Female Sexual Dysfunction

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How Diabetes Affects Sexual Health

Both uncontrolled blood glucose levels and diabetes-related complications can play havoc with a woman’s sexual desire and performance. Here are some common ways diabetes can affect sexual health:

• Infections and irritation. Chronic high blood sugars promote yeast infections and vaginal irritation.
   
• Low blood flow. Vascular damage caused by poorly-controlled diabetes restricts the blood flow to the vagina, which causes vaginal dryness and interferes with arousal.
   
• Medication. Certain drugs, such as antidepressants, birth control pills, tranquilizers, and high blood pressure medication can cause decreased libido as a side-effect.
   
• Menopause. "The change" and its effects on the body may cause a serious change in your sex life.
   
• Nerve damage. Women who have neuropathy to the genital area, the reproductive organs, or the vagina may have difficulty achieving orgasm.
   
• Neurogenic bladder. Women with nerve damage to the bladder may have incontinence problems that make sex difficult and/or embarrassing. It can also make urinary tract infections (UTIs) more common, which may make sex uncomfortable.
   
• Vaginismus. Some women experience vaginismus, a tightening of the vaginal walls which can make penetration painful or impossible.

Many women find that their blood glucose levels are affected by their menstrual cycle. Tracking glucose levels in tandem with your cycle can help you understand if hormones are having an impact on your diabetes control. Discuss the results with your doctor. Adjustments in medication, insulin, exercise, and diet may be necessary to bring your glucose levels back to normal during this time.

Mind over Mattress

Depression and anxiety, particularly in newly diagnosed women who are just learning about diabetes management, can interfere with sexual desire. So can the mechanics of treatment (wearing a pump, for example, or the need to do a blood sugar check before sex) insofar as they may make some women self-conscious with their partners and less likely to initiate or participate in sex.

If your lack of libido stems from diabetes-related depression or anxiety, therapy and/or medication can help. Make sure you talk to your doctor about the possible sexual side effects of any antidepressant they may prescribe. Wellbutrin, a newer antidepressant drug, has a lower risk of sexual side effects and may be preferred in depressed women with decreased sex drive.

Your RX for Better Sex

The best way to avoid diabetes-related sexual dysfunction is to manage your disease well and keep blood glucose levels in control, which will lessen your risk for neuropathy, circulatory problems, and chronic infections.

Women with good diabetes management habits also have higher energy levels and less anxiety, which also contribute to more enjoyable love making. If your blood glucose levels aren't where they should be, adjustments to your diet, medication, and weight loss is beneficial for both diabetes control and self-esteem.

Women experiencing vaginal dryness should consult with their doctor and/or gynecologist to see if low estrogen levels are the cause. Hormone replacement therapy (HRT) can reverse this problem in some women; however, the safety of HRT is currently a matter of some controversy, so discuss the issue with your doctor. You should also realize that estrogen may elevate blood glucose levels in some women. If vaginal dryness is diabetes related, over-the-counter lubricants may be a safer choice. Check with your doctor before considering these medications.

SOURCE:

NIDDK. Sexual and Urologic Problems of Diabetes. http://diabetes.niddk.nih.gov/dm/pubs/sup/index.aspx. (Accessed 6/29/11).

Reviewed by Francine Kaufman, MD. 4/08