Sex and blood sugar

Sex isn’t just physical; you also need to take into consideration the psychological components of sex. The mere suggestion or warnings about erectile dysfunction when you are living with diabetes can cause difficulties in arousal. Living with diabetes your body can go through many changes such as weight gain or loss, scarring from insulin injections, and amputations. For insulin pump users, navigating sex with something constantly attached to you can be a challenge at first. The body image issues that can stem from diabetes complications can have a very real impact on your self-perception and confidence during sex and other moments of intimacy. The first step towards regaining your sexual confidence if you are feeling it lacking is to accept and love yourself for the way you are. Sounds a bit corny, but it’s true. Speaking with your partner about how you are feeling about sexual complications and body image issues is the next step; secrecy and shame about your sex life or your body will only create more diversions in bed. Remember that intimacy with your partner does not just mean sex; foster the emotional aspects of your relationship as well.

Keeping track of your blood sugars and communicating are key to improving sexual health and intimacy. And yes, that is your Dario in your pocket! Monitoring your blood sugars with Dario and keeping track of their changes can help you stay healthy and feel sexy. If you are experiencing symptoms of sexual dysfunction, speak with your doctor to discuss your options. Start an open dialogue with your partner about how you can increase the intimacy in your relationship. And since we started off on a musical note, to quote Justin Timberlake, you can “bring your sexy back!”

NIH Publication (2008). Sexual and Urologic Problems of Diabetes. NIH Publication No. 09-5135

Castleman, M. (2013) The Real Truth About Sex and Diabetes. Psychology Today (Online).

Spero, David. (2008) Partners speak out about sex. Blog Diabetes Self-Management. (Online)

Many women with diabetes experience sexual difficulties. If not properly controlled, high blood sugar can damage nerves and blood vessels, including those needed for good sexual function. It can also inhibit blood flow to the genitals, which heightens sensation and triggers lubrication.

Here are some of the more common issues diabetic women might face:

• Low desire and arousal. A woman’s brain is an important part of her sexuality. When she is sexually stimulated, her brain sends messages to her genitals to start getting ready for sex.

But sometimes, nerve damage from diabetes can interfere with the way these signals are transmitted. Consequently, a woman might lose interest in sex. She might not feel the pleasurable sensations. Or her body may not prepare for it sufficiently.

• Vaginal dryness. Typically, the vagina becomes wet when a woman is sexually aroused. However, high blood sugar can interfere with lubrication, leaving the vagina dry and tight. As a result, intercourse can become quite uncomfortable.

Some women find that an over-the-counter lubricant relieves dryness. ( to learn more about the different types of lubricants.) Estrogen therapy is another option.

• Yeast infections and urinary tract infections. High blood sugar can leave diabetic women more prone to these infections, which irritate vaginal tissue.

• Orgasm difficulties. Proper nerve signaling and genital blood flow are both necessary for sensation and orgasm.

• Depression and anxiety. Diabetes can be stressful. Managing medications, following diets, and testing blood sugar can take their toll after a while. With stress at the forefront of her mind, a woman may have trouble relaxing and enjoying intimacy.

What can diabetic women do? The first step is seeing a doctor. While diabetes can impact a woman’s sex life, other factors can, too. For example, menopause, medications, and relationship problems can all contribute to sexual problems. A complete physical may reveal other conditions that need attention.

Keeping blood sugar under control is critical, for sexual health and overall health. Women should monitor their blood sugar, follow their diets, and take medications and insulin exactly as the doctor prescribes. Regular checkups are important in case any adjustments need to be made.

Some women benefit from seeing a counselor or sex therapist as well. Sometimes, the stress of managing diabetes is overwhelming. A therapist can help a woman (and her partner) work through that stress and related anxiety.

Dear Diabetes Health,

Both my husband and I are over 60 and have type 2 diabetes. He lost interest in sex a few years back, I think because he couldn’t get erections. I don’t really miss sex. It wasn’t that great for me, anyway. But I’ve been reading that sex is good for your health and that it prevents heart attacks. Is this really true? Does sex help diabetes? Should we try to be sexual because it’s good for us?

