All of us know that diabetic patients are told to refrain from sugar because of their condition, but did you know that diabetes can affect your sex life as well? Are diabetes and sex connected?
We know that you are too embarrassed to discuss it with your doctor, yet you are hoping every day that your situation will improve. However, with time, there is no progress and eventually, you give up on sex. This not only starts affecting your physical health but you and your spouse start drifting apart.
As per a study published in the journal Diabetes Care, only 50% of the men and 19% of women with diabetes discuss their sexual problems with their physicians.
What was even alarming is the fact that even doctors are not comfortable in prodding their patients about details of their sexual lives. This is the reason diabetic patients know how the diabetes is going to affect their eyes, nerves, kidney and feet but never about its effects on sex life.
All the diabetics out there, you should know that diabetes is not transmitted through sex and having regular sex can have a positive impact on your overall health and wellness.
It is extremely important that people remain open and honest about issues arising in their sexual lives. If there is any problem with the sexual function of the body, it might also indicate other underlying health problems. For instance, many men who suffer from erectile dysfunction, often discover later that they have diabetes. On the other hand, diabetic person facing problems in his sexual life can be due to nerve damage, hormonal imbalance and blocked arteries.
Although there is a lot to learn about how diabetes affects sexual function of people, scientists are confident about one thing: Sexual problems often arise due to chronic high blood glucose levels and therefore, the first line of treatment should be focused on improving the blood glucose level.
Table of Content
- Low Sex Drive
- Blood Sugar Highs and Low
- Sexual Problems
- Your Feelings About Sex
- Sexual Issues for Men
- Sexual Issues for Women
- Lifestyle Tips
- How to Prevent Diabetes from Hijacking Your Love Life
Low Sex Drive
Low sex drive is a real problem and is known to affect a lot of people, irrespective of their diabetes status. However, when a person has uncontrolled diabetes, his/her sex drive is sure to take a dip. If you observe that your sex life is getting stalled, take a look at your blood glucose level and discover if it is out of line. Try to keep your blood glucose level under check and take necessary steps to maintain it that way. If you are taking some medicines like antidepressants, they can also cause a decrease in sexual desire. You should discuss such problems with your partner as well as your doctor and save your relationship. 
Researchers theorize that sexual desire comes from brain and inflammation on the body can dampen desire. If the molecules resulting from inflammation crosses the blood-brain barrier and reaches those parts of the brain which controls sexual desire, then it is plausible that desire to get intimate will get affected.
Another possible culprit for low sex drive in diabetic patients is decreased level of testosterone hormone, which is known to affect both men and women. Testosterone is found in both men and women, although its level varies in both the genders. In males, it is a dominant hormone, whereas, in females, it is present in very less amount. When testosterone level drops in either male or female, there is a drop in libido as well as promotion of fatigue and depression. 
Blood Sugar Highs and Low
Sex is basically an exercise and therefore will cause a drop in your blood sugar level. If you are a diabetic and consume alcohol, you are more likely to have hypoglycemia.
Most people, whether diabetic or not, face sexual difficulties at some point or other in their life. However, having diabetes does not mean that there will be sexual dysfunction.
Some of the reasons how diabetes affects the sexual drive of men and women are:
• Side effects of medicines used for treating depression or high blood pressure
• Extreme fatigue
• Hormonal changes
• Relationship issues
High blood sugar level can damage nerves and blood vessels, including those supplying to sexual organs. This is called diabetic neuropathy which can result in pain, numbness or lack of sensation in the genitals. This causes difficulty in getting aroused or reaching an orgasm or even feel sexual stimulation. All these factors can make sex painful or less enjoyable. Additionally, a diabetic person becomes more prone to thrush and urinary tract infection.
Sexual problems do not affect everyone with diabetes however you should decrease your risk of developing these complications by making yourself more and more aware of these problems so that you can take necessary action when the time comes. 
