Women Sex Diabetes
When most people hear the words "diabetes and sexual dysfunction," they automatically think it’s the man’s problem.
But women with diabetes can also experience sexual problems related to their blood sugar levels.
For diabetes educator Ann Albright, PhD, RD, that’s not only a medical fact, it’s a fact of life.
Living with type 1 diabetes for 41 years, Albright says that when glucose isn’t under good control, a woman’s sex life can suffer.
"It’s not diabetes per se that harms your intimate life. It’s the complications of uncontrolled blood sugar levels that cause problems for both men and women -- the only difference is that many women simply aren’t as aware of this complication as men are," she tells WebMD. Albright also is the president of health education for the American Diabetes Association.
Albright says women are getting better at coming forward with intimacy issues, but when it comes to diabetes, most are still reluctant to talk to their doctor.
Endocrinologist Loren Wissner Greene agrees. "Women aren’t talking to their doctors about it, doctors aren’t talking to women about it, and so for many it remains a silent problem that goes undiagnosed and untreated." Greene is a clinical associate professor at NYU Langone Medical Center in New York City.
In the study, 35% of women with diabetes reported being unable to have an orgasm during intercourse, compared to just 6% of the women who didn’t have diabetes.
Albright says one reason women with diabetes may have trouble achieving orgasm is that high blood sugars can affect vaginal lubrication.
"The lubrication issues not only can impact sensation, they also can make sex very uncomfortable, even painful," she says.
In a 1986 study now considered a cornerstone of research on the topic, nearly half the women in the study had a sexual problem. Of these, 32% of women reported experiencing problems with lubrication. Eighty-nine percent said the problems started after their diabetes diagnosis.
Albright says there are many health benefits of good blood sugar control, but many women don’t realize that better lubrication, and, ultimately, a better sex life may be among them.
"It all comes down to microcirculation," says Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "When blood glucose is uncontrolled, it impacts the tiny blood vessels that feed our nerves and allow a woman to experience the full spectrum of intimate sensation."
When microcirculation is impaired in men, erectile dysfunction occurs -- so the impact is obvious to both partners, he tells WebMD. In women, the effect isn’t as apparent. It’s all about arousal and sensation in the genital area, which frequently no one but the woman herself must acknowledge.
Greene says the longer sugar levels remain uncontrolled, the more likely it is for circulation problems to interfere with intimacy.
"Over time, increased glucose in the blood begins to destroy myelin -- a protein that covers nerves," Greene says. When this happens, it leads to neuropathy -- a type of nerve damage.
The most frequent type is peripheral neuropathy. It commonly results in foot problems such as numbness and tingling. Another type of neuropathy -- autonomic neuropathy -- affects nerves in areas such as the stomach and urinary tract and may also impact the nerves in the pelvis -- nerves that are directly connected to sexual stimulation.
"Again, it’s damage to the tiny blood vessels supplying the nerves that are at the root of the problem," she says.
"Some people believe only those with type 1 diabetes, which develops at an early age, are at risk for these kinds of problems, but in reality many people with type 2 diabetes have it for many years before they are diagnosed, and when they are diagnosed, most of the time some damage has already occurred," Greene says.
"The vagina is a moist, warm place that favors the overgrowth of yeast anyway -- add excess sugar into the mix and you have the ideal breeding ground for yeast, one reason women with uncontrolled blood sugars frequently develop chronic yeast infections," Mezitis says.
What many may not recognize is the impact these infections have on delicate vaginal tissue -- and the role they can play in making sex very uncomfortable, even after the infection has cleared.
"It can leave the vaginal tissue raw and irritated, particularly if the infections are chronic and keep coming back -- the irritation continues, and combined with a lack of lubrication, this can make sex extremely uncomfortable, even painful," Greene says.
But women with diabetes can also experience sexual problems related to their blood sugar levels.
For diabetes educator Ann Albright, PhD, RD, that’s not only a medical fact, it’s a fact of life.
Living with type 1 diabetes for 41 years, Albright says that when glucose isn’t under good control, a woman’s sex life can suffer.