Elaine in Alabama
Dear Elaine,

Most of the studies saying that “sex prevents heart attacks” or things like that are “population studies,” sometimes called epidemiological studies. For example, scientists at the New England Research Institute in Massachusetts tracked the sexual activity of about 1000 men ages 40 to 70. They found that those who had sex twice a week had only half the risk of heart attack, compared to men who had less sex.

In another study, scientists at Wilkes University in Pennsylvania tested the saliva of 112 college students who reported their frequency of sex. Those having sex two to three times a week had higher levels of IgA, an immune molecule that fights infection, than those who were abstinent or had sex less than once week.

Writing on Web MD, health journalist Kathleen Doheny described a study in the journal Biological Psychology, wherein researchers reported that couples who lived together and had frequent sex tended to have lower diastolic blood pressure.

Population studies prove nothing about cause, though. Did men have fewer heart attacks because they were having more sex, or were they having more sex because they were healthier? Maybe having stronger immune systems led the Pennsylvania students to have more sex, rather than the other way around. These studies are not strong evidence that sex improves health.

Different kinds of studies provide stronger evidence. If you look at what happens in people’s blood while having sex or after orgasm, you can see changes that may well provide health benefits. Sex and orgasms both raise the level of oxytocin, the “bonding hormone.” Oxytocin lowers blood pressure and reduces levels of the stress hormone cortisol. Oxytocin and endorphins (which also increase after sex) help relieve pain and promote sleep. Several studies have shown that even moderate sleep deprivation increases insulin resistance. So a good night’s sleep will likely help your glucose control.

In his blog “Conquering Diabetes,” Michael Dansiger, MD, wrote, “Healthy sleep habits are very important for diabetes management–and sex and sleep are closely related. Sex releases hormones that help promote sleep (especially in men), and sleep promotes hormones that favor good blood sugar control and appetite control. By the same token, inadequate sleep quality or quantity promotes hormones that worsen blood sugar control, appetite, weight gain, diabetes, and heart disease.”

Sex is also a mild form of exercise, although you would need a lot of it to see any effect. The strongest sex/health connections are with better sleep and the stress-reducing effects of oxytocin.

What’s the Downside?

Are there health risks to sex in a loving relationship? If there are, they don’t seem significant. According to the physicians’ education website “UptoDate,” sex may increase the risk of heart attack by as much as one percent in men with existing cardiac problems. But probably even this tiny increase is due more to anxiety than to the physical activity. A Japanese report found that most men who died during sex were cheating on their wives at the time.

Likewise, a population study from Wales found that frequency of sex was not associated with stroke in the 914 men they followed for 20 years. Sex seemed somewhat protective against death from heart attack in this group. So relaxed sex appears to be safe. Stressful sex may not be.

Because good sex is healthy, but bad sex not so much, if neither you nor your partner wants sex, it’s probably not worth it. You’ll definitely want to get lots of hugs and touching, though, and it doesn’t all have to come from your husband. You might give more hugs to other family members and friends. Most human contact seems to promote oxytocin. You also can get some of the oxytocin benefit from pets, by petting a cat or a dog, for example.

And we wouldn’t give up on sex prematurely. Sex does not have to mean intercourse, and erectile dysfunction does not have to mean “no sex.” In fact, since intercourse “wasn’t that great” for you before, you might be able to have better sex if you try some new things. You can share touch and closeness, which can include intense pleasure and orgasm, without intercourse, or even without genital contact of any kind.

Even without the direct health benefits, sex can strengthen your relationship. Oxytocin binds mothers to infants, and it seems to have similar affects on sexual partners. You don’t necessarily need to go all the way to get some of the benefits. “Oxytocin is like a hormone of attachment,” said Carol Rinkleib Ellison, former assistant clinical psychiatry professor at the University of California, San Francisco. “It creates feelings of calm and closeness.”

