Control your diabetes, enjoy your sex life

Learn ways to minimize the effect diabetes can have on sex life.

When it comes to causing sexual complications, diabetes is fair to both genders. The men usually suffer from erectile dysfunction [a condition that affects a man’s ability to get/sustain an erection] and retrograde ejaculation [a condition in which during ejaculation, part or all of a man’s semen goes into his bladder rather than out from the tip of the penis].

With retrograde ejaculation, the semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation mostly becomes aware of this condition only when fertility problems arise.

Sexual problems in diabetic women include acute vaginal dryness due to insufficient lubrication. This is because diabetes hardens the vaginal blood vessels and restricts blood circulation. Due to vaginal dryness, such women find intercourse extremely uncomfortable. Also, diabetic women find it difficult to become/remain sexually aroused with reduced/almost no sensation in the genital region. Reaching an orgasm becomes a tough task. These women are at a greater risk of frequent urinary tract infections, making it worse for them to have a normal sex life.

Prevention possibilities

Diabetes minimize their risk of sexual dysfunction by:

  • Keeping your blood glucose under control. HbA1c, which measures average blood glucose over the past three months, should be less than seven per cent. Insulin therapy is considered if HbA1c is over 9.5 per cent at the time of diagnosis or more than 7.5 per cent even after taking oral drugs.
  • Maintaining blood pressure and cholesterol levels close to the target numbers recommended by your doctor.
  • Exercising regularly to increase blood flow, improve your mood and energy levels, and reduce stress. Being physically active and maintaining a healthy weight can also help prevent other long-term complications of diabetes. If you haven’t exercised for a while, start with something easy, such as a daily walk.
  • Quitting the habit of smoking will lower the risk of developing sexual problems. It also reduces the risk for other health problems related to diabetes, including heart attack, stroke, kidney disease and foot amputation.
  • Limiting alcohol intake to no more than two drinks per day. Drinking more than that can damage your blood vessels and can lead to various sexual dysfunctions.
  • Eating healthy and diligently following your doctor’s advice.

Treatment measures

Here’s how to overcome the sexual problems that diabetes brings along:

  • If you feel diabetes is causing problems in your sex life, talk to your doctor. Many men and women are reluctant to discuss sexual dysfunction with their doctors. A big reason for that is they never associate it with diabetes. A small conversation can make a big difference to your life. Do not attempt to self-diagnose or self-treat based on what others say. Your doctor will carefully study the underlying causes of sexual dysfunction. Counselling, medications, surgery, and hormone therapy are among treatments that can be of great benefit.
  • If erectile dysfunction is a concern, make sure to discuss your health history and the medications you take with your doctor—because some medications can lead to erectile dysfunction. If your medication is the cause of your sexual problems, the doctor will replace it with another that does not have such a side-effect.
  • Prescription of vaginal lubricants may be useful for women experiencing vaginal dryness. Kegel exercises that help strengthen the pelvic muscles may also improve sexual response.
  • Relaxation techniques [meditation or yoga] or herbal medications can also be of help here. Check with your doctor before you try out any such alternative method.
  • It is vital to follow a disciplined, diabetes-friendly lifestyle and check your blood sugar levels regularly. This helps you avoid most health complications and also take quick precautions if any problem is detected.

Mostly good control of diabetes and a little help and support from your partner and doctor is all that’s needed to lead a healthy, enjoyable sex life.

Why it happens?

One of the less-discussed repercussions of diabetes is its impact on one’s sex life.

Constantly elevated blood glucose levels [that cause hardening and narrowing of the blood vessels] and nerve damage in various parts of the body—both common occurrences in diabetics—can lead to complications in blood flow of the sexual organs, affecting performance.

Other factors that can cause or aggravate sexual dysfunction in people with diabetes include high blood pressure, being overweight, urinary tract complications, certain medications, depression and tiredness. The problems compound if the person also engages in alcohol abuse or smoking. The good news, though, is that with good control of diabetes and appropriate medicine, diabetics can definitely delay the onset of sexual problems.

Rajiv Kovil
Dr Rajiv Kovil, MBBS, is a consultant diabetologist at Dr Kovil's Diabetes Care Centre at Andheri, Mumbai


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