Sex is good for diabetes. It's good for the heart and circulation, helps sleep, and improves mood. So why are many women with diabetes not enjoying sex?
The reason, of course, is that although sex may be good for diabetes, having diabetes is not always good for sex. Nerve damage, or neuropathy, can make it difficult to have orgasms, and can cause vaginal dryness, making intercourse painful. Bruising from injections and fears about blood sugar plummeting can zap your self-confidence. And if you wear an insulin pump, where does it fit into intimacy?
Diabetes-related issues may seem overwhelming, but they're solvable, experts say. "Many times I've heard people say, 'I'm done with sex,'" says Janis Roszler, RD, a diabetes educator and coauthor of Sex and Diabetes (American Diabetes Association, 2007). "It's sad because there's so much that can be done."
As with most diabetes complications, high blood sugar levels are often the cause of sexual side effects, so keeping them under control is the No. 1 strategy. But even women with tight control of their blood sugars can face some sexual challenges. Here are some common problems and ways to conquer them.
Sex and Diabetes: Dealing with Vaginal Dryness
Experts say that for women, vaginal dryness is the most common sexual side effect of diabetes. Emotional issues such as depression, or damage to the nerves responsible for vaginal lubrication can cause vaginal dryness.
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.
Diabetes-related vaginal dryness can also be due to yeast infections associated with poor blood sugar control, especially in women with type 1 diabetes. In older women, menopause and hormonal swings may also play a role.
If you have symptoms of a yeast infection, such as vaginal itching, burning, or pain during intercourse or while urinating, an over-the-counter topical antifungal medication may help but speak with your health care provider first.
For other vaginal dryness, water-based vaginal lubricants can help. Some lubricants may also help with sexual arousal. If you plan to become pregnant, be sure to ask your obstetrician for advice on choosing a lubricant, because some can affect conception.
"Estrogen replacement, including vaginal estrogen, can be helpful in post-menopausal women," says Vivian Fonseca, MD, FRCP, chief of endocrinology at Tulane University School of Medicine in New Orleans and president-elect of medicine and science for the American Diabetes Association.
Although hormone replacement therapy may increase risk of breast cancer and stroke, using estrogen in a vaginal cream or ring is thought to be a lower-risk treatment. That's because it's used at a lower dose and is only applied in the vagina. You and your doctor can weigh the risks and benefits for you.