Your Feelings About Sex
There are a number of reasons why people who lose their desire for sex. If you are facing some difficulties with your sex life, it might not be all due to diabetes. Tiredness, depression, certain medicines and low self-esteem can all contribute to low sex drive. Even your emotions play a major role in determining your sexual desire. If you feel embarrassed about your insulin pump, or you are feeling shy about some other thing can start a vicious cycle in which you completely lose your desire for sex.
It is important to communicate freely with your partner. A lack of communication can have a negative impact on the sexual as well as an intimate part of your relationship. An illness can give your partner a reason to ‘check out’ of the relationship sexually. Sometimes it seems easier to slip away rather than confront your feelings. This can damage the relationship permanently.
If one partner becomes the primary caregiver of the other, it can change the way in which he /she looks at his/her partner. It is extremely easy to slip into the role of caregiver and patient and let romance vanish in thin air.
It is not easy to cope up with all these feelings and you might wonder how long you have to suffer before you come out of this cycle. There is a lot of help available outside. People and organizations are waiting to hold your hand and drag you out of this bog.
Sexual Issues for Men
One of the most commonly observed sexual issues observed in men is erectile dysfunction. In some case, diabetes gets diagnosed when a person visits the clinic seeking treatment for ED.  Failure to maintain or achieve an erection until ejaculation occurs can be due to damage to:
• Vascular structures
Other conditions that might accompany diabetes along with erectile dysfunction include:
• Low self-esteem
• Not enough exercise
Retrograde ejaculation is another issue that plagues diabetic men. It is a condition in which the semen gets ejaculated in the bladder instead of outside the penis due to malfunctioning of sphincter muscles. These muscles help in opening and closing of passages in the body. When there is abnormally high blood glucose level in the body due to mismanaged diabetes, the nerves can get damaged which causes retrograde ejaculation. 
Sexual Issues for Women
Vaginal dryness is one of the most common issues faced by diabetic women. This is mainly caused by hormonal changes or decreased blood flow to the genitals. There is an increased probability of falling prey to vaginal infections and inflammation that can make sex a painful experience.
When there is nerve damage of bladder, urinary incontinence can become a common problem which can be embarrassing for women. Urinary tract infections are also commonly seen in diabetic women which can make the physical act of love a painful and dreadful experience.
A diabetic woman undergoing menopause can experience episodes of low blood sugar which might affect her sex life as she has to check her blood glucose level before and after the act. Even during the act, there might be episodes of low blood sugar which might become a matter of inconvenience and embarrassment. All these things can affect the woman’s ability to enjoy sex.
In order to avoid nerve damage due to diabetes, it is important to keep the blood glucose level in check. Some of the ways by which you can keep your blood sugar level in control are insulin, medicines and monitoring glucose levels regularly.
a. Treatment for Men
There are a number of medicines that can be prescribed to diabetic men so that they can fully enjoy their sex life. Some of these medicines include tadalafil and sildenafil. However, these medicines might not be suitable for everyone, especially for those who are suffering from heart condition and hypertension.
There are a few mechanical methods too through which you can improve blood flow to sexual organs. These devices include vacuum pumps and injections in the penis. Sometimes, surgery might be performed to get a penis implant so as to get a proper erection.
b. Treatment for Women
Women might use a lubricant before engaging in sexual intercourse in order to reduce pain and friction during the act. A water-based lubricant can be purchased from the drug store and used safely.
c. Treatment for Both Men and Women
Through hormone replacement therapy, both men and women can improve their sexual desires. However, since serious side effects can occur if this therapy is started without consulting a doctor. Therefore, discuss this as a treatment option with your doctor.
There are a few changes that you can make in your lifestyle in order to enjoy your sex life. Eat a healthy diet and exercise regularly. This will keep your blood glucose level in check as well as keep you healthy and fit. Being fit will boost self-esteem which will go a long way in improving your love life.
Pelvic Floor Exercises
You can also do pelvic floor exercises in order to strengthen your pelvic muscles. This will help all the beautiful woman out there in improving their sexual response.
