Sexual Problems as a Red Flag Symptom
Sexual Performance can be affected when you have diabetes, no matter what type of diabetes. But it is an issue that can be difficult to discuss in a consultation with a health care professional, especially if your partner maybe with you, or if you are from Ireland, there was no such thing as sex in Ireland before The Late Late Show (in house joke amongst the Irish!). Many people may not even be aware that their sexual problems maybe linked to their diabetes and that sexual problems such as erectile dysfunction in men can be the first sign that more serious complications are occurring such as neuropathy.[pull_quote align=”left”]There was no sex in Ireland before The Late Late Show[/pull_quote]
I always speak about sexual issues within my practice to my clients and nine times out of ten people are relieved when I discuss it, because there is an issue and they were either too afraid or embarrassed to talk about it. I am not afraid of my own sexuality, therefore I have no problem discussing it amongst my clients If a health care professional is too awkward to discuss it, this becomes a barrier to effective communication and an important red flag symptom for a more serious problem/complication which could occur becomes missed.
The sad thing is, the more the issue is ignored due to fear or embarrassment, the bigger the problem it becomes. Most sexual Issues in diabetes can be treated or reversed. There are now a variety of treatments that can be used, so please discuss with your GP/diabetes team if you are experiencing an issue.
We also need to consider all sorts of possibilities when dealing with & discussing sex such as age, sexual orientation, teenage sex, sexual preferences. At Diabetes Insight/Helena Farrell Consultancy, we provide a confidential and safe environment for people to discuss sexual issues they maybe having, and refer to the relevant professionals if needed.
Diabetes, Sex & Men
Up to 50% of men can experience some difficulty with sexual performance when they have diabetes. The most common problem for men is the issue of erectile dysfunction. As the penis has an extensive nerve and blood supply this can become damaged over time from diabetes, from vascular damage and also diabetes neuropathy. For many men the problem of erectile dysfunction can be the first time they find out they have diabetes. Erectile Dysfunction can also occur or can cause psychological issues, many people with diabetes suffer from depression and may not even realize it.
Erectile Dysfunction can be very easily treated, and there are a variety of treatments available, so please discuss with your diabetes/medical team if you are experiencing difficulties.
Low Testosterone levels amongst men can also lead to erectile dysfunction. The symptoms of low testosterone maybe missed as they are very similar to other conditions. If you have concerns or require further information the American Diabetes Association have the ADAM Questionnaire that you can take to assess your symptoms.
Diabetes, Sex & Women
Women can suffer from a variety of problems when it comes to sexual performance. Bacterial or recurrent yeast infections such as cystitis or thrush. This can cause burning and itching, which can lead to sex becoming painful for many women.
Also many women may suffer from Vaginitis, which is inflammation of the vagina, dryness of the vaginal area, difficulty stimulating the clitoris or achieving orgasm. Lack of libido can also be an issue for women who have diabetes. These issues occur similar to men, from vascular damage and diabetes neuropathy (damage to the nerves), as there is an extensive nerve and vascular supply to the vaginal area in women.
Menstrual Cycles & Menopause will also affect sexual performance, not just women with diabetes, but all women
It is essential that you talk to your diabetes/medical team if you are considering have a baby. Having diabetes should not stop any woman from having a baby, but issues can arise if blood sugars and diabetes management are not controlled for both mother and baby.
Hypoglycemia & Sex
Sex is an exercise, so your risk of going hypoglycemic either during or after sex is the same for any exercise. This can be especially true if you are combining alcohol and sex, as alcohol can lower your blood sugar levels. Romantic thought isn’t it? It probably takes a little from the spontaneity of having sex for some people. But it does not have to be like this.
- If you know you are going to have sex (lucky you!) and you are on insulin, you may need to adjust your insulin &/or have a snack.
- Always check your blood glucose levels before and after sex. You may need a snack after sex as you would with any exercise.
- If you use an insulin pump, you may want to set a temporary basal or disconnect it during sex to avoid going low. The length of time you can safely keep the pump off without an injection depends on how active you are. Ask your health care team for advice about this.
If you have an understanding partner, there should not be much of an issue, once you are both open and discuss about how diabetes can affect your sexual performance. But if you are in a new relationship, you maybe tempted not to tell your partner about your diabetes, which can lead to problems, as sooner or later your diabetes will emerge and your partner will need to know how to handle certain situations when you can’t.
Tiredness can be a problem for people with diabetes, which is normal to experience when you have diabetes. When you are tired you are less likely to engage in sexual activities. Also psychological issues such as depression, stress and anxiety can lead to problems with sexual performance. It is important to discuss with your medical team, as your sexual issues may not suggest a physical problem, it maybe psychological, vice verse or a combination of both.