- Diabetes, Sexual, & Bladder Problems | NIDDK
- Can sexual and bladder problems be symptoms of diabetes?
- When should I see a doctor about my sexual or bladder problems?
- What makes me more ly to develop sexual or bladder problems
- What sexual problems can men with diabetes have?
- Erectile dysfunction
- Retrograde ejaculation
- Penile curvature
- Low testosterone
- Fertility problems
- What sexual problems can women with diabetes have?
- Low sexual desire and response
- Painful sex
- Yeast and bladder infections
- Pregnancy concerns and fertility problems
- What bladder problems can men and women with diabetes have?
- Frequent and urgent urination
- Trouble “going”
- Leaking urine
- Bladder infections
- How can I prevent and treat my sexual or bladder problems?
- Diabetes & Sex: Women’s Sexual Dysfunction
- What is sexual dysfunction?
- What are the types of sexual dysfunction?
- What are the symptoms of sexual dysfunction in women?
- How does diabetes affect sexuality?
- How are sexual issues in women with diabetes diagnosed?
- How are sexual issues treated in women with diabetes?
- What type of contraception is best for women with diabetes?
- How does diabetes affect fertility?
- Men & Diabetes
- Type 2 Diabetes and Your Sexuality
- Why Nerve Damage Causes Sexual Dysfunction
- Type 2 Diabetes and Sexuality: Finding Solutions
- 4 Ways to Prevent Sexual Dysfunction if You Have Diabetes
- Better Sex With Diabetes
- Sexual health
Diabetes, Sexual, & Bladder Problems | NIDDK
In this section:
Sexual problems and bladder problems are common as people age, but diabetes can make these problems worse. You or your partner may have trouble having or enjoying sex. Or, you may leak urine or have trouble emptying your bladder normally.
Blood vessels and nerves can be damaged by the effects of high blood glucose, also called blood sugar. This damage can lead to sexual and bladder problems. Keeping your blood glucose levels in your target range is an important way to prevent damage to your blood vessels and nerves.
Work with your health care team to help prevent or treat sexual and bladder problems. These problems may be signs that you need to manage your diabetes in a different way. Remember, a healthy sex life and a healthy bladder can improve your quality of life, so take action now if you have concerns.
Sexual and bladder problems may be signs that you need to manage your diabetes in a different way.
Can sexual and bladder problems be symptoms of diabetes?
Yes. Changes in sexual function or bladder habits may be a sign that you have diabetes. Nerve damage caused by diabetes, also called diabetic neuropathy, can damage parts of your body— your genitals or urinary tract. For example, men with diabetes may develop erectile dysfunction (ED) 10 to 15 years earlier than men without diabetes.1
Talk with a health care professional if you have any symptoms of diabetes, including sexual and bladder problems.
When should I see a doctor about my sexual or bladder problems?
See a health care professional for problems with sex or your bladder. These problems could be a sign that you need to manage your diabetes differently.
You may find it embarrassing and difficult to talk about these things. However, remember that health care professionals are trained to speak with people about every kind of health problem.
Everyone deserves to have healthy relationships and enjoy the activities they love.
What makes me more ly to develop sexual or bladder problems
You’re more ly to develop sexual or bladder problems if you have diabetes and
- have high blood glucose that is not well controlled, also called high blood sugar
- have nerve damage, also called neuropathy
- have high blood pressure that is not treated
- have high cholesterol that is not treated
- are are overweight or have obesity
- are not physically active
- are taking certain medicines
- drink too many alcoholic drinks
Research also suggests that certain genes may make people more ly to develop diabetic neuropathy.2
What sexual problems can men with diabetes have?
Changes in your blood vessels, nerves, hormones, and emotional health during diabetes may make it more difficult for you to have satisfactory sex. Diabetes and its related challenges also may make it harder for you to have a child.
You have ED if you’re unable to get or keep an erection firm enough for satisfactory sexual intercourse. More than half of men with diabetes will get ED.
Men who have diabetes are more than 3 times more ly to develop ED than men who do not have diabetes.1 Good diabetes management may help prevent and treat ED caused by nerve damage and circulation problems.
A doctor can help treat ED with medicine or a change in your diabetes care plan.
Managing your diabetes may help prevent and treat ED caused by nerve damage and circulation problems.
Rarely, diabetes can cause retrograde ejaculation, which is when part or all of your semen goes into your bladder instead of your penis during ejaculation.
