“I’d like to be more sexual,” wrote Marsha, a 38-year-old woman with Type 1 diabetes, in an online forum, “but my body doesn’t agree. Things that used to turn me on leave me cold now. When we try, it doesn’t feel good. My husband acts sympathetic, but I know he’s upset.”
A lot of women with diabetes share Marsha’s problems. Studies highlighted by the National Institutes of Health have found that as much as 27 percent of women with Type 1 and up to 42 percent of women with Type 2 experience some kind of sexual dysfunction.
A Turkish study of 176 sexually active women found those with Type 2 diabetes had more sexual problems. Women with higher HbA1c (a measure of glucose control over the previous 2–3 months) and women who had diabetes longer had higher rates of sexual problems.
According to the Cleveland Clinic, sexual problems for women with diabetes include:
• lack of desire or arousal
• difficult or absent orgasm
• loss of vaginal lubrication before and during intercourse
• inability to relax the vaginal muscles
• numbness or decreased feelings in the genitals
• pain with intercourse
Diabetes can cause sexual dysfunction in women in several ways. High blood sugars can cause damage to the nerves needed for sexual arousal, function, and pleasure. Blockage of small blood vessels in the genital area limits lubrication, sensation, and muscle function.
Some diabetes medications decrease interest in sex, as do some blood pressure and pain medicines. See a list of medications that can cause sex problems, and better alternatives here.
Diabetes often causes anxiety, depression, and stress. All those feelings can block a woman’s interest in sex. Women with diabetes are at higher risk of vaginal and urinary tract infections, either of which can make sex unpleasant and undesirable.
WebMD points out that Type 2 diabetes and its treatments can cause a person with diabetes to gain weight. Weight gain can affect sexual confidence or sense of attractiveness.
Issues other than diabetes can interfere with sex. These include low levels of sex hormones, other illnesses, and aging. There may be relationship problems. Sex may not have been very good in the first place. So a lot of things can go wrong, but most of these problems can be treated and self-managed.
Treatments for diabetes sex dysfunction in women
• Personal lubricants can completely solve dryness problems. These are widely available and come in a huge variety, including some that stimulate nerves and increase sensitivity.
• Estrogen creams or vaginal tablets, used regularly, can heal vaginal tissues and stop pain with intercourse.
• Personal vibrators can give pleasure without intercourse and often wake up nerves that seem to have stopped working.
• Keeping blood sugars well controlled increases energy and may improve nerve function.
• Taking steps to prevent urinary tract infections and vaginal infections can help as well.
• Be evaluated for hormone replacement therapy if your doctor agrees. Low hormones can include testosterone as well as estrogen, and both hormones are needed for sexual desire in women.
According to Diabetes Self-Management, some women may benefit from sex therapy or counseling to resolve “underlying issues, including anxiety, depression, guilt, past sex abuse, or loss of self-confidence…. It may also be helpful to have the sex partner involved.”
Self-management for better sex
Sex problems usually affect two people. Talking openly with your partner is a difficult but crucial step. According to WebMD, “These issues can take a toll on your relationship, especially if you keep them to yourself…. It’s important to talk about what you’re feeling. Being open with your partner can help ease any tension that may be affecting your sexual relationship. It may even bring you closer together.” It’s OK, and often desirable, to get help with this conversation from a therapist, clergy person, or trusted friend.
The Mayo Clinic website gives some good suggestions for reawakening sexual interest.
• Change your sexual routine. Try different positions. Experiment with erotic books or videos. You might want to visit a sex store and get some suggestions.
• Sensual but nonsexual massage “may help to increase the comfort and communication between sex partners.”
• Stop smoking. Smoking can damage nerves and blood vessels in the same way diabetes does and often causes similar sexual symptoms. Excessive alcohol consumption kills desire and sensation.
• Resolve problems in your relationship that may make sex stressful.
• Make time for sex. Don’t go right from childcare/housework/job to lovemaking. Get some rest, go on a date, spend some quality time together.
• Also, consider that sexual pleasure is not limited to conventional intercourse. Couples can do many things to each other with hands, mouths, and toys that don’t involve intercourse and give many people greater pleasure than intercourse ever did. Read some ideas about sex without intercourse here.
Remember that bad sex, in which your needs are not met, will not make you want more. Take time for better sex, get your blood sugar under control, treat the treatable problems, and your sex life may return, better than before.
Want to learn more about diabetes and sexual health? Read “When Viagra Doesn’t Work: Treating Erectile Dysfunction,” “When Diabetes Affects Your Sex Life,” and “Sex and Diabetes.”