Addressing the Sexual Problems of Diabetic Women

Written by Shauna S. Roberts, PhD

Diabetes need not hinder a happy, healthy sex life

Once, researchers basically ignored women's sexual problems. The only area deemed worthy of study involved difficulties bearing children.

Times are changing. As the Baby Boomers age, menopause and its problems are attracting more attention. And the increasing number of people with diabetes encourages more researchers to focus on diabetes-related problems, including sexual problems in women.

Sexual Problems Of Women With Diabetes

Experts divide women's sexual problems into four general categories:

• Lack of sex drive (libido), including a lack of sexual fantasies
• Problems becoming aroused (not enough vaginal lubrication, not feeling aroused, decreased sensation, tight vaginal muscles)
• Recurrent or persistent delay in or lack of orgasm

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• Recurrent of persistent pain during sex or sexual stimulation

Experts label these situations "problems" only when they cause a woman distress. For example, a woman who has no partner may not consider lack of sex drive to be a problem.

Women with diabetes can experience all four problems. What scientists don't yet know is whether these problems are more common in women with diabetes than in other women. What little research has been done has produced conflicting results. For example, some studies have found women with diabetes have decreased libido compared with other women; others haven't. Estimates of the percentage of women with diabetes who have decreased sexual desire vary widely, ranging from 4 to 45 percent.

However, when it comes to arousal difficulties, research results have been fairly consistent: Women with diabetes appear to be twice as likely as other women to have decreased lubrication of problems becoming sexually stimulated.

Diabetic nerve disease is a major cause of impotence in men with diabetes. Men's and women's bodies are similar enough that researchers have expected nerve disease to underlie sexual problems in women with diabetes, too. But so far, research has found no link.

Two studies have looked at whether poor blood glucose (sugar) control or diabetes complications are associated with sexual problems in women with type 1 diabetes, as they are in men. Neither study found such an association. However, one of the studies found that the more complications a woman had, the more sexual problems she was likely to have.

One important way that diabetes affects women's sexuality is through its psychological effects. Diabetes doubles the risk of depression, a known cause of sexual problems in women. Diabetes changes a couple's relationship, sometimes for the worse. Having a chronic illness can damage self-esteem and alter a woman's perception of her desirability. Like a stone thrown into a pond, the psychological effects of diabetes ripple throughout many aspects of life, including sex.

High blood glucose levels also make it easier to get urinary infections and yeast infections, which can make sex uncomfortable.

In addition, women with diabetes can develop sexual problems for the same reasons as other women. One cause is menopause. The drop in hormones during menopause can reduce the sex drive. When estrogen levels drop, the lining of the vagina can become thin, which can make sex painful. Also, lubrication may decrease, possibly leading to pain during sex.

Other factors that increase the risk of sexual problems are:

• Having a disease involving the nerves, such as Parkinson's disease of a spinal cord injury
• Having a chronic illness
• Having had genital surgery
• Having liver or kidney failure
• Having disease of the blood vessels of the feet and legs
• Having been abused sexually
• Being under stress
• Having problems in a relationship
• Taking certain drugs (A wide variety of common drugs, including antihistamines, some kinds of high blood pressure pills, birth control pills, alcohol, and antidepressants, can cause sexual problems in women.)
• Worrying about getting pregnant