Could a chronic condition be to blame for your sexual dysfunction?

Most people are aware that diabetes contributes to heart disease, stroke, peripheral vascular disease, blindness and renal failure. It’s a progressive disease that can debilitate one’s body, organ by organ, when left out of control. But did you know that, long before any of these take place, diabetes can kill your sex life?

Diabetes itself is not responsible for the damage done to the body.  Instead, it is the rise in blood sugar that comes from either insufficient insulin release (type 1 diabetes) or a body’s resistance to the effects of insulin (type 2 diabetes).  Unlike type 1 diabetes, which starts in childhood, type 2 diabetes begins in adults and is almost always related to being obese or overweight for some time.  Often, it can be reversed if you return to a normal weight.  Many doctors are happy if they see their diabetic patients maintain their blood sugar under 150, or even 180 if they’ve had the disease for a while.  I believe, however, these levels still permit slow degeneration of the tissues and nerves of the body, which can severely affect quality of life.  Ideally, a level between 80 and 125 is best.

Good sexual functioning depends on good blood flow and the ability to not only perceive sensations, but to have the organs and tissues respond to these sensations.  When your blood sugar is high, cells cannot function properly and nerve endings become damaged.  This can cause numbness—or worse, uncomfortable tingling.  Uncontrolled levels of blood sugar also damage the blood vessels by decreasing their ability to relax and contract when needed, as well as by raising the risk of atherosclerosis, which in turn impairs blood flow.

These changes can affect your sex life, too. Nerve damage can result in decreased sensation in the genitals, which makes it more difficult to become aroused when touched or stroked.  Impaired blood flow commonly causes erectile dysfunction in men and lack of lubrication or difficulty reaching orgasm in women.  To make matters worse, patients with diabetes have a poorer response to medications for erectile dysfunction.

Maintaining very careful control of your blood sugar can prevent damage, but requires close attention to food choices, avoidance of sugar and simple carbohydrates, portion control and complete compliance with diabetic medications.  The damage to your sex life can sneak up on you, but it’s very disheartening when it happens.  Prevention is key.

If you have diabetes, be sure to take care of your:

1. Arteries. Keep your arteries healthy by eliminating trans fats from your diet. Eating a balanced diet low in sugars and high-glycemic carbohydrates also keeps your body from producing too many triglycerides, which clog up arteries by sticking to their walls. Also, consider reducing the amount of fructose and high-fructose corn syrup (corn sugar) in your diet, since the body does not treat these the same as sugar, and instead increases your triglycerides in response to them. High blood pressure also decreases the availability of blood to the tissues because the arteries tend to tighten up. Watch your salt intake and take five to 10 minutes each day to practice some quiet relaxation or meditation. These are proven ways to protect against high blood pressure.

2. Nerves. Diabetes and chronically elevated blood sugar are the biggest culprits in nerve damage. People with diabetes often develop neuropathy in later life if they have not kept their blood sugar under control. Eating smaller, more frequent meals rather than a few very large meals a day helps your body maintain a steadier blood sugar level without the spikes that damage the body and the lows that make you insanely hungry. Watch your alcohol intake too, since it tends to cause uncontrolled blood sugar and produces toxins that pickle your nervous system as your body metabolizes it.

3. Tissues. Our bodies are designed to be in motion and be put to use. Yet our modern lifestyle allows for the opportunity to sit on our behind for most of the day, decreasing blood flow to our legs and genitals, and putting a great deal of strain on our lower backs. We have to get up and move for at least a few minutes every half hour or so.

“If you want to have good blood flow to your genitals, you’ve got to use your genitals and have sex,” says Ian Kerner, author of the Good in Bed Guide to Overcoming Premature Ejaculation. In fact, people who have sex at least once a week have a better chance of keeping their sexual functioning as they get older because they are encouraging regular bursts of blood flow to the area.

Diabetes is a serious, chronic disease that can affect your whole body—including your sexual health. Don’t risk an unnecessary wrinkle in your sex life by letting it go unchecked. Remember, better control of your blood sugar can mean better outcomes in the bedroom, too.

A psychiatrist specializing in sex therapy with couples and individuals, Dr. Madeleine Castellanos is committed to helping others learn about their own sexuality, and how to achieve physical and emotional balance in their sex lives. She is the author of the Good in Bed Guide to Male Sexual Problems.