Diabetes and Female Sexual Dysfunction

You don’t hear people talk a lot about diabetes and sexual dysfunction in women. Yet sexual dysfunction is a concern to many diabetic women. Diabetes is an all-encompassing disease and can by an underlying cause of the dysfunction. However, sexual dysfunction may also be an indication of diabetes that has not yet been diagnosed.

Sexual Dysfunction: Typology

Essentially, diabetes can affect your sex life and sex drive on two different levels: emotionally or psychologically and physically. For women, this is a difficult complication of diabetes because it forces a woman to deal with a chronic disease and a feeling of sexual inadequacy at the same time. While diabetes may not be the only issue causing sexual dysfunctional, if you are diabetic it will most likely play a contributing role.

Factors Affecting Sexual Dysfunction

Research indicates that diabetes plays a different role in sexual dysfunction for women than for men. Moreover, the determinants vary for woman in accordance with their type of diabetes. While both type 2 (T2D) and type 1 (T1D) diabetic women are influenced by psychological factors in both normal and dysfunctional sex, other determinants may also have an impact. [1] Determinants affecting sexual dysfunction for T2D women include:

  • Age – this is still a matter of debate in some studies
  • Length of time with diabetes – This is also questionable since, according to some studies, there is not a measurable difference between women who have (unspecified type) diabetes and those who do not
  • Vascular complications
  • Menopause

However, in the case of T2D, the major factors influencing sexual dysfunction are psychological are physiologic according to the studies.

Physical Affects and Possible Treatments

Women who have diabetes do report more instances of sexual dysfunction than those who do not have the disease. One primary symptom is decreased lubrication as a response to sexual arousal.[2]

  • Sexual Arousal – Vaginal secretions are essential if intercourse is not to be painful. In this process the autonomic nervous system plays a part. If it is affected by a diabetic neuropathy there may not be secretions, no matter the degree of arousal. You can decrease this problem with a vaginal lubrication jelly.

Related to sexual arousal is sensation in the region of the vulva and vagina. If there is neuropathy of the peripheral nerves that are distributors to the perineal area, sexual arousal too may be decreased or altered to unpleasant sensations instead of pleasure.[3]

A skilled gynecologist may be able to locate the physical cause or issue during an examination. The doctor, however, will need to take care that the problem is not related to another medical issue separate from the diabetic condition.

  • Infection is another potential cause of sexual dysfunction in women. Urinary tract infections (UTI) are often linked to poor management of diabetes. In addition, vaginal yeast infections are quite common.[4] They do occur with greater frequency among diabetic females who do not control their diabetes. This is because the normal vaginal secretions contain more glucose. Yeast absolutely thrives on glucose. The result – increased yeast infections.
  • Menses – Menstruation normally causes an increase in blood glucose levels. This is simply the response to the release of hormones. It can be controlled by slightly increasing the amount of insulin during this period (pun intended). During your menstruation cycle, you will also need to be aware of insulin levels if you generally suffer pre-menstrual stress. This, too, may require adjusting your insulin dosage to address specific needs.

While physical issues may interfere with sexual pleasure, they do not need to. Talk to your doctor frankly about any problems that may occur. He or she can advise you when it comes to the physical aspects causing sexual dysfunction. You may have to consult someone else if the basis of the problem lies in emotional and/or psychological issues.

Emotional Affects resulting in Sexual Dysfunction

Research indicates the prominence emotional and psychological factors play in sexual dysfunction among diabetic women. The result can be a decrease in the overall quality of the relationships between sexual partners. The most common, or at least most frequently reported, factors include[5]:

  • Depression –  a significant predictor for sexual dysfunction in both women with diabetes and control subjects
  • Lack of feeling sexual – There were significant differences in diabetes-related psychological factors between those with and without sexual problems.
  • Negative feeling about their diabetes – Research indicates that diabetic women experiencing sexual dysfunction were more negative about their diabetes, had difficulty adjusting emotionally to it, were not happy with treatment and felt treatment had a huge impact on their daily life.
  • Thinks a partner does not find you attractive – this may sometimes be the response of a painful sexual encounter
  • Feeling unattractive – due to having diabetes
  • Fear something will happen during the act – This is a viable fear. It can, however, be taken care of by reconsidering the dosage and type of insulin you may require if you plan a particularly active bout of physical activity in bed.

Some of these issues may require you talk to someone skilled in this field. Others may resolve themselves over time. It is not, however, a good idea to allow your perceived problems to interfere with your relationships without at least seeking help.

Issues: Birth control medication

When it comes to sex – functional or dysfunctional – it is important to consider various issues connected to diabetes. Birth control is one such issue. Does taking the pill have a negative effect upon your body? Can it cause some form of sexual dysfunction? Is it harmful? Are there risks in using birth control pills with your diabetic medication? Are the risks imposed by contraception hormones worse for diabetics?

The American Diabetes Association recommends that there be no distinction between diabetic women and non-diabetic women when it comes to contraception. The most reliable method of contraception for each patient should be used regardless of their status as diabetics.

Issues: Menopause

If you are going through menopause, you should discuss the possibility of taking sex hormone replacement therapy. There has been significant controversy over the past few years regarding these supplements and the risks and benefits should be completely discussed with your doctor. Of note, hormonal swings during this stage of life can affect insulin requirements.

Conclusion

Women with diabetes do suffer sexual dysfunction, which can affect the overall quality of life. For this reason alone, more research needs to be done to look at the causes, issues and remedies or therapies available. Women also need to be more vocal when talking to their physicians, psychologists, friends and lovers about the issues involved.

References

[1] Esposito, K; Maiorino, MI; Bellastella, G; Giugliano, F; Romano, M and Giugliano, D (2010). “Determinants of Female Sexual Dysfunction in Type 2 Diabetes.” International Journal of Impotence Research, 22: 179–184.

[2] Enzlin, P; Mathieu, C; Van den Bruel, A; Bosteels, J; Vanderschueren, D; and Demyttenaere, K (2002). “Sexual Dysfunction in Women with Type 1 Diabetes A Controlled Study.” Diabetes Care, 25 (4): 672-677.

[3] American Diabetes Association (2009). Type 2 Diabetes. Your Healthy Living Guide. Alexandria, VA: ADA.

[4] Stanley, K (2009). 50 Things You Need To Know About Diabetes. Alexandria, VA: ADA.

[5] Enzlin et al (2002). Op. cit.

[6] This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.