When you have an underlying chronic health condition, it is not uncommon that your sexual life often takes a backseat. However, when it comes to maintaining a good quality of life, healthy sexual life and sexual expression should also be at the top of the list, no matter what other problems a person has to face. People with type 2 diabetes are no exception when it comes to sexual issues. It is important that they recognize and address the sexuality issues as type 2 diabetes is known to cause sexual complications for both men and women. Here’s everything you need to know about type 2 diabetes and sexual health.
Sexual Issues in Type 2 Diabetes That Affect Both Men and Women
One of the most common sexual health problems observed in people who have type 2 diabetes is a marked decrease in libido or the loss of sex drive.(1, 2, 3, 4) This can be frustrating for anyone, especially those who had a thriving libido and a satisfying sex life before they were diagnosed with type 2 diabetes.(5, 6, 7) Some of the causes of low libido in people with type 2 diabetes include:
- Lack of energy
- Hormonal changes
- Side effects of medications for high blood pressure or depression
- Anxiety, stress
- Relationship issues
Some of the other causes of low libido in both men and women with type 2 diabetes are as follows.
- Diabetic Neuropathy: Diabetic neuropathy is a type of nerve damage that is commonly associated with diabetes. Diabetic neuropathy can cause sexual issues in both men and women. Pain, numbness, or lack of feeling can also affect the genitals. This can even lead to erectile dysfunction (ED).(8, 9) Diabetic neuropathy can make it difficult to feel sexually stimulated or inhibit orgasm. These side effects also make sex less enjoyable or painful.
- Relationship Concerns: In any relationship, communication between partners about any sexual issues is crucial. A lack of communication in such issues can cause harm to the intimate and sexual side of your relationship. A health condition can make it easier for couples to check out of the relationship sexually. Sometimes, it may also seem easier to simply avoid talking about the issue instead of seeking a solution. At the same time, if one partner ends up becoming the primary caretaker of the other, it can also change the way in which they view one another. It is easy to get involved in the roles of patient and caregiver and let the romance slip away.
Sexual Health Issues in Men with Type 2 Diabetes
One of the most commonly reported sexual health issues that men with type 2 diabetes face is erectile dysfunction. In fact, many cases of diabetes are first diagnosed when a man goes to seek treatment for erectile dysfunction itself.(10)
Failure to achieve or maintain an erection until ejaculation can be caused by damage caused to the muscles, nerves, or vascular structures. According to research, nearly half of men with type 2 diabetes will experience erectile dysfunction at some point in their life.(11)
In some cases, the side effects of certain medications can also change the testosterone levels, which may cause erectile dysfunction as well. Some other conditions that accompany diabetes can also lead to erectile dysfunction. These include:
- Low self-esteem
- High blood pressure
- Being inactive or not getting enough exercise
Another sexual health problem that commonly affects men as a complication of type 2 diabetes is retrograde ejaculation.(12) In retrograde ejaculation, semen is ejaculated into the bladder instead of out of the penis. This is caused by the internal sphincter muscles not functioning properly. These sphincter muscles are responsible for opening and closing the passages in the body. Having abnormally high glucose levels can lead to nerve damage to the sphincter muscles, which can cause retrograde ejaculation.(13)
Sexual Health Issues in Women with Type 2 Diabetes
In women with type 2 diabetes, the most common sexual health issue is vaginal dryness. This is usually a result of hormonal changes or decreased blood flow to the genitals. Women who have diabetes are also more likely to have increased rates of vaginal inflammation and infections. Both of these conditions can make it painful to have sex. Nerve damage to the bladder can also lead to incontinence during sex.(14)
Women with diabetes are also more prone to getting frequent urinary tract infections (UTIs). This can also make sex uncomfortable and painful.(15)
Tips to Prevent Discomfort in your Sex Life with Type 2 Diabetes
Sexual problems that occur in people with type 2 diabetes can create a lot of frustration and anxiety. You may even feel like giving up on sexual expression altogether as that might be easier than findings ways to adjust or cope. However, you can still try to have an active sex life despite having type 2 diabetes. Lifestyle changes, keeping your diabetes under control, taking your medications, and keeping the lines of communication open with your partner are just some of the things that may help.
Some other tips that may help include:
- Choose A Different Time In The Day: If you are faced with low energy and fatigue as the main challenge, you can try having sex at a different time of day when your energy levels are at a peak. Nighttime might not always be the best time as, after a long day and the added fatigue that accompanies diabetes, the last thing you may have energy left for is sex. Try to have sex in the mornings or afternoons. Experimenting with different times will help you find out what works best for you.
- Use Lubricants If Faced With Vaginal Dryness: You can try to liberally use lubricants to overcome vaginal dryness. The best option is to use water-based lubricants, and there is a wide range of brands available that you can buy over-the-counter as well from any pharmacy. In fact, don’t be afraid to stop during sex and add more lubricant if needed.
