Living with type 2 diabetes may not be easy on some days, but learning how it affects you is the first step toward feeling better.
Diabetes may affect your diet. Managing your blood sugar levels may be part of your daily routine, too. It’s also common to take medications that may affect your libido and cause sexual side effects.
The good news is that sexual challenges are very treatable. Just as managing your diabetes is important, a healthy sex life can help boost your quality of life, too.
Did you know? One analysis reported that as many as 52 percent of men with diabetes experienced erectile dysfunction (ED). A 2015 study found that in women with diabetes, reported sexual concerns, especially among those who also had depression.
Here’s why you may be experiencing some challenges in the bedroom and what you can do about them.
What causes sexual challenges in people with diabetes?
People of all ages can experience sexual dysfunction. Symptoms tend to increase as you age. Pinpointing the exact causes of sexual symptoms in diabetes is complicated, as reasons are often layered and vary from person to person. But you can get answers.
For instance, Mark Canada has had type 2 diabetes for over 15 years. More recently, he’s seen improvements in his well-being due to lifestyle changes.
Although he reports never experiencing ED, he has experienced a decreased interest in sex. He associates this with his fatigue, stress from a demanding career, aches and pain in his body, and periods of poor communication in his marriage.
“I just wanted to come home, climb in a big easy chair, and forget about things,” he shares. “We managed, but it could have been better.”
Debra Wickman, MD, FACOG, is the section head of female sexual health, menopause, and vulvar medicine at Banner University Medical Center. She tells Healthline that any area of well-being that’s out of balance can affect sexual desire.
Typically, when there’s a chronic condition like diabetes in the mix, there’s more than one area contributing to sexual challenges. In addition to the physical symptoms, there could also be stressful emotions, relationship conflicts, and other issues that may be contributing to sexual problems.
Sexual symptoms and bladder function may also be a sign of diabetes. If your blood sugar levels are high and left unmanaged, diabetes can lead to nerve damage that can affect different parts of your body, including your sexual organs.
As a result, you may experience numbness, pain, or lack of feeling in your genitals.
In men, decreased blood flow can affect arousal, preventing erections. A low sex drive is also common.
Due to decreased blood flow, nerve damage, or emotional strains, women may experience:
- vaginal dryness
- difficulty becoming aroused
- pain during sexual intercourse
- low sex drive
Although many women may focus on their lack of interest in sex, there’s often a physical complication behind the disinterest.
“You have a population of women who, because of their diabetes, have decreased blood flow. They have nerve endings that aren’t as healthy,” says Lauren Streicher, MD, clinical professor of obstetrics and gynecology and the medical director of the Center for Sexual Health and the Center for Menopause at Northwestern University.
“Women are going to have decreased sensation, less lubrication, and more pain with sex. And as a result of all of that, they’re going to have decreased libido,” she says.
The good news: Sexual challenges are treatable
If the bad news about sexual side effects and diabetes is that these complications are common, the good news is that they’re also incredibly treatable.
There are a variety of options both men and women can explore with a healthcare provider who specializes in sexual health.
For anyone, making healthy lifestyle changes is often a first step toward a better quality of life and increased satisfaction with their sex lives. (It also helps with managing blood sugar levels.)
Managing your blood sugar, staying active, eating healthier, and losing weight are all associated with improving diabetes symptoms and boosting confidence and energy.
Mary Roberts, who received her diagnosis of type 2 diabetes in 2008, says that changing her diet and losing weight haven’t only made her diabetes symptoms more manageable, but they’ve had a marked increase in her sexual desire.
While she was once fatigued and facing dissatisfaction with her body, she now has an active sex life and higher quality of life, Roberts shares.
That being said, a healthier lifestyle is important, but it might not provide a remedy to all of the sexual symptoms you’re experiencing as a result of your type 2 diabetes. This is especially true if there are symptoms related to pain and dryness.
“It is important to acknowledge that people have specific physical problems that can impact on the ability to have pleasurable sexual activity,” Streicher says. She warns against deeming lifestyle changes as the ultimate fix for sexual dysfunction.
Possible treatments for women
Although lifestyle changes can make a big difference, Streicher recommends a few extra specific steps to make sure sex is more pleasurable for women:
Find the right lubricant
Not all lubricants are a good fit for someone with diabetes.
Streicher recommends a silicone-based lube for women with diabetes. She warns that water-based lubes often absorb and break down vaginal tissue.
Additionally, many water-based lubes include glycerin, which is a sugar — and a poor choice for anyone trying to manage their blood sugar.
Need more lubricant information? Check out our guide here.
Explore prescription options
Prescriptions are available that can address vaginal dryness or decreased libido, such as estrogen therapy. This can include creams, rings, and oral medications. Your doctor can discuss your options and whether any are right for you.
Talk to your doctor about vaginal laser treatment
In Streicher’s practice, they also offer the option of laser treatment. It targets dry, painful tissues. This may encourage lubrication and new blood vessel growth.
It’s important to note that the safety and effectiveness of vaginal laser treatments haven’t yet been scientifically established. Speak to your doctor about the benefits and risks and if it’s right for you.
Possible treatments for men
For men experiencing ED as a result of their diabetes, there are a few additional medical options worth pursuing:
Take a prescription medication
Some of the most common oral medications include:
They work by encouraging increased blood flow to your penis.
There are also injections and suppositories available if oral medication isn’t a good fit for you. Talk to your doctor about the best options for you. They can also discuss any possible interactions with medications you’re currently using.
Try a vacuum pump
A vacuum constriction device (sometimes called a penis pump) helps draw blood into your penis, encouraging an erection. Your doctor can help you select a device that meets your specific needs.
How couples can get their groove back
With the lifestyle and prescription options available to you, there’s still more you can do to help ramp up your sexual life:
Find creative alternatives
David Spero, BSN, RN, writes about his own ED, which was the result of chronic illness, for Diabetes Self-Management.
He shares that he and his wife found creative ways to be physically intimate without penetration and recommends other couples do the same. Specifically, he suggests using your mouth or hands to stimulate sensitive body parts if sexual penetration isn’t an option.
Pursue counseling or sex therapy
Relationship and sex therapy is another helpful course of action. Wickman says it provides resources within a relationship as couples navigate a chronic condition, decreased sex drive, lowered self-esteem, and more.
Ultimately, the important thing to understand is that if sex isn’t pleasurable for you, there are treatment options available. For many, the key is to find the right doctor or therapist who specializes in sexual health. Find a directory of certified sex therapists here.
“If you have not been given a solution, it does not mean there isn’t a solution,” Streicher says. “You just haven’t been given the right resources to find the solution.”
Mary is a writer living in the Midwest with her husband and three children. She writes about parenting, relationships, and health. You can find her on Twitter.