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Sexual Health Challenges

You may have no problem talking to your doctor about some of the symptoms you have with diabetes. But when it comes to talking about your sexual health, you may not feel comfortable discussing it honestly. You are not alone.

Americans as a whole do not talk candidly to their doctors about their sexual health. This can have a major impact on your health and the health of society as a whole. In fact, taboos surrounding conversations about sex have been linked to the increasing problem of sexually transmitted infections (STIs) in the United States.1

Talking to your doctor about sex is an important aspect of your diabetes management. Diabetes may lead to sexual health challenges. Having a conversation with your doctor about these might be your first step in helping to resolve these problems.

Decreased libido

Your low libido may be due to poorly managed diabetes and chronic inflammation. If your sex drive is low, your doctor may first look at your blood sugar (glucose) levels. Your doctor will then consider the drugs you take. Certain drugs, such as antidepressants, can lower sexual desire, so be sure to talk to your doctor.2

Problems with arousal

Men with diabetes are between 2 and 3 times more likely to develop erectile dysfunction (ED) (achieving and maintaining an erection) than men without diabetes. Many other men with ED later learn they have diabetes. Damage to the vessels and nerves in the body from diabetes is what leads to ED in people with diabetes.2

Why does diabetes lead to sexual health challenges?

High blood sugar

Having high blood sugar levels over time (hyperglycemia) is the biggest reason why your sexual health may be suffering. High blood sugar causes many problems within the body that could lead to sexual dysfunction, including:2,3

  • Blood vessel damage
  • Nerve damage
  • Problems with mucus membranes, resulting in problems such as dryness of the vagina and pain and difficulty during sex.
Vaginal infections

Women with uncontrolled diabetes are at increased risk of a variety of infections, including vaginal infections, which can result in pain and difficulty during sex.3

Blood vessel damage

High blood sugar can damage blood vessels throughout the body, including those that supply blood to sexual organs. Vascular disease can reduce genital blood flow in both men and women. This can result in problems such as ED, decreased sensation, and difficulty achieving orgasm and/or ejaculation.2,3

Neuropathy

Neuropathy (nerve damage), which also results from high blood sugar, can lead to sexual health challenges in diabetes. This includes impaired arousal and problems such as ED, decreased sensation, and difficulty achieving orgasm and/or ejaculation.2,3

Mental factors

Mental factors may impact sexual performance or desire. These may include a mental illness such as depression or anxiety, stress from the burden of having a chronic disease like diabetes, or interpersonal difficulty with a sexual partner.2

Other factors

Several other factors may also contribute to sexual problems in a person, regardless of whether they have diabetes or not. These include:2,3

  • Drug and substance (tobacco, alcohol, or other drugs) use
  • Hormone birth control drugs have been shown to decrease libido in women (both with and without diabetes).
  • Nicotine has also been shown to decrease sexual arousal in women.
  • Alcohol abuse can impair sexual function in both men and women. Alcohol may also add to other health problems that impact sexual function.

Treatment

Your sex life does not have to end if you have diabetes. Talk to your doctor about the treatment that is best for you. Your doctor may:2,3

  • Prescribe drugs that help with achieving or maintaining an erection
  • Offer suggestions for various lubricants
  • Refer you to mental health professionals if needed
  • Managing your blood sugar will be the biggest factor when facing sexual health challenges.

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Written by: Jonathan Simmons and Katie Murphy | Last reviewed: March 2021.