Diabetes

Many men and women with diabetes complain about sexual problems. Usually these symptoms occur at later stages of the disease. However, occasionally sexual problems are some of the first symptoms, and some men having trouble with their erections become diagnosed with diabetes.

Since late-stage diabetes can affect the functioning of nerves as well as of small blood vessels, both of these changes may interfere with sexual function. Other problems may be changes in eye-sight, reduced sensation in feet, reduced kidney function, etc.

 

General suggestions related to sexual problems and their management

 
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The most important way to reduce the symptoms in your various organs (eyes, kidneys, sexual organs, etc.) is to keep your blood-sugar well regulated.

 
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If you have not already done so, see your doctor regularly in order to find the best treatment options for you. There are many good medications available. It is also important that your doctor know about any new symptoms you may be experiencing.

 
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If you feel reduced interest in sex, remember that you still can have a loving relationship with your partner without sexual activity. There are many ways of expressing your love and fondness, without having sex, including cuddling and kissing each other.

 
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If you feel very tired, try to plan intimate time with your partner at times when you are most rested.

 
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If the diabetes is not well controlled, many women are prone to vaginal infections. If left untreated, these infections can lead to pain during intercourse. Try to keep your blood-sugar well regulated, and seek medical care as soon as you think that you may have a vaginal infection. Some of the symptoms are irritation, itching, a burning sensation when urinating, an excessive or disagreeable discharge, and pain during intercourse.

 
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Women with decreased vaginal lubrication can use water-soluble lubricants (K-Y jelly, Astroglide, etc.), sold over the counter in most pharmacies.

 
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Some men with poorly controlled diabetes experience erectile problems. It is important to know that erectile function often improves when better blood-sugar control is achieved.

 
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Some men who have lost their erectile ability are still able to experience orgasms and to ejaculate. If erectile function is severely affected there are several ways to help you have better erections. Several medications are now available on the market; vacuum devices have been useful for many; and penile implants are available for severe erectile dysfunction.

 
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Sexual counseling or sex therapy can be helpful.

 
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Remember that erectile dysfunction does not prevent you from being sexually active and giving towards the one you love. This may be a good time to explore alternative ways of being loving and intimate with your partner.

 
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Dry orgasms (retrograde ejaculation) happen in some men. Usually this is due to the ejaculate not flowing out through the urethra, but rather being emptied (flowing "backwards") into the bladder. This condition is not dangerous. Most men with dry orgasm claim that the sensation during orgasm is unchanged.

Fertility & pregnancy

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If you are in the reproductive age, discuss the best method of birth control with your doctor. Sometimes birth control pills may disturb the diabetic control, and other methods (diaphragm, intrauterine device, cervical cap, condoms, etc.) may be a better solution for you.

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If you have diabetes and wish to become pregnant, it is important to attempt optimal control of your blood-sugar even before conception. Your gynecologist should follow you closely throughout your pregnancy and adjust your medication if necessary.

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Some women with diabetes have more complications during pregnancy and delivery than women without the disease. Babies often tend to be larger, and sometimes your gynecologist will choose to induce labor a few weeks before your actual due-date.

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Male fertility may be affected by an inability to achieve erections, retrograde ejaculation, and endocrine abnormalities.

 

References

Bancroft, J. (1989) Human sexuality and its problems. Churchill Livingstone, ISBN: 0-443-03455-9

Milsten, R. & Slowinski, J. (1999) The sexual male. Problems and solutions. Norton, ISBN: 0-393-04740-7

Schover, L.R. & Jensen, S.B. (1988) Sexuality and chronic illness. A comprehensive approach. The Guilford Press, ISBN: 0-89862-715-X

Sipski, M.L. & Alexander, C.J. (1997) Sexual function in people with disability and chronic illness. Aspen Publishers, Inc., ISBN: 0-8342-0886-5

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