While the internet is overloaded with articles on the potential effects diabetes can have on a man’s sexual health, there are very few studies looking closely at the sexual health of women with diabetes.

The reality is that diabetes — both type 1 and type 2 — can absolutely affect and interfere with your ability to enjoy sex as a woman.

More specifically, there are three ways diabetes can impact your body’s sexual function and well-being:

• Nerve damage in the clitoris
• When low blood sugars prevent orgasms
• Overall lack of lubrication 

Diabetes can affect nearly every single part of your body — including the parts that make sex happy and make sex feel good!

Let’s take a closer look.

Nerve damage in the clitoris

Chances are if you’ve developed nerve damage in your fingers and toes (neuropathy) or your eyes (retinopathy, you may have nerve damage in other nerve-laden areas of your body, too — like your clitoris. 

Also referred to as “the pleasure center” by PlannedParenthood, the clitoris’ only purpose is that physical “feel good” sensation when you’re aroused. 

The clitoris also contains thousands of nerve endings — “more than any other part of the human body” according to PlannedParenthood!

More than any part of the human body. And we know that two ways persistently high blood sugars can create long-term damage in the human body is through damaging blood vessels and nerve endings. 

• If you’ve experienced nerve damage in your clitoris, you may struggle to feel as much pleasure when you’re engaged in sexual activity. 
• You may also struggle to achieve an orgasm when your clitoris is being stimulated (by you or your partner) because the damaged nerves mean you’re going to feel less overall.
• And high blood sugars can also mean less blood flow (poor circulation). Just like a man’s erection relies on blood flow, a stimulated clitoris also relies on blood flow. 

Unfortunately, there isn’t a way to repair the damaged nerves, but improving your blood sugars will ensure you don’t succumb to further damage. 

• Since there are thousands of nerves in your clitoris, there’s plenty of them worth saving by working with your healthcare team to bring your blood sugars down to a healthier, safer range. 
• And healthier blood sugars also mean healthier blood flow — which means more fun for you between the sheets.

When low blood sugars prevent orgasms

You can likely recall how weak your arms or legs or brain feels when your blood sugar is low — right? And the explanation is pretty simple: when your blood sugar is low, your body will struggle to function at full-steam. 

Your brain is going to become first priority, and guess what? Your clitoris is likely near the bottom of the priority list when glucose is scarce.

• That means a low blood sugar with poor timing — like when you’re engaged in an activity that would normally lead to a mind-blowing orgasm — could very easily keep you from orgasming.
• If your heart is already pounding from all the fun activity and you’re already a little sweaty, it might be hard to notice the usual symptoms of low blood sugar during sex. Instead, you’re fully engaged in the shenanigans and working towards an orgasm that just doesn’t seem like it will ever arrive.
• You may realize mid-shag, and grab some glucose tabs from your nearby nightstand, or you may not notice until all the fun has stopped, you stand up, and realize you’re extremely dizzy from good ol’ fashioned hypoglycemia.

Either way, it’s annoying. Sometimes really frustrating or even embarrassing. And it’s not always preventable.

• What you can do, on some occasions, is to anticipate that a half-hour of sex is like a 15 to 20 minutes of power walking, in terms of how it might impact your blood sugar. Or three hours of sex is like an hour of power walking.
• Now, certainly, sex is never the same experience or physical intensity every time and it’s remarkably impossible to anticipate, but if you know it’s on your upcoming agenda, you may consider cutting back the insulin dose for dinner that night or popping a bit of glucose (via candy, juice, tabs, etc.) before things get too wild, to prevent hypoglycemia.
• It’s a tricky game, with no one-size-fits-all approach.

Check often. Keep glucose nearby. Tell your partner what’s up so they can support you. And of course, have fun. 

Overall lack of lubrication

Well, yeah, if you’ve experienced nerve damage in your clitoris from persistently high blood sugars, this also means you’ve probably experienced blood vessel damage, too, and you likely struggle with overall blood circulation.

The vagina produces its own lubrication in response to arousal. 

• If your body is struggling with blood circulation due to high blood sugars, nerve damage, and blood vessel damage, your vagina isn’t going to get all the cues it needs in order to self-lubricate during sexual activity.
• This can lead to regular vaginal dryness which can make sex pretty uncomfortable, and downright painful for some women.
• There are certainly other causes of vaginal dryness, including breastfeeding, menopause, and medications. 
• For women with diabetes struggling to maintain healthy blood sugar levels, vaginal dryness is unfortunately just another way diabetes impacts your overall health.

The first thing you can do is talk to your healthcare team ASAP and work together to improve your blood sugars. This may be through an increase in your insulin or other diabetes medications, changes in your diet, or adding exercise to your daily routine.

The second thing you can do is talk to your gynecologist about different approaches to treating persistent vaginal dryness. 

While there is a slurry of lubricants available on the shelf at any pharmacy, there are also prescription lubricants that can be applied every few days that will ensure more moisture for a couple of days after it’s been applied. This means you don’t have to sneak to the bathroom right before having sex or deal with the embarrassment of asking for more lubricant to be applied. 

Sexual health is not an easy topic to talk about. It can come with a lot of embarrassment, shame, and confusion.

If you think your diabetes is having a major impact on your sexual wellbeing, talk to your doctor. That’s what they are there for — and you can be sure that you aren’t the first patient they’ve had who needed help on this topic.