Talk to your doctor about sex.
Diabetes can affect many aspects of a person’s life. But issues in one area often aren’t spoken about, even though they can have an especially detrimental effect. Men and women with diabetes are more likely to experience sexual problems — ranging from low libido to erectile dysfunction — than those without the chronic disease; and those issues are more common when diabetes is poorly controlled. These problems “cause a significant amount of bother and impact on quality of life,” says Aruna Sarma, a research professor of urology and epidemiology at the University of Michigan, who has studied urologic complications and sexual dysfunction among those with diabetes.
Don’t ignore the impact.
A disease that occurs when a person’s blood sugar levels are too high, Type 1 or Type 2 diabetes can put one’s health in serious peril, particularly if it’s not well managed. It can cause damage to the eyes (retinopathy), kidneys (nephropathy) — up to kidney failure — and nerves (neuropathy), while also raising cardiovascular risk. Given that, sexual issues can get overlooked — but they shouldn’t be, since analysis finds people are particularly bothered by these issues. “In men and women with Type 1 diabetes, the urinary incontinence, the ED, the FSD [female sexual dysfunction] were much, much more impactful [in regards to] poor quality of life than these other complications of nephropathy, neuropathy and retinopathy,” Sarma notes.
Address sexual dysfunction.
The most obvious type of sexual dysfunction that can be associated with diabetes is ED, or impotence. “This can be due to neuropathy, which affects the important nerve circuits that are responsible for developing and maintaining an erection,” says Dr. Leann Olansky, an endocrinologist at Cleveland Clinic. Diabetes also can have an effect on the blood vessels that can impact blood flow to the penis, which can contribute to ED. Whatever the cause, it’s important to talk with a doctor about sexual dysfunction — which women with diabetes experience as well, including decreased desire and arousal, difficulty achieving orgasm and pain during intercourse. Treatment can range from medication to address ED in men to better management of blood glucose levels for men and women.
Don’t neglect other issues down there.
People with diabetes more frequently suffer from urinary tract infections and bladder issues than those without the chronic condition. Not surprisingly, that can have an impact on what happens in the bedroom. “People with lower urinary tract symptoms or incontinence — those symptoms are correlated with report of sexual dysfunction, and vice versa,” says Sarma, who was the lead author of the chapter “Urologic Diseases and Sexual Dysfunction in Diabetes” in the latest edition of the “Diabetes in America” report published by the National Institute of Diabetes and Digestive and Kidney Diseases. “People may avoid sexual activity because they’re worried about leakage.”
Mind depression — and anxiety.
Overall, rates of depression tend to be higher for people with chronic diseases including diabetes. “That can impact sexual function,” Olansky says. Depression and anxiety — which is also more common with diabetes — can take away one’s desire to have sex, the American Diabetes Association notes, adding that medicine or counseling can help with depression and anxiety disorder. For some with mild depression, therapy alone or lifestyle changes like exercising may be enough to boost mood. For others, medication may be needed, though it’s important to discuss sexual side effects of antidepressants and whether certain medications that have a lower incidence of sexual side effects, like bupropion (Wellbutrin), would be appropriate.
Consider your lifestyle.
Want to have more fun in the bedroom? Get more exercise outside of it. And while you’re at it, pay careful attention to your diet — don’t shrug off the endocrinologist’s orders. Oh, and if you smoke — quit. “People with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and with controlling their disease,” the Centers for Disease Control and Prevention notes. Ultimately, as with being sedentary or having a poor diet, lifestyle habits that get in the way of properly managing blood sugar can exacerbate sexual dysfunction — and lead to less sex.
Above all, involve your partner.
It’s a team game after all. “Having a supportive, understanding partner of course is important,” Olansky says. With erectile dysfunction, for example, it’s not exactly the same every time. “Sometimes there may be adequate function, and other times there may not be,” she says, adding that for a partner to understand that it’s not personal, and what that individual is going through is very helpful. Talking through management of the disease — when a person may check blood sugar (or how they do it — say, with a continuous blood glucose monitor) is also key, experts say, so you can stay in the moment.
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Got Diabetes? 7 Ways to Improve Your Sex Life originally appeared on usnews.com
