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Sex and Diabetes

Sex and Diabetes | Jo Divine

Due to the increase in obesity in the UK, type 2 diabetes is rapidly rising. Approximately 3.5 million people are affected by type 2 diabetes.

According to Diabetes UK, type 2 is the most common form of the disease, accounting for 85-95% of all cases. Type 2 diabetes is mainly caused by poor lifestyle choices and can be reversed or controlled through a healthy, balanced diet and taking regular exercise to lose weight. People may also have to take medication too.

Type 1 diabetes affects around 10% of adults, typically occurring in childhood or before the age of 40 and is not caused by obesity. Insulin producing cells in the body are destroyed or damaged leaving the body unable to produce the hormone to control sugar levels. It is controlled by daily insulin injections or using an insulin pump.

Diabetes not only affects your general health but can impact upon your sexual health and pleasure too. Although sex problems are more common in people who have diabetes, there are many ways in which you can still enjoy a healthy, fulfilling sex life.

Men and women who have diabetes often suffer from different sexual problems, including erectile dysfunction in men and vaginal dryness and lack of sensation in women, but they can both suffer from low libido. Diabetes causes damage to nerves and small blood vessels which affects the body’s response to sexual stimuli. Damage to these nerves hinders nerve signals to the genitals and can decrease blood flow to the tissues of the sexual organs, impacting upon normal sexual function.

Who is more at risk of developing sexual problems?

Diabetic neuropathy and related sexual problems appear to be more prevalent in people who:

  • have poor blood glucose control
  • have high levels of blood cholesterol
  • have high blood pressure
  • are overweight
  • are older than 40
  • smoke
  • are physically inactive

Causes of low libido

  • depression
  • extreme fatigue
  • lack of energy
  • side effects of medication, such as those taken for high blood pressure and depression
  • hormonal changes
  • mental health problems such as stress, anxiety and relationship issues

Diabetic neuropathy

This can cause numbness, pain or decrease in sensation in the genital area leading to inability to orgasm or less intense orgasms, painful sex and less pleasurable sex as a result of diminished sexual stimulation.

Relationship issues

Sexual function problems can lead to relationship issues as a result of a lack of communication between couples. Often couples give up on their sex life to avoid discussing the problems rather than opening up the conversation to talk about how they each feel and explore ways in which their sexual problems can be overcome.

The role a person takes on as the primary caregiver can alter the way in which they see their partner sexually. Getting caught up in the roles of “caregiver” and “patient” can detract from the physical and emotional aspect of the relationship, with romance and the sexual relationship being left behind or completely overlooked.

Male sexual problems

The most widely reported problem faced by men who have diabetes is erectile dysfunction (ED), the inability to maintain or get an erection sufficient enough to have sexual intercourse. The prevalence of ED in men with diabetes varies widely, ranging from 20%-75%. Men who have diabetes are 2-3 times more likely to experience ED than men who do not have the disease. Among men who have ED, those with diabetes develop the problem 10-15 years earlier than men who do not have diabetes. ED is often seen as a warning sign of a diagnosis of diabetes, especially for men under 45 years.

The side effects of medication for other medical conditions can cause ED. Symptoms that co-exist with diabetes which can contribute to ED include:

  • obesity
  • high blood pressure
  • emotional and psychological problems such as depression, self esteem and anxiety
  • lack of exercise

Retrograde ejaculation

Retrograde ejaculation is another sexual problem that may occur in men with type 2 diabetes. This occurs when some or all the semen is ejaculated back into the bladder instead of via the penis and is caused by abnormal glucose levels damaging the sphincter muscle, controlling the opening and closing of the sphincter at the base of the bladder. The man experiences an orgasm but often with little or no ejaculate, known as a “dry orgasm”. It does not pose a threat to health but may cause problems when trying to conceive a baby.

Balanitis

Balanitis is the inflammation of the end of the penis and foreskin (the glans) caused by infection, such as thrush, bacterial infections, sexually transmitted diseases, skin irritations and certain skin conditions. Men with diabetes often experience this problem due to sugary urine, causing thrush which sits at the end of the penis.

Female sexual problems

Vaginal dryness

The most commonly reported sexual health problem in women who have type 2 diabetes is vaginal dryness, caused by hormonal changes to the walls of the vagina and reduced blood flow to the genital area. There is also an increased risk to developing vaginal infections such as thrush which thrives on sugar and vaginal inflammation, making sex painful. Nerve damage to the bladder can lead to urinary incontinence and frequent urinary tract infections, which can make sex uncomfortable and painful as well as embarrassing.

Diabetic neuropathy

Diabetic neuropathy can affect the nerves in the genital area, causing desensitisation in the clitoris and making sexual arousal more difficult to achieve.

How to enjoy sex when you have diabetes

Many of the problems mentioned above can be frustrating, annoying, painful, embarrassing and cause anxiety. They can impact upon relationships during a time when the person with type 2 diabetes needs support. Many people give up on their sex life, but there are many simple ways in which you can ease the pain, discomfort and embarrassment these problems cause and enjoy a fulfilling sexual relationship.

Combating low energy and fatigue

This is a problem that affects both sexes, so why not try having sex at a different time of day if you find yourself flagging when evening arrives. Set the alarm 15 minutes earlier in the morning and enjoy the benefits of early morning sex to kick-start your day. Plan a secret lunchtime rendezvous for some quickie sex or enjoy a long leisurely afternoon in bed, exploring your partner. Experiment with what works for you.