You can follow these simple instructions in order to isolate and exercise these muscles:
• Sit on the toilet and try to stop a stream of urine to identify the pelvic floor muscles. Otherwise, insert a finger into your vagina and try to squeeze your vaginal muscles around the finger. These are the target muscles.
• Tighten and hold the muscles. Hold the muscles for about 3 seconds and then release it for 3 seconds. Repeat this exercise for 10 minutes in a row, if possible.
• Repeat this exercise at least twice a day and gradually increase the length of time for which the muscles remain contracted from 3 to 5 seconds.
Pelvic floor exercise, also known as Kegel exercise, can also be done by men in order to improve their control over ejaculation and decrease the incidence of incontinence.
Diabetic people can engage in stress-busting practices like meditation, exercising, reading a favorite book or listening to music.
How to Prevent Diabetes from Hijacking Your Love Life
Sexual problems arising from diabetes can be embarrassing, frustrating and causes anxiety. You might feel that it is easier to adjust rather than finding ways to cope. Here we give you some tips by which you can maintain an active sex life despite having diabetes:
a. Fight Low Energy and Fatigue
If you think that low energy and fatigue are coming in the way of having sex, nighttime might not be the best time for you to engage in such an energy consuming activity. After a long day, you have very less energy left for sex. You can choose some other time to have sex when you and your partner are more energetic. Experiment and determine what works best for you.
b. Use Lubricants to Overcome Dryness
If you are facing vaginal dryness, you can use lubricants to reduce friction. There is a plethora of water-based vaginal lubricants available in the market. Do not stop having sex just because you do not have enough lubrication.
c. Improve Libido with Medication
You can undergo hormone replacement therapy in order to deal with the following issues:
• decreased libido
• erectile dysfunction
• vaginal dryness
Hormone replacement therapy can be taken in the form of:
• injectable medications
d. Stay Healthy
Staying healthy is extremely important to boost your morale and self-esteem. If you think you are beautiful, you will act beautiful and the relationship will become beautiful. If you are a diabetic, to remain healthy, you need to maintain your blood sugar level within normal range. Sex is an exercise and requires energy and therefore you need to be aware of your glucose level.
If you are on medicines that increase the level of insulin in the body, hypoglycemia can occur in the body during sex. You should try to check your glucose level before getting engaged in sexual activity.
You should also keep it in mind that whatever is good for your heart is good for your genitals. Vaginal lubrication, sexual arousal and erection increase blood flow which is important for promoting heart health and circulation. This helps in improving your energy level, body image and mood.
e. Do Not Let Incontinence Become a Barrier
There are a number of diabetic patients who experience incontinence but there is no need to feel embarrassed about it. Everyone urinates and therefore, there is nothing to feel shy about it. If you are feeling shy due to urine leaks and are uncomfortable discussing it with your sexual partner, don’t shy away. You can make use of urine pads or several layers of towel to ease your situation. Urine pads can be easily purchased from medical stores and enjoy the intimacy.
Discuss your sexuality issues with your doctor and your partner. Sexual dysfunction is an indicator of disease progression or indication towards unmanaged diabetes. Do not be afraid to discuss the sexual side effects of your medicines. You can also ask your doctor to change your medicine.
There are medicines available for treating erectile dysfunction as well. Penile pumps and medicines are good options for people suffering from erectile dysfunction.
If you are unable to express your love through sexual intercourse, you can show your affection through cuddling, massages and baths. Pay close attention to your relationship and take out time for each other. Do not get too engrossed in caregiver and patient relation. Try to keep the spark alive in each other. Have date night where you won’t discuss diabetes.
Communicate with your partner about your feelings and possible sexual issues. You can also consider going for a therapy or counselling with your partner.
It is possible to have a healthy and satisfying sex life even if you or your partner have diabetics. All it requires is a little understanding, commitment and effort from both the partners. Diabetes should not come in the way of expressing love to your partner and living life to its full capacity