Type 1 diabetes can increase the risk of sexual dysfunction in both men and women. The good news is that it can be preventable, and if it does, there are treatments that can help.

Diabetes: sexual problems in men

In men, nerve damage and circulation problems that are common complications of type 1 diabetes can lead to erection or ejaculation problems.

“Hyperglycemia [high blood sugar] affects blood vessels everywhere – heart, eyes, kidneys. Changes in blood vessels can also affect the ability to get and maintain an erection, ”says Jennifer Goldman-Levine, PharmD, diabetes educator and associate professor of pharmacy practice at the Massachusetts College of Pharmacy and Health Sciences in Boston.

Erectile dysfunction is much higher in patients with type 1 diabetes than in the general population, and it directly reflects high blood sugar and poor blood sugar control,” Goldman-Levine explains.

With diabetes, the blood vessels supplying the erectile tissue in the penis can become hard and narrow, preventing the adequate blood supply necessary for a firm erection. Nerve damage caused by poor blood sugar control can also cause the ejaculate to enter the bladder instead of passing through the penis during ejaculation, called retrograde ejaculation. When this happens, the semen leaves the body in the urine.

Diabetes: sexual problems in women

The cause of diabetes-related sexual dysfunction in women is also due to poorly controlled blood sugar levels leading to nerve damage, reduced blood flow to the genitals, and hormonal changes.

It is estimated that up to a quarter of women with type 1 diabetes have sexual dysfunction, often due to hardened blood vessels in the vaginal walls. Sexual problems can include vaginal dryness, pain or discomfort during sex, decreased libido, and reduced sexual response; there may be difficulty arousing, reduced genital sensation, and an inability to reach orgasm. Women with type 1 diabetes may also experience an increase in yeast infections.

Diabetes: think prevention first

Controlling your blood sugar is the best way to avoid diabetes-related sexual dysfunctions. “In this case, prevention is the best medicine,” says Goldman-Levine.

Follow your doctor’s recommendations on how to monitor and regulate your blood sugar. Your doctor may find that your blood sugar needs to be better controlled.

Or your doctor might find that the problem is with something unrelated to diabetes, like the medications you’re taking, smoking, or other health issues. In these cases, alternative medications, lifestyle changes, or treatments can help alleviate the problem.

Diabetes: Sexual Solutions for Men

Sexual dysfunction associated with diabetes can be treated in several ways.

  • Drug for erectile dysfunction. Drugs used to treat erectile dysfunction may work in men with diabetes, but the dosage may need to be higher than in the general population, Goldman-Levine explains.
  • Other treatments for erectile dysfunction. Your doctor may recommend a vacuum pump, placing lozenges in your urethra, injections of medicine into your penis, or surgery.
  • Medication for retrograde ejaculation. A specific drug that strengthens the sphincter muscles in your bladder can help with retrograde ejaculation.

Diabetes: Sexual Solutions For Women

Simple remedies can easily correct sexual problems with diabetes:

  • Vaginal lubricants. For women with vaginal dryness or pain or discomfort during sex, using a vaginal lubricant can help.
  • Kegel exercises. Regularly performing Kegel exercises, which strengthen the pelvic floor muscles, can improve a woman’s sexual response.

Type 1 diabetes is a difficult disease, but it should not interfere with or limit your ability to have sex. If you experience anxiety about sexual performance, consider seeing a doctor to help relieve stress and other emotional issues that are hampering your sex life. It is important to explore all possible solutions with your diabetes medical team to ensure that you are able to get the full benefit of your life.