Be liberal with lubrication

The benefits of using lubrication during sex cannot be underestimated. Hormonal changes, pregnancy, stress and the menopause can all affect the amount of vaginal lubrication we produce. A good water-based lubricant can make sexual intercourse feel more comfortable, increase pleasure and last longer for both women and men. Use as much as you want to ensure that sex feels great. Avoid lubricants containing substances which may cause an allergic reaction or thrush. YES organic lubricant is completely free of chemicals and only contains plant based materials.

Don’t attempt to DIY your lubricant either, as many people assume that house-hold items can double up as lubricant. The main offenders are Vaseline and cooking or coconut oil, but this can do more harm than good.

Increase your libido

Hormone replacement therapy can help both men and women with type 2 diabetes, so speak to your GP to see if this is a possibility for you. Making changes to your diet can help boost testosterone and improve your libido.

Ensure that you stay healthy

Ensuring that your overall health is good will lead to a healthy sex life. Maintaining normal blood glucose levels is important because sex uses energy. Hypoglycaemia can occur during sex as with any exercise, so ensure that you check your blood glucose level before having sex and take medication or a sugary snack if needed.

Maintaining a healthy weight is essential to keep your heart in shape. Good blood flow around the body will benefit sexual arousal, erections and vaginal lubrication. Taking exercise will help you to lose weight as well as being able to sustain sex activity for a longer period of time. It can also help boost self esteem and body confidence too. Taking regular exercise can also help reduce depression by releasing feel good endorphins which can boost your mood and lowers blood pressure, reducing the risk of heart attack, stroke and renal disease.

Overcoming lack of sensation

Neuropathy in diabetic women can reduce clitoral responsiveness to touch, affecting the ability to become aroused and have orgasms. Using lubricants and vibrators can increase sensitivity to touch. Most vibrators will help, but using products that have strong vibrations such as the Satisfyer Pro 2 or Doxy Massager will produce clitoral stimulation in almost any woman. Used as an all over body massager, you can experienced sexual sensations in your breasts and other erogenous zones.

Using a couples’ toy such as We-Vibe 4 Plus or a small clitoral vibrator such as Je Joue Mimi Soft or Rocks-Off Ignition can increase sexual stimulation during sexual intercourse. Using pelvic floor exercisers such as LELO Luna Beads can improve the strength of your pelvic floor, making orgasms more intense and helping to combat urinary incontinence.

Overcoming Erectile Dysfunction

If you think that your medication may be causing ED, talk to your GP to see if you can try an alternative drug with fewer side effects. Making changes to your lifestyle, such as losing weight, taking moderate exercise, reducing alcohol consumption and giving up smoking can improve ED. If these measures do not help, your GP can prescribe medication to improve symptoms of ED.

Some men are unable to take medication for ED, so using a vacuum constriction device such as the Bathmate Hydromax can enable a man to get an erection. Creating a vacuum around the penis by inflating a hand held pump or using the Bathmate Hydromax in the bath or shower with water causes the blood to be drawn into the penis. A constriction ring can then be slipped over the penis to help maintain the erection during sexual intercourse. Using both medication and a penis constriction device have been found to greatly improve erections.

Treating Balanitis

Balantitis can be easily treated with anti fungal creams and medication to clear the infection, as well as ensuring that penis hygiene is meticulous. Wiping the head of the penis after urination and ensuring that you wash beneath the foreskin daily will help prevent this condition occurring. A circumcision may be necessary if the condition does not respond to conventional treatment. Using a sexual lubricant such as YES organic lubricant can reduce the prevelance of thrush developing.

Great sex without intercourse

You can still enjoy a full sex life even if penetrative sex is no longer possible. Sex without intercourse can allow many couples to enjoy a more fulfilling sex life. With intercourse off the menu, couples can focus on the many other ways they can make love by using erotic touch with a great lubricant, experimenting with sex toys, reading erotic fiction or watching films, and exploring the use of light bondage. Being inventive about how you have sex and what you can try will help you to enjoy a satisfying sex life. Some sex toys such as the Hot Octopuss Pulse III Duo offer sexual stimulation to both the man and women when penetration isn’t possible.

Talk to each other

Sexual problems often occur when communication breaks down in relationships. If this is the case, speak to your GP who can refer you to a sex therapist, a qualified professional who will listen to your issues and give advice and ideas about how to overcome these problems.

Being honest with each other can help open up channels of communication to express how you feel about your diabetes or your partner’s diabetes. You may find that you both have the same fears and worries and can support each other to ensure that your relationship gets back to normal. It may never return to the way it was before the diagnosis of diabetes, but making changes to your relationship can help you both to enjoy a satisfying and fulfilling sex life.

Having a diagnosis of diabetes does not mean you should give up on your sex life. Many people with diabetes do not experience any of the symptoms mentioned above, but if you think that you may have any of the symptoms, seek medical advice. There are many ways in which you can overcome sexual problems and still enjoy a fulfilling sex life. Keep experimenting to find ways to enjoy sex that suit you and your partner, don’t give up because a healthy sex life is important.

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

Useful websites

Diabetes UK :www.diabetes.co.uk

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