*Womens Sexual Health*

Sexuality and Diabetes

Having type 1 or type 2 diabetes can affect a woman's sexual experience both physically and emotionally. A woman's level of interest as well as her sexual functioning can be affected. Physical problems related to diabetes can affect a woman's enjoyment of sex. Most of these problems can be resolved. They do not need to have a long-term impact on a woman's sexual activities. They usually resolve with improved control of blood glucose.

The effect of diabetes on women's sexual health is more subtle than the erectile difficulties sometimes experienced by men. Your sexual health is important to your overall health. Discuss these concerns with your doctor. Talking with your partner and physician is the first step towards finding a solution. Here are some of the specific issues affecting the sexual experience of a woman with diabetes.

Infections

Vaginal infections or urinary tract infections are more common in women with diabetes, especially when blood glucose is generally high. Vaginal infections, for example yeast infections, can lead to itching, unusual discharge and pain during intercourse, but they are responsive to treatment. A urinary tract infection can lead to cloudy or bloody urine, a burning sensation and/or a constant feeling that you need to urinate. This problem should be addressed immediately to decrease the chance of subsequent kidney infection. Your physician will prescribe an antibiotic. Until the urinary tract infection has cleared, it is best to avoid sexual intercourse.


High Blood Glucose

Persistently high blood glucose can affect a woman's energy level and lead to significant fatigue. This in turn may decrease interest in sex. Achieving an acceptable blood glucose level can improve mood and libido.


Reduced Vaginal Lubrication

A complication of diabetes called neuropathy (nerve damage) can reduce vaginal lubrication in some women.
A decrease or loss of vaginal lubrication can make a woman uncomfortable during sexual intercourse and limit her pleasure. A decrease in, or lack of, lubrication can occur for many other reasons such as menopause, the use of birth control pills and stress. Water-based lubricants are effective in improving dryness and sensitivity to touch. For severe dryness, a vaginal suppository can be used. Learning how to relax the muscles around the vagina using contraction and relaxation exercises, or trying different positions can help decrease pain during intercourse.

During and after menopause, hormone replacement therapy may help improve sexual desire, vaginal elasticity and lubrication. Topical hormonal creams or an estrogen ring, which can be inserted into the vagina, are also available to treat these problems.



Fear of Pregnancy

Fear of pregnancy can affect responsiveness. A reliable method of contraception can remove this fear.


Heart or Kidney Disease

Heart or kidney disease can affect energy levels and increase anxiety regarding what effect sex may have on health. The intrusion of diabetes on this aspect of a woman's life can be frustrating and upsetting for both the woman and her partner. It becomes very important to communicate these fears or concerns and discuss what works and what does not work for you.


Fear of Hypoglycemia (low blood glucose)

Women who take insulin or pills for diabetes often fear that sexual activity may lead to low blood glucose (hypoglycemia). Your body uses extra energy during sexual activity. Testing your blood glucose prior to intercourse and having some extra carbohydrate either before or just afterwards can help prevent low blood glucose from interfering with your sexual enjoyment.