Disorders of Aging: September 2020

The Link Between Diabetes and Sexual Dysfunction

Here’s what you need to know to get your sex life back on track

July 29, 2020 (Cleveland Clinic) – In the famous words of George Michael, “Sex is natural, sex is good.” Of course, we know the obvious — when the mood is right and the chemistry is there, sex can be mind-blowingly awesome.

From lowering blood pressure to even helping ease stress and anxiety, sex offers quite a few health-related benefits. But if you’re one of the 300+ million Americans living with Type 2 diabetes, sex might not be that spectacular to you.

Endocrinologist Shirisha Avadhanula, MD, explains how diabetes could impact your desire or ability to enjoy sex. And she offers suggestions to help you get back to having fun in the bedroom.

The sexual side effects of diabetes

“Sexual dysfunction includes any problems that happen within the sexual response cycle,” says Avadhanula. “Everything from attaining an erection to reduced libido can be an issue for people living with diabetes.”

Avadhanula says that while most of the studies focus on sexual dysfunction in men with diabetes, the disease affects women as well. “With both genders, the longer you have diabetes, the more likely you are to experience sexual dysfunction in some way,” she says.

If you have diabetes, plus any of these symptoms, there may be a connection:

  • Lessened (or nonexistent) libido: Do you feign headaches more often than not to get out of sex?
  • Arousal inability: Does it no longer get up the way it used to? Or, have you stocked up on lubricant because you go through it so quickly?
  • Decreased sensation: Are you going through the motions without the promise of an orgasm?
  • Intercourse-related pain: Do you avoid sex because it just plain hurts?
  • Infections: Have you routinely experienced vaginitis or urinary tract infections?

Diabetes increases the risk of sexual dysfunction

There are several reasons people with diabetes experience sexual dysfunction more often than the general public.

Obesityhigh blood pressuresleep apnea and depression are common conditions that occur alongside diabetes,” says Avadhanula. “Obesity can indirectly lead to erectile dysfunction (ED). Sleep apnea can cause ED for men or put women at a higher risk for sexual difficulties. Depression and anxiety can also negatively impact the libido or lead to the use of medication that affects sexual interest or function.”

Emotional health concerns

Men and women who wear an insulin pump may feel self-conscious. Plus, the time and energy spent managing diabetes and related conditions can take a toll on emotional health. This may lead to disinterest in sex or the use of a medication that negatively affects sexual function.

Hormonal changes

“Changes in testosterone or estrogen (because of diabetes, menopause or co-occurring conditions) can impact libido, lubrication and the ability to become sexually aroused,” says Avadhanula.

Less blood flow

Diabetes impacts blood flow, which could affect blood reaching the penis or vagina. For a man to achieve and sustain an erection, he needs blood to flow to the penis. In women, decreased blood flow could play a role in vaginal dryness.

Medication side effects

“High blood pressure medications may impact the ability to achieve or maintain an erection,” says Avadhanula. “And some medications which  help manage depression or anxiety are notorious for inhibiting arousal or sexual interest.”

Nerve damage

Having high levels of glucose can damage nerves. The tip of the penis and clitoris are loaded with nerves. If those nerves become damaged, the result might be decreased sexual sensation or even painful intercourse.

Diabetes doesn’t have to ruin your sex life

“The reasons for sexual dysfunction are different for each person. It’s the role of your provider to tease things out to get to the bottom of what’s causing the concerns,” says Avadhanula. “But some people go years without saying anything to their doctor.”

According to Avadhanula, approximately 80% of patients reported they prefer if a doctor asks about sexual function, so they don’t have to bring it up. “If your provider doesn’t ask about your sex life, bring up any concerns because sex is an important component of a high-quality life.”

Avadhanula says providers will ask a series of questions to determine the cause of the sexual dysfunction. Your provider will also perform a physical exam. This approach helps your doctor determine what the cause could be and how to treat it.

“There are treatment options for both men and women,” says Avadhanula. “You may not see instant success but keep talking with your care team to move to the next option. There is hope that you can resume an active, enjoyable sex life.”

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