There are two myths about sex and diabetes. One: Men with the disease develop erectile dysfunction (ED). And two: Diabetic women suffer few, if any, sexual effects. Both are wrong. Diabetes can impair sex, but those affected can also enjoy great sex.
Problems in Men
When men get diagnosed with diabetes, they hear they’ll soon develop ED. The anxiety this engenders can cause the problem. Diabetes may, indeed, impair erection. But ED is not inevitable. If it occurs, several safe, effective treatments are available.
Syracuse University researchers reviewed 23 studies of ED in diabetic men. About 30 percent reported severe ED, twice the risk of non-diabetic men, but these findings also show that diabetic men are not fated to develop ED.
Diabetic ED may result from cardiovascular complications (atherosclerosis) and/or nerve damage (neuropathy). Diabetes accelerates arterial clogging, which reduces erection-producing blood flow into the penis. Diabetic neuropathy damages the erection nerves.
Risk factors for diabetic ED include:
- Duration. The longer men have diabetes, the greater their risk.
- Type. ED is more likely in men diagnosed with type 1 diabetes in childhood than in men diagnosed with type 2 diabetes as adults.
- Some blood pressure medications. One side effect of some blood pressure drugs is erection impairment.
- Obesity. It’s associated with cardiovascular disease.
- Smoking. It accelerates the development of cardiovascular disease.
If you suffer diabetic erection impairment, don’t despair. Today, numerous treatment options can help:
- See your doctor. Physicians can review your medications to see if they have erection-impairing side effects. Doctors can also prescribe erection medications. The drugs work best in men whose ED is related to cardiovascular disease. The drugs don’t help as much in men whose ED stems from neuropathy. You might ask your doctor about drugs derived from the African yohimbe plant: Yocon, Yohimbine, and Aphrodyne. They’re FDA-approved and may help.
- Consult a sex therapist. Compared with doctors, sex therapists are generally better informed about all possible causes of ED, including: depression, relationship distress, and anxiety about the sex-impairing effects of diabetes. The therapist works with both partners, teaching the couple to adopt a more communicative, more sensual, whole-body, massage-oriented approach to lovemaking. Treatment typically takes a few months of weekly sessions. To find a sex therapist near you, visit the American Association of Sex Educators, Counselors, and Therapists. Sex therapy costs $150 to $300 an hour. Health insurance may or may not cover it.
- Vacuum constricting devices. They create a partial vacuum around the penis that draws blood into the organ, causing temporary erection. They include a plastic tube that fits over the penis fitted with a squeeze-bulb pump. Users squeeze the bulb, which evacuates the air from the plastic tube, drawing blood into the penis. One study evaluated vacuum constricting devices in 21 men—six with diabetes. Seventeen (81 percent) reported full erections or semi-erections sufficient for intercourse. Sex toy catalogs offer several models, but for best results, urologists can help you obtain custom-fitted devices.
- Surgery. If ED is more related to cardiovascular than neurological issues, a penile artery bypass can improve blood flow into your penis. Similar to heart bypasses, surgeons remove a piece of unclogged artery elsewhere in the body, and use it to construct a detour around blockage in the penile artery. Two newer surgical procedures—aortoiliac reconstruction and dorsal vein arterialization—also increase penile blood flow. One evaluation showed that after recovery from penile surgery, about half of men can raise erections.
Problems in Women
So little is written about the effects of diabetes on women’s sexuality that you’d think the disease has none. But it does. Its effects in women are more subtle than those in men. Nonetheless, they are quite real, and deserve more attention than they receive.
The main problem is vaginal dryness. Production of natural vaginal lubrication depends on healthy blood flow into the vaginal wall. Diabetes reduces blood flow into the vaginal wall. The solution—a commercial lubricant available over-the-counter at pharmacies. Look near the condoms.
Neuropathy in diabetic women can reduce clitoral responsiveness to erotic touch, impairing ability to enjoy sex and have orgasms. Lubricants may also help this problem by increasing sensitivity to touch.
Another way to increase clitoral stimulation is to use a vibrator. Any vibe may help, but plug-in models (Hitachi Magic Wand) are more powerful and offer the most intense stimulation. Vibrators are available at some pharmacies and through sex toy catalogues.
References:
El-Bahrawy, M. et al. “Noninvasive Vacuum Constriction in the Management of Erectile Dysfunction,” International Journal of Urology and Nephrology (1995) 27:331.
Weinhardt, LS and MP Carey. “Prevalence of Erectile Disorder Among Men with Diabetes Melllitus: Comprehensive Review,” Journal of Sex Research (1996) 33:205.
DePalma, R.G. et al. “Vascular Interventions for ED: Lessons Learned,” Journal of Vascular Surgery (1995) 21:576.