Sex and Diabetes

Welcome to Diabetes Health's new column on sex and diabetes, by David Spero RN and Aisha Kassahoun. Once a month, we'll publish questions submitted by our readers, along with David and Aisha's responses. Send your questions to love@diabeteshealth.com and watch for their answers to appear in this column.

Dear David and Aisha,

My husband was diagnosed with type 2 diabetes seven years ago and put on oral medication. We've had some sexual problems since then, and lately there has been no sex at all. He says that he doesn't want it or need it. We had a very good sex life before this. What can I do? I think we all need intimacy in our lives. At least I do. I don't feel that it is fair to me to be left high and dry, and I want to do something to help him.

High and Dry in Tennessee

Dear H and D,

Yours is a sad and very common story. Diabetes can impact our sex and love lives physically and emotionally. But there are ways of maintaining and even improving sex and intimacy with diabetes.

Here are some possibilities to consider:

• How good is your husband's diabetes control? High sugars can drag a person down so he doesn't feel like doing anything physical, including sex. If his glucose is up, he probably won't be down for loving.

• How physically active is he otherwise? Maybe he needs to get his body moving. Exercise can make him feel more positive, improve his blood sugar control, and increase his sexual desire.

• He might be depressed. Is he being treated for that, and if so, how? Depression kills desire, and sometimes antidepressant medicines (especially the SSRIs) can knock out sex drive. Blood pressure medicines can also have sexual side effects.

• Quite possibly he is reacting to erection problems by withdrawing, without admitting that's the reason. Diabetes can make erections (and lubrication in women) more difficult. Some men will say "I don't want to" when they really mean "I'm afraid I can't."

• His testosterone level may be low. Many men and women with diabetes are low in testosterone and consequently have low sex drive.

• Other relationship issues and other emotions might be involved. There may be anger, grief, fear, or disagreements in your lives that interfere with his wanting you. These feelings could be his, yours, or both of yours.

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