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Excerpted from Chapter 7 – Say Yes To….An Active Social Life
Step 14 – Prepare for Intimacy
If you expect to become physical with your significant other, check your blood glucose frequently and treat hypoglycemic symptoms with glucose tablets or a fast-acting carbohydrate food, such as regular soda or fruit juice. Sex is a physical activity just like running and dancing, and cause your blood sugar level to drop quickly.
As mentioned earlier, diabetes can affect sexual performance. Men may have a difficult time achieving or maintaining an erection or may experience a drop in libido; and women may have difficulty becoming aroused, may lack adequate vaginal lubrication, have difficulty achieving orgasm or feel pain during intercourse. There are many treatments available. If your first choice doesn't work out, try another. Don't let diabetes rob you of one of the most important connections that you can have with a loved one.
Men's Diabetes-Related Sexual Issues
Here are some of these treatments for erectile dysfunction (ED):
• Improved blood sugar control – This will help prevent problems from occurring and can improve them once they develop.
• Blood pressure control – You need to keep the blood vessels in this region of the body as healthy as possible. If your blood pressure is not at a normal level, it may be more difficult for you to achieve and maintain an erection.
• Blood lipid (fats) and cholesterol control – It helps to keep blood vessels clear, so adequate blood flow can reach the penis.
• Regular physical activity – Exercise helps improve circulation, reduces blood pressure, increases energy, improves the body's sensitivity to insulin, heightens feelings of well being, and improves blood sugar control.
• Counseling, with or without a partner – Some cases of ED occur because of emotional problems or stress. If you aren't attracted to your partner, are angry, or feel dissatisfied with the relationship, counseling may help put things back into a healthy perspective.
• Vacuum pumps, constriction rings, and penile support sleeves – These tools work, but you must learn to use them properly. If you have any questions about how to use one of these items, ask your health-care provider to refer you to someone who can teach you the correct way to use it.
• Oral agents, such as Viagra, Levitra, and Cialis – These pills are frequently offered as a first option. They work for many men, but not all. If you don't get the results that you expect, contact your physician.
• Penile suppositories and injections – Many men find these extremely helpful. The injections may sound gruesome, but they work quite well.
• Surgical treatments, such as semi-rigid and inflatable penile implants – These work also, but must be surgically implanted and should only be considered after all other options have failed.
Women's Diabetes-Related Sexual Issues
Few women realize that diabetes can affect their ability to have a meaningful sexual experience. Poor diabetes control can cause mood swings, decreased interest in being sexual, vaginal dryness, decreased sensitivity, problems with achieving orgasm, and yeast and urinary tract infections. Many of the women's treatments for diabetes-related sexual issues are similar to the men's. They include:
• Improved blood sugar control
• Blood pressure control
• Blood lipid (fats) and cholesterol control
• Physical activity, which improves circulation, reduces blood pressure, helps increase energy, improves the body's sensitivity to insulin, heightens feelings of well being, and can improve blood sugar control
• Counseling, with or without a partner
• Vaginal lubricants, such as K-Y, Replens, and Astroglide to help increase vaginal lubrication and reduce pain during intercourse
• Vibrating tools to help encourage lubrication and orgasm. This can help if you have reduced sensitivity in the vaginal area
• Masturbation to help encourage lubrication and orgasm
• Counseling to help learn ways to achieve orgasm and handle feelings of depression and loss of self-esteem
If you have a urinary or vaginal infection, it can interfere with your intimate life also. Diabetes can cause them to develop, and abnormal blood sugar level will make them occur more frequently. Symptoms of a yeast infection include vaginal itching, irritated skin in the genital area, pain while urinating, burning or pain in the genital area during intercourse, and an odorless, white vaginal discharge that resembles cottage cheese. Symptoms of a urinary tract infection include pain or burning when you urinate, a frequent urge to urinate small amounts, cloudy or foul-smelling urine, pain on the side of your back under your ribcage, fever chills, nausea, vomiting, and a feeling of tenderness in your lower abdomen.
Speak with your physician or gynecologist if you have any of the symptoms listed above. There are several over-the-counter medications that you can use to treat vaginal infections, but you should first confirm that this is what you have. To help prevent these conditions from developing, keep your blood sugar level in a normal range, wear cotton underwear, eat low-fat yogurt that contains active cultures, drink plenty of water, drink artificially sweetened cranberry juice, bathe regularly, wipe the genital area from front to back after going to the bathroom (to avoid introducing new bacteria into the vaginal area), and only participate in intimate activities with a partner who has recently bathed.
Most people are uncomfortable discussing intimate issues. If you feel that way, you are not alone. Don't let your discomfort prevent you from receiving help. Speak with a health-care provider whom you trust and believe will be sensitive to your needs, and discuss with your partner what might enhance your experience together.
Last Modified Date: August 07, 2013
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Gone are the days of repelling Mission Impossible-like from the hospital ceiling to retrieve Charlie's medical files before the CDE entered our exam room. It's not that I don't care anymore about his A1c. Of course I care. Maybe in the past I was more consumed by it. For a very long time I so desperately wanted to see an A1c below 8. Now that we've been comfortably in the low to mid-7s for the last couple of years, there's just an expectation. It's become a little anticlimactic....
dLife's Sex & Intimacy Content is contributed & moderated by
Janis Roszler MSFT, RD, CDE, LDN
Janis Roszler, MSFT, RD, CDE, LD/N is the American Association of Diabetes Educators' 2008-2009 Diabetes Educator of the Year. She is a certified diabetes educator, marriage and family therapist, and registered dietitian. Her books include Sex and Diabetes (ADA) Diabetes on your OWN Terms (Marlowe & Co) and The Secrets of Living and Loving with Diabetes (Surrey books).
Donna Rice MSW, BSN, RN, CDE
Donna Rice MBA,RN,CDE,FAADE is the 2007 Past President of the American Association of Diabetes Educators. She is a registered nurse, diabetes educator and has developed numerous educational programs on sexual health and wellness. She is the co-author of Sex and Diabetes (ADA) and Diabetes and Erectile Dysfunction - A Quick ‘n' Easy Handbook For the Diabetes Educator (Bella Vita). Her newest publication is a children's book, The Magic is Me (Searchlight Press).