likely cause of your sexual dysfunction, it may be possible to take a brief “drug vacation” (usually 2–3 days) for sexual activity. However, you should be sure to clear this with the doctor who prescribed the antidepressant rather than doing it on your own. If you smoke, drink more than moderate amounts of alcohol, or use illegal drugs, your doctor may be able to offer treatment or refer you to a treatment program for substance abuse.

Your doctor may also prescribe drugs or devices specifically for your sexual problems. For men with erection problems, there are three oral pills, an injectable drug, a urethral suppository, as well as vacuum devices. Men who are found to have low testosterone levels may benefit from testosterone supplementation.

For women, treatment of sexual dysfunction can include treatment of vaginal or urinary tract infections, treatment for urinary incontinence, estrogen therapy or over-the-counter lubricants for vaginal dryness, and testosterone supplementation for decreased desire, vaginal dryness, and diminished genital sensation. However, this use of testosterone is not approved by the Food and Drug Administration (FDA), so its safety is not established, and not all doctors may be willing to prescribe it. A device called Eros Therapy is approved by the FDA for sexual arousal and orgasmic disorders in women. The device applies a gentle vacuum to the clitoris, increasing blood flow to the clitoris and surrounding tissue, and is available by prescription.

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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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