How Diabetes Affects a Woman's Sexual Health

From the WebMD Archives

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

If you have diabetes and have had painful sex or trouble getting aroused, though, sex may not seem too sexy. About 35% of women with diabetes seem to have sexual issues. That doesn't mean you have to live with them. There's help to get your sex life going again. 

"Some women's issues may be more complex to treat than those of men, but most can be treated," says Janis Roszler, a diabetes educator, marriage therapist, and author of Sex and Diabetes: For Him and For Her. "There's no reason for any woman with diabetes to deny herself the opportunity to have a fulfilling and pleasurable sex life."

Sexual Challenges for Women

The causes of sexual issues for women with diabetes are less clear than those in men with diabetes. But nerve damage, slowed blood flow to vaginal and genital tissues, and mood and hormone changes may play a part.

Common sex-stallers include:

  • Vaginal dryness. This is the biggest sexual complaint in women with diabetes. Vaginal dryness is, this  twice as likely if you have diabetes. If you are in menopause or postmenopause, less estrogen may be the cause. If you aren't, damage to the nerves that lubricate your vagina may be. Vaginal dryness can become a painful cycle. If sex hurts because of it, you may tense up during sex, causing more pain, or avoid sex altogether.
  • Vaginal infections. Urinary tract infections (UTIs) may make sex painful. Yeast infections can also cause pain during sex, as well as vaginal dryness. "If you have poorly controlled diabetes, you're more likely to have yeast and other vaginal infections," says David G. Merrero, PhD, president of Health Care and Education at the American Diabetes Association.
  • Sex drive and orgasm issues. Maybe you find it hard to get in the mood. Or you get in the mood but don't climax. Trouble with orgasms is a concern for many women with diabetes. A 2012 study found that women who took insulin for diabetes were 80% more likely to have trouble reaching an orgasm than women who don't have diabetes. The exact reasons for low libido and orgasm troubles are not clear.

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How to Get your Sex Life Back on Track

For some sexual matters, a quick fix may be enough. For others, you may need a two- or three-pronged approach.

  • Start with your doctor. About 80% of women with diabetes don't bring up sexual issues with their doctors. Don't be one of them. Your doctor can narrow down the possible causes of your sexual problems and suggest treatments. If you don't feel comfortable talking to your doctor about sex, ask for a referral to a doctor who specializes in sexual medicine.

    Sexual issues can have many causes, and some may not even be related to diabetes. Medications, like some antidepressants and antibiotics, can cause sexual side effects. Other health issues or habits, like smoking and drinking too much alcohol, can also have an impact.
  • Ease vaginal dryness. Prescription or over-the-counter vaginal lubricants can smooth the path to better sex. But don't just reserve them for sex. It may help to use one regularly. Ask your OB/GYN doctor to suggest a lubricant, especially if you are trying to get pregnant. (Some can interfere with sperm.)

    If you are in menopause or postmenopause, a prescription low-dose estrogen ring or cream that you apply in your vagina can help. Taken in this form, your whole body doesn't absorb the estrogen. So heart disease, stroke, and cancer are less of a risk. There is also a non-estrogen pill that may help with painful sex after menopause. Ospemifene (Osphena) acts like estrogen to help make the vagina thicker and less fragile. It does carry warnings about increased risks of stroke, deep vein thrombosis, and endometrial cancer.
  • Explore your pleasure zones. New techniques or sex toys may help if you have lost sexual desire or sensation. Explore areas of your body beyond your genitals. Spice up intimacy with oral sex, a vibrator, stroking, or a massage. Also, slow down sex if you need to. "Your body responds more slowly because of diabetes," Roszler says. "Tell your partner if you need more time."
  • Move your body outside of bed. Exercise can improve your sex life in many ways. It reduces stress, improves flexibility, releases feel-good hormones, and keeps you looking and feeling good. 
  • Consider depression. "Be aware that depression is an issue for many women with diabetes," Marrero says. "Get screened for it if it's a concern. Get treated if you have it." Counseling, antidepressants, or a combination of both can help. Counseling may also help if you’re anxious about sex because of pain, Roszler says.
  • Try a Mediterranean diet. In a 2010 study, women with type 2 diabetes who ate a diet focused on fruits, vegetables, potatoes, beans, and whole grains reported being more satisfied in all areas of sex than women with type 2 diabetes who did not. A Mediterranean diet also appears to improve blood sugar levels more than a standard low-fat diet and protects against diabetes-linked health issues. So it may be a win-win for you.
  • Get your diabetes under control. Keep your blood sugar levels, blood pressure, and cholesterol in check. Among other benefits, you'll have less chance of getting urinary tract and vaginal yeast infections. You may still have some sexual challenges. But just as sex is good for diabetes, staying healthy is good for sex.
WebMD Feature Reviewed by Michael Dansinger, MD on February 11, 2015

Sources

SOURCES:

American Diabetes Association: "Depression," "Depression a Major Predictor of Sexual Dysfunction in Women with Type 1 Diabetes."

Copeland, K. Obstetrics & Gynecology, August 2012.

Diabetes Forecast: "Diabetes and Sex: What You Wanted to Know," "Embarrassing Body Problems You Need to Know About," "A Mediterranean Food Plan Can Protect Health."

Enzlin, P. Diabetes Care, May 2009.

Esposito, K. Diabetes Care, April 2014.

Giugliano, F. Journal of Sexual Medicine, May 2010.

Joslin Diabetes Center: "Sexual dysfunction and diabetes."

Kutteh, W. International Journal of Fertility and Menopausal Studies, July-August 1996.

David G. Merrero, PhD, director, Diabetes Translational Research Center, Indiana University, Indianapolis; president, Health Care & Education, American Diabetes Association.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): "Sexual and Urologic Problems of Diabetes."

Janis Roszler, RD, MSFT, dietitian, diabetes educator, and marriage and family therapist, Miami; author, Sex and Diabetes: For Him and For Her.

Tessler, S. Diabetes Care, October 2010.

University of California, San Francisco: "Women with Diabetes More Likely to Experience Sexual Dissatisfaction."

FDA: “FDA approves Osphena for postmenopausal women experiencing pain during sex.”

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