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Blood Sugar, Insulin Pumps, and Spontaneous Sex continued...

If you're worried about low blood sugar, it may help to eat a hard candy or a little ice cream before getting intimate. "Or if you have surprise sex in the middle of the night, afterward have something with sustained sugar, like juice with the fruit pulp in it or milk," says Lois Jovanovic, MD, chief scientific officer of Sansum Diabetes Research Institute.

Sparling, who wears an insulin pump, has found a way to deal with her diabetes so that "spontaneity is never an issue." She wears a continuous glucose monitor, which she can check to see if she's "in a decent range" to get romantic. She often wears it on her thigh because, she says, she feels sexier when it's attached, working, and out of sight.

Sparling removes her pump before sex, as she does when she exercises. (Pumps can be safely taken off for 45 minutes to an hour. But many experts suggest using a short/rapid-acting insulin shot to cover the period while the pump is detached.) After sex, she checks her blood sugar again and takes a dose of insulin if it is high or has a snack if it's low. "I don't know other people who have so many cookies by the bed," she says.

"For me, this works," Sparling says. "But just like everything else, you need to find what works for you and to not be afraid to go through a trial-and-error period."

Problems With Sex Drive and Orgasm

Problems getting in the mood -- whether it's because you have less interest in sex or problems having orgasms -- are more common. They can also be more complex if you have diabetes.

Poor blood sugar control can drag down your sex drive. So can depression, which is more common in women than in men. Some drugs used to treat depression may also dampen your desire.

If you've been depressed or anxious for more than a couple of weeks, talk to your doctor. Counseling, drugs, or learning how to lower stress can help. If you are already taking a depression drug and think it may be bringing down your interest in sex, talk to your doctor. You may be able to find one that is less likely to cause sexual side effects.

You may need more time and stimulation to climax when you have diabetes. Whether the cause is nerve damage or emotional issues, make foreplay part of sex, if it isn't already. Oral sex, sex toys, stroking, and cuddling can help arouse women and men, especially as you age. "Self-stimulation, or masturbation, can also help a woman get to know her body better," Roszler says.

If you can't climax because you have a lot of nerve damage, counseling can help you learn to enjoy sex without orgasm.