How does diabetes affect my sex life?

Diabetes, or sugar imbalance, can affect the sexual function of both men and women. People with diabetes tend to have problems with sexual function earlier in life than people who do not have the disease. How much diabetes affects sexual function may depend on how severe the disease is and how old you are when the disease began. In general, men and women with diabetes are more likely to have episodes of decreased interest in sex. This is especially common when the diabetes is not under good control.

Sexual changes are often more subtle in women with diabetes. Diabetes can lead to changes in the architecture of the blood vessels in the vaginal wall, leading to decreased blood flow. This may cause the vagina to be drier than normal, and it may also change the balance between the good and bad bacteria in the vagina, which may lead to repeat genital infections or yeast infections.

How much diabetes affects sexual function may depend on how severe the disease is and how old you are when the disease began.

Women with uncontrolled diabetes may also experience recurrent yeast infections and, as a result, may experience vaginal pain and discomfort. Pain during intercourse is not infrequent. You may also notice that you are not as easily aroused or that it takes longer to become lubricated and wet. Sometimes medications that you take to control your diabetes can also influence your sexual response cycle, so it is also advisable to seek medical professional care to reassess your medications and see whether they may be contributing to your sexual dysfunction.

Some women with diabetes complain of less sensitivity and less pleasure from touching or stroking during lovemaking. Other women complain of lowered libido, diminished sexual interest, and orgasmic dysfunction. In the author's clinical practice, sexual enhancers, as discussed later in this book, may be helpful if you have difficulty having or achieving an orgasm.

Women and men who suffer from diabetes may also experience changes in mood, exhaustion resulting from constant diabetes management, weight gain, guilt over their disease, or even anger about their partner's disease. Your healthcare provider should address all of these other issues as well because they can influence your interest in sexual activity.

Regulation of sugar levels (blood glucose) to within the normal limits is essential to overall health and sexual wellness. Often, the better controlled and treated your diabetes is, the less severe your sexual problems are. An excellent resource is a DVD titled Sex Intimacy and Diabetes, a 3-minute informative documentary about intimacy and diabetes; you can obtain this DVD from the Public Health Foundation Learning Resource Center at or 1-877-252-1200.

Does fibromyalgia affect my intimate relationships?

According to the National Fibromyalgia Association, women with fibromyalgia often have serious concerns about sexuality and how the disease affects their intimate lives. If you have fibromyalgia, sometimes you might feel too fatigued or in too much pain to seriously think about sexual activity. Sometimes your pain medications can affect sexual interest or libido. Sometimes your energy level dwindles. Often the disease can take over and affect communication between you and your partner as well. Depression and low mood may also confound the situation.

Despite the pain, exhaustion, and side effects from medications, many women with fibromyalgia can enjoy vibrant sexuality. According to Marlie Emmal, author of Fibromyalgia and Female Sexuality, sexual activity may actually be good for fibromyalgia pain: "Sexual activity releases natural hormones in the brain and changes hormones in the bloodstream that may affect and decrease pain levels." Carolyn Dodge Adams, the vice president of patient services for the Arthritis Foundation, Southern California Chapter, recommends setting a date with your partner. Try to balance your energy, balance your fatigue, and prepare yourself emotionally. Some women with fibromyalgia can be extra sensitive even to a gentle touch on the skin so that it is uncomfortable; if this is so, it is important to communicate this to your partner.

Warm baths or warming massage oils may be helpful to reduce muscle tension and strain. Massage or physical therapy can elicit relaxation and heighten sexuality. Do not let your muscle pain and fatigue get the better of your intimate life with your partner. Try creative solutions and consult a specialist in sexuality and chronic medical disease.

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