Hormonal Changes. Many women find that during their menstrual cycle, and especially around the time of their period, their blood glucose levels are erratic, and they have less energy for everything, including sex. During menopause, hormone levels change, and some women find that their blood glucose levels go up and down. Mood changes and hot flashes are also common during this time. Although menopause does not affect sexual desire, some women find that they have vaginal dryness that can cause sexual relations to be painful or uncomfortable. You can buy lubricating gels (e.g., water-soluble jelly) that can help.
You can also ask your provider about estrogen creams.

Lack of Sexual Desire. Some women find that they are just too tired. They are coping with busy lives, caring for children and
grandchildren, working, and trying to find some time for themselves. Diabetes adds additional stress and work to their lives.
High blood glucose levels add to feeling tired and run down.

Because of nerve changes related to diabetes or simply due to getting older, some women find that they need more stimulation to fully enjoy sex.

Depression is more common among people with diabetes.
Depression usually causes people to feel less interested in sex. In addition, some of the medications used to treat depression can affect sexual desire.

For women using insulin, worries about low blood glucose reactions during sex can get in the way. Women with either type 1 or type 2 diabetes may feel less desirable or that their bodies are less attractive as they get older and perhaps heavier. Having complications from diabetes can also cause you to feel less desire both emotionally and physically.

There are things that you can do:

•   If you have dryness, infections, or are worried about getting pregnant, talk with your diabetes care provider or your gynecologist.
•   If you are worried about your blood glucose levels, do a quick check before you have sex. Knowing that you are not likely to have a reaction can help you relax and enjoy yourself. You may also want to keep something to treat a low glucose by your bedside so that if you do go low, you won’t have to get up.
•   If you feel sad and blue or if your sadness is affecting your desire for sex, talk with your provider. There are medicines that will work for depression that do not affect your desire for sex.
•   Help set the stage to get into the mood. Take time for yourself and your partner. Let your partner know what will help you to feel more romantic and in the mood.

—
Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association

American Diabetes Association Complete Guide to Diabetes