Sex is an important part of life and relationships. But diabetes can affect a woman's sex life. Some women with diabetes have less interest in sex because of depression or changes in blood glucose levels that can leave them feeling tired or irritable. Or perhaps intercourse is painful because of vaginal dryness. Problems with having sex aren't a normal part of getting older and don't happen to all women who have diabetes.
If you find that you don't enjoy sex anymore, it's normal to feel upset. You may blame yourself or your partner. Some women feel angry or depressed. These feelings can make it hard for you to talk openly with your partner. Don't give up! Find someone on your health care team to talk with. Learn about medicines or counseling that can help.
Depression and Anxiety
Both depression and anxiety can take away your desire for sex. Medicine or counseling can help with both depression and anxiety disorder. If you've been feeling depressed or worried for more than two weeks, talk with your health care team.
Are you thinking about having a baby? Start working with your health care team before you get pregnant. Have your A-1-C, blood pressure, heart, kidneys, nerves, and eyes checked. See your dietitian to review your meal plan. Talk with your health care team about how being pregnant will affect your long term health.
If you take diabetes pills, you may need to switch to insulin to protect the baby. You may be referred to a special diabetes and pregnancy team.
You will help keep yourself and your baby healthy and safe if you keep your blood glucose (sugar) in your target range before you get pregnant and until the baby arrives. That will lower your chances of having a premature baby or a baby that's larger than normal.
You'll also lower the risk of having a baby with birth defects by keeping your blood glucose close to normal in the first few weeks of pregnancy. Today, more women with diabetes are able to have healthy babies. With planning and hard work, you can too.
If you don't want to get pregnant, you'll need to use some kind of birth control. Even if you don't have regular periods, you can still get pregnant. Most birth control methods are safe for women with diabetes. Talk with your health care team about your options.
Hormones & Menstrual Cycle
Some women find it hard to keep their blood glucose on track the week before and during their menstrual period. Your blood glucose levels may go up and down because of changes in hormone levels.
Make a note of the days when you're having your period in your blood glucose record book. Look for patterns and then talk with your health care team about changing your care plan before, during, or after your period to keep your blood glucose levels on target.
Here are a few tips:
- Work with your health care team to keep your blood glucose levels on target during your monthly cycles.
- Talk with your health care team about hormone replacement therapy as you get close to menopause.
Menopause and the years leading up to it when your body gradually produces less estrogen and progesterone (perimenopause) may present unique challenges if you have diabetes. How these hormonal changes affect blood glucose may vary depending on the individual. Many women, however, notice that their blood glucose levels are more variable (increasing and decreasing) and less predictable than before. The hormonal changes as well as swings in your blood glucose levels can contribute to menopausal symptoms such as mood changes, fatigue and hot flashes.
Menopause and diabetes produce similar symptoms. You may mistake menopausal symptoms such as hot flashes, moodiness and short-term memory loss for symptoms of low blood glucose. If you incorrectly assume these symptoms are a result of low blood glucose, you may consume unnecessary calories in an effort to raise your blood glucose, and inadvertently cause a surge in blood glucose.
Because of your diabetes, however, you may experience stronger and more frequent episodes of low blood glucose, especially at night. This can further compromise sleep already interrupted by menopause-associated hot flashes and night sweats. Such sleep deprivation can cause fluctuations in blood glucose that make control more difficult.
Hormone Replacement Therapy
Hormone replacement therapy is a complicated issue. On one hand, estrogen can decrease the risk of osteoporosis and vaginitis and alleviate hot flashes. On the other hand, it can increase the risk of breast and uterine cancer, heart disease, and stroke.
- The current recommendation is to take the smallest dose of hormone replacements for the least amount of time possible to control symptoms.
- Reevaluate your treatment plan every six months.
- Women with breast cancer, heart disease, or a history of blood clots should avoid hormone replacement therapy.
Whether you decide to use hormone replacement therapy is up to you. Many factors can influence your decision, like whether diseases like cancer, heart disease, and osteoporosis run in your family.
As a woman with diabetes, you need to play an active role in your overall health care throughout menopause and beyond. You have more at stake during this time in your life than women without diabetes. As with other issues related to your sexual health, it's important that you discuss concerns with your provider and other health care team members.
You may be interested in our book, Sex and Diabetes: For Him and For Her.