Sex, Intimacy, and Diabetes

I’ve got a whole new career! What a surprise! I never expected to be a sex educator. My partner and I are giving workshops on Sex and Intimacy in Chronic Illness and Disability. We’ve given some for the Multiple Sclerosis Society and some in the community for people with illness, psychotherapists, ministers, and sex educators.


How did this happen? I was a health educator, nurse, and author writing about self-care and the social causes of illness. I really didn’t think much about sex, except as it related to health.

Strangely, I started getting interested in sex education when I lost interest in sex. My partner and I have been married for over 30 years, and sex had been our main way of connecting. We didn’t communicate very well; we just smoothed differences over with sex. Two or three years ago, I lost most of my ability to have erections. Partly this was due to my multiple sclerosis, and partly because of problems in our relationship, I think. I tried some other ways to be sexual, but mostly I withdrew into working more. Our relationship became more distant; we were more like roommates than we were a couple in love.

It got to the point where my partner started looking for sex in other places. She wasn’t sneaking around or having an affair. She was honest with me and told me everything she was doing. We started communicating better about sex, and this helped us communicate about other things.

I felt a great weight had been lifted from me, because I didn’t have to try to satisfy her when I thought I couldn’t. I was liberated to try some new things. I discovered that I could give her better orgasms with my hands than I ever could, or than anybody else had, with regular intercourse. We got very creative with the use of hands and with help from other body parts, and now our sex life is better than it has ever been, and so is our love.

It turns out that you can do more with hands and/or toys than you can do with an erect penis, which is sort of a one-trick pony—it can only go in and out. It usually misses women’s most responsive, sensitive areas. Most of these involve the clitoris, which actually runs most of the way around the outside of the vagina, and the G-spot, which is just inside in the direction of the belly button. These are easily reached with fingers, thumbs, or hands.

There are a lot of other erotic areas for both women and men. You can find all kinds of ways to give and receive pleasure if you relax, explore, and communicate with each other. I’ve been talking about these methods with other couples, and it works for them, too. One couple, Linda and Jeff, told me they are having the best sex of their lives. This wouldn’t be anything special; lots of married couples say that. But Linda and Jeff are 85 years old!

If it works for them, it could work for you. Many people with diabetes have sexual problems, and loss of sex really can knock a hole in your relationship and your quality of life. A lot of men get erection problems; a lot of women have vaginal dryness, frequent yeast infections, and loss of sensitivity. Many doctors are not comfortable talking about sex beyond prescribing drugs like sildenafil (brand name Viagra). It may be hard to find help from either medical or psychological professionals.

A lot of these problems can be resolved with better blood glucose control. But many can also be resolved by learning some alternative ways to do sex—things you can do with your hands, mouth, or other body parts, and places you can stimulate like the G-spot, prostate, and other sensitive organs. Use more supports, whether medicines, lubricants, or toys. Try new, easier positions as ways of dealing with fatigue, pain, and other health-related problems.

I’m planning to write about these issues occasionally in the coming weeks. What sex questions would you like answered? How has diabetes affected your sex life? How have changes in your sexual relationship affected other areas of your life? Post ideas or questions here, or visit me at

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  • germare

    I have been using levitra & testosterone replacement injections. This has done wonders,improved health,activity level,sex drive & performance. It’s helped our relationship alot. At 68 this is great!!!
    Have you considered providing more detail about the new hands on/sex tools &/or methods. Always interested in learning more. I learned that I was a type 2 diabetic 2 yrs ago,with diet & meds this hasn’t been a problem. Eagerly awaiting your reply.

  • ms mel

    dear david, at the age of 50, I have lost all interest in sex. I have been a type 2 diabetic since the 80’s and I don’t understand why. I keep the diabeties under control but not all the time. very depressing it is that is for sure.

  • Beth

    I’m glad you’re talking about sexual problems. Here is my question:

    I have had chronic recurrent major depression. I have tried numerous antidepressants, and finally found a medication and a dose that works for me. what a relief it is not to have to fight depression all the time!

    Unfortunately, I am experiencing sexual side effects — or rather, lack of desire as a side effect.

    I have been married more than 35 years to a wonderful husband who has stayed with me through the hard times. Now that I am not so depressed, I’d love to feel like having sex more often. But I just don’t have the desire that I used to. In fact, I really would rather not have sex. Not that it’s a strong aversion — just that other things are more interesting. My husband is VERY unhappy about this, and I’d love to please him more.

