You guys know I’m always keepin’ it real. When it comes to living with diabetes, sex is a pretty important topic, and we’ve got to talk about it. It’s an even more important topic if you’re in an ongoing relationship with someone that you’re recurrently having sex with.

Men and women with diabetes are at risk for some of the same sex-related issues, but each group also experiences a few unique challenges. The most important thing to remember when learning about how diabetes affects your time in the bedroom, whether you’re male or female, is that it all comes down to blood sugar regulation and management. Time and time again, evidence has shown us that diabetes complications are significantly reduced when blood sugars are managed over time (yes, sexual disturbances are considered a complication of diabetes).

Let’s discuss the issues that affect both sexes.

1. Mental health is a huge one; diabetes and depression are very closely linked. In fact, a large majority (wish I knew the current stat) of people with diabetes experience either depression or diabetes distress at some point while living with diabetes. I 100% fall into this category. The connection here between depression and sex is simple – most people that are clinically depressed experience minimal motivation to do much of anything. Depression is characterized by poor appetite, weight loss, reduced motivation, fatigue/lack of energy and a reduction in hope or feeling worthwhile. Don’t know about you, but none of that screams, “I want to have sex!”
2. On the blood sugar topic, fluctuating blood glucose (BG) will greatly impact an individuals’ energy level; if you’re anything like me, one low (about 55mg/dL or lower) or one high (about 250mg/dL) and my energy is zapped for the day, even when I’m back in range. I personally think fluctuations take more out of us than anything. And when we’re feeling this shitty, sex isn’t on the forefront of our minds. 
3. Side effects of medications. This isn’t specific to just people with diabetes or diabetes medications. A lot of medications have the side effects of fatigue or stomach upset. I think of Metformin specifically when I think about a diabetes medication that many, many people experience side effects with. Nothing about diarrhea screams sexy to me!
4. Diabetic neuropathy is characterized by numbness, pain and/or lack of sensation to an area caused by nerve damage; it’s a diagnosis we commonly associate only with lower extremities. But diabetic neuropathy has the potential to affect all of our organs. For example, gastroparesis is a condition often caused by an insult to the nerves in our intestines as a result of poorly managed BG’s. Our genitals are no exception; reduced or poor blood flow significantly impacts how our sexual organs perform. (Side note: look up autonomic neuropathy – it’s fascinating.)

When it comes to sex, the two biggest issues affecting men that have diabetes are erectile dysfunction (ED) and reduced testosterone levels. I didn’t know until today – close to half of all men with diabetes experience ED at some point during their lives! Wow. 

For women, vaginal dryness tends to be a very common side effect of diabetes. Women with diabetes also tend to have more vaginal infections, including UTI’s, than women without diabetes. 

So, wow, this is a lot to digest, right? This is a really important topic to discuss, you guys. The more we talk about these issues as medical professionals and human beings, the less people with diabetes will feel frightened to talk about them. I did not look up the research on this, however I can guarantee that many of the aforementioned sexual issues go unaddressed because the person with diabetes does not feel comfortable speaking up to their partner or their physician about what they’re experiencing. That makes me sad, because there are ways to fix or help these issues!

What are the ways?

1. Lube. Lubricant is your friend! Firstly, people with and without diabetes use lube. There is nothing to be embarrassed about here. Using lube will make sex more enjoyable for you as well as your partner. Hopefully, it’s a no brainer. 
2. Communication is key. This should have been number one, actually. If you’re a person with diabetes experiencing a disruption in your sex life that you think is related, set aside time (when you are not about to get it on with your partner) to discuss any issues you might be having. If you are a partner of someone with diabetes and you suspect there might be an issue – my advice is the same for you – bring the topic up when you are not about to engage in sexual activity. 
3. Manage your blood sugars. This is key. I wish I could emphasize how important this piece is. Now, do perfect blood sugars guarantee no sexual issues? Of course not! This is diabetes, you guys! This disease will always throw a wrench at you and find a way to one-up you! However, your chances of having issues is drastically reduced. It’s just like any other complication – I get my eyes checked every year and have “no signs of diabetes in my eyes”, but because I have diabetes, I still run the risk of having diabetic retinopathy some day. It’s just the messed up reality of having diabetes. 
4. Hormone replacement therapy (HRT). I am no expert on this. Talk with your physician. If you’re unsatisfied with the response, seek a second and third opinion. 

To end things on a light note, I’d like to mention the very un-harmful, yet totally awkward, complication of wearing an insulin pump during an intimate sexual experience. I used to wear a tubed pump (meaning it was the kind of insulin pump that had a tube that connected my body to the device). You’d be hard pressed to get me to tell you that part of the reason for wearing an Omnipod wasn’t because it didn’t have a tube. When I was on a tube, it was somewhat…awkward…unromantic…during that moment when I no longer had clothes on and my pump was just…there, hanging. Needless to say, my hubs did have to learn how to remove the pump! For those of you on a tubed pump: teach your partner how to remove it when necessary! 

Hit me up with any issues/questions/concerns you have!

Cheers,

Kel