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Author: Janis Roszler, R.D., CDE, LDN
Source: Diabetic Living, Fall 2007

Research has shown that individuals who achieve good diabetes control lower their risk for diabetes-related sexual problems.

It’s easy to pin a lagging libido on stress, depression, age, or lack of sleep. But when you  have diabetes, there may be an underlying factor – symptoms related to diabetes. “When I began to lose interest in intimate activity, I blamed it on my hectic schedule,” says Sarah Davis, 53. “But that wasn’t the problem – my diabetes was. That was a real eye-opener.”

If your sexual feelings have changed or if intercourse has become uncomfortable, your diabetes could be the cause. Sexual complications can develop when blood glucose levels remain elevated for months or years. (An occasional high level will not cause long-term problems.) Fortunately, you can take action to improve your sex drive and your diabetes care at the same time.

You’re Not Alone

Experts estimated that 75 percent of men and 35 percent of women with diabetes experience some sexual problems due to diabetic neuropathy or nerve damage. The good news? Research has shown that individuals who achieve good diabetes control (blood glucose, blood pressure, cholestrol, and triglyceride levels) lower their risk for diabetes-related sexual problems. The Diabetes Control and Complications Trial (DCCT), a 10-year National Institutes of Health study of individuals with type 1 diabetes, found that improved diabetes control decreased the risk of developing neuropathy by 60 percent. This means the steps you take to manage your diabetes are the same keys that open the doors to a healthy sexual relationship.

The Feminine Mystique

Women with diabetes may find it difficult to stimulate lubrication, experience orgasm, or even feel sexual desire. This could be due to diabetes-related nerve damage or depression. If you’ve gained weight and feel less attractive, you may not be open to sexual contact. You can’t feel good about sex if you don’t feel good about yourself. Couple those feelings with mood changes brought on by blood glucose swings and diabetes-related stress, and the resulting tension can disturb the rhythm of even the most loving relationship.

“Looking at Helen Singer Kaplan’s early work, as far back as 1974, we’ve known that a woman’s negative or sex-irrelevant thoughts, fears, and worries could affect her ability to experience erotic pleasure,” says Yolanda Turner, Ed.D.(c). adjunct professor in the human sexuality doctoral program at Widener University in Chester, Pennsylvania.” Current research has confirmed this and has also demonstrated that body image has a definitive impact on a woman’s experience of desire and orgasm. When women feel less positive about their appearance, they’re less likely to want to participate in sexual activity.”

Being overweight can contribute to low self-esteem and loss of libido. According to a recent Duke University study, shedding a few pounds improved life in the bedroom by making participants feel better about their bodies. In the study, 187 obese women and men lost an everage of 17.5 percent of their body weight and felt better about sex than they had previously. If weight is an issue for you, talk to a registered dietician or participate in a healthful weight-loss program to achieve your goals.

Stress can also inhibit sexual desire, whether it’s related to diabetes control, work, or family situations. In any case, it’s helpful to remove as many stressers from your life as possible and to equip yourself to better handle unavoidable tension. You might try stress-reduction activities, such as yoga or meditation, to feel calmer about anxiety in your life.

If you’ve been feeling low and have had little interest or pleasure in sex or other activities for more than a couple of weeks, you may want to talk to your health-care provider about further assessment for depression.

If your sexual problem is more physical than emotional, try some simple steps to correct it. For persistent vaginal dryness, purchase a water-base vaginal lubricant over the counter from any pharmacy. You might also work on relaxing the muscles around the vagina with Kegel exercises, the practice of contracting pelvic muscles to control the flow or urine.

The Male Libido

The most common sexual complication for men with diabetes is erectile dysfunction (ED), the inability to achieve or maintain a satisfactory erection is more than half of the attempts. “There are many different causes of ED. Even if you have diabetes, it may not be the cause of your sexual performance problem, so don’t let your fears prevent you from getting the treatment you deserve,” says Bill King, a 47-year-old from Philadelphia who has type 1 diabetes.

Like women, men can gain weight or experience depression, which can cause a drop in libido. But many men with diabetes develop ED because of a testosterone deficiency, which can be detected by a simple blood test.

If you’re dealing with some of those issues, you’ll find many products available that can help. You can try prescription medications (such as Viagra, Cialis, or Levitra), testosterone treatments, penile constriction rings, penile vacuum pumps, injections, suppositories and surgical implants. A penile sleeve can help you enjoy intercouse if you’re physically unable to maintain an erection. But before you invest in a solution, find out if it’s proven to work, then see if your health insurance will cover it. Ask your doctor or pharmacist what he or she might recommend.

Work Together

Despite the sexual problems you may be experiencing, remember that it takes two to tango. Talk to your partner about your concerns. You may want to meet with a relationship counselor to learn how to communicate more effectively and resolve any issues that may be standing in the way of a healthy relationship.