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Kos Diabetes Group: Diabetes and Your Sex Life (yes I'm going there and talking about that) [1]
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Date: 2022-11-04
For a society that is obsessed with sex on TV and in the movies, we're awfully shy about sex when it comes to our health. Even though people with diabetes are at a higher risk for sexual problems, a study in Diabetes Care found that only about half of all men with diabetes and 19 percent of women with diabetes have broached the topic with a doctor.
Approximately 80% of patients reported they prefer if a doctor asks about sexual function, so they don’t have to bring it up. But many doctors don't feel comfortable prodding patients for details on sexual function either. That’s why the newly diagnosed quickly learn about their risk for eye, nerve, kidney and heart complications, but hardly ever hear how diabetes can affect their sexual health. It is important for people to be open and honest with their doctors regarding all health concerns—even problems with sexual function. If your provider doesn’t ask about your sex life, bring up any concerns because sex is an important component of a high-quality life.
One of the most common sexual side effects of diabetes in men is erectile dysfunction. Erectile dysfunction (ED) is the inability to get or maintain an erection firm enough for sex. It can stem from damage to nerves and blood vessels caused by poor long-term blood sugar control.
Nerve damage can cause the brain to be unable to properly communicate with the nerves in the sexual organs and the body might not be able to shuttle blood there, impairing a man's ability to get an erection. The ability to keep an erection can also be affected, because the brain must communicate with the nerves to hold blood in the penis.
Damage to the vascular system can reduce blood flow. If the blood vessels aren't functioning properly or if an artery is blocked, not enough blood will travel to the penis, making it difficult to get an erection.
Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and heart disease
Having erectile dysfunction can be a real challenge. It can leave you and your partner feeling frustrated and discouraged. Take steps to cope with erectile dysfunction — and get your sex life back on track.
Managing your diabetes can stop the progression of ED, but sometimes symptoms don't improve because of nerve damage that has already been done. There are many treatment options for ED if you don't see an improvement after getting your diabetes under control.
Here are some steps you can take
Tell your doctor what's going on. Your doctor will consider underlying causes of your erectile dysfunction and can give you information about medication and other erectile dysfunction treatments. Find out your options.
Ask if there's anything you can do to better manage your diabetes. Improving your blood sugar levels can help prevent nerve and blood vessel damage that can lead to erectile dysfunction. You'll also feel better overall and improve your quality of life. Ask your doctor if you're taking the right steps to manage your diabetes.
Ask about other health problems. It's common for men with diabetes to have other chronic conditions that can cause or worsen erectile dysfunction. Work with your doctor to make sure you're addressing any other health problems.
Check your medications. Ask your doctor if you're taking any medications that might be worsening your erectile problems, such as drugs used to treat depression or high blood pressure. Making a change to your medications might help.
Seek counseling. Anxiety and stress can make erectile dysfunction worse. Erectile dysfunction can also have a negative impact on your relationship with your intimate partner. A psychologist, counselor or other mental health specialist can help you and your partner find ways to cope.
There are several treatments available for erectile dysfunction.
Viagra
Oral medications. Erectile dysfunction medications include sildenafil (Viagra), tadalafil (Cialis, Adcirca), vardenafil (Levitra, Staxyn) or avanafil (Stendra). These pills can help ease blood flow to your penis, making it easier to get and keep an erection. Check with your doctor to see whether one of these medications is a safe choice for you.
Other medications. If pills aren't a good option for you, your doctor might recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base or side of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.
Vacuum-constriction device. This device, also called a penis pump or a vacuum pump, is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection. A band placed at the base of the penis maintains the erection after the tube is removed. This hand- or battery-powered device is simple to operate and has a low risk of problems. If a vacuum-constriction device is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it's made by a reputable manufacturer.
Penile implants. In cases where medications or a penis pump won't work, a surgical penis implant might be an option. Semirigid or inflatable penile implants are a safe and effective option for many men with erectile dysfunction. It was impossible to find pictures of things relevant to this topic that I could use legally so you get some cute kittens instead
Besides erectile dysfunction, which affects only men, there are other sexual dysfunctions that affect both men and women.
Low libido, or sexual desire, is a problem that affects people with diabetes more than those without. The time and energy spent managing diabetes and related conditions can take a toll on emotional health. This may lead to disinterest in sex. Both men and women can experience low libido as a result of poorly managed diabetes.