During retrograde ejaculation, semen enters your bladder, mixes with urine, and is safely urinated out. A urine sample after ejaculation can show if you have retrograde ejaculation.
Some men with retrograde ejaculation may not ejaculate at all.
Men with diabetes are more ly to have Peyronie’s disease, also called penile curvature, than men who don’t have diabetes.3 Men with Peyronie’s disease have scar tissue, called a plaque, in the penis, making it curve when erect. Curves in the penis can make sexual intercourse painful or difficult. Some men with Peyronie’s disease may have ED.
Men’s testosterone levels naturally lower with age. However, lower-than-normal testosterone levels may be the cause of some men’s ED, or can explain why some men often feel tired, depressed, or have a low sex drive. Men with diabetes, especially those who are older and overweight, are more ly to have low testosterone, or “low T.”
If your doctor thinks you might have low T, you will probably be asked to give a blood sample, and a health care professional will give you a physical exam. Your doctor may suggest treating your low testosterone with a prescription gel, injection, or patch.
Several studies show that, along with good diabetes management, testosterone therapy can lessen a man’s sexual problems.4 However, testosterone therapy may have serious risks and may not be safe for all men. Talk with your doctor about testosterone therapy’s side effects and whether it’s right for you.
Some studies show that men with diabetes can have problems with their sperm that make it harder to conceive. Your sperm could be slow or not move well, or your sperm may not be able to fertilize a woman’s egg well.5 Working closely with your partner and a health care professional trained in fertility issues may help.
If you and your partner want to conceive a child, your doctor may treat retrograde ejaculation caused by diabetes with medicine or by changing your diabetes care plan. Or, talk with a urologist who is a fertility expert. He or she may be able to collect your sperm from your urine and then use it for artificial insemination.
What sexual problems can women with diabetes have?
Low sexual desire and response, vaginal dryness, and painful sex can be caused by nerve damage, reduced blood flow to the genitals, and hormonal changes.
Other conditions can cause these problems, too, including menopause. If you notice a change in your sex life, talk with your health care team.
A physical exam, which will include a pelvic exam, and blood and urine tests may help your doctor find the cause of your problems.
Low sexual desire and response
Low sexual desire and sexual response can include
- being unable to become or stay aroused
- not having enough vaginal lubrication
- having little to no feeling in your genitals
- being unable to have an orgasm or rarely having one
With diabetes, your body and mind will ly go through many changes. For example, both high and low blood glucose levels can affect how and if you become aroused. Or, you may find yourself more tired than usual or depressed and anxious, making you less interested in sex.
Your health care team can help you make changes to your diabetes care plan so that you‘re back on track. Women who keep blood glucose levels in their target range are less ly to have nerve damage, which can lead to low sexual desire and response.
Some women with diabetes say they have uncomfortable or painful sexual intercourse. The nerves that tell your vagina to lubricate during stimulation can become damaged by diabetes. A prescription or over-the-counter vaginal lubricant may help if you have vaginal dryness. Managing your blood glucose well over many weeks, months, and years can help prevent nerve damage.
Yeast and bladder infections
Women with diabetes are more ly to have yeast infections, because yeast organisms can grow more easily when your blood glucose levels are higher. Yeast infections can be uncomfortable or painful and prevent you from enjoying activities, including having sex.
Although some yeast infections can be treated at home, talk with a health care professional first about your symptoms. Some symptoms of yeast infections are similar to other types of infections, including sexually transmitted diseases.
Pregnancy concerns and fertility problems
If you have diabetes and plan to become pregnant, it’s important to get your blood glucose levels close to your target range before you get pregnant. High blood glucose can harm your baby during the first weeks of pregnancy, even before you know you’re pregnant.
If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby.
Conditions such as obesity and polycystic ovarian syndrome (PCOS) that are linked to diabetes can make it harder to conceive a child. Talk with a health care professional, such as a gynecologist or a fertility specialist, if you’re having problems conceiving a child.
If you notice a change in your sex life, talk with your health care team.
What bladder problems can men and women with diabetes have?
Diabetes can cause nerve damage to your urinary tract, causing bladder problems. Overweight and obesity also can increase bladder problems, such as urinary incontinence (UI). Managing diabetes is an important part of preventing problems that can lead to excess urination.
