Diabetes and sexual problems in Women
In one of the few studies done on the effect of Diabetes on female sexuality, pre-menopausal women with Type 1 (insulin-dependent) Diabetes had no major increase in sexual problems, in comparison to women without Diabetes. However, there was a greater increase in sexual problems in women with Type 2 Diabetes (non-insulin-dependent). These women experienced less desire and avoided intercourse more often, they also had more difficulties with lubrication, orgasms, higher incidence of pain during intercourse and less satisfaction than women without Diabetes.
One possible explanation for increased pain in women with Type 2 Diabetes, is that these women are older than women with Type 1 Diabetes, which is more likely to appear during menopause, which can cause decreased elasticity and vaginal lubrication, leading to uncomfortable and painful intercourse. Estrogen replacement therapy can reverse these menopausal effects.
Another reason may be that Type 2 Diabetes occurs when the woman have already established a relationship and lifestyle patterns, so it may be difficult for a woman to adjust to all the changes required by Diabetes control, as these may affect the relationship.
Although women with Type 1 Diabetes aren’t more susceptible to sexual problems in comparison to women without Diabetes, this doesn’t mean that they’ll never experience any of these problems. Some of the most common in women are:
Insufficient lubrication: The sexual problem most commonly related to Diabetes in women is decreased vaginal lubrication. Lubrication occurs during the excitation phase, which is also where the vagina expands in preparation for the sexual act. If there’s a lack of expansion as well as vaginal dryness, this results in pain and irritation during sexual intercourse. There are many vaginal lubricants in the market that can be used to avoid these annoyances. Make sure to use a water-based one; oil-based products shouldn’t be used because they aren’t absorbed, like water-based products are, and can promote bacterial growth and subsequent infection. Lubricating gels can be inserted into the vagina with an applicator or finger, before sexual intercourse. For cases of severe dryness a vaginal suppository can be inserted before sex. Although these products can be obtained without prescription, it’s important to previously discuss their use with your doctor.
Inability to reach orgasm: Diabetes shouldn’t affect a women’s ability to orgasm. Moreover, if you are having trouble reaching orgasm, it is likely that Diabetes has nothing to do with it. Approximately one third of women (with or without diabetes) can’t orgasm during intercourse without direct clitoral stimulation, either by hand, with a vibrator or with help from their partner. However, a problem in the excitation phase, such as insufficient lubrication (Certainly related to Diabetes) which can cause discomfort and pain, may diminish the orgasmic response. A decrease in orgasmic response may also be caused due to a decrease in desire, which can be affected by factors related to Diabetes. Elevated blood glucose levels can cause fatigue, which as a consequence leads to loss of desire.
Vaginal infections: women who consistently have elevated blood glucose levels (hyperglycemia) are more prone to vaginal infections, which can cause discomfort and consequently may lead them to avoid sexual activities. Some women feel that their genitals aren’t clean, usually due to social or cultural factors. Advertisements for feminine hygiene products, help reinforce this myth, but actually healthy genitals don’t require special care to keep them clean. Vaginal infections may also cause an unpleasant odor, and increase that feeling of uncleanliness, leading women to avoid certain kinds of sexual foreplay. Again, it’s important to remember that well controlled blood glucose levels can help prevent vaginal infections.
Hypoglycemia: Many women worry that they may have low blood sugar during sex, especially in the initial stages of adapting to Diabetes. Even worse, in some cases the symptoms of hypoglycemia may be confused with sexual arousal. Although sexual activity reduces glucose levels, it doesn’t really lead to hypoglycemia. In fact, one of the few studies on this showed that there are no significant changes in glucose levels during sex. It’s still a good idea to monitor your blood glucose levels before and after sex, noting the time of day in correlation to insulin peak action time, meal schedule and duration of sexual activity. All of these factors can affect glucose levels and knowing how your body will respond to sex can clear certain anxieties in this regard. If you need to take certain precautions, such as eating a snack to prevent hypoglycemia, do so. Also remember that if your glucose level is low, before intercourse, it can affect your ability to get aroused.
If you keep your levels of blood glucose and Hemoglobin A1C levels under control, you can reduce the problems that Diabetes can cause in your sex life. Checking your blood sugar levels before and after sexual activity, will allow you to prevent any hypoglycemic episodes that may occur, and thus be more relaxed and calm so you can enjoy a pleasant, healthy and happy sex life.