How Diabetes Affects Sexual Function

What You Need to Know about Diabetes and Sex

Diabetes can affect sexual function, and as uncomfortable as it may sound, you may need to discuss this with your doctor (and certainly with your partner). To help you out, I have done research to bring you information about this most sensitive of subjects.

First of all, having any chronic disease may in itself cause anxiety, which can result in sexual dysfunction. But having said that, it is also true that diabetics do report more sexual dysfunction than the populations at large. In his book Talking About Sex (American Psychiatric Press, Inc., 1995), Derek C. Polonsky, MD states that 20% of people with diabetes, both men and women, report sexual dysfunction.

Please read the following with an open mind, not looking for something bad which will happen to you or a loved one. Rather use it as a tool to make you better informed, and more able to talk to the professionals in your life who can help when you need it.

As Dr. Polonsky says, "What starts out as a physical problem is compounded by the emotional reaction to it." This article is shared to help all of us deal with the physical before this occurs.

Research on Diabetes and Sexual Dysfunction

There is more research on sexual dysfunction in males than females.

In males, current research points to the need to develop a comprehensive biopsychosocial evaluation and treatment of diabetic patients with sexual dysfunction because of the high incidence of major depression and anxiety disorders noted in impotent men with neuropathy as compared to those who did not have depression, anxiety, or impotence, but had neuropathy.

One caveat here is that just learning to cope with a chronic disease may cause psychiatric problems which may lead to lack of compliance, and may snowball into chronic complications, and so the process feeds on itself. For these reasons, any complicated behavior such as sex deserves a comprehensive work-up by a trusted physician.

Sexual Dysfunction in Women with Diabetes

In women, even as late as 1989, it was thought that there was no greater incidence of sexual disorders in diabetics than in the general population.  By 1994, however, researchers noted that problems with libido, arousal, and orgasm are common in both men and women with diabetes.

Let us begin with common answers about sexual dysfunction in women.

It is true that some women with diabetes experience decreased sex drive or the inability to achieve orgasm. Like other complications of the disease, this is a slow and progressive pattern. It is thought to be a result of diabetic neuropathy and/or vascular disease.

Also, the fact that uncontrolled diabetes can sap strength and therefore sexual desire, may play a role in the problem. Diabetic women have a predisposition to chronic vaginal infections, which may also interfere with normal sexual pleasure.

Add to this the effects of medications taken for other medical problems such as heart disease, and the fears that many of us carry concerning the complications of pregnancy, the effect of our disease on our marriages and work, and you can begin to appreciate the complexity of trying to ferret out the causes of sexual dysfunction.

More research has been done on type 1 diabetic women than women with type 2 diabetes. However, research completed does show that type 2 diabetic women are more likely to experience some sort of dysfunction.

Participants reported less sexual desire, less satisfaction, more avoidance of sex, difficulty with lubrication, and fewer orgasms. Researchers postulated that these type 2 diabetic women had more neurovascular problems which would account for lubrication difficulties.

These researchers also examined psychological aspects of older type 2 diabetic women who reported that they felt their bodies were less sexually attractive than non-diabetic women.

Now the good news. More than 60% of women in the study did not report any dysfunction.

Researchers point out that if you are experiencing difficulties, a candid talk with your physician about the side effects of medications you take which may impact your sex life is very important. For example, certain medications for hypertension may affect orgasm.

As important is to monitor food intake and exercise. Controlling weight and diabetes will enhance self esteem and body image. Also, knowing that as we age we may need more time for arousal, it is important to share your needs with your partner, and if necessary, to ask for help from the appropriate professional.

Sexual Dysfunction in Men with Diabetes

For men, as for women, the process of developing a sexual dysfunction may be slow and progressive. In men, impotence may come and go at times. It may begin with erections that are less firm than before, and then progress to those which are shorter duration and less firm.

The man will continue to have interest in sex and be able to have orgasms. It is thought that this process occurs in about half of all diabetic men and is caused by diabetic neuropathy.

Experts report that it can be slowed down and treated, but that actual tissue damage can not be reversed. It is therefore very important to report symptoms early as apposed to later in the process to get the most effective treatment.

Sometimes impotence is a flag of undiagnosed diabetes, and then the impotence has a rapid onset. It comes with the other classic signs of the diabetes. In these cases, it can usually be resolved with good control of glucose levels.

As with women, there may be others reasons for developing sexual dysfunction. It may be a response to the fears and stresses of having diabetes, or the fear of developing impotence.

It may also be a result of medications taken for other conditions or a combination of medications taken. It may also be a result of other illnesses which,, when resolved, will alleviate the problem.

Talking to Your Doctor about Sexual Dysfunction

If you are experiencing sexual dysfunction, do talk to a trusted physician and get a referral to the appropriate specialist. We all know that talking about sex is sometimes difficult, and talking about sexual dysfunction is next to impossible for some.

But not getting sound medical advice will leave you in the dark hole where you are now only it will continue to get darker.

According to a new national survey, the MUSE Impotence Report, most men (64%) have never discussed their sex life with a physician. And most women (58%) mistakenly believe their partner would be upset if they took the initiative in arranging a doctor's appointment.

Sexual Dysfunction Treatments for Men with Diabetes

There are several treatments available for sexual dysfunction in men with diabetes.  These include:

  • penile implants:  Your ability to undergo the surgery for an implant will be affected by the normalcy of your blood supply, your healing ability, and existing tissue damage.
  • medications that work by dilating blood vessels, allowing more blood to flow into the penis
  • non-surgical methods such as sliding a gel-coated pellet into the opening of the penis, a vacuum device, or injecting medication into the base of the penis with a needle.

Make sure you speak to a urologist who is experienced with dealing with diabetes, and do talk to other couples who use the implant.

In the meantime, remember that relationships are not just about sex, but about truth and sharing. So while you and your doctor are working on understanding your needs, you can continue to be the loving partner you have always been. Remember, our bodies may change, but we remain us, the same person we were at age 21, only better in many important ways.

Updated on: December 4, 2012