When my client Jeffrey was diagnosed with type 2 diabetes, he didn’t take it very seriously. After all, he felt fine. He never checked his blood sugar, ate whatever he wanted, and prided himself on being a “couch potato” who burned calories each time he pressed the buttons on his TV’s remote control. Then, his intimate relationship began to be affected. Diabetes had entered his bedroom, and he could no longer ignore it.
Another story I’m familiar with: Diane lived with type 1 diabetes and tried to manage it well. She exercised regularly and kept her blood sugar and other levels within a healthy range for her. Yet recently, she had felt discomfort during intimacy with her partner. Diabetes had made its way into her bedroom, too.
These stories are not uncommon: many American men and women living with diabetes have experienced a negative effect on their intimate lives. The issues may be emotional or physical for both men and women.
When blood glucose is out of range, for example, both men and women may experience a decrease in libido and feel less interested in sexual activity. Those who are overweight or have bruises or other skin reactions from injections may feel less attractive or less confident about intimacy. And, both sexes in an emotionally strained relationship may have a harder time enjoying intimate activity.
When it comes to sexuality, the mind is a powerful tool, especially in women. Some women may find it helpful to nurture their emotional connection and give their bodies time to respond. Sometimes, seeing a marriage and family therapist may help improve relationships and enhance communication between partners.
But not everything is in the mind, and physically, the issues differ for men and women. Low testosterone levels are a common issue for men who are living with diabetes. Low testosterone often goes undiagnosed because the symptoms may resemble those of other conditions. A blood test can determine if levels are low, and once identified, a doctor might recommend and prescribe the use of a topical gel or other form of testosterone replacement for appropriate patients. For men, blood sugar control may also affect the ability to be intimate and the likelihood of experiencing erectile dysfunction, also known as “ED.” For men with ED, improving blood glucose control may improve the situation. But if ED condition persists, despite improved blood glucose, individualized medical advice should be sought, with possible options ranging from oral ED medications to permanent surgical procedures. Talk to your diabetes care team about your what might be best for you.
Women, too, may be physically affected by diabetes, though often differently than men. Higher blood sugar levels may raise the risk of urinary tract infections. Women living with diabetes are also more likely to feel discomfort or dryness during intimate moments. Talk to your diabetes care team to understand your options, which could include over-the-counter products or hormone suppositories, and to see what might work best for you.
If you have diabetes and are experiencing sexual difficulties, my advice is don’t be shy – seek help! Talk to your diabetes care team to help you find ways to enjoy your intimate relationship.
Janis Roszler, MSFT, RD, CDE*, LD/N is the American Association of Diabetes Educators 2008-09 Diabetes Educator of the Year. She is a registered dietitian, certified diabetes educator, and marriage and family therapist. Her books include Sex and Diabetes and The Secrets of Living and Loving with Diabetes. Roszler is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2013 The DX: The Diabetes Experience