Your health care team may be able to help you manage your blood glucose levels and help you lose weight, if needed. Doctors use blood and urine tests to diagnose bladder problems or conditions with similar symptoms. Doctors also may use urodynamic testing to see what kind of bladder problem you have.
Frequent and urgent urination
Some people with diabetes who regularly have high blood glucose levels may have to urinate too often, also called urinary frequency.
Even men and women with diabetes who manage their blood glucose levels within their target range sometimes feel the sudden urge to urinate, called urgency incontinence. This can happen at night, also.
Medicines may help reduce the symptoms of bladder control problems.
You may find that diabetes causes you to no longer feel when your bladder is full. Many people with diabetes report that they have trouble “going.
” Over time, having a too-full bladder can cause damage to your bladder muscles that push urine out. When these muscles don’t work correctly, urine may stay in your bladder too long, also called urinary retention.
Urinary retention can cause bladder infections, urine leaks, and the feeling that you always have to go.
People with diabetes are more ly to have other types of UI, such as stress incontinence. Nerve damage, obesity, and bladder infections, which are linked with diabetes, are often related to bladder control problems. Leaking urine can cause you to avoid activities you once enjoyed, including sex.
If you’re overweight, losing weight can help you have fewer leaks. Avoiding weight gain may prevent UI. Studies suggest that, as your body mass index (BMI) increases, you’re more ly to leak.6 If you’re overweight or have obesity, talk with your doctor about how to lose weight.
Work with your health care team to help manage and prevent urine leaks. Bladder control problems are often treatable and are very common, even in people who don’t have diabetes. You don’t have to accept rushing to the bathroom all the time to avoid leaks.
People with diabetes are more ly to have urinary tract infections, also called bladder infections, or cystitis. See a doctor right away if you have frequent, urgent urination that may be painful.
Bladder infections can develop into kidney infections and can make bladder symptoms, such as leaks and urine retention, worse. Also, bladder infections can get in the way of your everyday life, including intimacy.
Managing your blood glucose levels can help prevent bladder infections.
Managing your blood glucose levels can help prevent bladder problems.
How can I prevent and treat my sexual or bladder problems?
Managing your diabetes can help prevent nerve damage and other diabetes problems that can lead to sexual and bladder problems. With your health care team, you can help prevent and treat your sexual or bladder control problems by
Sex is a physical activity, so be sure to check your blood glucose level before and after sex, especially if you take insulin. Both high blood glucose levels and low blood glucose levels can cause problems during sex.
Counseling may also be helpful when you notice changes in your sexual function or desire. These types of changes are very common as people age or adjust to health problems.
If you have a partner, he or she also may be an important member of your health care team. You may find it helpful to share your concerns and have that person join you at the doctor’s office or at counseling. Your friends and family may also be able to support you if you’re having bladder problems.
 Kouidrat Y, Pizzol D, Cosco T, et al. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabetic Medicine. 2017;34(9):1185–1192.
 Witzel I, Jelinek HF, Khalaf K, Lee S, Khandoker AH, Alsafar H. Identifying common genetic risk factors of diabetic neuropathies. [published online May 28, 2015] Frontiers in Endocrinology. 2015;6:88. doi:10.3389/fendo.2015.00088.
 Al-Thakafi S, Al-Hathal N. Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Translational Andrology and Urology. 2016; 5(3):280–289.
 Putta S, Peluso I, Yarla NS, et al. Diabetes mellitus and male aging: pharmacotherapeutics and clinical implications. [published online August 22, 2017] Current Pharmaceutical Design. doi:10.2174/1381612823666170823103830.
 Ding G, Liu Y, Liu ME, et al. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis. [published online March 24, 2015] Asian Journal of Andrology. 2015;17(6):948–953.
 Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. The Journal of Urology. 2011;186(2):589–593.
Diabetes & Sex: Women’s Sexual Dysfunction
Sexuality not only implies sexual activity but includes the full spectrum of sexual topics which are dependent upon the medical, psychological and sociocultural aspects of a woman. Sexuality covers not only actual sexual activity, but thoughts about sex, physical attributes, and desire for sexual activity. Related issues include fertility and contraception.
What is sexual dysfunction?
Sexual dysfunction refers to a problem occurring during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle traditionally includes excitement, plateau, orgasm, and resolution.
Desire and arousal are both part of the excitement phase of the sexual response. Research suggests that sexual dysfunction is common, but many people are hesitant to discuss it.
