Diabetes doesn't have to feel like a third -- and unwanted -- party in bed. You can deal with things like low blood sugar, vaginal dryness, or erection problems by looking at them as hurdles you can overcome, instead of roadblocks that put a stop to sex.
Planning ahead can ease some of the challenges. You may associate prep work more with house painting than with having sex, but it can make intimacy more relaxed. Also remember that taking good care of your diabetes is the No. 1 way to prevent or limit sexual issues with diabetes.
These tricks and tips can also make sex easier and more fun.
10 Strategies for Better Sex
- Approach sex like exercise. This helps prevent dreaded blood sugar lows. "Hypoglycemic events during sex are a real buzzkill," says Kerri Morrone Sparling, the author of Balancing Diabetes: Conversations About Finding Happiness and Living Well, who blogs about her life with type 1 diabetes. "Your body just shuts down during a low, so it crushes the enjoyment." If you use insulin, check your blood sugar before sex and have a snack if it's low. For more fun, incorporate snacks into foreplay. Try strawberries or a little ice cream or chocolate.
- Just go with it. Planning can be helpful, but don't sweat it if sex just happens. "There's no reason not to grab the opportunity if it pops up just because you haven't followed your diabetes exercise routine," says Scott K. Johnson, a diabetes advocate who blogs about his life with type 1 diabetes. Just check your glucose level after.
- Use a lubricant. If you are a woman with vaginal dryness, a vaginal lubricant can make sex feel better. Ask your doctor about using one regularly, not just during sex. "Think of it like hand cream," says Janis Roszler, a diabetes educator in Miami and author of Sex and Diabetes: For Him and For Her.
- Prepare a sex arsenal kit. Keep anything you might need for optimal sex next to the bed. Include a box of juice or glucose tablets and test supplies. "These are things we should all have with us all the time anyway," Johnson says. "And it would bum me out if I had to stop sex because I didn't have something there." If you're a woman, you may want to have a lubricant in your kit. Feel free to include massage oils or other supplies to enhance the mood. You can pack a mini-kit of supplies for when you're on the go.
- Get a room. Treat yourself and your partner to a night at a local hotel. "It's a great libido enhancer," Roszler says. Especially if you have children and a hard time getting time alone. "Plan it days in advance and then tease each other before with texts or notes. It's planning, but it's planning something fun."
- Get in some practice. If you are a man who uses a device like a vacuum pump or constriction band to help with erectile dysfunction, take time to learn how to use it right. "You don't want to be fumbling around with it in front of a partner," Roszler says. "The more comfortable you are with any device, the more relaxed you will be about using it."
- Consider a continuous glucose monitor (CGM). Both Sparling and Johnson say this a boon for sex. "Wearing a CGM keeps me aware of where my blood sugar is and how it's trending," Johnson says. "It helps a lot with planning or spontaneity." If you don't wear a monitor, though, blood sugar testing doesn't have to be a big deal. "You can do a quick 30-second blood sugar test anywhere," Johnson says. "It can be very discreet."
- Creativity is sexy. If you have trouble getting aroused, stretch beyond your go-to bedroom moves. Watch erotica or porn together. Try out new positions or sex toys. Explore different ways to climax. Most women don't climax from intercourse alone, anyway. Some men can have an orgasm from prostate stimulation.
- Limit alcohol. A little alcohol may boost your desire, but drinking can also make your blood sugar level drop quickly. If you drink alcohol, you might sip some champagne during intimacy. Or have a drink earlier with a meal or snack. This will limit its effects on your blood sugar. Go lightly if you are a man who has trouble keeping erections.
- Get help for emotional issues. Depression, anxiety, poor self-image, and other emotional concerns can hurt your sex life. And if you have a partner, sex troubles can put stress on your relationship. Individual or couples counseling can help you talk about issues and work out solutions. Your doctor can suggest treatments for most sexual issues, from painful sex to trouble with orgasms. But you may need to address emotional or relationship concerns before they will work.
- Relax. How you feel about your diabetes can set the stage for sex. With diabetes, you have to expect the unexpected, and it helps to have a sense of humor if something goes wrong. Your partner, especially a new partner, will likely take clues from you. "If you are confident, comfortable, and relaxed, you will convey the message that this is something to be relaxed about," Roszler says.
To Pump or Not to Pump
Some people think insulin pumps don't get in the way of good sex. Others feel that having tubes attached makes them less attractive or kills the mood.
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. If you're worried about falling asleep or forgetting to reconnect, you can set the alarm on your pump or cell phone.
If you don't want to disconnect your pump, using long tubing can give you more freedom to move around. And it helps to let your partner know where it's attached so the person doesn't grab it by accident. If it does get yanked out and starts to bleed, though, it's not a problem, Roszler says. "Just put pressure on the area until the bleeding stops."
With a regular partner, a glitch like this, or disconnecting a pump during foreplay, may not be awkward. But what if you're with a new partner you haven't told about your diabetes? This is not a problem for Sparling or Johnson, who are both married. But Johnson says he could see that some people might prefer insulin shots over a pump if they're playing the field.
"With an injection, you might not have to mention your diabetes unless and until you want to," he says. "A pump kind of forces the disclosure."
Sparling believes in "full disclosure" about diabetes before intimacy -- for safety reasons, if nothing else. And she thinks a sexual partner should be able to accept that you wear a pump if you accept it. If not, she says, you might want to reconsider whether they are a good choice for a partner.
Good Diabetes Health = Good Sex
Taking care of your diabetes is the best sex strategy. Good blood glucose control can prevent or ease sexual issues so you can "do everything you want to do in sex," Sparling says. "And what better impetus to diabetes control is there, especially if you're young, than getting to have a good, healthy sex life?"