Damage done by high blood sugar levels could be the real reason you're not feeling frisky in the bedroom. Try these tips for better sex with diabetes.
Medically reviewed by Niya Jones, MD, MPH
When you have diabetes, it may take some extra effort to rev up your sexual engine and keep it running, but you’re not alone. Sexual dysfunction is a complication of diabetes that isn’t widely talked about, even though it's very common. More than half of all men with type 2 diabetes have trouble getting erections, while over a third of women with diabetes may have sexual problems.
According to a 2013 meta-analysis published in the Journal of Sexual Medicine, which looked at 26 studies of nearly 6,000 women with sexual dysfunction, sexual dysfunction is reported to be higher among those with diabetes. Erectile dysfunction may be up to three times more common in men who have diabetes than it is in those who don't, according to research published in the journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy in 2014.
High blood sugar levels can damage blood vessels and nerves, and that can lead to erectile dysfunction in men; vaginal dryness, pain, and trouble having an orgasm in women; and low libido in both.
In addition, prescription medications, from antidepressants to high blood pressure drugs, can be a huge factor in loss of libido, says Susan Thys-Jacobs, MD, an endocrinologist in the department of medicine at Mount Sinai St. Luke's Roosevelt Hospital in New York.
This is often all happening against a backdrop of other midlife changes, including menopause for women and naturally declining testosterone levels for men.
“This is a period of time when couples disappear from each other sexually, and that takes a toll on their overall intimate relationship,” says Joseph B. Nelson, LP, CST, a psychologist and sex therapist in private practice in Golden Valley, Minn., and department editor of the American Association of Diabetes Educators. “Part of the challenge is not giving up just because sexual energy seems to be low.”
He encourages couples to practice how to be sexual as things change. Making that effort, along with doing what you can to fix any physiological problems related to diabetes, can lead to better sex.
Diabetes and Better Sex
Your first steps should be to keep tabs on your blood sugar, focus on eating healthy, exercise regularly, take your medications as prescribed, and make any other lifestyle changes recommended by your doctor. Diabetes complications, including sexual dysfunction, tend to be much worse in people with uncontrolled blood sugar, Dr. Thys-Jacobs says.
Sexual function may improve with better blood sugar levels alone. If you’ve already made lifestyle changes and you’re still experiencing sexual dysfunction, don’t assume it’s because of diabetes. There could be other factors, so address your concerns with your doctor and get a full assessment.
What Men Can Do
Once you’ve ruled out other factors that may be causing sexual dysfunction, try these next steps:
Get checked for low T. Nelson recommends that men have their testosterone levels checked if they’re having sexual problems, along with any other tests recommended by the doctor. Low testosterone is common among men with diabetes, and improving the level can help improve physical functioning and help medications used to treat sexual dysfunction work better.
Take intercourse off the table…temporarily. Men experiencing sexual dysfunction are going to have anxiety about it. To lower anxiety, Nelson says to spend several weeks being sexual without having intercourse, which eases the pressure of having to get an erection to be intimate.
Consider drugs for erectile dysfunction. It’s no secret that men can take a pill like sildenafil if they’re having trouble getting erections. Such drugs are extremely effective for men who have inadequate blood flow to the penis, Nelson says.
Keep at it. While medication for erectile dysfunction can work like magic for many men, there are still others who aren’t helped by it. Rather than giving up, keep working on sexual health and engage your partner in the process.
What Women Can Do
Too often it’s suggested that when women have trouble with arousal it’s psychological, but it could be physiological, Nelson says. Consider these next steps:
Get tested. Schedule a physical exam and talk to your doctor about getting blood work done to test your thyroid hormone level, Thys-Jacobs says.
Kick up the foreplay and try lubrication. Vaginal dryness is common with diabetes. Nelson suggests spending more time in playful stimulation to become aroused. Also, try different forms of lubrication.
Talk to your doctor about medications. Erectile dysfunction medications usually prescribed for men can also create more blood flow to the genitals for women and increase arousal, Nelson says.
For Men and Women
Be open and honest with your partner about what you’re experiencing. Talk about any concerns you have about your sex life, as well as your ideas for improving the level of intimacy between you. And don’t shy away from the idea of sex therapy. It can foster understanding and compassion and may even help the two of you uncover new ways to be intimate and to become more sexually satisfied.
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