A healthy sexual relationship can be one of life’s greatest expectations and pleasures. Our sexuality is important at any age. Sometimes however, as we get older, our ability to enjoy and even participate in sexual activity may lessen. When things go wrong, it is hard to accept that there might be a problem that may need to be discussed or even treated.
Sexual problems are common in people living with diabetes and may affect both men and women. Some of these problems are no different to those that the general population might have.
Clear communication with spouses/partners is very important, but conversations about sexual health problems can be difficult to talk about. Knowing that sexual problems are common, and understanding what is happening, can help to reduce our fears and ask for help. You could talk to your GP to begin with.
Some sexual problems that may affect men with diabetes are:
Difficulties with erections due to:
- Out of target blood glucose levels (BGLs)
- Stress or fear of not being able to achieve an erection
- Damage to the nerves or blood vessels supplying the penis
Men living with diabetes may have high BGLs, which can cause a lower sex drive (also known as libido). Bringing BGLs into target again may sometimes restore a man’s sex drive.
In men with diabetes, continuously high BGLs can damage the nerves over a period of time. If the nerves connected to the penis are damaged then messages from the brain may not reach the penis. Such nerve damage can cause ejaculation difficulties. Those with long term diabetes may also have damaged blood vessels. Lack of blood supply to the penis may make it difficult to achieve an erection.
‘Erectile dysfunction’ is often used to describe erection problems that happen more than three quarters of the time. Erectile dysfunction occurs more often, and on average, 10-15 years earlier in men with diabetes than in men without diabetes.
What can help?
Currently only ten percent of Australian men with erectile dysfunction ask for help from their doctors. There are many options available:
- Talking to the right health professional about issues such as relationship problems, financial problems, certain medications, stress and depression can be helpful.
- Oral medications such as Viagra, Cialis and Levitra have shown to be effective in treating erectile dysfunction in men with diabetes.
- Vacuum devices are a physical method and another way for inducing erection. Injection into the penis with the medication Caverject is also another treatment for Erectile Dysfunction.
Your doctor is the best person to talk to when discussing erection problems and also the best person to advise which treatments would be most suitable.
Some of the sexual problems that affect women with diabetes are:
- Dryness of the vagina
- Pain during sex
- Decreased sexual desire
Vaginal dryness is due to lack of lubrication and can lead to painful intercourse. It is thought that nerve and blood vessel damage in diabetes contributes to this effect. Vaginal dryness can also be caused by a slowing of oestrogen production during and after menopause.
Pain during sex can be due to yeast infections (thrush) as well as vaginal dryness. Women with diabetes with persistent BGLs above target are more susceptible to vaginal yeast infections.
What can help?
- Vaginal dryness may be remedied by using a water soluble personal lubricant (such as Sylk ®) to provide relief from discomfort during sex. Oestrogen creams or pessaries can also help.
- Vaginal thrush can be treated with oral tablets, anti fungal creams or vaginal pessaries. If blood glucose levels are continuously above target range, thrush may return or may not go away.
- Restoring and maintaining BGLs within target. Seek help from your health care team for advice and support.
- As for men, issues such as relationship problems, financial problems, certain medications, stress and depression can also cause sexual difficulties for women. Talking to a health professional about these problems can be helpful.
As explained, diabetes can cause a range of sexual health difficulties and problems for both men and women. Each problem needs to be assessed individually and the best treatment or management should be discussed with your health professional.
Discuss your concerns with your partner: discuss what you enjoy sexually, explore ways to give and receive pleasure and explore feelings of being attractive and desirable. Relax, talk openly and your communication can improve. Remember, that active listening and emotional sharing are the keys to good communication. Let your partner know that you care.
Take the self blame and shame out the relationship. These are often common issues in people with type 2 diabetes. For instance, “If I had taken better care of myself I wouldn’t be having these sexual problems”. Partners can also blame the person with diabetes which can further damage self esteem. On the other hand, partners can also experience feelings of rejection, unattractiveness and guilt in relation to their partners’ sexual difficulties.
Communicating with your partner is essential. Talk openly with your health professionals about sexual health difficulties and problems.
Find out more about Impotence Australia or phone them on 1800 800 614
Find out more about Relationships Australia or phone them on 1300 364 277
Find out more about Andrology Australia or phone them on 1300 303 878
This article was originally published by Diabetes Victoria at www.diabetesvic.org.au