Having type 1 diabetes can increase the risk of sexual dysfunction for both men and women. The good news is this may be preventable and, should it occur, there are treatments that can help.
Diabetes: Sexual Problems in Men
In men, the nerve damage and problems with circulation that are common complications of type 1 diabetes can lead to problems with erection or ejaculation.
“Hyperglycemia [high blood sugar] affects the blood vessels everywhere — the heart, eyes, kidneys. Changes in blood vessels can also affect the ability to have and maintain an erection,” explains Jennifer Goldman-Levine, PharmD, a diabetes educator and associate professor of pharmacy practice at Massachusetts College of Pharmacy and Health Sciences in Boston.
“Erectile dysfunction is much higher in patients with type 1 diabetes than in the general population, and it is directly reflective of hyperglycemia and poor blood sugar control,” Goldman-Levine says.
With diabetes, blood vessels supplying the penis’s erectile tissue can get hard and narrow, preventing the adequate blood supply needed for a firm erection. The nerve damage caused by poor blood glucose control can also cause ejaculate to go into the bladder instead of through the penis during ejaculation, called retrograde ejaculation. When this happens, semen leaves the body in the urine.
Diabetes: Sexual Problems in Women
The cause of diabetes-related sexual dysfunction in women is also due to poorly controlled blood glucose levels leading to nerve damage, reduced blood flow to the genitals, and hormonal changes.
It is estimated that up to a quarter of women with type 1 diabetes experience sexual dysfunction, often due to hardened blood vessels in the vaginal walls. Sexual problems can include vaginal dryness, pain or discomfort during sex, decreased sex drive, and reduced sexual response; there may be difficulty becoming aroused, reduced genital sensation, and inability to reach orgasm. Women with type 1 diabetes may also experience an increase in yeast infections.
Diabetes: Think Prevention First
Controlling your blood glucose levels is the best way to avoid sexual dysfunction related to diabetes. “In this case, prevention is the best medicine,” says Goldman-Levine.
Follow your doctor’s recommendations on how to monitor and regulate your blood glucose levels. Your doctor may find that your blood sugar needs to be better controlled.
Or your doctor could find that the problem stems from something unrelated to diabetes, like medications you’re taking, smoking, or other heath conditions. In these cases, alternate medications, lifestyle changes, or treatments may help alleviate the problem.
Diabetes: Sexual Solutions for Men
Diabetes-related sexual dysfunction can be treated in a number of ways.
- Erectile dysfunction medication. Medications used to treat erectile dysfunction may work in men with diabetes, but the dosage may need to be higher than that for the general population, says Goldman-Levine.
- Other treatments for erectile dysfunction. Your doctor may recommend a vacuum pump, placing pellets into your urethra, injections of medications into your penis, or surgery.
- Medication for retrograde ejaculation. A specific drug that strengthens the muscles of the sphincter of your bladder can help with retrograde ejaculation.
Diabetes: Sexual Solutions for Women
Simple remedies may easily correct sexual problems related to diabetes:
- Vaginal lubricants. For women with vaginal dryness or pain or discomfort during intercourse, using a vaginal lubricant may help.
- Kegel exercises. Regularly performing Kegel exercises, which strengthen the pelvic floor muscles, can improve a woman’s sexual response.
Type 1 diabetes is a challenging condition, but doesn’t have to interfere with or limit your ability to have sex. If you are experiencing anxiety about sexual performance, consider counseling to help relieve stress and other emotional issues that are hampering your sex life. It’s important to explore all possible solutions with your diabetes medical team to be sure that you are able to enjoy all facts of your life.
