Sex and Diabetes

While sex seems to be everywhere --television, billboards and advertising--Americans are still reluctant to go to the doctor to talk about a sexual problem or issue. However, many people, whether they have diabetes or not, have sexual problems. The Journal of the American Medical Association reported in February of 1999 about a survey conducted of 1,749 women and 1,410 men aged 18 to 59. The survey found sexual dysfunction is more prevalent for women (43%) than men (31%).
Diabetes may affect sexual functioning in several ways, but there are some things you may need to look out for:

Menstruation - Women may find that the menstrual cycle affects blood sugar. If you seem to be having trouble with control around the time of your menstrual period, keep careful records of your levels around that time of the month. Look to see if there is a pattern. For example you may find that your blood sugar is higher than normal the week before your period. You may need to add extra exercise or avoid eating extra carbohydrates. You may talk to your doctor about adjusting your insulin or any other medication at this time.


Lubrication - Women with diabetes may be more prone to have problems with vaginal lubrication. You may also have trouble with sexual response because of nerve damage. There are some medications that can also affect sexual response. These are things that can be addressed, but in order to get help you need to talk to your doctor about these issues. Although it may be hard to discuss these things, the best approach is to be matter-of-fact.

Impotence - Having impotence is the consistent inability to sustain an erection enough to engage in sexual intercourse. Many men have impotence problems at some point during their lives, especially in their 50's, 60's and older. For men with diabetes, these problems can arrive 10 to 15 years earlier than for men without diabetes. Some estimates place the incidence of diabetes-related impotence in men at more than 40 percent.
Sometimes nerve disease related to diabetes causes impotence. When nerves are damaged, as can happen with the condition, the flow of blood to the penis may be lessened and so an erection can't occur. Blood vessel damage can also cause impotence.
It may be that medications taken for diabetes, high blood pressure or for other conditions can be the cause. Drinking too much and smoking can also cause the problem.
Your doctor can help determine how much of this problem is physical or psychological and prescribe treatment. Whatever the cause, it's important to tell your health care provider if you are experiencing impotence. Your doctor may change your medication or determine if there is a blockage in the blood vessels. Diabetic-related impotence may be treated successfully, depending on the cause.

After Sex - If you use insulin, be aware that sometimes sex can cause low blood sugar levels. Test your blood sugar before having sex or consider eating just before or right afterwards as you would for exercise. Also you may want to have a snack before going to sleep at night.