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Let’s Talk About Sex – Diabetes and Sexual Health

Oct 02, 2018

Individuals, families and couples are affected in many ways by diabetes. The impact is experienced physically, socially, emotionally and psychologically.  Some of these things are transparent and visible, for example dietary modification or taking insulin shots.  Others are invisible to other people but can have a big impact on how we feel or act in a given situation.  This can add to the burden of diabetes and increase feelings of loneliness or isolation.  Sex and intimacy come here.  Our sexuality is a big part of who we are yet is often overlooked for many reasons.  Our body-image, self-confidence and interactions with partners or potential partners are all affected by how we feel about ourselves.

Sexual health remains a much-neglected area in diabetes care. This is perhaps surprising since considering that sexuality for many is so central to being human and our connection with others.  Diabetes and sexual issues are very complicated as they often involve both the physical element of complications and the psychological effects of managing diabetes as well as the sexual problem. As such, it is unsurprising that sexual health is markedly affected by diabetes. Effective treatments are available which cover both psychological and/or pharmacological approaches however an understanding of the complexities of the issues is required.

Diabetes plays a role in how we feel about ourselves, how we look, how we experience and our expectations from life.  The medicines we take, or the devices we wear to manage diabetes also play a role in how that makes us feel.  What to do with diabetes devices during intimacy, for example, is a commonly asked question by people with dibetes.  Also, the visibility of such devices can impact on a person’s body image and self-confidence.

Recent research has shown that, for women, diabetes has resulted in a loss of self-esteem, feeling less attractive, feeling lonely or isolated and has a negative effect on relationships. Physically women may experience loss of desire, lack of lubrication and difficulty reaching orgasm. This research reinforces data from 20 years ago, showing that sexual health issues continue to affect large numbers of people with diabetes. Many people are not aware that these problems are common in diabetes and most do not discuss sexual health with their healthcare team.

We’d like to start a conversation about sexual health and diabetes, for men and women, and how it impacts quality of life.  We’ve listed a few questions to start that conversation but are very happy to take different or additional questions that you may have. 

Please consider the following questions:

Thinking of your own personal experience

  1. Has diabetes affected your sex life?
  2. If so, in what ways?
  3. How has this issue affected you emotionally?
  4. Have you talked with anyone about this problem?  If so who?  If not why not?
  5. Has diabetes made you feel less attractive?
  6. What does your health professional tell you about sexual problems and diabetes?
  7. What support do you think should be available?

From your clinical experience

  1. How do you start the conversation about sexual health with your patients?
  2. What support/resources would you find useful when discussing sexual health issues with your patients?
  3. Have you found the number of sexual health problems reported by your patients has increased over the years? 

Recommended links for more information:

Reference reading:

DR Meeking, JA Fosbury, MH Cummings.  Sexual dysfunction and sexual health concerns in women with diabetes.  Practical Diabetes October 2013 https://onlinelibrary.wiley.com/doi/abs/10.1002/pdi.1805

Information about the discussion leaders

Prof Katharine Barnard Cpsychol AFBPsS, is a Professor of Health Psychology and Managing Director of  BHR Ltd. She is an internationally renowned expert on the psychosocial aspects of diabetes and leads global research into sexual health issues for men and women with diabetes. She has co-authored national and international health guidelines, published over 200 peer-reviewed articles and made significant contributions to information for people living with chronic conditions, academic literature and education materials for healthcare professionals.

Joseph B.Nelson M.A., L.P., CST is a psychologist in private practice dealing with individuals and couples who live with diabetes, sexual problems, relationship issues, anxiety and depression.  He is a behavioral consultant to Elsevier publishing, and deals with patient and professional education materials.