"It’s not diabetes per se that harms your intimate life. It’s the complications of uncontrolled blood sugar levels that cause problems for both men and women -- the only difference is that many women simply aren’t as aware of this complication as men are," she tells WebMD. Albright also is the president of health education for the American Diabetes Association.
Albright says women are getting better at coming forward with intimacy issues, but when it comes to diabetes, most are still reluctant to talk to their doctor.
Endocrinologist Loren Wissner Greene agrees. "Women aren’t talking to their doctors about it, doctors aren’t talking to women about it, and so for many it remains a silent problem that goes undiagnosed and untreated." Greene is a clinical associate professor at NYU Langone Medical Center in New York City.
When Glucose and Intimacy Collide
Although women with diabetes may be slow to admit there is a problem between the sheets, the medical community has been even slower to study the issue. It wasn’t until 1971 that a groundbreaking study was published on this subject in the journal Diabetes. In the study, 35% of women with diabetes reported being unable to have an orgasm during intercourse, compared to just 6% of the women who didn’t have diabetes.
Albright says one reason women with diabetes may have trouble achieving orgasm is that high blood sugars can affect vaginal lubrication.
"The lubrication issues not only can impact sensation, they also can make sex very uncomfortable, even painful," she says.
In a 1986 study now considered a cornerstone of research on the topic, nearly half the women in the study had a sexual problem. Of these, 32% of women reported experiencing problems with lubrication. Eighty-nine percent said the problems started after their diabetes diagnosis.
Albright says there are many health benefits of good blood sugar control, but many women don’t realize that better lubrication, and, ultimately, a better sex life may be among them.
Blood Sugar and Sexual Desire
Lubrication can be a huge intimate issue, but it’s not the only one women with diabetes may have. Endocrinologist Spyros Mezitis, MD, says there are also important links between glucose levels and genital stimulation -- a factor that affects not only how pleasurable sex feels, but also a woman’s desire for it. "It all comes down to microcirculation," says Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "When blood glucose is uncontrolled, it impacts the tiny blood vessels that feed our nerves and allow a woman to experience the full spectrum of intimate sensation."
When microcirculation is impaired in men, erectile dysfunction occurs -- so the impact is obvious to both partners, he tells WebMD. In women, the effect isn’t as apparent. It’s all about arousal and sensation in the genital area, which frequently no one but the woman herself must acknowledge.
Greene says the longer sugar levels remain uncontrolled, the more likely it is for circulation problems to interfere with intimacy.
"Over time, increased glucose in the blood begins to destroy myelin -- a protein that covers nerves," Greene says. When this happens, it leads to neuropathy -- a type of nerve damage.
The most frequent type is peripheral neuropathy. It commonly results in foot problems such as numbness and tingling. Another type of neuropathy -- autonomic neuropathy -- affects nerves in areas such as the stomach and urinary tract and may also impact the nerves in the pelvis -- nerves that are directly connected to sexual stimulation.
"Again, it’s damage to the tiny blood vessels supplying the nerves that are at the root of the problem," she says.
"Some people believe only those with type 1 diabetes, which develops at an early age, are at risk for these kinds of problems, but in reality many people with type 2 diabetes have it for many years before they are diagnosed, and when they are diagnosed, most of the time some damage has already occurred," Greene says.
Women, Sex, and Diabetes: The Role of Infections
In addition to problems related to blood supply and nerve function, doctors say women with diabetes are also prone to two types of medical problems that also can interfere with intimacy: Yeast infections and urinary tract infections. "The vagina is a moist, warm place that favors the overgrowth of yeast anyway -- add excess sugar into the mix and you have the ideal breeding ground for yeast, one reason women with uncontrolled blood sugars frequently develop chronic yeast infections," Mezitis says.
What many may not recognize is the impact these infections have on delicate vaginal tissue -- and the role they can play in making sex very uncomfortable, even after the infection has cleared.
"It can leave the vaginal tissue raw and irritated, particularly if the infections are chronic and keep coming back -- the irritation continues, and combined with a lack of lubrication, this can make sex extremely uncomfortable, even painful," Greene says.
