A couple of years ago, I clumsily wrote a post about how there is simply not enough information available about women, diabetes and sex. That post remains one of the most read posts on this blog. Within half an hour of pressing the publish button, over two dozen women I don’t know reached out to me to say it was the first time they had ever read anything about the issue, and that their concerns and questions have never been addressed…mostly because they didn’t know how to ask them.
A week or so ago, the topic came up again thanks to a new survey that is being conducted out of the UK, headed up by health psychologist Kath Barnard. The introduction to the survey highlights that sexual health issues for women with diabetes are a neglected are of study, acknowledging they have an impact on wellbeing, self-image and relationships.
Here is what I wish I was told about sex and diabetes when I was diagnosed – or at least could easily find information about somewhere.
- Diabetes can affect how you feel about sex. (Seriously, being diagnosed as a 24 year old, this should have been a headline.)
- And it can affect sexual function in women. I really wish I had known this, because it was not mentioned when I was diagnosed (or for a long time after). Sex was different after diabetes, but because no one told me that it could be, or what might happen, I thought that this was just me. And because I thought it was just me, I didn’t speak to anyone about it. I guess because I was embarrassed and ashamed.
- Yes, sex is exercise and can result in hypos. But it’s not just lows that affect sex. (This was literally all I was told at diagnosis about the impact of diabetes on sex: ‘You might have a hypo after or during sex, so eat a sandwich beforehand.’ And all I could think about in that moment was trying to work out how to incorporate a sandwich in foreplay. (Please do not send suggestions.)
- High glucose levels are not good for libido. Sitting with glucose levels in the high teens and twenties does not put me ‘in the mood.’ It makes me feel tired, grumpy, frustrated and stressed. All of these feelings are conducive to diminishing sex drive.
- And rollercoaster glucose levels don’t help either.
- While I was warned that sex can cause hypos, I wasn’t equipped with how to deal with that. ‘Sorry, honey – I need…well, I need some honey, because I think I’m about to pass out,’ is a mood killer. For everyone involved. I learnt that very early on.
- I wish I had been told how to speak about my concerns about sex – with HCPs and especially with Aaron. I felt like my body was failing at everything and that made me feel decidedly unsexy. But by not having the words or ideas of how to speak about it, I simply didn’t. (And again, I wouldn’t have had any solutions even if I did speak about it, so what would have been the point.)
- The body image issues I had been living with for some time became amplified once I had diabetes. Suddenly not only could I see all these faults with my body, but now it was also broken from the inside. I felt unattractive, I didn’t want to have my body on show because to me it felt inadequate. It would have been good to have someone suggest I speak to a psychologist and work through this sort of shit!
- ‘Here are some ideas that might work if lubrication becomes an issue, because it might.’ That would have been a mighty useful comment to have received, instead of feeling like my body was slowly, but surely, shutting down all functions that I had, until that point, taken for granted.
- Here’s an idea: often, at diabetes events, we receive bags chock full of goodies: Foot cream, alcohol swabs, glucose tabs, cardboard-tasting muesli bars, recipe books. Throw a tube of lube in there too, event organisers! At least this will get people thinking, realising that if this is an issue for them, they’re not the only ones, and probably start some conversation.
- I wish HCPs understood that this may be a really difficult and awkward conversation for some people, and many women with diabetes won’t feel comfortable raising the issue. So please take the lead here and ask questions – even: ‘Have you noticed any difference in how you feel about sex?’ Do it gently…
- Desire and arousal are not the same thing. Wanting to have sex, but knowing that it may be painful, difficult or just plain not the same as before, plays with your mind. I wish that had been explained to me, because arousal issues actually meant desire was affected.
I think that had I been better informed about all of these factors, or at least told that sex was something that diabetes could (or would most likely) affect, I would have been better equipped. It took me a while to muddle through it all myself.
I know that talking about sex – in and out of a diabetes context – is not always easy. But just because something is difficult doesn’t mean that it should be swept under the carpet and ignored.
Unsurprisingly, it was speaking with other women and learning that they had the same issues, questions and concerns that led me to seeking clinical and psychological help to work through everything. I feel like I got there in the end, but it took a lot longer that it needed to. Because I honestly thought that I was the only one dealing with it all. However – as is so often the case with diabetes – our concerns and stories are already someone else’s, and there are answers to be found if we know where to go to looking. I just wish that instead of having to search, they had been given to me at the beginning.
Please consider filling in the Female Sexual Health and Diabetes survey here. It only takes about ten minutes.
12 comments
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May 31, 2018 at 4:31 pm
Rien
Pretty much the same applies to blokes as well. At least you were told at diagnosis about hypos and sex. When I have high sugars at bed time, my wife has been known to say: “Would you like me to fix your sugar?” 🤪
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June 1, 2018 at 4:05 pm
Candy
Literally the same comes out of my fiance when I’m high 😂 “you want me to help bring that blood sugar down, honey?” *Wink wink*
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May 31, 2018 at 6:28 pm
Beate
Thank you!! 🙏🏻
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May 31, 2018 at 7:11 pm
dianamaynard
My feelings about this topic in a nutshell: if your partner doesn’t understand any issues you might have around this topic (hypos, highs, pumps being attached to you, etc etc) then you have the wrong partner. End of story. Rien’s comment above has it spot on.
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May 31, 2018 at 7:33 pm
Cath
All of the above match my experiences, except that I never got any answers & quit looking for a relationship because of it. Angry!!
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May 31, 2018 at 10:12 pm
RenzaS / Diabetogenic
I’m really sorry to hear your story. I’m also sorry to say that I have heard other women say the same thing. I really believe we have been let down in this area.
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May 31, 2018 at 7:39 pm
bectogriffin
So glad that you have broached this Renza – this is literally the first time I have ever seen anyone talk about this – I hope it’s not the last .
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May 31, 2018 at 7:58 pm
Matt
So interesting, thanks Renza. I agree with Rien, I feel like it’s pretty much the same for guys… except for one rather important detail!
I was diagnosed at 4 so I got absolutely no info either and also muddled through it. And because I didn’t get into a serious relationship until my late 20s a lot of the psychology of diabetes and sex was an equally messy and late discovery.
Here’s a thought. As someone who doesn’t have a pump or closed loop set up, what does one do with all dat cords???
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May 31, 2018 at 10:13 pm
RenzaS / Diabetogenic
Thanks for your comment, Matt. I disconnect my pump. CGM is on my arm and not in the way.
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May 31, 2018 at 11:18 pm
Anonymous
Thank you, Renza. I have been told by endo there is no time to discuss. No psychosocial support in all my years as a T1. Asked twice this year and was told just live with it because it is what it is and no support – it’s not going to change.
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June 2, 2018 at 11:36 am
B Choi
Thank you so much for sharing your ideas, Renza! Could I just translate your article and share with Korean people via social media or my blogs if you would not mind? Sadly, a number of Korean people are not so informed about what the reality of having diabeties is, especially about type 1 diabetes. My family member has got one; type 1 diabetes, but has never had any idea why her sex life has been so tiring.
I am afraid I cannot find out where your contact is, however, I promise that I will share this article not for profit but public issue!
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June 2, 2018 at 1:19 pm
RenzaS / Diabetogenic
Hello and thanks for reading. Please feel free to share and translate. Thank you for asking!
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