The particular effects of their illness on their sexual health are not always well known or understood by people living with type 1 diabetes (T1D). Understandably, it’s not the easiest topic to discuss with your friends or healthcare team.
Respective impacts on women and men
Living with T1D can have significant physical impacts on sexual health, especially when blood sugar levels are not well balanced.
Women with blood vessel damage caused by chronic hyperglycemia are at risk of lower blood supply to the vagina, which can cause chronic vaginal dryness. Also, diabetic neuropathy (nerve damage) can lead to loss of sensation in the clitoris. There are very few studies on this topic, but a number of women with T1D have spoken out about this condition.
Men with chronic hyperglycemia can also develop bloodstream issues and nerve damage. If the penis is affected, maintaining or getting an erection can be more difficult. Many studies show that erectile dysfunction is more common among men with T1D than among those who don’t have T1D.
Both women and men living with T1D are at a greater risk of genital and urinary tract infections, which are known to cause discomfort and pain during sex.
It is important to know that many factors need to be considered when evaluating sexual dysfunctions, such as age, duration of illness, smoking, depression, stress, etc. Aside from these factors, most issues can usually be avoided with good glycemic balance.
Some valuable insights
It is crucial to understand that just like any other physical exercise, sex increases the risk of hypoglycemia for up to 48 hours. So, you should take the same precautions, i.e., check your blood sugar level beforehand, eat carbs, etc.
Last but not least, good communication between partners is important, especially with people living with T1D. Treatment devices such as insulin pumps can raise concerns and cause discomfort. You could be tempted to disconnect your pump, or worry about bumping your continuous glucose monitor. It’s not hard to imagine that some people will make choices that go against their treatment, such as delaying an injection or disconnecting and forgetting to reconnect an insulin pump.
This is completely normal, and you shouldn’t feel guilty or judged. It’s not unusual to deviate from your treatment every once in a while. Just make sure you take those missteps into account in your routine and when analyzing your blood sugar levels.
A healthy sexual life? Mission: possible
Despite the many challenges associated with T1D, most people living with this condition don’t experience any major issues. Maintaining an adequate glycemic balance, good communication with your partner and an open dialogue with your healthcare team are all good ways to enjoy a healthy sex life in spite of T1D.
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- Sexualité féminine et diabète. (n.d.). Retrieved November 30, 2020, from http://www.diabete.qc.ca/fr/comprendre-le-diabete/tout-sur-le-diabete/complications/sexualite-feminine-et-diabete/
- Dysfonction érectile. (n.d.). Retrieved November 30, 2020, from http://www.diabete.qc.ca/fr/comprendre-le-diabete/tout-sur-le-diabete/complications/dysfonction-erectile/
- Enzlin, P., Rosen, R., Wiegel, M., Brown J., Wessells, H., Gatcomb, P., Rutledge, B., Chan, K-L., Cleary, P.A., Sexual Dysfunction in Women With Type 1 Diabetes, Diabetes Care, (2009), 32 (5) 780-785; DOI: 10.2337/dc08-1164
- Hunter Wessells, David F. Penson, Patricia Cleary, Brandy N. Rutledge, John M. Lachin, Kevin T. McVary, David S. Schade, Aruna V. Sarma, Effect of Intensive Glycemic Therapy on Erectile Function in Men With Type 1 Diabetes, The Journal of Urology, 2011, 1828-1834, https://doi.org/10.1016/j.juro.2010.12.098
- Both, S., ter Kuile, M., Enzlin, P. et al. Sexual Response in Women with Type 1 Diabetes Mellitus: A Controlled Laboratory Study Measuring Vaginal Blood Flow and Subjective Sexual Arousal. Arch Sex Behav 44, 1573–1587 (2015). https://doi.org/10.1007/s10508-015-0545-x
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