Diabetes Type 2

Sexual problems

Many people with diabetes type 2 will experience sexual problems. According to Diabetes UK, more than half of men with diabetes may be affected and the possibility of problems increases with age. Female sexual dysfunction (FSD) is thought to be twice as common in women with diabetes. Diabetes in men can cause erectile dysfunction (ED) or impotence. Some men may experience ED before they know they have diabetes, but generally it tends to occur later as the disease progresses.

Lawrence noticed occasional erectile problems before he was diagnosed with diabetes and thought...

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Age at interview: 38

Sex: Male

Age at diagnosis: 37

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In fact it started it started, that was probably one of the early symptoms but I didn't understand or didn't associate it then because, I started having erectile problems earlier on before my toilet runs increased. And I thought maybe it was just fatigue or stress or whatever, so I didn't put much to it, and it didn't occur on a regular basis it was, you know, once in a while. So you know, then I understood that I had an erectile problem and then when the diabetes picture then came in and then I put one and one together and I realised that okay that's what it is. But, you know, you come to, to understand that that's what it is and you get a choice of how you want to deal with it, either you go into abstinence or you use medication so, you know, we've gone the medication route and we, and that's what's helped us yeah.

Sexual dysfunction in men means that they cannot get and/or maintain an erection. In women it means that they lose desire, suffer from vaginal dryness or experience pain during sex and cannot reach orgasm. Sexual dysfunction is more likely to occur when someone's blood glucose levels are not being well controlled which means that nerves and nerve endings become damaged and physical sensations are reduced.

It is not always possible for doctors to know exactly what causes erectile dysfunction; it may be the result of diabetes or other health conditions such as hyperthyroidism. Also, some medications such as beta blockers which slow the heart rate may affect the ability to have erections.

Andy thinks that his erectile dysfunction may be a side effect of Prozac which he takes for...

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Age at interview: 52

Sex: Male

Age at diagnosis: 52

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The one thing that he warned me about there are side effects with a number of the drugs, medicines sorry, that I'm taking, can cause depression. And I could see on occasions like this black fog coming down, and I knew it was depression, and I fought it and I fought it and I fought it and I wouldn't let it get to me. I had a bit of a bad time a work and next thing I know is [clicks fingers] I'm depressed. And I could recognise it but there was nothing I could do about it. I didn't want to do anything about it actually. I suddenly went from, I am going to fight this to, I've got it and I don't care. I didn't care. I didn't not care either. I didn't do anything'

Eventually I kind of, yeah alright, I'll go and see the GP. Made an appointment and he asked me all these questions. There was ten questions he asked me, to do with state of mind and what you're thinking and stuff and. 'Yep', he said, 'You're depressed', [laughs]' So he put me on Prozac. Again I reacted, quite upset tummy and stuff for the first few days I was taking that. And there's a bit of spark back to me now.

Are there side effects with Prozac?

Well there are side effects to everything. Most the worst side effect to everything is erectile dysfunction. I was struggling anyway with my bad back because of the damage to my disc and lower back, so there was a problem anyway. But the combination of all these tablets in my system has just finished everything off. So that's a contributor to depression for a bloke particularly.

The tablets, I think it's the tablets that were sort of, because depression, as I understand it, is a chemical misbalance in the brain, and I could kind of see that it was there and I'm pretty sure that the tablets were contributing to that; mucking up the chemical balance, so it was kind of there but I was fighting it off.

Sexual dysfunction in men and women with diabetes may also happen when someone is depressed about how diabetes is affecting their lives. Several people said that diabetes had affected their self-confidence and caused depression and mood swings.

Gugu says that diabetes has affected every part of her life including her interest in sex and...

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Age at interview: 43

Sex: Female

Age at diagnosis: 33

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' I think neglect. I would say neglect of' And you know, like I said to you at the beginning, the warning signs and they were just sort of' They were easier to ignore. But when you have the diabetes now, I can try and ignore it, but it's not easy any more because its impacting on my day-to-day life, I mean it's impacting on everything. I mean even in terms of relationship, libido, everything it's just like, do you know... You just don't know. I just had no idea of all the things that, you know, it can sort of enter every part. It's not just a health thing it's...

Tell me about the libido because a lot of men have talked to me about that, but not so many women.

Well, for me, whilst I was, before I separated' I mean it was just like' it's the tired. You see the thing is maybe it was a bit of both with the thyroid thing going on and the, so I don't know which, which came first, you know what I mean, so. But yeah, just feeling, just not ever wanting to have sex again, and it's quite strange for someone who wanted a child, not to be, do you know what I mean? Even for that I just lost my appetite for it completely. But then also, I also acknowledged that I had, sort of like, heavy bleeding for two months and obviously it all goes to have an impact on relationships, you know what I mean, and the mood swings from both, or from all three things really, you know, so.

Most men said they were not as yet having any problems about sex, but felt that if they did experience ED it would be a serious worry for them that could well affect their relationship with their partners but would also affect their sense of masculinity. Those men who admitted to having experienced ED at some time said that even though their masculinity was affected it would probably not diminish their long-term relationship with their partners.

