With chronic conditions, sex can get put on the back burner. However, healthy sexuality and sexual expression are at the top of the list when it comes to maintaining quality of life, no matter what other problems a person may face.

People with type 2 diabetes are no different. It’s important to recognize and address sexuality issues that affect people with diabetes. Type 2 diabetes can cause sexual complications for both sexes.

A common sexual health issue seen in people with type 2 diabetes is a decrease in libido, or loss of a sex drive. This can be frustrating if someone had a thriving libido and satisfying sex life before a type 2 diabetes diagnosis.

Causes of a low libido associated with type 2 diabetes include:

Diabetic neuropathy

Diabetic neuropathy, a type of nerve damage associated with diabetes, can cause sexual issues. Numbness, pain, or lack of feeling can also occur in the genitals. This can lead to erectile dysfunction (ED).

Neuropathy may also inhibit orgasm or make it difficult to feel sexual stimulation. These side effects can make sex painful or unenjoyable.

Relationship concerns

Communication between partners about any sexual issues is important. A lack of communication can harm the sexual and intimate side of a relationship.

A health condition can make it easy for couples to check out of the relationship sexually. Sometimes it may seem easier to avoid talking about the issue rather than to seek a solution.

If one partner becomes the primary caregiver of the other, it can also change how they view one another. It’s easy to get caught up in the roles of “patient” and “caregiver” and let the romance slip away.

The most widely reported sexual health issue facing men with diabetes is ED. Some cases of diabetes are first diagnosed when a man seeks treatment for ED.

Failure to achieve or maintain an erection until ejaculation can be caused by damage to the nerves, muscles, or vascular structures. According to the Cleveland Clinic, about half of men with diabetes will experience ED at some point.

Side effects of certain medications can alter testosterone levels, also causing ED. Other conditions that accompany diabetes can also contribute to ED. They include:

Retrograde ejaculation

Retrograde ejaculation is another sexual health issue that men may experience as a complication of type 2 diabetes. It occurs when semen is ejaculated into the bladder instead of out of the penis.

It’s caused by your internal sphincter muscles not working properly. These muscles are responsible for opening and closing passages in the body. Abnormally high glucose levels can result in nerve damage to the sphincter muscles, causing retrograde ejaculation.

For women, the most common sexual health issue that comes with type 2 diabetes is vaginal dryness. This can be the result of hormonal changes or reduced blood flow to the genitals.

Women who have diabetes have increased rates of vaginal infections and inflammation. Both of these can make sex painful. Nerve damage to the bladder can also cause incontinence during sex.

Women with diabetes are also more likely to have more frequent urinary tract infections (UTIs). This can also make sex painful and uncomfortable.

Sexual problems that occur with type 2 diabetes can be frustrating and cause anxiety. You may feel that giving up on sexual expression is easier than finding ways to cope or adjust.

However, you can try to maintain an active sex life despite having type 2 diabetes. Lifestyle changes, medications, and opening up the lines of communication with your partner are just a few of the things you may find helpful.

If low energy and fatigue are a problem, try having sex at a different time of day when your energy is at its peak. Nighttime may not always be the right time. After a long day, and with the added fatigue that comes with diabetes, the last thing you may have energy for is sex.

Try sex in the mornings or afternoons. Experiment to see what works best for you.

Liberally use lubricant to deal with vaginal dryness. Water-based lubricants are best, and there’s a plethora of brands available. Don’t be afraid to stop during sex to add more lubricant.

Shop for lubricant.

Hormonal replacement therapy (HRT) can help both men and women with issues such as decreased libido, vaginal dryness, and ED.

Ask your doctor if this is a possibility for you. HRT can come in the form of:

  • pills
  • patches
  • creams
  • injectable medications

Maintain good overall health for a healthy sex life. For people with diabetes, this includes maintaining proper blood sugar levels. Sex is exercise in the sense that it uses energy, so be aware of your glucose levels.

If you’re using medications that increase the amount of insulin in your body, hypoglycemia (low blood sugar) can also occur during sex. Consider checking your blood sugar levels before engaging in sexual activity.

Also keep in mind that what’s good for your heart is good for your genitals. Sexual arousal, vaginal lubrication, and erection all have a lot to do with blood flow. Engage in a lifestyle that promotes good heart health and proper blood circulation.

This includes participating in regular exercise. Exercise can also have the added benefits of improving your energy level, mood, and body image.

Many people with type 2 diabetes experience incontinence. If you experience uncomfortable urine leaks, talk about them with your partner. Padding the bed can go a long way to help.

Lay down a couple of towels or purchase incontinence pads to help ease the situation.

Shop for incontinence pads.

Discuss sexual health issues with your doctor. Sexual dysfunction can be a sign of disease progression or that treatment isn’t working.

Don’t be afraid to discuss sexual side effects of medications. Ask if there are different medications that don’t have the same side effects.

Also, feel free to ask about ED drugs. If you aren’t a good candidate for ED drugs, then penile pumps may also be an option.

Pay close attention to your relationship. Find other ways to express intimacy when desire isn’t at its peak. You can express intimacy that doesn’t involve intercourse with:

Make time for each other to be a couple that isn’t focused on caregiving. Have a date night where the topic of diabetes is off-limits. Communicate with your partner about your feelings and possible sexual issues that may occur.

Also consider support groups or counseling to help with the emotional issues associated with chronic conditions or sex.

Having a healthy and active sex life is important to your quality of life. Type 2 diabetes may make sexual activity more challenging, but it doesn’t mean you have to completely forgo sexual expression.

When diabetes treatment is successful, sexual issues often resolve themselves. If you stay healthy and communicate with your partner and healthcare provider about any issues, you can maintain a healthy sex life.

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