Neuropathy, Diabetes, and Sex

A major form of diabetic nerve damage manifests as sexual dysfunction. When nerves are injured by high sugar or poor blood flow, sex lives can suffer.

In men, sexual neuropathy can cause loss of desire, loss of erections, or inability to orgasm. In women, nerve damage can diminish lubrication, pleasure, orgasm, and relaxation. So what can we do about it?

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The first treatment is to get blood sugar levels down. A study at the Cleveland VA hospital showed that A1C levels were the single best predictor of erectile dysfunction (ED).

The big news is that there was “a significant correlation of neuropathy with hemoglobin A1C, but not with patient age, duration of diabetes, or [blood pressure medicines].” That means if people get their A1C levels down, in most cases their neuropathy, including sexual function, improves dramatically. We have lots of articles on lowering glucose through diet (especially low-carb diets), exercise, medications, and herbs on this site.

Neuropathy treatments

There are other ways to improve nerve function, as I wrote about last week. For sex problems, these ways include medications, supplements, self-care, and modifying your sex life.

Medications: The ED drugs such as Viagra, Cialis, and Levitra work very well for up to 60% of men with diabetes. They also have been found to improve sex function in women in studies. They may even help other forms of neuropathy such as leg and foot pain.

You’ll want to get your testosterone level checked (women, too). Low testosterone equals low desire, low energy, and poor sexual function. Testosterone levels can often be raised with a rub-on testosterone gel.

Women dealing with pain, dryness, loss of desire, or difficulties with orgasm might benefit from estrogen supplements used vaginally. These meds are available without a prescription.

Other medical treatments for erections include prostaglandin injections, vacuum pumps, and implanted devices to create erections. Read more about these treatments here.

Supplements: Many nutrients can help with neuropathy, including sexual neuropathy. Among them are acetyl l-carnitine, vitamin D, alpha-lipoic acid, B vitamins, and fish oil.

Another way is exercise. From a sexual standpoint, exercise has at least four benefits. It lowers glucose and seems to improve circulation to the genitals. It increases energy levels and might increase your desire. Besides, you’ll look better to your partner.

Behavior change

The biggest sexual disability most people have is believing there is only one way to do sex. If they can’t do it their way, they give up. Why not try something new? For intercourse, try different positions. Woman on top is often most comfortable for both partners.

Remember that there is far more to sex than intercourse. Using hands, mouths, toys, and imagination, people can have great sex without genitals coming together. I wrote about some of those ways here. Scroll down to the section called “Trying Something New.”

Be careful about lows. Like any exercise, sex can lower your blood sugar. Maybe check your glucose before starting, to see where you are at. Have glucose tabs or juice handy and maybe take some before you need it to be safe and keep from having your loving interrupted by a hypo. Some people say sex is better if their glucose is just a little higher than normal, like in the 100–130 range.

Use a lot of lube. You can buy “personal lubricants” at drugstores or a supermarket these days, and it makes everything easier and more enjoyable.

Practice. WebMD suggests that if you’re a man using a vacuum pump or constriction band, practice with it before trying it with a partner. If you’re comfortable and natural with it, your partner won’t have a problem. The same thing goes for glucose pumps or continuous glucose monitors (CGMs). Decide if you’re going to leave them on for sex or disconnect them, and practice doing it in an unobtrusive way.

Take time for sex. Don’t treat it as an afterthought or something you do when you’re already tired and stressed from a long day. Make it a priority. Get some rest beforehand. Do something romantic or arousing together, like a warm shower, a romantic dinner, a dance, or a sexy movie.

Deal with personal issues and relationship issues. The better you feel about yourself, the sexier you will be. The better your relationship, the more likely you are to have good sex. Some individual or couples counseling and support might be helpful.

If your nerves or blood vessels are severely damaged, things like exercise, relaxation, or a better relationship might not bring them back right away. But they help. And with treatment, getting your glucose down, and taking a more flexible approach to sex, almost anyone can restore a high-quality sex life.