Lawrence describes how he and his wife have coped and how the GP helped them sort things out.

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Age at interview: 38

Sex: Male

Age at diagnosis: 37

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It's something that you learn as you go along, you know, as much as the doctor can tell you, 'Look you're gonna have problems in terms of your erections.' And you say, 'Oh okay, fine.' But it's different when you get into the practicalities of things and you know, fortunately I have a very understanding wife so she understood that. But it does have an effect, you know, when I was going through the internet that's when I really read it in detail and the biological effects it has, you know, on your , on your erectile system and so forth. So that again was so like a sub-shock in itself to say, 'Oh okay, right this is...' because obviously any healthy marriage, sex is an intimate part of it, and that then compromises in terms of, you know how you deal with it and so forth. But fortunately my doctor's able to help me and , you know, that's, that's come about quite nicely so, again it's something that you have to learn to do.

Is the medication route viagra basically?

Yeah it's viagra I wasn't sure whether I should use the name or not but, but yeah it is viagra and, and I think also [name] the other thing that helps is both the husband and wife's attitude towards it. Because, you know if, if you take it as a loss it, it can create so much stress in your marriage, and, and it can cause complications in terms of the relationship between the two of you, the emotional response to it because you know, as a man, you know, [laughs] you measure your manhood in terms of your sexual prowess and so forth, for want of a better word. And so when that's taken away, that's like taking an engine away from a car, it can't operate, but because my wife and I, you know, discussed this and came to an understanding about what is going to happen and how it's going to affect us, we took a positive approach to it, in terms of well this is what we have, how can we get around it, or how can we get by with it?

And I spoke to my doctor and he said, 'Look there are options.' And back then I thought viagra was just something, but he says, 'Look you, you've got an option of viagra.' Which I discussed with my wife and we said, 'Yeah well let's go for it.' So that's the upturned side. But you know, even now I don't necessarily need it all the time it's just, you know, periodic that once in a while that I get to use it but, that's also helped, and, and of course just being positive about it, yeah.

Very few men had ever discussed the possibility of sexual dysfunction with anyone face-to-face, including the GP. Most men took the view that as long as everything was going fine they didn't particularly want to talk about ED, and that they hoped they would never have any sexual problems. Some men said they only knew about erectile dysfunction because they had read about it on the internet, or in articles in the media. One man said he first read about ED in Balance, a magazine produced by Diabetes UK. A few men had attended lectures that had mentioned erectile dysfunction at a diabetes support group.

Paul says he has a good sex life but that he would seek help immediately if anything changed.

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Paul says he has a good sex life but that he would seek help immediately if anything changed.

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Age at interview: 52

Sex: Male

Age at diagnosis: 38

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Oh yes of course it would. Yes, it would. It's obviously, you know I'm 52, but to me I am still a reasonably young man. So yeah, I do enjoy a good sex life and I want to carry on enjoying a good sex life, and yes it would be something that would worry me, if it affected things like that. But again if it does affect it, you can't be embarrassed about it, you've got to go and see about it. The quicker you go and see about it, the quicker you can get a result. Because if there's something wrong they can sort it out. But if you leave it, and leave it, till the point of no return, there's nothing you can do. Oh yes. It's sort of, you do get asked that at your MOT.

Oh you do?

Yes.

Yes and is it something that, you could discuss with anybody else do you think in the diabetic group?

I can. I am not embarrassed about it. I could discuss it with you. But certain people, can't. So, if you can't, then you've got to find somebody who you're comfortable with, talking with, to discuss it. But you can't sort of push it to one side, and say, 'I am not talking about this.' Because you can't, you've got to get it sorted. You know it's like loads of things, if your eyes are blurry, you'd go and see an optician. If you had a bad foot, you'd go and see' You'd go and see a doctor, or you would go and get it sorted. If you have got a problem sexually, you either need to go and see a doctor, or you need to talk to somebody who you feel happy with talking to. Probably the best one to talk to is your doctor. Male or female. If you're not, if you're not prepared to talk, or are sceptical of talking in front of female about it or you get embarrassed, then go and talk to a male doctor. If you are worried about talking to somebody face-to-face, then speak to somebody over the phone about it. But you can't leave it go, you can't, it is part, unfortunately it is part of the diabetes and you've just got to accept it, and just got to say, 'Fine, I'm having a problem with it. I'll go and see about it'. It could be something so simple. And it could be something, perhaps not so simple. But until you go and speak about it or get it sorted, then you're never ever going to get it sorted. And it will get to a point, perhaps they won't be able to do anything. I mean there is marvellous medication on thing I have been told. That's it. But no I'm fortunate, like as I said. I've been very fortunate with it. I sort of haven't had any side effects at all, as yet. I never say I never will, because it's 'as yet'.

People approached sexual dysfunction in different ways, and not everyone had yet discussed the problem with their partners. Those who had experienced ED on several occasions and had gone to the GP for advice, were pleased to discover that something could be done to help. One man had changed his anti-diabetes medication, and another had been prescribed Viagra (sildenafil).

Last reviewed March 2016.

Last updated March 2016.