Diabetes in the Bedroom

I have often wondered why ears perk up when sex is mentioned. Advertisers use sex to sell very non-sexual items. Just putting a picture of a beautiful woman on the box of tools increases men’s interest, somehow making them think the tools work better!  😊  For this reason, it seems that people with diabetes would be more forthright about their sexual difficulties to their doctors. However, most don’t bring it up if the doctor doesn’t say anything, and most doctors don’t ask.[1] So, people get drugs for blood sugar and related issues, but their sexual dysfunction remains unaddressed.

For this reason, I will try to address at least the major concerns of sexual dysfunction in Type 2 Diabetes Mellitus (T2DM) and find a solution to the problem. These include:

• Decreased libido. Pain, weakness, fatigue and stress all contribute to desire. If you don’t feel well, it might be difficult to feel a desire for sex.
• Decreased function. Sometimes the body doesn’t work, preventing a sexual satisfaction.
• Decreased arousal. Even if you have the desire, it may take longer to become aroused; some will give up on themselves or their partner.
• Decreased sensation. The nerves are very sensitive to circulation and energy. Diabetes is an energy issue which affects the sensitivity of nerves all over the body.
• Especially for women, less lubrication can lead to painful intercourse.
• A low-grade, or underlying urinary tract, prostate or vaginal infection can affect sensation and performance.

After explaining the causes of these issues, I will enumerate what you can do to repair the damage and return to normal, youthful function.

Neuropathy and Sexual Dysfunction

Diabetes is a metabolic problem that affects energy production. The nervous system is the most sensitive to energy. Those who have peripheral neuropathy, such as numbness or tingling in the toes or feet, also tend to have decreased sexual function. The autonomic nervous system is even more directly related to sexual function. Those who have blood pressure, heart rate, and temperature changes have significantly increased risk of sexual dysfunction.

Erectile Dysfunction (ED) and Diabetes Connection

The most common sexual dysfunction in men with diabetes is ED.[2] As discussed above, the nervous system controls the sexual response.[3] When the nerves aren’t functioning well, ED becomes common, even in young men. The following chart shows ED rates in men with T2DM who have two types of neuropathy. Clearly peripheral neuropathy increases ED, but autonomic neuropathy almost guarantees it at any age.

Hormone Imbalance Due to Diabetes

T2DM affects hormones as well. Insulin resistance causes more belly fat, which changes testosterone into estrogen. Men develop “man-boobs” and lose their libido. Women likewise get “estrogen dominance” syndrome, and lose their libido.  Moreover, other hormone changes lead to sleep issues, fatigue, and vaginal dryness in women.[4]

Diabetes Medications and Sexual Health

There are many medications recommended by doctors for those with T2DM that can cause sexual dysfunction. Chief among them are the blood pressure medications. An erection requires good blood pressure and tight sphincter muscles. Many blood pressure medications lower blood pressure and relax smooth muscles that make sphincters work, leading to ED. Some are diuretics that cause dehydration that can lead to vaginal dryness. Thus, both men and women may be sexually diminished by medications for hypertension.

Other medications that can lead to sexual dysfunction include:[5]