Damage to the vascular system can reduce blood flow. If the blood vessels aren’t functioning properly or if an artery is blocked, not enough blood will travel to the penis, making it difficult to get an erection.
Nerve function plays a role, too. If the brain isn’t properly communicating with the nerves in the sexual organs, the body might not be able to shuttle blood there, impairing a man’s ability to get an erection. The ability to keep an erection can also be affected, because the brain must communicate with the nerves to hold blood in the penis. (Keep in mind: A man’s ability to get and hold an erection typically wanes with age.)
Fortunately, there are plenty of treatment options, including PDE5 inhibitors, such as Viagra and Cialis, which improve blood flow, testosterone injections or gels (if testosterone levels are low), injectable medications or suppositories, constriction rings that sit at the base of the penis, vacuum pumps that draw blood into the penis, support sleeves that hold the penis in place during sex and penile implants. Be sure to talk to your doctor to see if there’s an option that will work for you.
Nerve damage may also cause vaginal dryness, which is twice as common in women with diabetes as it is in women without diabetes. It’s also a result of aging. Vaginal dryness is very common among women who are menopausal or post-menopausal, due to a lack of estrogen. Problems may be treated with prescription estrogen, available in pills, a patch or a cream used in the vagina.
Because researchers don’t understand exactly why women’s bodies lose the ability to self-lubricate when menopause isn’t the cause, treatment options are slim. Most experts recommend using store-bought lubricant.
Women with diabetes are also prone to the same blood-flow issues men face because of nerve or blood vessel damage. Diabetes complications may make it difficult for blood to move to the vagina and clitoris.
There are also some women with excellent A1Cs who don’t have any blood vessel issues or neuropathy, but still have sexual problems. Because studying female arousal problems is difficult for many reasons-women may have a hard time determining just how turned on they are, and there’s less of a physical sign of arousal in women than there is in men-treatments are few. But the research is promising.
A small study in an issue of The Journal of Sexual Medicine found that women with type 1 diabetes who took 5 mg of tadalafil (Cialis) for 12 weeks reported an improved quality of life, greater arousal and orgasm, more enjoyment and satisfaction from sex and more frequent sex. This doesn’t mean you should start sneaking your partner’s pills-please don’t! The treatment is currently not approved in women, dangerous in some people with heart problems and generally unsafe until proved otherwise. But it does show promise for female treatments of the future.
As for the present, some women use clitoral pumps to aid blood flow but keep in mind that this device isn’t for everyone.
The big O-orgasms
An orgasm is a sought-after sexual reward, but for people with diabetes it can feel like an unattainable goal. And, yes, we’re talking about women and men here. Both can struggle with the elusive O, and the first thing they and their doctors should check are the medications they take, such as antidepressants.
Having an orgasm is usually pretty easy for men, which is why it can be so frustrating if a man’s unable to finish. Men suffering from neurovascular damage-and the lack of blood flow and/or sensation it creates-can have a hard time reaching an orgasm. Men can get around erectile dysfunction with a variety of treatments, ranging from medications to vacuum pumps, but these treatments will not fix neuropathy.