Sadly, diabetes can affect everything... including what goes on in your bedroom.

This week, for our Saturday advice column Ask D'Mine, your host Wil Dubois (veteran type 1, diabetes author and educator) takes on this sticky topic. Prepare for an R-rated, yet very informative read.

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Mary, type 1/ LADA from Wisconsin, writes: Some day I would like to read a column about dyspareunia; all we hear about is erectile dysfunction.

Wil@Ask D'Mine answers: Your wish is my command. Let's talk about dyspareunia, which as you might suspect, most people have never heard of. (Yes, I had to Google it myself.) But you lovers of language are really going to get off on the origins of the word, at least I did. The word, like the names of many medical conditions, comes to us from the Greek. Dys, of course, means "bad," and we often use this as a prefix in medicine. Examples would include dysplasia, dysmenorrhea, dysuria, and dyspepsia. It's also worked its way into common usage with words like dysfunctional; and the modern slang of someone dissing you comes to us from the same root.

Clearly then, we are talking about bad something here. So what does pareunia mean? Well, that comes to us from parenunos, meaning "bedfellow." So that's it. Bad Bedfellow.

Dyspareunia translates to a partner who's bad in bed.

Why would someone be bad in bed? Well, medically speaking, anyway, it might be because it HURTS. And that's what dyspareunia (dis-puh-ROO-ne-uh) is really all about. It's a difficult to diagnose, and treat, condition that makes it hurt to, umm, get it on. And it's an equal opportunity medical condition that affects both men and women — although it strongly favors women (in a bad way).

By definition, the pain can be caused by either physical or psychological causes — although apparently this is controversial. And this pain isn't limited to wild monkey sex, it can happen in any (and for some people, all) sexual encounters. It can also occur before, during, or even after intercourse.

As you can imagine, we're really going to have to stretch our PG-13 rating here today, because for the rest of the column we're going to be talking the nuts and bolts of sex. Along with penises and vaginal lubrication.

Ladies first. Apparently one in five women will suffer dyspareunia at some point in her life. My dears, you can apparently have all sorts of pain: entry pain, penetration pain, thrusting pain, and deep pain. Who knew? (Well, I guess one in five women on the planet knew.) The pain can be painy-pain, burning pain, or aching pain.

The most common causes of lady-pain are apparently lack of lubrication from idiot partners who rush through the all-important foreplay, post-menopausal estrogen shortages, antidepressants and high blood pressure pills (among others), injury or surgery, and infections. The actual list of things that can cause a woman to be a lousy bedfellow would take me all day to type up, but here's a link to the top one hundred causes. There's also a whole 'nother ball game of girl-pain called vaginismus, which is a cascade of involuntary spasms of the muscles that line the vaginal wall.

And in case you are wondering, no, most women who suffer dyspareunia don't have a history of sexual abuse.

How's it treated? Well, that depends on the cause, and as we talked about there are a million and one causes. Therapy can range from something as simple as a pre-coitus aromatherapy bath, to something as complex as surgery. In between are tubes of lube, a change of meds, girl-on-top sex (no kidding), desensitization therapy, and even vaginal self-dilation. There are also some solutions in the medicine chest, but don't use medical marijuana. For some women that can actually reduce vaginal lubrication.

Sounds miserable. But we're not off the hook, Guys. Sex can hurt for us, too. With men the pain can be, from top to bottom: At the tip or foreskin, in the shaft, in the testicles, or deep in the pelvis or abdomen. Guy sex pain can be burning, sharp, searing, or cramping. Yikes!

As with the fairer sex, the cause of male dyspareunia is widely varied, but often associated with injury, either to the shaft or the thin skin that covers the penis, which apparently can be injured while penetrating an un-lubricated partner — which I'm guessing would result in simultaneous dyspareunia. I also read that dyspareunia in men can be caused by death-grip masturbation. I should be able to come up with some sort of snarky quasi-obscene comment about getting a grip, but I'm drawing a blank today.

Other male issues include Peyronie's disease (which causes crazy, abnormal bending of the penis of up to 90 degrees when erect), overly tight foreskin called phimosis, prostrate or bladder problems, and gonorrheal infections. Oh, and a condition called urethritis can even make mere stimulation painful. So men with urethritis shouldn't surf the porn net.

On the rarer side, some men's penises are allergic to contraceptive foams and creams; and the very well endowed among us sometimes reportedly get the tips of their penises scratched by the tail of an IUD, if their partner uses one. I tell you, sex is dangerous business!

And just like with the ladies, the treatment varies with the problem. Oh, and I really should point out the obvious for both men and women: Painful sex isn't fun sex. (Assuming you aren't some sort of pervert who actually enjoys pain.) So if it hurts and you don't enjoy that kind of thing, get it fixed! Go to your doc, pull down your pants, and declare the problem. As we've seen, the causes are far-ranging, but most seem fixable.

Now, where does diabetes cum... errr... come into all of this painful sex stuff? Well, I already told you that diabetes always makes everything worse, right? Well, one study showed that nearly half of all my diabetic sisters report dyspareunia. There's more than one reason for this, but chief among the diabetes-driven culprits are the facts that high blood sugar apparently reduces vaginal lubrication, as, of course, can autonomic neuropathy. D-ladies are also more prone to uniary tract infections and yeast infections, either of which — in addition to being a mood-killer — can make horizontal action painful. If any of our diabetes meds reduce vaginal lubrication, I couldn't find any info on that, but many women with diabetes take high blood pressure pills and/or anti-depressants that can make dyspareunia worse by reducing natural lubrication.

For D-dudes who aren't circumcised, that nasty phimosis is apparently linked to diabetes in a big way; and for the rest of us, Peyronie's is seen more frequently in men with diabetes than in sugar normals. As for the gonorrhea, I've never been able to find any data indicating that people with diabetes have higher rates of sexually transmitted disease, but it wouldn't surprise me.

Eat, drink, and be merry—for tomorrow we may die, right? But my informal poll of women with diabetes who practice D-cest (sleeping with our own kind) shows that D-men are waaaaaaaaaay better endowed than our non-D brothers. Naturally, the only problem seems to be that about half the time this super-sized gear doesn't work right.

Oops, sorry, Mary. You said you were sick of hearing about erectile dysfunction. But hey, it's another one of those dys words...



This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.


Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.