Because treatment options are available, it is important to share your concerns with your partner and health care provider.
What are the types of sexual dysfunction?
Sexual dysfunction generally is classified into four categories:
- Desire disorders: Lack of sexual desire or interest in sex
- Arousal disorders: Inability to become physically aroused or excited during sexual activity
- Orgasm disorders: Delay or absence of orgasm (climax)
- Pain disorders: Pain during intercourse
What are the symptoms of sexual dysfunction in women?
- Inability to achieve orgasm
- Inadequate vaginal lubrication before and during intercourse
- Inability to relax the vaginal muscles enough to allow intercourse
- Lack of interest in or desire for sex
- Inability to become aroused
- Pain with intercourse
How does diabetes affect sexuality?
It is fairly well-known that diabetes and complications can affect the sexuality in men, but it is true for women, also. Women are starting to bring questions about sexual function and diabetes to their healthcare providers. Here are some problems that might be found in a woman with diabetes:
- Less vaginal lubrication, leading to dryness and discomfort or pain during intercourse
- Less or no sexual desire
- Lower or no sexual response, including the inability to become or stay aroused, little or no feeling in your genitals, and the inability to orgasm, either occasionally or always
How are sexual issues in women with diabetes diagnosed?
It is important to note that if you are having these issues or noticing sexual problems, you should talk to your healthcare provider. He or she will ask you about:
- Your health history
- How often the problems happen and the details of them
- Possible infections
- Other diseases
- Whether or not you drink alcohol or smoke, and how often
- What type of medications you are taking
- Being pregnant or if you have reached menopause
- Whether or not you are depressed or have had any life changes
Your doctor might do a physical examination and/or order lab tests to help the diagnosis. Your doctor might also speak about blood sugar control.
How are sexual issues treated in women with diabetes?
Prescription or over-the-counter vaginal lubricants may be useful for women experiencing vaginal dryness. Techniques to treat decreased sexual response include changes in position and stimulation during sexual relations. Psychological counseling may be helpful. Kegel exercises that help strengthen the pelvic muscles may improve sexual response. Studies of drug treatments are under way.
What type of contraception is best for women with diabetes?
There is no single contraceptive which is ideal for all women with diabetes. Each method has some disadvantages and some advantages. You and your healthcare provider should discuss the most appropriate method for you.
- Oral contraceptives – Combination estrogen/progestin pills are best for women who are younger than 35 years old and who do not smoke. Women with uncontrolled high blood pressure should speak to their doctors before using this form of birth control. Oral contraceptives with less than 35mg of estrogen and a low progestin dose are recommended.
- IUDs (Intrauterine devices) – Hormonal IUDs (Mirena®) consist of a progestin (levonorgestrel) – Recent information suggests that there is no greater risk of uterine infections in women with diabetes. Women with multiple sexual partners or with a history of uterine infections should avoid this form of contraception.
- Barrier methods – Diaphragms with spermicidal jelly or condoms with spermicidal foam have no medical problems associated with diabetes but do not work quite as well as some other methods.
- Tubal ligation – This is a reasonable but permanent option for women who are sure that they do not want more children. There are no complications with respect to diabetes.
How does diabetes affect fertility?
Poor blood sugar control is related to higher miscarriage rates during the first three months of pregnancy. Also, some women with type 2 diabetes may be overweight and/or have polycystic ovary syndrome, which may make getting pregnant harder.
Again, though, these are the types of issues that women with diabetes should talk about with their healthcare providers so that treatments can be explored.
Last reviewed by a Cleveland Clinic medical professional on 04/03/2015.
- Bal MD, Yılmaz SD, Celik SG, Dinçağ N, Beji NK, Yalçın O. Does the diabetes of type 2 affect the sexual functions of women?. J Sex Marital Ther. 2015;41(1):107-13.
Men & Diabetes
It’s not easy to talk about health—especially sexual health—but don’t drop the ball. Speak with your doctor about managing diabetes-related problems that could keep you on the sidelines.
OK guys, let’s be honest. Some of you don’t take great care of your health. You walk off injuries. You may not pay attention to signs that something’s wrong. And the No. 1 reason you don’t go to the doctor? Research shows it’s because you don’t want to hear bad news. But that means you won’t get to hear the good news either. We’ll get to that below.
