Women, Sex, and Diabetes

It is well known that men with diabetes are at risk of erectile dysfunction (ED).  We are now learning that it is not only diabetic men that are at risk of sexual challenges - a new research study reveals that women with diabetes can struggle with several aspects of sexual function too.

The study, which was done in California, administered questionnaires to well over 2,000 women aged 40-80, asking questions about sexual function.  They found that:

• women with diabetes were more likely to report low sexual satisfaction;
• insulin treated diabetic women were more likely to have problems with lubrication and orgasm than women without diabetes.
• women with serious complications of their diabetes (eg heart disease, kidney complications, stroke) reported less sexual satisfaction and activity than diabetic women without these complications.

So what is the link between diabetes and lower sexual health?  Just like for men, several possibilities exist, including:

• blood flow to the genital organs may be impaired (in the same way that blood supply to other organs can be damaged over time, especially if blood sugar control is poor);
• the nerve supply can be damaged over time (just like nerves to the feet can be affected, again, especially if blood sugar control is poor over the long term);
• some medications can affect sexual function;
• sex drive can be decreased if a person is not well because of their diabetes, or diabetes-related complications.  

A note on the finding that insulin treated women had more problems with lubrication and orgasm -  this probably reflects the fact that the women using insulin had more advanced complications of their diabetes (eg nerve damage), and should NOT be interpreted to mean that insulin itself decreases sexual satisfaction.  That being said, if a woman on insulin is having frequent problems with low blood sugars, this could certain dampen the sex drive - the solution here would be to adjust the insulin dosing with the help of health care providers so that the lows are no longer occurring.   The psychological issues that are sometimes associated with starting insulin could have an effect on the libido as well, which can certainly take time to work through - I want to emphasize that the solution is not to stop the insulin, as not taking insulin when it's required can have truly devastating effects on health.   I always encourage my patients to think of starting insulin in a positive light, as it provides the opportunity to get good control of diabetes!


BOTTOM LINES:

1.  Diabetic women are at risk of having sexual health issues - both patients and health care providers need to ask about it, and talk about it.

2.  Preserving sexual health is one more important reason to have good control of blood sugars, as poor control increases the risk of damage to nerves and blood vessels that are important for good sexual function.

Dr Sue Pedersen www.drsue.ca © 2012 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen

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