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Aug 17, 2006

Sex and Diabetes

Joe Nelson

I just finished reading an article in a consumer magazine about sex and diabetes. In my experience as both a diabetes psychology specialist and a sex therapist, the article was what I expected. The issues discussed were related to physical problems common in men and women who have diabetes. The solutions offered in the article were fairly simple and focused on medical treatments. These are definitely important areas for people with diabetes to be aware of and important solutions for them to understand. Bravo to this article for addressing such a sensitive area. However, I do have something to add. Sex, whether or not someone has diabetes, is not a simple topic.

If everything works well, sex is likely a pleasurable experience. But those things that need to work well aren't just the physical aspects—they include communication, affection, energy, time of day, your interest, and your partner's interest. These factors in turn can be interfered with by a host of other factors, including any stressors, family history, abuse, emotions about your partner, your aching back, or a headache (although research suggests sex has a positive effect on headaches). In other words, the experience of sex is more than the sum of its physical parts.

I'm afraid we are tempted to look for the simple solution even when the issue is so complex. My concern is that health-care professionals can end up over-simplifying treatment and, by doing so, can cause couples to believe there is something wrong with them instead of with the treatment. For example, the usual course of action to treat erectile dysfunction (ED) is to offer the patient a PDE-5 inhibitor such as sildenafil (brand name Viagra), vardenafil (Levitra), or tadalfil (Cialis). In many cases, this is a good choice—these medicines have helped millions restore their sex lives. However, if the medicine doesn't help, a couple may think there is something wrong with them—after all, on TV it appears to work for everyone.

Those unfortunate couples who don't get the right treatment may discontinue treatment altogether. In some cases, the medicine may be the right treatment, but the couple still needs to work on the relationship before the the medicine will help. I also know that the causes of sexual problems for people with diabetes are not just physical. People with diabetes have as much of an opportunity as anyone else to have psychological problems. The causes of sexual dysfunction are multidimensional, and a holistic approach to assessing and treating the problem is more likely to help people regain a healthy and fun sex life.

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Yes, I have ED but my wife is fridged. She has not had any interest for many years. Is there a PILL that could chang that condition.

Posted by: Pater Bill | Aug 17, 2006 06:23 PM

I really would love to thank you guys on this article cause many people they think that people with diabetes are not able to have succesfull relationship specially sexually.
It was very clear that diabetes is a reason to not have a normal life including sex.
So thanks again & I hope that the site encourages all people to check the site cause it helps nondiabetics to know what to do.
best regards

Posted by: Hagag Hassan | Aug 18, 2006 03:58 AM

RE: Pater Bill's comments on his "fridged" wife...
The following comments are only my opinion and my own personal experience. I am not a doctor or sex therapist. I went from a relationship where I'd lost sexual interest in my husband to a relationship where I can't seem to get enough, and it has nothing to do with the physical qualities and abilities of either of them. My first husband was controlling, uncommunicative, he wouldn't take the time to listen to me and if he did he just criticized me and belittled my veiwpoint. He wanted sex when it was convenient for him and did little to get me in the mood. So he thought I was frigid. When that relationship ended and I met my current spouse who is kind and gentle and giving without demanding anything in return, who listens to me rant and prattle with respect; even if he thinks my ideas are "crazy" he never judges them. Who wouldn't want to have sex with someone who loves you without reservation, without expecting anything back?

Posted by: ~A~ | Aug 18, 2006 07:18 AM

MY HUSBAND HAS DIABETIS AND ED. WE WENT THRU THE SEX DRUGS, THEN SHOTS FOR 6MONTHS, EXPECTING SOMETHING GOT NOTHING, THE DR. SAID THE ONLY THING LEFT WAS AN IMPLANT, THAT WAS 8 WEEKS OFF WORK!! SO WE TRIED THE VACUUM PUMP, IT WORKS GOOD!! LAST S ABOUT 20 MIN,I KNOW HAVE DIABETIS AND I AM NOT INTERESTED IN SEX AT ALL, WHAT CAN I DO??

Posted by: DIXIE | Aug 18, 2006 12:07 PM

What a lousy article on sex and the diabetic. Certainly, nothing new - Use Viagra,etc.. All people know that. What's new?

Posted by: Fud1117 | Aug 19, 2006 11:47 AM

allyou didnt explain what a holistic approach is. help please.

Posted by: doug | Aug 26, 2006 02:32 PM

I have always believed that sex is 90% in the brain and 10% physical. I have had partners that have used viagra with varied results, although they all have agreed with this: if the brain/emotion is not into the girl, no amount of viagra will maintain an erection. Go Joe!

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Posted by: Korwin | Oct 19, 2006 07:20 AM

As with many of the other comments you have received on this article, there are plenty of treatments available for men, plenty of articles, plenty of advertising of clinics and professional to assist men. But us poor women fall into the too hard basket! When will someone take the plunge and assist us? Why is sexual function always seen as a male problem? I love my hubby to bits and I would love to be able to get as stimulated as he is on a regular basis, but like many other women with diabetes - I have no interest, I can't be bothered and it takes hours and much patience to get me relaxed enough to even think about it! Five years ago, pre-type 2, nothing stopped me! In fact hubby headed for the hills! So please can someone shed some light! Women do enjoy sex, it is important to us too!

Posted by: Karen | Nov 01, 2006 08:15 PM

so true that the usual prescriptions dont work, but what is a holistic approach? im desperate HELP!!!!!!!!!!

Posted by: still helpless | Dec 06, 2006 09:53 PM

Dear still helpless and others,

The process I suggest involves both a psychologist (sex therapist) and a medical specialist. The process is designed to identify the medical issues and the appropriate treatment but also deal with the psychological issues of getting back to being sexual again and how the relationship plays a part in what you are doing. Sex is an example of a mind/body issue, and most people can use some help in all of the related areas of mental (anxiety), physical (diabetes, testosterone, etc.), and relationship (how you treat each other and what are you doing physically with each other) health.

I do not agree with the comment that all you need is sildenafil. All some people need is this, but others need a broader combination of therapies. Contact AASECT online to seek a sex therapist in your area and see if they might be helpful.

Take care,
Joe Nelson

Posted by: Jnelson | Dec 10, 2006 01:49 PM

I need to know that what medications should i use to keep my sex balanced if i am diabetic.

Thanks

Posted by: Younas | Jul 24, 2008 08:32 AM

Younas,

You may want to check out some of the more recent blog entries on sex and diabetes at www.diabetesselfmanagement.com/blog/Sexual_Health.

Posted by: Tara Dairman, Web Editor | Jul 24, 2008 11:30 AM

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