Sexual health is an important part of your overall wellbeing. Sexual health is another aspect of health that is influenced by diabetes. Diabetes can affect the sexual health of both man and women. Controlling the blood glucose can prevent these common but less discussed side effects of diabetes. Some people find it difficult to discuss sexual matters. But it is important to discuss about this with your doctor if you have problems.

Erectile dysfunction

It is estimated that more than half of men aged 50 or above who have diabetes experience some degree of erectile dysfunction which is also called impotence. Erectile dysfunction refers to inability to achieve an erection of the penis or to maintain an erection long enough for sexual intercourse.

Erectile function is caused by both physical and psychological factors. Excess blood glucose damages the nerves and blood vessels responsible for erection and not enough blood reach the penis for erection. The psychological factors include stress, anxiety, fatigue and depression.

It is normal to experience erectile dysfunction occasionally. But if it occurs more frequently, then medical attention should be sought. The treatment includes:

• Drugs like sildenafil (Viagra), tadalafil (cialis) and vardenafil (Levitra), alprostadil
• Self administered intraurethral therapy with alprostadil
• Self injection therapy with alprostadil
• Vacuum devices
• Penile implants – semi-rigid bendable rod, Inflatable

Menstruation and diabetes

Diabetes can affect sexual health both during menstruation and after reaching menopause. During the menstrual cycle there is fluctuation of the hormones like estrogen and progesterone which can alter the blood glucose levels. Most women with menstrual related changes in the blood glucose notice it in the 7- 14 days before bleeding begins. Blood glucose generally stabilizes a day or two after bleeding begins. High blood glucose can lead to problems like:

• Yeast infection of the vagina
• Irregular menstruation
• Loss of skin sensation around the vagina

These are all treated by regularly monitoring the blood glucose levels. If abnormality persists, the dose of drugs for diabetes should be adjusted.

Menopause and diabetes

Even after menopause diabetes can affect sexual health in women. After menopause the ovaries stop producing estrogen and progesterone and there is a constant swing in the blood glucose levels. Due to hormonal changes you will be experiencing symptoms like hot flashes, mood changes and fatigue. Sometimes you might be wrongly attributing these changes to low blood glucose and start consuming more sugar which may increase the blood glucose levels. The problems caused by diabetes in menopausal women include:

• Vaginal dryness- the vagina becomes thin and dry due to a decrease in the blood flow
• Yeast infections – Increased levels of glucose in vaginal mucus and vaginal secretions that are less acidic and protective increase the susceptibility to such infections
• Urinary infections – Thinning of the lining of the urinary bladder increases the susceptibility to infections

Though you get confused by the symptoms of diabetes and menopause, you can treat them by regularly monitoring the blood glucose, working with the doctor and adjusting diabetes medications and getting the consultation of a gynecologist for relief of menopausal symptoms.