Sex and diabetes complications

Daniel Sher briefly covers how sexual dysfunction manifests in people with diabetes and gives some pointers for improving your sex life.

Does diabetes affect your love life? Do people with diabetes have an increased risk of sexual dysfunction? Unfortunately, the answer is yes: many people with diabetes also have sexual dysfunctions. As if we didn’t already have enough to worry about.

How common are sexual problems in people with diabetes?

In a recent study, 36% of men with diabetes reported a sexual disorder. The most common culprits were erectile dysfunction (in which a man struggles to get or maintain an erection) and orgasmic dysfunction (in which a man struggles with the timing of ejaculation).

What about women? The study found that 33% of women with diabetes experience a sexual disorder, including low sex drive, reduced vaginal lubrication or difficulties with reaching orgasm.

Why is this such a problem? Sexual health problems have a profound burden upon the psychological well-being of people with diabetes. Research tells us that people who have both diabetes and sexual dysfunction tend to experience:

• Reduced overall quality of life
• Greater risk of running into diabetes complications
• Overall poorer blood-glucose control
• Poorer psychological adaptation to diabetes demands
• Bigger risk of running into diabetes distress, or burnout.

Diabetes and relationships

The stress of managing diabetes can most certainly spill over into your relationship. One study found that two thirds of the people with diabetes interviewed said that their condition negatively affected their relationship with existing or potential partners. Why is this the case?

For some, diabetes can translate to low self-esteem and feeling less attractive as a result of their condition. There is already a huge amount of stigma faced by people with Type 2 diabetes.

For those with Type 1: children with diabetes often experience exclusion and othering during their school years, which can set them up to feel inadequate later in life.

What else? Generally speaking, sex and love require a person to be present and connected. It can be tough to connect with your loved one on this level if your mind is focused on your blood glucose. At the same time, though, diabetes is a 24/7 job, we never really get to switch off.

Stress is not sexy

We all know that living with a chronic condition can be stressful; and stress, quite simply, is not sexy. How so? Literally, high levels of stress send your brain into fight-or-flight mode, pushing adrenaline and cortisol (stress hormones) into your system. While these brain-body changes are great for helping you fight against or flee from a predator, they are not particularly useful when you’re trying to have sex.

Stress also makes a person less likely to be in the mood for romance; and it may mean that you simply don’t have time or energy to connect with your partner. Finally, stress tends to spike blood glucose levels, meaning that you have a greater risk of microvascular complications that can lead to sexual disorders.

Aside from that, people with Type 2 diabetes in particular often experience a far higher risk of major depression. People with Type 1 very often experience anxiety disorders. Both depression and anxiety disorders often involve sexual problems as symptoms.

What can you do?

First things first: if you are experiencing erectile dysfunction as a male with diabetes, it is vital to bring this up with your doctor, no matter how uncomfortable this might feel. Why? Erectile issues can, at times, be early warning signs for life-threatening heart conditions. Getting early treatment here can save lives.

Aside from that, often, sexual disorders in people with diabetes can be treated. At times, the treatment is medical; often, psychological input can help. Reach out to your doctor, psychiatrist or psychologist to find out more about getting the right support.

Generally, looking after your diabetes is the most important step to take in managing or preventing sexual issues. But remember that this is not a condition that you can thrive with if you’re doing it alone: learn to lean on your partner, community and treating team.

If you are feeling overwhelmed or hopeless about your diabetes, you might be struggling with diabetes distress (or burnout) which can worsen sexual dysfunction. Burnout and stress-management can be achieved through practices, such as mindfulness meditation, frequent physical exercise and proper time management, so that space for self-care is prioritised in your schedule.

Summing up

If you, as a person with diabetes, are finding that the condition is interfering with your love life, you are not alone. Research shows us that sexual dysfunction is a big risk factor for living with Type 1 or Type 2 diabetes. Unfortunately, sexual dysfunction placed on top of the demands of diabetes makes a stressful condition that much more challenging to manage. For this reason, it’s a really good idea to take proactive action as soon as you notice unwanted sexual symptoms creeping in. How? Speak up! Push through the discomfort and raise this issue with your doctor, so that you can get the treatment and support that you deserve.

References

 Corona, G., Isidori, A. M., Aversa, A., Bonomi, M., Ferlin, A., Foresta, C., … & Lombardo, F. (2020). Male and female sexual dysfunction in diabetic subjects: Focus on new antihyperglycemic drugs. Reviews in Endocrine and Metabolic Disorders, 21, 57-65.

 Van Cauwenberghe, J., Enzlin, P., Nefs, G., Ruige, J., Hendrieckx, C., De Block, C., & Pouwer, F. (2022). Prevalence of and risk factors for sexual dysfunctions in adults with type 1 or type 2 diabetes: results from Diabetes MILES‐Flanders. Diabetic Medicine, 39(1), e14676

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