Is diabetes interfering with your love life? Although issues with sexual functioning can be caused by aging and other medical conditions, men and women with diabetes do report more difficulties in this area. There are several reasons—both physical and psychological—why this is true.
Diabetic Neuropathy
Diabetic neuropathy, or damage to nerves and small blood vessels caused by diabetes, can lead to a variety of physical complications that can affect sexual activity. For men, this can take the form of erectile dysfunction (an inability to have or maintain an erection) or retrograde ejaculation (where some or all semen flows into the bladder, rather than out through the penis). For women, common problems include vaginal dryness, reduced sexual desire or response, and painful intercourse.
Nerve damage can also cause urological problems such as overactive bladder, urine retention, and poor sphincter (muscles that surround body openings) control resulting in urine leakage. These problems can lead to urinary tract infections and interfere with sexual activity.
Men and women are at higher risk of developing diabetic neuropathy and related sexual and urological problems if they are overweight; underactive; over 40 or smoke cigarettes, or if their blood pressure or cholesterol levels are high or blood glucose (sugar) is not controlled. At the same time, getting these factors in the ranges recommended by their healthcare providers through improved diet, increased physical activity, and appropriate medication can reduce risk.
Psychological Issues
Depression and anxiety—as well as the medications taken to relieve symptoms—can also play a role in physical sexual dysfunction and decreased desire. One study found that almost 80% of women with diabetes in their early to mid-forties reported sexual dysfunction, and the rates were especially high in women who also reported anxiety or depression. And about 60% of men with diabetes have experienced erectile dysfunction, delayed or premature ejaculation, or reduced sexual desire. Erectile dysfunction is also linked to cardiovascular (heart and blood vessel) disease, which is the number one cause of death in people with diabetes.
What You Can Do to Improve Your Sex Life
Many people with diabetes don’t even know that there is a link between sexual issues and diabetes-related medical problems. Although it is a sensitive issue, it’s important for men and women with diabetes to discuss sexual concerns with a trusted health care provider in order to identify the source of the problem and develop a care plan. Don’t be embarrassed! Sexual dysfunction is a medical problem that many doctors are prepared to address. Your physician has probably heard it before, and is in a position to help. That help may include a referral to an endocrinologist, urologist, psychologist specializing in sexual dysfunction, or another type of specialist. A doctor may prescribe medications to treat erectile dysfunction, increase desire, or help with contributing factors like high blood pressure and cholesterol levels.
"There are no quick fixes, because sexual health is complicated," says Minneapolis-based psychologist Joseph Nelson, M.A., L.P., C.S.T. "But speaking with your physician or diabetes educator is the first step toward getting your sex life back on track."
Joseph Nelson, M.A., L.P., C.S.T., reviewed this article.
Sources
Nelson, Joseph, M.A., L.P., C.S.T. Email to author June 25, 2015.
Corona G., C.B. Giorda, D. Cucinotta, P. Guida, E. Nada. "Sexual Dysfunction at the Onset of Type 2 Diabetes; the Interplay of Depression, Hormonal and Cardiovascular Factors." The Journal of Sexual Medicine 11, 8 (2014): 2065-73. doi: 10.1111/jsm.12601.
Forouzan E., Z. Kashi, B. Tasfieh A. Bahar, M. Khademloo. "Sexual Dysfunction in Women With Type 2 Diabetes Mellitus." Iranian Journal of Medical Sciences 40, 3 (2015): 206-213.
Sayuk G.S., B.M. Gott, B.D. Nix P.J. Lustman. "Improvement in Sexual Function in Patients With Type 2 Diabetes and Depression Treated With Bupropion." Diabetes Care 34, 2 (2011): 332-334. doi: 10.2337/dc10-1714.
National Diabetes Information Clearing House. "Sexual and Urologic Problems of Diabetes." NIH Publication No. 09-5135. December 2008. Updated June 29, 2012.