    Do you have any suggestions?

  • Beth

    For germare — who posted that he is using levitra and testosterone replacement — I assume you are a man. It seems to me that if one is going to have sex problems, it’s better to be a man, since the sex problems of men seem to attract much more research attention than those of women do.

    When I have asked my physicians (primary care, psychiatrist, and endocrinologist) whether they know of anything that could help me with my lack of sexual desire, all they have been able to suggest is that I could try stopping the antidepressant. This is not an option; two weeks after tapering off, I start sliding into depression. I cannot afford to go there again.

  • DavidSperoRN

    These are all good questions and great comments. I’ll address some of them in this week’s blog.

  • AskManny

    This is an incredible topic. I think it’s great that we’re being so open about this kind of thing.

    I wanted to invite you to join, a community for people touched by diabetes.

    In TuDiabetes, we have two groups of users that have been formed recently: Diabetes and Sexuality (Women) and Diabetes and Sexuality (Men), which have been growing in membership rapidly in the course of the past few days.

    I think it would be very valueble for all members of TuDiabetes to be able to hear what you have to share. I really look forward to seeing you there!

  • bell0106

    My husband recently got diagnosed with type 1 diabetes and he is only 27 years old. We have always had a great sex life and been very active, but ever since he was diagnosed he has little or no desire. It is hard not to take it personal and I am just wondering what I can do to help him. It’s not that he can’t, he just doesn’t seem to want to. Why would diabetes effect him like this?

  • Tara Dairman, Web Editor

    Hi bell0106,

    You may want to check out David’s most recent post about sex and diabetes, “ADA Advice on Sex.”

  • David Spero RN

    Hi Bell,
    If it’s not that he “can’t,” — which i wouldn’t expect at his age — you two just need to work on it. He could be depressed, he could be feeling unattractive, he could be afraid of what sex will do to his blood sugar. He might just be freaking out.
    There could also be relationship issues from before that are coming up now.
    I would suggest talking about it openly. You might want to get help from a counselor, or make sure you’ve got your communication skills (“I messages”, active listening, emotional sharing) together.

    You will definitely get over this. It’s a phase.

    Let me know how it’s going.

  • Jan

    Hi BellO

    I suspect that, when you’ve just had your world turned upside down by being told you have a chronic condition, sex is the last thing on your mind. Also, when your blood glucose is going up and down, you don’t always feel good physically. I was afraid my husband would leave me because I was no longer the “me” he married. He didn’t seem to be trying to learn anything about diabetes when that was all that was on my mind. Find out as much as you can, help him as much as you can, give back rubs with no expectations. Probably when he gets his head on a little straighter and and isn’t feeling as mentally or physically rocky, he’ll feel more like having sex again.


  • eddie


    Great topic, thanks for being so direct about diabetes, I have been suffering from Type 1 for 6 years now and just recently have been hit hard with erectile dysfunction. I invite you to comment in our blog that talks about ED and diabetes: Edguider Blog

    If you have any tips or suggestions for men who have diabetes and ED please share, I know that I could use them coming from you ūüôā

    Thanks again.

  • lma

    my husband got diabetes about 4years ago and suddenlly our sex life has changed i lost interest when he can’t stay up and i also had a hysterectomy he is now 70yrs and i’m 51yrs does the age makes a difference

  • David Spero RN

    Dear Ima,
    The things you mention – aging, diabetes, hysterectomy, can all affect sex and desire. You can manage all these issues if you’re open to trying new things. His doctor and/or your doctor may be able to help – there are many erection treatments.
    It would be very helpful if your husband could get great control of his diabetes and really get in shape. If you could walk, run, or dance together, that should increase sexual interest and ability.
    You mentioned losing interest when he lost erections. I would encourage you both to explore other ways of giving and receiving sexual pleasure. If you’re interested, you can e-mail me for some ideas at [email protected].

  • teresa

    Is delayed ejaculation a result of type 2 diabetes?
    Thank you

  • David Spero RN

    Hi Teresa,
    Delayed ejaculation could be related to diabetes, if there is nerve damage. The problem could also be due to medications he is taking. There could also be psychological or behavioral factors. A short article from the Mayo Clinic on this is at

    I would suggest that you and your partner start by not considering this a problem, but an opportunity. Unless you’re trying to get pregnant, ejaculation is not a necessary part of sex. There are many other things you can do.

