Jul 16, 2008

Partners Speak Out About Sex

David Spero

They say sex sells. Apparently, sex problems are also a hot topic. I received three comments on last week's post ("ADA Advice on Sex") from women whose male partners with diabetes have withdrawn from sex. There is a lot of this going around.

I want to thank and congratulate all the people who commented. It's brave to bring up sexual issues. It's also brave to bring up partner issues. My wife says partners get lots of pats on the head—"You're so brave," "You're really there for him"—but very little actual help.

I've led and spoken to all kinds of support groups since I was diagnosed with multiple sclerosis (MS) 22 years ago, and I know one thing. There are lots of support groups for people with problems, but very little for their partners. There is support, for example, for adult survivors of incest, but there are no support groups for partners of adult survivors of anything. This can cause problems for the person who needs help and the partner both.

A Personal Story
Since everyone is so honest here, I'll tell you a little of my story. About five years ago, my health got to the point where I couldn't have reliable erections either. We had other relationship problems that contributed to my losing interest, but the erection issues played a big part. I tried Viagra, but it didn't work very well. So I withdrew. It wasn't fair to my wife, but because of our other problems, I didn't really care.

She spent two years getting more desperate, and our relationship kept getting more distant. She looked into finding sex in other places, which was OK with me. It took the pressure off. I can tell you more about that if you write me.

The interesting thing was that, now that I could relax about sex, I stopped worrying about erections. I learned other ways to please her, and soon I found that we were having hotter sex than we ever had with intercourse. (I would be happy to share some of these practices, but you'll have to write me—I'm not sure DSM is ready for them!)

The weird thing is that, maybe because I could relax more, and because we worked out some of the problems in our relationship, I got good erection function back, with the help of Viagra. So now we have the best of both worlds. We can have intercourse and nonintercourse sex too. And I still think the nonintercourse stuff is way hotter.

Trying New Things
Unfortunately, many guys just will not try new things sexually. We're programmed to think that sex is about intercourse only. It's too bad, because I know older couples, including some in their 80s, who are having the best sex of their lives, mostly without intercourse. But you have to be willing to try. Sometimes a woman can show a man what she wants, if she has figured it out by practicing on herself. Sometimes the man will cooperate.

If it has to be intercourse or nothing, there are a lot of other things you can try. If Viagra doesn't work for you, there are other pills, there are implantable pumps, there are injections. If your diabetes doc won't help you, ask for a referral to a urologist or another professional who specializes in sex issues. Some doctors just aren't comfortable talking about it.

It's the Relationship
You also really need to look at your relationship as a whole. A guy who is saying he "doesn't want sex anymore" at age 50 must be very sick, unless he's got issues with anger, depression, or grief that are keeping him away. (Or if, for him, "no intercourse" = "no sex.") If you've been together for a long time, there are bound to be issues that could use some attention. That might not fix the sexual function problems—then again, it might—but it should at least get him interested in trying.

For a younger man, like the newly-diagnosed 27-year-old with Type 1 diabetes whose partner wrote in, the issues are much more likely psychological. These could be depression or fear related to diabetes. He may need more support with that. There could also be relationship issues he hasn't brought up, as 27-year-olds often don't.

So I encourage everyone to encourage their partners to try some new things, and get some new help. Don't give up. CDE Donna Rice, coauthor of the book Sex and Diabetes, says that nearly anyone with diabetes can have a good sex life. I agree.

More than anything, I'm interested in the communication issues. How has diabetes affected communication with your partner? Let's hear it from both sides.

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Emotional Health

Taking Care of Me (11/18/08)
A Good Cry? (11/12/08)
Free Depression Screening, In Person and Online (10/10/08)

Sexual Health

ADA Advice on Sex (07/09/08)
In The Mood (08/01/07)
Sex, Intimacy, and Diabetes (07/25/07)

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