You may hear quite a bit about diabetes and sex being a problem for men, but female dysfunction is also a reality for many women with diabetes. A woman's sexual drive may be low or absent, and sex is no longer as pleasurable. It may even be painful. This can cause problems in relationships and be misunderstood by both partners. This does not have to be a problem for most, and there are ways to help improve sexual problems.
In general, there is not a whole lot known about the physical causes of sexual dysfunction in women. This is probably due to the fact that previously many felt a woman's lack of libido was based on emotional, cultural and psychological factors. This has prevented women from seeking help when there is a problem, even when they have diabetes. Fortunately, there is now a lot of interest and research going into this area. Ongoing studies are being conducted on the causes and risks of female dysfunction in women with diabetes.
Limited studies in this area have found that this problem affects 53.4% of women with type 2 diabetes. Nearly 64% of menopausal women with diabetes experience sexual dysfunction, and 41% of women with diabetes and not in menopause experience it.
In addition, women with type 2 diabetes are more likely to stop having sex completely than men and are also less likely to discuss sexual problems than men, even with their doctors.
Sexual problems and some other conditions that make sex more difficult, like yeast infections, can be a sign of diabetes or indicate a high risk.
Causes
Female dysfunction can be caused by nerve damage and circulatory problems due to poor control of diabetes. Other causes include medications, smoking, alcohol abuse, hormonal changes, menopause, pregnancy, vaginal infections, anxiety, depression, stress, psychological problems and other diseases.
Risk factors include advanced age, a high body mass index, nephropathy, retinopathy and long duration of diabetes. More recent studies have shown a strong association between sexual dysfunction and age, metabolic syndrome and atherogenic dyslipidemia.
Medications that can affect sexual response and desire include those for high blood pressure, some types of birth control and antidepressants.
Female Sexual Problems Due to Diabetes
- Difficulty with sexual response
- Inadequate vaginal lubrication
- Lack of genital sensation
- Low or absent sex drive
- Discomfort or pain with sex
- Difficulty achieving orgasm
- Frequent gynecologic infections
How to Lower Risk
- Keep diabetes and blood sugar levels in good control
- Maintain a body mass index within normal limits
- Perform Kegel exercises to strengthen pelvic muscles
- Eat a healthy diet
- Exercise
Exercise has been found to be protective of healthy sexual function.
High blood sugar levels also can cause such gynecologic infections as yeast infections.
Poor control of diabetes can damage nerves and the circulatory system. These systems play a large part in arousal, sensation and vaginal lubrication. You cannot consciously command your sexual organs to respond like you can command your arm to reach for a computer mouse. Sexual responses are involuntary and automatic, so it is important to keep blood sugar levels in control to help these systems perform as they should.
What to Do
Talk to your healthcare provider, who may perform a physical exam and order lab tests to find the cause of your problems. Be prepared to offer information on your medical history, diabetes control, nature of your sexual problems, emotional situation and information about your lifestyle, including smoking and drinking habits. Seek out psychological and emotional support.
Treatment
- Good diabetes management
- Healthy diet and exercise
- Vaginal lubricants
- Education on sexual positions and stimulation techniques
- Psychological and emotional support
- Kegel exercises
- Hormone-containing medications, especially if you are postmenopausal
Sources:
Abu Ali MD, Ruba; Al Hajeri MD, Rabaa M; Khader SCD, Yousef S; Shegem MD, Nadima S; and Ajlouni MD FACE, Kamel. Sexual Dysfunction in Jordanian Diabetic Women. Diabetes Care 2008 31(8):1580-1581
Esposito, K; Maiorino, MI; Bellastella G; Giugliano, F; Romano, M; and Giugliano, D. Determinants of Female Sexual Dysfunction in Type 2 Diabetes. International Journal of Impotence Research 2010 22:179-184
Sexual and Urologic Problems of Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Accessed: 09/10/2011 http://diabetes.niddk.nih.gov/dm/pubs/sup/
Tessler Lindau MD MAPP, Stacy; Tang MS, Hui; Gomero BA, Ada; Vable MPH, Anusha; Huang MD MPH, Elbert S; Drum PHD, Melida L; Qato PHARMD MPH, Dima M; and Chin MD MPH, Marshal, H. DiabetesCare 2010 33(10):2202-2210 http://care.diabetesjournals.org/content/33/10/2202.short