  • mellie

    I’ve had diabetes since oct. of 2007, since then my sex life has gone down the toilet. I just don’t have any desire, it’s starting to affect my marriage.

  • David Spero RN

    Hi Mellie,
    Read some of my other blogs on sex and diabetes. You can find them by typing “sex” in the search box on DSM’s blog page.
    Loss of desire can have a lot of causes – not all related to diabetes. If you want, you can e-mail me directly at [email protected].


  • roxy

    my name is roxanne and my husbands name is tony and he has diabetse and he is haveing truoble in our sex life and its making this huge hole in our realionship and i dont want to leave him nor loose him my promble is that when we do somthing he ejackulets to fast and it makes me very upset and i aacuse him of messing around on me and i want to know what we should do to keep from loseng each other cuz other than this we have a good realionship thanks

  • David Spero RN

    Hi Roxanne,
    Premature ejaculation is probably not caused by the diabetes. There is all kinds of help and info out there on treating it. Playboy’s adivce site has a pretty good article. Usually, the main answer is for the man to relax more. He should go real slow. I mean really, really, slow, and concentrate on breathing. That might help.

  • nada

    hi david
    my name is nada n im having sex problems with my huspand im newelywed n his really frustrated becoz of what happends
    every time we have sex he gets tired n hes blood suger decreases alot n that really worries me alot so is there any thing i can do about n whats ur advice for that n will this get worse by time ?? i love him n im not intending to betrayal him his the love of my life plz i need ur advices
    thank u

  • David Spero RN

    If your husband’s blood glucose goes low during sex, the simple fix would be for him to eat before you start and have some glucose tabs or sweets that he can lick during sex to keep his glucose up. Any exercise, including sex, will lower blood glucose.

    He should probably also talk with his doctor — maybe his medication needs to be changed.

  • brendarockett

    HI david my exhusband alway wentme to have sex with him.and he is adiabetes.he is alsole remarried.what can ido brenda memphis tenn.

  • Jessica

    Hello, mynames Jessica and I am 20 years old. My soon to be husband is 29 and has been diagnosed as a type 1 brittle diabetic for 21 years. Weve been getting ready to start a family, but for the last 8 months or so he has had almost no interest in sex. And on the rare occasion he does were usually unable to because his sugar will be to low or high. I already worry about his fertility due to the damage thats been done to his body over the years, but no sex is an even bigger problem. What can I do to make him more interested, without making him feel bad? Any advice would help. Thank you..

  • ishwarlall purgas

    im 54 years of age n i have diabetes since 35 yrs but at the age of from 35 years to 50 i could have sex well but since 1 yr im getting problem during intercourse. My diabete is form 7 to 10 n im following treatment at the hospital. When i watch a film porno i don`t feel my penis getting longer, i don`t get any sensation as before. I can`t have sex everyday n wen im having it at times, my penis become soft. Please help me to become as i was at the age of 35.Thank u so much.

  • David Spero RN

    Hi Ishwarlall,

    I’m not sure anyone can make you become the way you were 20 years ago. But you can improve penis function by improving glucose control, getting more exercise, or taking one of the erection pills, the PDE-5 inhibitors (such as Viagra).

  • Nicolea

    My husband has type 2 diabetes and over the last 4 months i feel that he dont care about me anymore even though he says he loves me everyday. He doesnt kiss and cuddle me like he used to and we have sex maybe once every 3 weeks if im lucky.. he makes me feel like i dont matter, when i know he does love me. he falls asleep most evenings and i feel so alone.. i just dont know how to feel about this, i have never had to deal with diabetes before and i find it very hard to deal with the intamacy side of out relationship .

  • David Spero RN


    Since this change happened suddenly, and he is still telling you he loves you, it’s probably a health issue. He’s not just refusing sex; he’s falling asleep. Please make an appointment and go with him to it. His diabetes control and testosterone levels should be checked. He could also be depressed.

    Also, tell him how you feel and how important this is to you, without blaming him. Maybe get some couples counseling if that would help you talk it over.

  • Nicolea

    I have told him how i feel on more than one occassion. He rang the doctors as i have told him i cant go on like this anymore. he has has a blood test today because his sugar levels are still way too high although he takes his tablets. The doctors seem to think that they are no longer working and there maybe something new he can take.I might be being selfish and i know he cant help it but out relationship in breaking down and i really dont want it too. Hopefully now hes had the bloods taken something can be sorted .