As a guy, you’re more ly to get type 2 diabetes at a lower weight than women. One reason is that men store more fat in their bellies—a known risk factor. And more men than women have diabetes that’s undiagnosed; maybe it’s that “don’t want to hear bad news” thing.
Diabetes puts both men and women at greater risk for heart disease, stroke, vision loss, kidney failure, even amputation of a toe, foot, or leg. But some diabetes problems hit guys directly below the belt:
With ED, a man can’t get or keep an erection firm enough for sex. ED is common in middle-aged and older men – as many as 30 million in the United States have it. Men with diabetes are three times more ly to have ED. Getting older doesn’t cause ED, but it does increase your chance of getting it.
First, some facts. Here’s what ED isn’t:
- Occasional trouble having an erection. That really does happen to everyone.
- Less interest in sex. ED happens when a man wants to have sex but can’t have or keep an erection.
- Problems with ejaculation, which can mean a structural problem with the penis.
It’s not uncommon to have trouble getting an erection sometimes, but if it gets worse, happens often, or prevents you from living the life you want, it’s time to get it checked out.
Men who have diabetes are more ly to have heart disease, and ED can be a warning sign of blood vessel problems. If you have both, talk to your doctor about treatment. Some ED medicines are not safe to take with certain heart medicines, though, so make sure you let your doctor know about any medicines you’re taking.
Team up with your doctor to manage diabetes-related problems so you can stay in the game.
- Damage from high blood sugar or high blood pressure to nerves and blood vessels needed to have an erection
- Some medicines for high blood pressure, depression, or allergies (don’t stop taking them, but do talk with your doctor to see if you can take a different medicine or lower the dose)
- Treatment for prostate cancer or an enlarged prostate
- Surgery that affects the pelvic area or spinal cord
- Using tobacco or alcohol
- Sleep disorders
It’s important to visit your doctor to find out if any of these causes are contributing to ED.
It can be tough to talk about ED, but it’s a conversation you need to have with your doctor so you can get treated. The good news is more than 95% of men – you and almost all of the other guys in the waiting room with you – can be treated successfully.
- Medicine: If you have normal nerve function, you could take a type of medicine that increases blood flow to the penis. Sometimes these medicines don’t work well for guys with diabetes and should NOT be taken if you’re also taking nitrates for your heart. Be sure to check with your doctor about any possible medicine interactions.
- Testosterone: Sometimes having low testosterone (low T) can cause ED. Men with diabetes are twice as ly to have low T than men who don’t have diabetes. Taking testosterone may help you have normal erections or help ED medicine work better. It can also make low blood sugar worse and increase blood pressure, so make sure to get regular checkups to spot and manage any problems.
- Vacuum device: This is a plastic tube that fits over the penis, creating a low-pressure vacuum that causes an erection. An elastic ring is slipped onto the base of the penis to hold blood in and maintain the erection. With training, about 75% of men can get an erection firm enough for sex.
- Injection or suppository: For an immediate erection just before sex, you can inject a medicine into the side of the penis with a very small needle, or place a tiny pill in the urethra (the tube urine comes ).
- Implant: A penile implant placed inside the penis by surgery is often recommended if other treatments don’t work. However, if you’re having trouble managing your blood sugar, your chance for infection after surgery is higher and your doctor may advise against an implant.
Sometimes treatment for ED can cause a long-lasting erection. If yours lasts more than two to four hours, go to your doctor or the emergency room right away. This very painful condition can lead to permanent damage if not treated immediately.
ED doesn’t have to sideline you. Almost all men can be treated successfully. Talk to your doctor!
In addition to ED, nerve damage from diabetes can cause other problems for men, including:
- Overactive bladder (needing to urinate often, urinating often at night, leaking urine)
- Male incontinence (leaking urine)
- Urinary tract infections (UTIs)
- Retrograde ejaculation (semen is released into the bladder)
These problems could mean you need to change how you’re managing your diabetes.
Work with your health care team to keep your blood sugar levels close to your target to avoid or lessen nerve and blood vessel damage.
The less damage, the better your body will be able to function in every part of life.
Healthy habits help you stay in the game – being active on most days, eating healthy food, checking your blood sugar, managing your blood pressure and cholesterol levels, and going to doctor appointments.
Be sure to take advantage of diabetes self-management education and support services. Working with a diabetes educator can help you stay on track no matter what life throws at you.
