Aug 01, 2007

In The Mood

David Spero

Last week’s blog entry on sex and intimacy got some interesting replies. Today, I’ll talk about getting in the mood. Beth and Ms. Mel both described near-total loss of desire. Diabetes may not be the main cause of this.

It could be:

• Drug side-effects—Beth already recognizes this in her case. Antidepressants and blood pressure medicines are the main culprits.
• Depression—when you're depressed, nothing seems worth doing; you think you won't enjoy it, and who would want you anyway?
• Relationship problems—if you're angry with your partner, you may not feel like loving him or her up.
• Diabetes complications and symptoms that don't take away all sex drive, but can dampen it, including: fatigue, either diabetes-related or just caused by too many other demands, or neuropathy, involving either pain or loss of sensation.
• Other health issues, including low hormone levels or high blood pressure.

What We Can Do About It

Read all your drug inserts carefully. See if they list "loss of desire," "loss of sex drive," or "diminished libido" as side effects. If so, talk with you doctor about alternatives. The antidepressants bupropion (brand name Wellbutrin) and mirtazapine (Remeron) are reported to have fewer sexual side effects.

I'll write about ways of dealing with depression in another blog entry, but two things that help both fight depression and boost energy level are exercise and sunshine. So getting out for a brisk walk in the sun might boost your sex drive. And speaking of exercise, pelvic floor crunches (Kegels) can also build desire and improve sex. Kegels are good for men, too.

If your blood glucose level or blood pressure is out of control, that can interfere with sex big-time—another reason to get in better control. And relationship issues need to be addressed through communication, honesty, and often through outside help. You might start by being honest about sex and see if that helps in other ways.

But There Are Many Other Ways to Build Desire! Try Some of These:

• Reading some erotic literature or watching erotica, with or without your partner, can help. (In general, I think women writers are better.)
• Have a massage. If you can't afford one, give each other massages. Taking a shower with your partner is also good.
• If fatigue is a problem, have you considered getting more rest? Taking a few hours off to recharge might get you in the mood for loving.
• Using sex toys (like a vibrator) may also turn you on.
• Having a good talk with your partner about what he or she likes and wants, and what you want, leads to more desire and better sex.

See more ideas here.

On the same blog entry, Germane wrote that testosterone had increased his sex drive and also his health and energy levels. Testosterone (often called T) levels can be low in diabetes (see "Low Testosterone Levels and Type 2 Diabetes"), and T replacement can make a big difference.

Testosterone is also often very good for women's sex drive and energy levels. You have to get the dose right to avoid body hair growth, but it may well be worth the effort. And the drugs vardenafil (Levitra), sildenafil (Viagra), and tadalafil (Cialis) can help women as well as men enjoy sex more.

Another big help is lubricants. Some are safe for external use, including anal use, and other are vaginal-safe. You can read the labels or ask a pharmacist. I think just about everything feels better with enough lube, especially if a woman, because of aging or diabetes, is not making much of her own. Don't be stingy with it; spread it on freely.

Germane also asked for more info on ways to love a woman (or a man) with your hands and with toys. That will have to wait for another blog entry, or you can write me directly through my Web site, www.davidsperorn.com. While you're there, please check out my books, The Art of Getting Well, and Diabetes: Sugar-coated Crisis. Not much in there on sex, but a lot that may help with self-management. And please post comments and ideas here.

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Sexual Health

Partners Speak Out About Sex (07/16/08)
ADA Advice on Sex (07/09/08)
Sex, Intimacy, and Diabetes (07/25/07)

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