  • Ms. K

    Oh I completely agree with what you’re talking about… I had never felt as fulfilled sexually as I was when I dated a paraplegic man. He found all the right spots. I was 20 something when we dated. Fast forward about 13 years later I am married to a 21 year older man with 3 young children. Our sex life used to be healthy even after our twins but after we conceived the 3rd baby “naturally” either my husband is terrified to make another baby or his sex drive is “gone due to stress” as he says. It’s getting annoying and really ruining our relationship we have not been intimate in about 6 years (the last time was when we conceived our last baby. Months before we conceived the baby, (5 year old) our sex life was going downhill. I started to look elsewhere for an emotional connection with someone else I never cheated because I love my husband very much.

    I have brought it up to him several times that I am unhappy with how things are what’s the problem etc… He doesn’t budge. I’m ashamed to say it but I’ve even threatened to end everything because of it. I feel embarrassed to beg for sex or even touch or attention. I don’t even remember how to kiss. He seems to be very healthy when he had his last physical no cholesterol and all the usual they test for. he was a body builder. His testosterone showed low years ago he hasn’t done his fasting glucose so I don’t know how he’s doing there.

    I don’t know why to do anymore I took our vows very serious till death sickness and health. I just wish we could be a little closer intimately.

    Any help would be appreciated!

  • David Spero RN

    Hi Ms. K,

    I vote for couples counseling for you two. If his physical health is OK, something else is going on. Whether it’s mental health or another relationship, you need to talk about it. You are really hurting here.

    If he won’t go for counseling, you will have to consider whether to get affection elsewhere or break up the relationship (which would obviously be hard on the kids.)

  • Toni M.

    My soon to be husband has type one diabetes and at times I have a difficult time with him not being able to have sex due to his inability to have an erection. However I love him very much and he will not perform oral sex and that is okay with me. I do ask him alot if he would try to make love with me and it seems to make him more depressed if he can’t have an erection. My question is..Should I stop asking him to try and have sex?

  • David Spero RN

    Hi Toni,

    You’re in a tough situation. I would think several times before marrying someone who would not have sex with me. Has he tried all the erection remedies? There are pills, injections, vacuum pumps, and implants that all work for many people. Look them up or ask his doctor. There are other ways to have sex, as we wrote about at If he won’t do oral, can he learn to use his hands to please you? Quite possibly, his testosterone level is low; leading to lack of desire and function. He should be tested for that. If he’s willing to work on this, I’m sure you can come up with good solutions. If he’s not willing, then you have to decide if other things about the relationship make it worthwhile without the sex.

  • Neicy

    Okay, my problem is I have type 2 diabetes. I was having sex great but since my ex left me for a woman whom smokes weed I just haven’t trusted any man for that matter. My one friend has type 1 diabetes whom we had sex twice but it was awful with him like: can’t get it up,it is very small, he has fake teeth so oral bad, please help. I want to have an orgasm but it seems I can’t find a man I am attracted to it seems all these really old, fat men want to chat with me but am not attracted to those types

  • Deirdre

    This is my situation ~ My husband says he is not sexually attracted to me any longer. I think its a result of the changes that have occurred to him in the last year, he tells me “not” to blame the problems, but I can’t see how not to. He is 44, soon to be 45 (the 25th of this month), and last year he suffered a stroke, it was bad but not devastating. At the hospital he was diagnosed with Diabetes. He came home, recovered and went back to work. Shortly after that,he develped ED. Which is a problem for him. Just recently he joined a Gym, and have lost some weight. He told me three weeks ago that he wants to separate, because of the non sexual attraction to me. I think he needs to tell his doctor and be completely 100% honest with him about what is going on. I don’t believe he will expose himself that completely in front of the doctor. We were going to see the doctor together but the night before last, he said he changed his mind, and doesn’t want me to go because of things he wants to tell the doctor that he doesn’t want me know. So, that is why I believe he won’t be 100% honest with him. He told me that he can ejaculate to porn, but, not to me. He has agreed to go to counseling and is willing to work on the marriage, but that non sexual thing is a big deal. We are ‘talking’ tonight, and I need to know what to say. As I said, he told me earlier that I can’t blame the problem on his medical condition, but, I think that is the root of it. I plan on seeing his doctor on Friday to tell him all of this, but, in the meantime ~ I NEED help to save my marriage. I have been willing and have done anything sexually to help him, so that is not the problem. He says its ‘just’not there ~ the touch that I used to have that made him ~ you know. Anyway, sorry this is so long, but, I desperately need your help and assistance. Thank you in advance for the help.