Ready to step up your game? Find a doctor you can be open with. And earlier is better for best results. The ball is in your court!
Type 2 Diabetes and Your Sexuality
Nerve damage, or diabetic neuropathy, is one of the most serious side effects of type 2 diabetes, affecting everything from your hands and feet to your brain, heart, and more.
There are four significant types of diabetic neuropathy, including autonomic neuropathy, which can cause sexual dysfunction.
If you're experiencing decreased sexual satisfaction with diabetes, autonomic neuropathy is ly to blame. Try these tips to reclaim your love life.
Why Nerve Damage Causes Sexual Dysfunction
Poor glucose control causes diabetic neuropathy, which affects the nerves of the sexual organs.
According to Deena Adimoolam, MD, assistant professor of diabetes, endocrinology, and bone disease at the Icahn School of Medicine at Mount Sinai in New York City, uncontrolled diabetes can cause damage in blood vessels and nerves, which affects sexual health. “Poor blood sugar control has a big impact on the person's sex life,” she adds.
For women, nerve damage can lead to decreased stimulation, which means the vagina may not produce enough lubrication to allow for easy intercourse. This in turn creates a cascading number of problems, notes Dr. Adimoolam. Sexual problems in women include decreased vaginal lubrication, painful intercourse, and diminished libido or desire, she explains.
A study published in August of 2012 found that women who take insulin injections to treat diabetes are twice as ly to report sexual dissatisfaction as women without the condition.
A study published in August 2012 in the journal Obstetrics & Gynecology reported that women who do not treat their diabetes with insulin are still 40 percent less satisfied with their sex lives than women without the condition.
For men, this may mean that not enough blood flows to the penis to maintain an erection, Adimoolam explains. Known as erectile dysfunction (ED), this condition is two to three times more prevalent in men with diabetes than the general public, and may occur at an earlier-than-average age for them, too.
Type 2 Diabetes and Sexuality: Finding Solutions
Individuals who experience sexual dysfunction should speak to their healthcare provider to discuss treatment options, Adimoolam advises. Although sexuality might be difficult to talk about, it’s an important part of a full and healthy life, and sexual problems that result from diabetes can often be helped.
If you're a woman with type 2 diabetes and you're having diabetes-related sexual problems, you can first try over-the-counter lubricants to help overcome vaginal dryness. Choose a water-based lubricant — one that's meant for sexual activity and that won’t erode condoms or a diaphragm. Other forms of artificial lubrication that may be helpful include vaginal suppositories.
If you're a man with erectile dysfunction, there are many options to help you enjoy an active sex life again, including one of the popular ED prescription drugs, vacuum pumps to draw blood into the penis, and penile implants.
4 Ways to Prevent Sexual Dysfunction if You Have Diabetes
Since some of these sexuality-related problems result from uncontrolled diabetes, people with type 2 diabetes may avoid developing such complications by keeping their blood glucose levels as steady as possible. “Controlling diabetes through diet, exercise, and medication can help prevent sexual dysfunction or, in some cases, lessen its severity,” Adimoolam says.
The best way to control diabetes is to:
- Follow the diet recommended by your doctor, diabetes educator, or dietitian.
- Take medication as directed.
- Exercise regularly.
- Make sure your blood glucose levels are tightly controlled.
Communication is the first step to understanding sexual changes caused by diabetes. If you’re having, or want to avoid, sexual problems because of your type 2 diabetes, talk to your doctor or diabetes educator — and remember that they help patients with these issues every day.
Better Sex With Diabetes
From the WebMD Archives
Diabetes doesn't have to feel a third — and unwanted — party in bed. You can deal with things low blood sugar, vaginal dryness, or erection problems by looking at them as hurdles you can overcome, instead of roadblocks that put a stop to sex.
Planning ahead can ease some of the challenges. You may associate prep work more with house painting than with having sex, but it can make intimacy more relaxed. Also remember that taking good care of your diabetes is the No. 1 way to prevent or limit sexual issues with diabetes.
These tricks and tips can also make sex easier and more fun.
- Approach sex exercise. This helps prevent dreaded blood sugar lows. “Hypoglycemic events during sex are a real buzzkill,” says Kerri Morrone Sparling, the author of Balancing Diabetes: Conversations About Finding Happiness and Living Well, who blogs about her life with type 1 diabetes. “Your body just shuts down during a low, so it crushes the enjoyment.” If you use insulin, check your blood sugar before sex and have a snack if it's low. For more fun, incorporate snacks into foreplay. Try strawberries or a little ice cream or chocolate.