You and your husband need to talk about what you want as far as physical contact and sex. Though it may be difficult to start the conversation, you’ll probably both feel relieved once you do. Don’t be critical, though. Just say what you really feel. Remember, words can never hurt you if they’re said with love. But not saying what you feel can damage lives and relationships. Bottom line: sex is good for you, but only if you want it.

Birth Control, Pregnancy & STDs

Can I Get Diabetes From Having Sex?

Can I get diabetes from my boyfriend if I have sex with him?
– Katharine*

No, you can’t. It’s impossible to get diabetes from another person. Diabetes is a disease that develops inside the body in some people who have the genes for it. Scientists haven’t yet pinpointed exactly what causes diabetes, but they do know it’s not contagious. You can’t “catch” it like you might a cold or mono.

You can’t get diabetes from having sex, but you can get lots of other diseases or infections — like hepatitis, herpes, or HIV (the virus that causes AIDS). The only way to completely avoid sexually transmitted diseases (STDs) is abstinence.

If you and your boyfriend decide to have sex, protect yourselves from STDs and unintended pregnancy by using a condom every time you have oral, anal, or vaginal sex.

People with diabetes might feel “different” because they often need to give themselves shots, test blood sugar, or do other things that make it obvious they have a disease. Everyone handles things in their own way: Some people don’t want anyone to make a fuss or ask questions. Others want to feel understood and supported — especially by the people they feel closest to. Finding out how your boyfriend wants to be treated and respecting his wishes is a great way to show you care.

Reviewed by: Steven Dowshen, MD
Date reviewed: November 2013

*Names have been changed to protect user privacy.

People with diabetes may also experience diabetic neuropathy, or peripheral nerve problems, which can cause numbness, pain, or lack of feeling in the genitals. This can prevent orgasm or make sex painful and unenjoyable. For women, this also often means vaginal dryness or difficulty reaching orgasm. Diabetic women also have increased rates of vaginal infections, inflammation, and urinary tract infections. Vaginal dryness can be easily remedied with lubricant (just make sure it’s sugar free!), or with prescription estrogen. Trouble orgasming also can be due to antidepressants or medications. Women should also pay special attention to vaginal pH levels, as increased blood glucose can throw those levels out of whack.

Let’s Get It On

First, set the scene. Remember that, while sex is important, so is your relationship. There are plenty of ways to attend to your relationship and share intimacy without sex, such as a date night, a bath, or massages. If you feel that diabetes and its care have overtaken parts of your relationship, suggest a date night where diabetes-talk is off limits. Maybe you’ll even get lucky later.

If low energy is a problem, try having sex at times when your energy is peak, as opposed to the evening after a long day. Also, the vascular changes and nerve damage caused by diabetes can mean that what used to stimulate you may not work any more. All this means is that you shouldn’t be afraid to experiment. If you experience neuropathy, or reduced sensation in certain areas, sex toys like vibrators may help. It’s been found that using a vibrator on areas with reduced feeling for a few minutes per day can actually restore stimulation in both men and women.

Pour Some Sugar On Me

Much like with exercise, sex will lower your blood sugar levels – and nothing says “romance” quite like a hypoglycemic episode, right? No, so make sure you check your blood glucose levels before sex and be prepared to treat low blood sugar, if needed, with snacks (strawberries? cream?). Make sure that your partner is aware of how you are managing your diabetes.

Sexual Healing

If your diabetes is brought under control, sexual issues often resolve themselves. Not only can exercise reduce symptoms associated with diabetes, but it also can invigorate your sex life by strengthening your heart, improving flexibility and stamina, and increasing blood flow to those all-important areas.

I Will Always Love You

Remember that regardless of your diagnosis, you want your partner – and all the people in your life – to love you for who you are. So don’t be afraid to start a conversation about your diabetes, whether it be with a new potential partner or someone you’ve loved for years.

Now go out there and get it on.

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