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Sex is good for diabetes. It's good for your heart and blood flow, helps sleep, and boosts your mood.

Diabetes is not good for sex, though. Nerve damage, or neuropathy, can make it hard to have orgasms. It can cause vaginal dryness, make it hard to get aroused, dampen your desire, and make sex painful. Bruising from shots and fears about blood sugar dropping can zap your self-esteem in the bedroom. And if you wear an insulin pump, where does it fit in?

All of these issues are solvable, experts say. "Many times I've heard people say, 'I'm done with sex,'" says Janis Roszler, RD, a diabetes educator and co-author of Sex and Diabetes. "It's sad because there's so much that can be done."

As with most diabetes problems, chronic high blood sugar is often the cause of sexual side effects. So keeping them under control is No. 1. But even if you have tight control of your blood sugar, you can face some sexual challenges. Here are some common problems and ways to get the best of them.

Dealing With Vaginal Dryness

For women, vaginal dryness is the most common sexual side effect of diabetes. Emotional issues such as being depressed can cause it. So can damage to the nerves that lubricate your vagina.

Vaginal dryness can become a painful cycle. "If a woman has pain during sex because of inadequate lubrication, she may anticipate pain the next time, and then have it because she tenses up," Roszler says.

You can also get vaginal dryness from yeast infections caused by long-term high blood sugar. If you are older, menopause and swings in your hormones may also play a role.

If you have symptoms of a yeast infection, such as vaginal itching, burning, or pain during intercourse or when you urinate, using an over-the-counter antifungal drug on the area may help. But speak to your doctor first.

For other vaginal dryness, water-based vaginal lubricants can help. Some may also boost your sexual desire. If you are trying to conceive, though, ask your doctor for advice on choosing a lubricant. Some can hinder sperm and make it harder to get pregnant.

"Estrogen replacement, including vaginal estrogen, can be helpful in postmenopausal women," says Vivian Fonseca, MD, of the Tulane University School of Medicine. Vaginal estrogen replacement comes in a cream or ring. You and your doctor can weigh the risks and benefits for you. Your doctor may also suggest other creams if sex is painful during menopause.