Here on Glu, we offer people living with type 1 diabetes the chance to be open and honest, sharing challenges and gaining support from others who know how much this disease can get in the way of life. Having an anonymous forum allows us to gain real perspective on some deeply personal matters.
Several months ago, we polled the community on one of our most personal topics to date: physical intimacy.
In response, 63% of the community reported that T1D has had a negative effect in this area of their lives, blaming devices, sudden swings in blood sugar, and recurrent infections. Likewise, there is at least one published research study proving that people with diabetes and poor glycemic control reported significantly reduced intimacy and satisfaction in their marriages(1).
In a follow-up question, we learned how people’s sex lives have been affected. Here is a list of the most commonly reported problems, and potential strategies for solving them.
- “My blood glucose is too low for sex.”
Having low blood sugar (BG) can interrupt anything; you just have to put everything else on hold and deal with it immediately. As the most commonly mentioned barrier to sex (one user commented that low blood sugar can “really kill the moment”), knowing your BG prior to sex is always a smart idea, as is adjusting any dose of rapid insulin prior to activity. Additionally, having a small snack before any physical activity may help prevent a low. You can also keep some ‘fast carbs’ near the bed, such as juice, gummy snacks, or glucose tabs. If you do experience a low during sex, despite your precautions, openness and communication can be key. If you’re intimate with someone, you should be able to trust them to try to help you in a medical situation, such as a low BG. And expect that they will understand, and not misinterpret what happened. This can be a big source of tension for a couple, but as the person with diabetes, you have the right to expect this level of support from your partner.
- “My blood glucose too high for sex.”
Alternatively, when your blood glucose is high, you might feel ill, tired, and just generally uninterested in sex. Women may also experience vaginal dryness, which can cause difficulty and pain during sex. If your BG is very high, it’s best to treat the high BG and wait for your levels to even out before attempting to have sex. If you’re only moderately high and feel generally ok, there is no harm in proceeding. If dryness is a problem, there are several over-the-counter lubrication products that may help as well.
- “Device alarms keep interrupting!”
Using insulin pumps, continuous glucose monitors, or both to manage blood glucose level can help prevent swings in BG, so device use may actually improve your sex life. However, beeping alarms can be a nuisance when you’re trying to concentrate on…something else. Some people may choose to turn off alarms temporarily, but that can be risky. In many cases, it is best to just quickly turn the alarm off and carry on with business. As one wise Glu member put it “I am fortunate that my husband does not mind all my devices (pump and CGM) or the issues that come up. It is just a part of life – take it in stride, laugh, and move on.”
- “My device just gets in the way.”
Alarms are not the only reason devices impact sex. Insulin pump tubing can get in the way, or you can feel embarrassed about wearing a device while being intimate. Some devices allow you to disconnect and then reconnect later, which can be a good strategy – as long as you don’t forget to reconnect! To alleviate feeling awkward or self-conscious, talk with your partner and only proceed when you feel more comfortable. If you feel extremely uncomfortable with your body due to your devices (to the point that is it stopping you from doing things you want to do), talk with a friend who also has T1D or consult a therapist. (And if your partner thinks that your device makes you less attractive, maybe they need to see a therapist!)
- “I get recurrent infections (UTI or yeast) from sex.”
This is a tricky one for sure. Women with diabetes are particularly prone to intercourse-related infections, such as urinary tract infections (UTI) or yeast infections. Yeast infections specifically have been linked to elevated BG levels.(2) To prevent this common problem, several Glu users suggested rinsing the genital area with warm water, before and after sex. Additionally, your physician may prescribe you antibiotics to prevent the occurrence of infection. If you think you are getting UTI’s or yeast infections from sexual activity, talk to your doctor. There are many other treatments and strategies that can help, and it might be a sign of a more serious underlying physical problem.
- “Intercourse is painful”
Women with T1D may be more prone to some conditions that can make intercourse uncomfortable or even painful, like vaginal dryness. This is especially true for post-menopausal women, and early menopause is more common in women with T1D. As with yeast infections and UTI’s, there are medical strategies and treatments that might help, so check with your doctor.
In addition to the issues above, erectile dysfunction (ED) is very common in older men with diabetes. Sometimes ED is a sign of a serious underlying medical condition, such as heart disease, testosterone deficiency, or an excess of the hormone prolactin, but it can also be a side effect from a medication. A related problem in both men and women is delayed or reduced ability to sexually climax. This can be from neuropathy, but it can also be a side effect of certain medications used to treat depression. If you think you might be having this problem, check with your doctor. There are many treatments that are available.
Having T1D presents very unique challenges, but many of these can be overcome. Being conscientious about your health, communicating with a trusted partner, and talking to your doctor when needed will go a long way in reducing the burden of T1D in the bedroom.
-Danielle Gianferante (GluDanielle) and Nicholas Argento, MD (Dr. Nick)
- Trief, P. M., Himes, C. L., Orendorff, R., & Weinstock, R. S. (2001). The marital relationship and psychosocial adaptation and glycemic control of individuals with diabetes. Diabetes Care, 24(8), 1384-1389.
- Pozzilli, P., & Leslie, R. D. G. (1994). Infections and diabetes: mechanisms and prospects for prevention. Diabetic Medicine, 11(10), 935-941.