Female Sexual Dysfunction
In this post-Viagra age, the American public is well aware of the problems of male impotence. But female sexual dysfunction and arousal problems remain a less publicized cause. You may be surprised to learn that according to results of a national study published in the Journal of the American Medical Association, sexual dysfunction was actually more prevalent in women than in men (43 versus 31 percent).
Uncontrolled blood glucose levels affect arousal, performance, and overall well-being. High blood sugars trigger yeast infections and vaginal irritation. In addition, vascular damage can restrict blood flow to the vagina, causing lubrication problems. Women who have neuropathy that affects the genital area, the reproductive organs, and/or the vagina may have difficulty achieving arousal and orgasm.
Psychological Factors
Sometimes the problem is more psychological than physical. The less-romantic aspects of treatment, such as needing to do a blood sugar check before sex, can make some women self-conscious and less likely to initiate or participate in it.
Fear may be a factor in your ability to let go and relax, as well. You may be afraid that the physical exertion of sex will trigger hypoglycemia. Taking the same precautions you do for exercise will usually prevent blood sugar lows.
However, make sure your partner knows that in the unlikely event that you do lose consciousness, it wasn't his performance that did it. Give him a briefing on when to seek emergency medical care for you.
Other Culprits
A number of other issues can contribute to sexual difficulties in women with diabetes:
Certain medications (e.g., antidepressants, hypertension medications)
Menopause (low estrogen levels can cause vaginal dryness)
Vaginismus (a tightening of the vaginal walls that may make sex painful)
Excess weight or obesity — overweight women may feel self-conscious and unattractive
Alert
If you're suffering from sexual dysfunction, you need to talk to your doctor about the problem. In some cases, it may be a sign of a diabetic complication that needs treatment. Even if it is something more benign, you owe it to yourself to find a solution. Don't let the embarrassment stop you — your doctor is there to help.
Treatments
Therapy and/or medication may help you overcome depression. Make sure you talk to your doctor about the possible sexual side effects of any antidepressant she may prescribe. Some drugs, such as Wellbutrin (buproprion), have lower risks of sexual side effects and may be preferred.
If low estrogen levels are at the root of vaginal dryness problems, hormone replacement therapy can sometimes alleviate this problem, but it should be prescribed with caution in some women. Over-the-counter lubricants are also available to ease dryness and painful penetration.
If your partner uses condoms, stick with water-based lubricants, as oil-based products react with latex and can encourage breakage. Medical devices designed to stimulate blood flow in the genitals and increase lubrication may also be prescribed. Your gynecologist or urologist can tell you more about these options.
As with most complications related to diabetes, adjustments to your diet, medication, and exercise routines may improve both your diabetes and your sex drive.