- Just go with it. Planning can be helpful, but don't sweat it if sex just happens. “There's no reason not to grab the opportunity if it pops up just because you haven't followed your diabetes exercise routine,” says Scott K. Johnson, a diabetes advocate who blogs about his life with type 1 diabetes. Just check your glucose level after.
- Use a lubricant. If you are a woman with vaginal dryness, a vaginal lubricant can make sex feel better. Ask your doctor about using one regularly, not just during sex. “Think of it hand cream,” says Janis Roszler, a diabetes educator in Miami and author of Sex and Diabetes: For Him and For Her.
- Prepare a sex arsenal kit. Keep anything you might need for optimal sex next to the bed. Include a box of juice or glucose tablets and test supplies. “These are things we should all have with us all the time anyway,” Johnson says. “And it would bum me out if I had to stop sex because I didn't have something there.” If you're a woman, you may want to have a lubricant in your kit. Feel free to include massage oils or other supplies to enhance the mood. You can pack a mini-kit of supplies for when you're on the go.
- Get a room. Treat yourself and your partner to a night at a local hotel. “It's a great libido enhancer,” Roszler says. Especially if you have children and a hard time getting time alone. “Plan it days in advance and then tease each other before with texts or notes. It's planning, but it's planning something fun.”
- Get in some practice. If you are a man who uses a device a vacuum pump or constriction band to help with erectile dysfunction, take time to learn how to use it right. “You don't want to be fumbling around with it in front of a partner,” Roszler says. “The more comfortable you are with any device, the more relaxed you will be about using it.”
- Consider a continuous glucose monitor (CGM). Both Sparling and Johnson say this a boon for sex. “Wearing a CGM keeps me aware of where my blood sugar is and how it's trending,” Johnson says. “It helps a lot with planning or spontaneity.” If you don't wear a monitor, though, blood sugar testing doesn't have to be a big deal. “You can do a quick 30-second blood sugar test anywhere,” Johnson says. “It can be very discreet.”
- Creativity is sexy. If you have trouble getting aroused, stretch beyond your go-to bedroom moves. Watch erotica or porn together. Try out new positions or sex toys. Explore different ways to climax. Most women don't climax from intercourse alone, anyway. Some men can have an orgasm from prostate stimulation.
- Limit alcohol. A little alcohol may boost your desire, but drinking can also make your blood sugar level drop quickly. If you drink alcohol, you might sip some champagne during intimacy. Or have a drink earlier with a meal or snack. This will limit its effects on your blood sugar. Go lightly if you are a man who has trouble keeping erections.
- Get help for emotional issues. Depression, anxiety, poor self-image, and other emotional concerns can hurt your sex life. And if you have a partner, sex troubles can put stress on your relationship. Individual or couples counseling can help you talk about issues and work out solutions. Your doctor can suggest treatments for most sexual issues, from painful sex to trouble with orgasms. But you may need to address emotional or relationship concerns before they will work.
- Relax. How you feel about your diabetes can set the stage for sex. With diabetes, you have to expect the unexpected, and it helps to have a sense of humor if something goes wrong. Your partner, especially a new partner, will ly take clues from you. “If you are confident, comfortable, and relaxed, you will convey the message that this is something to be relaxed about,” Roszler says.
Some people think insulin pumps don't get in the way of good sex. Others feel that having tubes attached makes them less attractive or kills the mood.
Sparling removes her pump before sex, as she does when she exercises. (Pumps can be safely taken off for 45 minutes to an hour. But many experts suggest using a short/rapid-acting insulin shot to cover the period while the pump is detached.
) After sex, she checks her blood sugar again and takes a dose of insulin if it is high or has a snack if it's low. If you're worried about falling asleep or forgetting to reconnect, you can set the alarm on your pump or cell phone.
If you don't want to disconnect your pump, using long tubing can give you more freedom to move around. And it helps to let your partner know where it's attached so the person doesn't grab it by accident. If it does get yanked out and starts to bleed, though, it's not a problem, Roszler says. “Just put pressure on the area until the bleeding stops.”
With a regular partner, a glitch this, or disconnecting a pump during foreplay, may not be awkward. But what if you're with a new partner you haven't told about your diabetes? This is not a problem for Sparling or Johnson, who are both married. But Johnson says he could see that some people might prefer insulin shots over a pump if they're playing the field.