- Take Medication For Improving Your Libido: There are many types of medications today that can help improve your libido. Hormonal replacement therapy (HRT) can help both men and women with issues like vaginal dryness, erectile dysfunction, and decreased libido. You can always consult your doctor if this is a possible solution for you and your partner. Hormonal replacement therapy is available in the form of creams, patches, pills, and even injectable medications.(16, 17)
The most important thing to remember is that you must maintain good overall health in order to continue having a healthy sex life. For people with diabetes, this includes maintaining proper blood sugar levels. Sex is also a form of exercise as it uses energy, so be aware of what your glucose levels are. If you are on medications that increase the amount of insulin in the body, then do be mindful that hypoglycemia (low blood sugar) is a possible risk that can occur during sex. You can consider checking your blood sugar levels before taking part in any sexual activity. Also, keep in mind that having an active lifestyle that promotes proper blood circulation and good heart health will also be good for your sexual and overall health.
- Chatterjee, S., Khunti, K. and Davies, M.J., 2017. Type 2 diabetes. The lancet, 389(10085), pp.2239-2251.
- DeFronzo, R.A., Ferrannini, E., Groop, L., Henry, R.R., Herman, W.H., Holst, J.J., Hu, F.B., Kahn, C.R., Raz, I., Shulman, G.I. and Simonson, D.C., 2015. Type 2 diabetes mellitus. Nature reviews Disease primers, 1(1), pp.1-22.
- Vijan, S., 2010. Type 2 diabetes. Annals of internal medicine, 152(5), pp.ITC3-1.
- DeFronzo, R.A., 2004. Pathogenesis of type 2 diabetes mellitus. Medical clinics, 88(4), pp.787-835.
- Kizilay, F., Gali, H.E. and Serefoglu, E.C., 2017. Diabetes and sexuality. Sexual medicine reviews, 5(1), pp.45-51.
- Kautzky-Willer, A. and Harreiter, J., 2017. Sex and gender differences in therapy of type 2 diabetes. Diabetes Research and Clinical Practice, 131, pp.230-241.
- Kacerovsky-Bielesz, G., Lienhardt, S., Hagenhofer, M., Kacerovsky, M., Forster, E., Roth, R. and Roden, M., 2009. Sex-related psychological effects on metabolic control in type 2 diabetes mellitus. Diabetologia, 52(5), pp.781-788.
- Giugliano, F., Maiorino, M., Bellastella, G., Gicchino, M., Giugliano, D. and Esposito, K., 2010. Determinants of erectile dysfunction in type 2 diabetes. International journal of impotence research, 22(3), pp.204-209.
- Chitaley, K., 2009. Type 1 and Type 2 diabetic‐erectile dysfunction: Same diagnosis (ICD‐9), different disease?. The journal of sexual medicine, 6, pp.262-268.
- Isidro, M.L., 2012. Sexual dysfunction in men with type 2 diabetes. Postgraduate medical journal, 88(1037), pp.152-159.
- Kouidrat, Y., Pizzol, D., Cosco, T., Thompson, T., Carnaghi, M., Bertoldo, A., Solmi, M., Stubbs, B. and Veronese, N., 2017. High prevalence of erectile dysfunction in diabetes: a systematic review and meta‐analysis of 145 studies. Diabetic Medicine, 34(9), pp.1185-1192.
- Fedder, J., Kaspersen, M.D., Brandslund, I. and Højgaard, A., 2013. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus: a prospective, controlled study. Andrology, 1(4), pp.602-606.
- Ohl, D.A., Quallich, S.A., Sønksen, J., Brackett, N.L. and Lynne, C.M., 2008. Anejaculation and retrograde ejaculation. Urologic Clinics of North America, 35(2), pp.211-220. Hotaling, J.M., Sarma, A.V., Patel, D.P., Braffett, B.H., Cleary, P.A., Feldman, E., Herman, W.H., Martin, C.L., Jacobson, A.M., Wessells, H. and Pop-Busui, R., 2016.
- Cardiovascular autonomic neuropathy, sexual dysfunction, and urinary incontinence in women with type 1 diabetes. Diabetes Care, 39(9), pp.1587-1593.
- Geerlings, S.E., Stolk, R.P., Camps, M.J., Netten, P.M., Collet, T.J., Hoepelman, A.I. and Diabetes Women Asymptomatic Bacteriuria Utrecht Study Group, 2000. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes care, 23(12), pp.1737-1741.
- Ferrara, A., Karter, A.J., Ackerson, L.M., Liu, J.Y. and Selby, J.V., 2001. Hormone replacement therapy is associated with better glycemic control in women with type 2 diabetes: The Northern California Kaiser Permanente Diabetes Registry. Diabetes Care, 24(7), pp.1144-1150.
- Nazıroğlu, M., Şimşek, M., Şimşek, H., Aydilek, N., Özcan, Z. and Atılgan, R., 2004. The effects of hormone replacement therapy combined with vitamins C and E on antioxidants levels and lipid profiles in postmenopausal women with Type 2 diabetes. Clinica Chimica Acta, 344(1-2), pp.63-71.
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