Living with Type 1 Diabetes

Sex and the Single Insulin Pump

 

Sex with an insulin pump is a hot topic on diabetes websites. T1 blogger Kerri Sparling, who has written about pump sex in her blog SixUntilMe.com, says it’s definitely a popular conversation among T1 women’s discussion groups, with FAQs like “How do you deal with wearing a device when naked?”, “Do you disconnect a pump during intimacy?”, and “Does the pump get in the way, physically or emotionally?”

Andrea Z., a 38-year-old single business executive and pump user (who prefers not to give her last name), admits that she’s gotten a few “interesting reactions and facial expressions” from boyfriends when the pump is exposed during sex, but the awkward moment is usually fleeting.

“I try to explain my situation early on so they’re not surprised,” she says. “And, I’ll remove it if it gets in the way of too much fun.”

For some pump users, sex is a non-issue; it’s something they’ve learned to adapt to and communicate about with a sexual partner. But for others, being intimate with someone, especially for the first time, brings up self-conscious thoughts and insecurities. Some people wonder if they can still be seen as sexually attractive with tubes attached. Others wonder if asking a partner to shift because he or she is pressing on the pump will kill the mood. Results vary, of course, but the good news is that sex with a pump is not only doable, but can be pleasurable, according to most pump users. A 2010 study published by Diabetes & Metabolism found that 90% of T1 folks on pump therapy did not find the pump an obstacle to sexual activity.

Sparling chooses to disconnect the pump before sex. Even then, it sometimes has gotten in the way during foreplay, like when she’s trying to disconnect the pump and trying to figure out where to stash it. For her, the pump is more of a postcoital problem, as she needs to remember to reconnect it. Some women set the alarm on their pump or set reminders on their phone to remember to reconnect before dozing off. She also admits there have been times when it has gotten in the way emotionally. She admits in her blog that being completely naked (sans pump site and CGM transmitter) “is a weird feeling, and I always feel like I need to give my husband a head’s up as to where my devices are currently connected.”

Disclosure and communication are the two main issues that tend to come up when talking about sex and diabetes, says Dr. Amber Taylor, director of the diabetes program at Mercy Medical Hospital in Baltimore. She believes honesty is the best policy.

“It’s an important part of being you, and, if they’re a keeper, they’ll want to know how they can be helpful,” Dr. Taylor says.

What to do with the pump is a personal choice, she says. Most folks leave their pumps on and set them next to them in the bed. Some women clip their pump to their bra or a necklace, while others create a waist strap for holding the pump. Those who choose to disconnect temporarily will still have insulin circulating in their systems, so there is still the risk of lows. If a pump user chooses to disconnect, it’s important to make sure to reconnect within 30 minutes or one’s BG will start to climb.

Sexual activity doesn’t burn as many calories as we might think (or hope), and most people don’t notice an appreciable BG drop, but there are always exceptions, Dr. Taylor says. This is especially likely to occur if you’re “distracted” for an extended period of time and miss your usual meals or snacks.

Scott Johnson, a T1 blogger (http://scottsdiabetes.com/) who uses a traditional tubed pump, confesses he’s had some lows during sex, which can can kill the mood altogether. Though he tries to be vigilant regarding his blood sugar, he admits it can often be hard to “prepare” because sex is not always a scheduled activity, especially with young kids in the house. Johnson says he might drink a juice when he sees a downward trend on his CGM or feels “funny” as things heat up. It’s rare that it’s problem, but just as with everything with diabetes, lows happen.

“I’ve gotten lows when I’ve done everything right,” he says.

Johnson says sex can be an especially sensitive subject for men with diabetes, and he’s avoided discussing it to this point on his blog, even though he’s aware that sexual dysfunction is a major concern for men with diabetes. Like Amber Z. and Sparling, he’s a big believer in communication. He talks to his wife often about how diabetes and sex intersect, and finds she is a very understanding partner. She’s been with him since high school and was instrumental in his decision to move to a pump.

Sex is also something people with diabetes should discuss with their doctors, but about half of all men with diabetes and a fifth of all women have broached the topic in the doctor’s office, according to the Diabetes Care study. If you’re feeling bashful about talking about pumps and sex, Dr. Taylor suggests looking for answers on online forums, but she hopes more people will grow comfortable talking to doctors and nurses about this important subject in the future.

“Sexuality is a normal and expected part of life, so feel free to ask your pump educator or doctor these questions,” says Dr. Taylor. “Be reassured that we’ve heard it all before!”

shutterstock_106348880_Happy_In_Bed_300pxAs for how to enjoy sex safely, there are some steps to take beforehand that can help, especially if you’ve experienced low blood sugars during intimate moments. If sex seems like it’s in the cards, Dr. Taylor suggests approaching it the same way you’d approach any exercise regimen. This includes timing it roughly 90 minutes after a meal, decreasing basal prior to the event, and checking blood sugar before you begin. Of course, none of that is easy to do with an unplanned sexual encounter, and no pre-planning can guarantee good BG all the time, so sometimes you just have to roll with it.

“Funny stuff happens in the bedroom, not all of it is related to diabetes,” Dr. Taylor says. “It’s best to prepare, but if you have a low when you weren’t expecting it then fix it, laugh it off, and move on. Maybe your mate will be pleased with themselves for inspiring such a dramatic effect.”

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Jeanne Muchnick is a freelance writer who specializes in health and lifestyle issues for a variety of print and online venues.

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