Studies have shown that men with diabetes, especially those who have Type 2 or are overweight, or both, have about twice the risk of low testosterone as their peers without the disease, which can affect a man's passion for sex. When low testosterone is treated through losing weight and/or testosterone therapy, many men have a renewed desire for sex.
Treating women isn't quite as simple. It's hard for researchers to determine whether a particular woman's low libido is a result of diabetes, emotional issues or something else entirely because low libido is common in women regardless of the presence of diabetes. Some studies suggest that taking testosterone can increase sexual desire in women—but the treatment is still understudied, particularly its long-term effects on women's health.
Arousal is another area of sexual difficulties. There's a difference between desire and arousal. First, sexual desire must occur; then the body responds, signaling arousal. That is, if everything's working properly. Both men and women with diabetes may feel desire but struggle with arousal problems, though the mechanisms behind this sexual dysfunction are better studied and understood in men.
Studying female arousal problems is difficult because women may have a hard time determining just how turned on they are and there's less of a physical sign of arousal in women than there is in men. Treatments for female arousal problems are few.
For both men and women, a good place to start looking for possible causes is your medicine cabinet. When meds aren't behind a person's hampered arousal, diabetes may be to blame.
Does the cuteness make this topic less awkward?
Orgasm is the sought-after sexual reward, but for men and women with diabetes it can feel like an unattainable goal.
Having an orgasm is usually pretty easy for men, which is why it can be so frustrating if a man is unable to climax. Men suffering from neurovascular damage—and the lack of blood flow and/or sensation it creates—can have a hard time reaching an orgasm. Men can get around this with a variety of treatments but these treatments will not fix neuropathy.
Women in general report more difficulty having an orgasm than men, and those with diabetes have even greater difficulty. A woman's inability to climax often has to do with her mental or emotional state but diabetes may play a role as well. According to a study published in the journal Obstetrics & Gynecology, middle-aged women whose diabetes requires insulin are 80% more likely to report trouble reaching an orgasm than women without diabetes.
Women with diabetes are also prone to the same blood-flow issues men face because of nerve or blood vessel damage. Diabetes complications may make it difficult for blood to move to the vagina and clitoris. If the small nerves of her clitoris and vagina are not working properly, then she can have sensation problems. For the clitoris to have the engorgement it needs to orgasm, it needs to have the blood flow and sensation.
Sex is supposed to bring you and your partner pleasure, so pain is an indication that something isn't right. Even if you're shy, it's important to discuss issues of painful sex with a doctor.
Men with diabetes are at an increased risk for developing Peyronie's disease, a condition in which scar tissue inside the penis causes a curved and painful erection. Penises all vary in shape, and a little curve isn't a big deal, however, with Peyronie's disease, the curve or bend is significant and can make having sex and getting or keeping an erection difficult and painful. A doctor can advise whether you should wait it out, take medication or have surgery.
Vaginal dryness is one of the main reasons women with diabetes have pain during sex. As natural result of aging, vaginal dryness is very common among all women who are menopausal or post-menopausal, due to a lack of estrogen, but researchers don't understand exactly why women's bodies lose the ability to self-lubricate when menopause isn't the cause. In women with diabetes, nerve damage may cause vaginal dryness. Regardless of the cause, better lubrication is the answer. Problems may be treated with prescription estrogen, available in pills, a patch or a cream used in the vagina. The goal is to be well lubricated before sex.
Women with diabetes are also at a greater risk for urinary tract infections (UTIs) and vaginal yeast infections, which in turn may lead to painful sex. Lower your chances of getting a UTI or yeast infection by managing your blood glucose, and head to the doctor at the first sign of discomfort.
What can I do
Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis.
If you've tried to quit on your own but couldn't, don't give up — ask for help. There are a number of strategies to help you quit, including medications.
Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
Limit or cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for persons older than age 65, and up to two drinks a day for persons age 65 and younger.
See a mental health professional or a doctor who specializes in sexual medicine. Talking with a mental health professional is an important step because relationship problems, body issues, stress and a host of other emotional baggage can affect all aspects of your sex life. You may be too self-conscious to get in the mood or get aroused, or maybe you're too stressed to have an orgasm. A counselor can also help you and your partner work out any strain your sexual dysfunction may have caused. Sexual dysfunctions can create such emotional tension in a relationship that it can permeate the entire relationship—not just in the bedroom, so talking it out and can help you find a way to work around your sexual problems.
A healthy active sex life is an important part of life. Don't let embarrassment keep you from getting help. One small conversation can make a big difference.
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