What is diabetes?

Diabetes means that there is too much sugar (glucose) in your blood. Your body breaks down some of the foods you eat into sugar. Your blood carries the sugar to the cells of your body. You need some sugar in your cells for energy, but too much sugar in your blood can cause many problems, including heart disease, stroke, blindness, kidney failure, nerve damage, and sexual problems. People with diabetes tend to have sexual problems earlier in life than people who don’t have the disease.

How does diabetes affect the body?

Diabetes can lead to hardening and narrowing of the blood vessels, which decreases blood flow. In men, decreased blood flow to the penis may make it harder to have or keep an erection. This is called erectile dysfunction (ED). Along with the need to urinate and drink often, ED may be an early sign of diabetes. In women, decreased blood flow may cause the vagina to be drier than normal. It also may increase the risk of yeast infections. These changes can cause pain and bleeding during sex.

Having high or low blood sugar may make you feel too tired for sex. Diabetes can also cause damage to nerves in the body. This can result in problems such as:

• Semen may go into a man’s bladder instead of out the tip of the penis.
• Women may be less sensitive to touching and stroking.
• It may be more difficult to have an orgasm.
• Weakness, numbness, or pain in general can make sexual activity more difficult.

How are sexual problems treated?

If you think you have a sexual problem related to diabetes, see your healthcare provider. Treatment for women may include:

• Taking estrogen hormone pills or using vaginal cream
• Medicine to treat vaginal infections
• Use of water-based lubricants such as KY jelly

Treatment for men may include:

• Taking the hormone testosterone
• Having sex only when well rested (such as early morning hours when testosterone levels are higher)
• Taking a medicine or using a device prescribed by your healthcare provider to make it easier to have and keep an erection

Both men and women may benefit from seeing a counselor, to talk about their feelings. There may be options of less tiring positions, different methods of arousal and ways to feel close when not having sex.

How can I help prevent sexual problems caused by diabetes?

• Control your diabetes. Try to keep your blood sugar in the range recommended by your healthcare provider.
• Keep your blood pressure at a normal level.
• Keep your cholesterol (blood fats) at a healthy level.
• Exercise regularly according to your healthcare provider’s recommendation to keep good blood flow, especially in your feet and legs.
• Limit the amount of alcohol you drink, because alcohol can cause nerve damage too.
• Eat healthy meals that include whole grains, fresh fruits and vegetables, and foods low in saturated fat.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. Learn ways to manage stress. Keep all appointments for provider visits or tests.

You can get more information from:

• American Diabetes Association, Inc.
  800-342-2383
  http://www.diabetes.org