Does diabetes affect sex?

Originally Published: December 31, 2010
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Dear Alice,

I have been diabetic for 19 years now (I'm 20 years old) and I was wondering: does having this disease for so long have long-term effects on my sexual health? I am a man and so far I have no issues.

Dear Reader,

It's great that diabetes is not affecting your sexual health, and it's also great that you are preemptively asking about potential complications. Research indicates that about 75 percent of men and 35 percent of women with diabetes do experience some sexual issues, mostly as a result of diabetic neuropathy (nerve damage) to the nerves that stimulate normal sexual response. The good news: research has found that individuals who take care of their condition by controlling blood glucose levels, lowering blood pressure, cholesterol, and triglyceride levels, can lower their risk of developing diabetes-related sexual problems.

In addition to neuropathy, men with diabetes can be challenged by erectile dysfunction (ED), low testosterone, and low libido. ED, defined as the inability to achieve or maintain an erection satisfactory for sexual intercourse, can develop because of a testosterone deficiency. According to the American Diabetes Association (ADA), over 13 million men suffer from low testosterone and 90 percent of those go untreated. Men with type 2 diabetes are two times  more likely to suffer from low testosterone than men without diabetes. A simple blood test can detect this deficiency and it can be treated quite easily with gels, patches, or injections to increase the amount of testosterone in the body.

Men can also experience a drop in libido because of diabetes-related weight gain, depression, stress, and/or high blood pressure. In order to keep your sexual health in good standing, it might be a good idea to pay special attention to your body and take note if you experience any of the abovementioned symptoms.

For women, long-term effects of diabetes on sexual health can include decreased vaginal lubrication, difficulty achieving orgasm, low libido, and pregnancy issues. The hormonal swings that often accompany menstruation and menopause require increased attention to blood glucose levels. In addition, women with diabetes are at an increased risk of heart disease after menopause due to a loss of estrogen. While this litany of possible complications may sound overwhelming, for each problem, there are several solutions. Water-based lubricants can be very effective against persistent vaginal dryness and are widely available. To ensure a normal and safe pregnancy, women with diabetes can switch to insulin instead of diabetes medication. And women can monitor hormone and glucose levels with supervision from a health care provider.

For both women and men, it's important to bring sexual health concerns to a health care provider who can diagnose and treat any conditions. Columbia students can see a health care provider at Primary Care Medical Services by calling x4-7426, or by logging in to Open Communicator.

So, in short, Reader, it's great that you are not experiencing negative effects of diabetes on your sexual health. To keep it that way, a smart plan might be to continue to monitor and treat your diabetes, keep your weight and blood pressure at healthy levels, and be sure to see a health care provider should you notice any changes in your libido, mood, or erectile abilities.

Alice