“With an injection, you might not have to mention your diabetes unless and until you want to,” he says. “A pump kind of forces the disclosure.”
Sparling believes in “full disclosure” about diabetes before intimacy — for safety reasons, if nothing else. And she thinks a sexual partner should be able to accept that you wear a pump if you accept it. If not, she says, you might want to reconsider whether they are a good choice for a partner.
Taking care of your diabetes is the best sex strategy. Good blood glucose control can prevent or ease sexual issues so you can “do everything you want to do in sex,” Sparling says. “And what better impetus to diabetes control is there, especially if you're young, than getting to have a good, healthy sex life?”
American Diabetes Association: “Alcohol.”
Columbia Education, Go Ask Alice: “The male hot spot – massaging the prostate.”
Diabetes Forecast: “Diabetes and Sex: What You Wanted to Know.”
Scott K. Johnson, diabetes blogger, speaker, and advocate.
Janis Roszler, RD, MSFT, dietitian, diabetes educator, and marriage and family therapist, Miami, author, Sex and Diabetes: For Him and For Her.
Kerri Morrone Sparling, diabetes blogger and author, Balancing Diabetes: Conversations About Finding Happiness and Living Well.
Society of Obstetricians and Gynecologists of Canada: “Female Orgasm: Myths and Facts.”
UCSF Diabetes Education Online: “Pump FAQs.”
© 2015 WebMD, LLC. All rights reserved.
A healthy sexual relationship can be an important part of someone's life. When things go wrong, whether or not we have diabetes, many of us find it hard to accept that there might be a problem. It’s important to know support available.
- While most people with diabetes, both male and female, are able to lead completely normal sex lives, diabetes may contribute to sexual problems for some people
- The most common problem is erectile dysfunction in men (also known as impotence) which results in the inability to get or keep an erection long enough for intercourse. Ejaculation may or may not be affected. Fertility remains normal
- Both men and women with diabetes may also lose their sexual desire when their blood glucose levels are high
Most men have an occasional problem with erectile dysfunction at some time in their life. This can be caused by many factors including being tired, stressed, and depressed or drinking too much alcohol.
Some medications may also cause erectile dysfunction. This can include medications taken for high blood pressure, depression or stomach ulcers.
It’s important to always tell your doctor about any medications you may be taking for other conditions.
Reduced blood flow and nerve damage to the penis are generally the underlying reasons for erectile dysfunction for men with diabetes. Often men with diabetes who have the condition also have other complications related to nerve damage or blood circulation problems, such as high blood pressure, high cholesterol or heart disease.
Erectile dysfunction can be treated in a number of ways including:
- Tablets (e.g. Viagra, Cialis and Levitra)
- Prostaglandin injection into the side of the penis (e.g. Caverject)
- Devices such as the vacuum pump
- Surgery such as penile implants
While tablets are easy to take, they may not work for everyone. So discuss all the options with your doctor to decide what’s best for you.
Resources:Diabetes Australia in conjunction with Eli Lilly and Impotence Australia have released a publication to help you understand the impact of diabetes on erectile dysfunction. – Treat ED: Diabetes Edition
In general, much less is known about sexual problems in women and this includes women with diabetes.
The main sexual problems that women deal with are vaginal dryness, a decrease in sexual desire, pain during sex and trouble having an orgasm.
Whether diabetes affects these problems is unclear although women who find it hard to come to terms with living with diabetes are more ly to report sexual problems.
Women with diabetes that is not well managed are more ly to have frequent bouts of thrush (yeast infection). In most cases, keeping blood glucose levels within the target range will help.
During periods or menopause, blood glucose levels may change. Women affected by this will need to adjust their treatment. Your doctor or Credentialled Diabetes Educator will help during these times.
Sexual problems are the same as any other medical problem. You need to talk to your doctor about the strategies that will best suit you and your lifestyle.
Accept that there is a problem. Thinking it might go away will only delay treatment. The sooner you seek help the sooner the problem can be treated. If you have a partner, talk through the problems you are both experiencing. Sexual problems have the potential to cause a strain in the relationship. If you feel this is happening, you may to contact Relationships Australia.
Learn about the condition. Finding out as much as you can and the treatments available will bring positive results and improve your sense of well being.