  • Allez

    My husband can no longer have sex in a normal way. I try to stay intimate with him but won’t just “service’ him (hand jobs) whenever he wants.
    He is getting very angry at me and jealous. When my kids text me he asks who is always texting you?!! Then tonight he told me that he will not be ignored and when he speaks I had better listen. He has NEVER spoken to me like that before! What is going on?
    Is his high blood sugars (He has uncontrolled, non-compliant diabetes 2) and loss of physical abilities taking a dangerous toll on our relationship that I should be aware of?
    I love him and have never looked elsewhere for sex in 35 years of marriage.

  • David Spero RN

    Hi Allez,

    Your husband needs help. Sounds like he is letting diabetes kick his butt. Then he takes it out on you. Maybe he could see a counselor who know about both diabetes and family issues? Or you could seek couples counseling together. Or maybe he would be more willing to accept going to a support group instead of therapy. You should get some support too.

  • Amy

    In my world it wouldn’t make any difference whether my husband has diabetes or not. The out come would be the same.
    Married 47 years and he only had sex or any kind of intimacy once in our entire marriage. He had said he was a virgin before we were married and I believe him. He’s a loner has no friends, no phone, tv, computer and he doesn’t even get mail. He goes no where! He’s lived in our basement for 47 years. I know he’s sick some where in his body.

  • Desiree

    My husband was diagnosed with diabetes 7 years ago. He took care of it for like 6 months then went off all medications. He now has high blood sugar and refuses to to take care of it. We have had a great sex life untill Recently he wants to have sex and he is always in the mood but he cant keep it up. I have tried to be patient but I can help but feel to blame for his ED. My husband keeps saying its not you, but he refuses to get treatment. What do I do. Im afraid this might lead to divorce even though iam trying to be understanding. Please help

  • Yvonne

    I have been feeling very frustrated. I have been with my husband for 7 years since he was 50 and I was 34. He recently had a conversation with me telling me that he was severe ED and that he did love me but that it was embarrassing for him to not be able to satisfy me like he wanted. When we first met he was somewhat ED but it has gotten worse over time. When he was exercising a few months back he was getting urges and he was having erections. Lately he is flatlined so to speak. He is not bothering much to try to please me in any other way. I know I show him resentment and distance and I keep myself busy with work. I know he feels all that from me and he does ask me if things are ok. However I am not sure if even having a conversation would help at this point. He is older and losing his manly confidence. I am still young and need intimacy like everyday if possible. Sounds crazy but when you don’t get it often it seems you want it more. Please advise as I am desperate to find a way to try to fix this problem which has gotten progressively worse.

    • Mia

      I understand as I am going through a similiar situation. My husband is 43 and I am 41. He comes with all kinds of excuses not to have sex; He is sick, tired, has to get up early in the morning, heartburn. He won’t please me in any other way or even try. I am getting angry and resentful. I have tried to talk with him but it doesn’t seem to help. His response is when are you going to go through menapause or not be so interested in sex.

  • Kate

    Ok so I have been married for 10 years and for the past 9 years my husband has not been able to get an erection. We have tried oral sex but every time he does it I get an infection so we stopped that. He has a lot of health problems, diabetes, teeth problems, ect…. I know it’s not his fault but I feel it kind of is because he won’t take care of himself. I am at the point where Im angry with him. He tries to have sex but I know it’s not going to happen and so I have got to the point where I wo even try with him anymore. I have had an affair and I love the interaction with this person. I just don’t know where to go from here. I need some advice. Please help!!!!

  • Salen

    I am 33 years old and my husband is 48 he has diabetes and its hard on me being pregnant and wanting sex more often. I feel like hes not interested in me due to getting fat and he feels pressured. I dont know what to do to make either of us happy and dont want to lose him due to us not seeing eye to eye please help.

    • Salen, these problems are common in pregnancy and in diabetes. The most important thing is to talk honestly with him about your feelings and his feelings. Perhaps you can both compromise he can get help with sexual function or try some of the ideas in the article. It doesn’t mean he is not interested in you. Pregnancy brings up sexual issues.

  • Salen

    I feel your pain i have the same problem but i am pregnant and feel like my husband is happier watching tv then with me