Diabetes In The Bedroom

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Ann Rosenquist Fee says that she has managed to keep diabetes out of the bedroom:

I was diagnosed just before my 3rd wedding anniversary. This summer, we'll celebrate our 25th. In those 17years, diabetes has been less disruptive to my sex life than the glasses I wear at night, or the mouth guard I use to keep from grinding my teeth when I sleep.

I don't wear an insulin pump, so as long as I can tell the difference between the flush/sweat/rapid pulse of lust and the flush/sweat/rapid pulse of hypoglycemia (I usually can and in case not, I've got glucose tablets in a drawer right next to the lube), diabetes stays out of my bed.

How does a woman feel sexy with a plastic pump attached to her legs, lower back, stomach, or arms? When your husband, boyfriend, or girlfriend puts their hand around your back, how do you feel when they brush against your pump? Do the bruises on your stomach from injections make you feel less desirable? Does the extra weight make you want to dress in loose, less revealing clothing?

Having sex for the first time can be an exciting, embarrassing, and overwhelming event. For young women with diabetes, the fact that we have to think about our blood sugar and/or medical supplies getting in the way can create additional feelings of self-consciousness. Diabetes may keep some women from rushing into having sex, whereas diabetes may act as a catalyst for others. For the rest, like Ann, diabetes won't make a difference under the sheets at all.

Self-esteem and Sex

My personal theory is that in order to feel sexy and fully enjoy sex, we need to feel pride instead of shame when it comes to our physical selves. I think, many women with diabetes are often at war with their bodies. We deny ourselves of food in order to be thin, beat ourselves up when we eat more than we think we should, and when we look in the mirror, we only see the things we don't like. As women with chronic illnesses, we are constantly "battling" our bodies into submission, we are "waging a war" against blood sugars, and war is not sexy. We treat our bodies like scientific experiments, and our sexual satisfaction will only increase when we learn to be kind to ourselves and honor our physical selves. Having good sex and feeling sexy doesn't come naturally for a lot of women, and if we want to get good at it, it'll take practice. We need to learn to visualize our physical selves as healthy, strong, and sexy.

Research has shown that up to 35% of adult women with type 1 diabetes report sexual dysfunction. Dr. Albright says there is not a lot of research about women, diabetes, and sexuality. "It appears as it is not as much about the complications or the blood sugar-blood pressure relationship that affects sexuality. It is shaped much more by confidence in yourself and by depression, and your relationship with your partner."

Lesley Hoffman Goldenberg says that there were a lot of other things to be self-conscious about, aside from wearing a pump.

Rachel Garlinghouse says that diabetes has taught her how important it is to take care of and be kind to her body:

I have curves and a healthy, able body. The most important thing is good health—not a number on the scale or a dress size. I appreciate how hard my body works for me, and I don't get caught up in insecurities, which will only hamper my diabetes progress. I have far too much going on in my life to stand in front of the mirror and pick out what I don't like about my body.

Diabetes educator and type 1 diabetic Claire Blum says:

I believe it is important for women to know that decreased sex drive is not necessarily a part of having diabetes. There is conflicting evidence regarding the impact of blood glucose control and sex drive . . . but there are many variables in the research that have not been controlled for . . . including the variability of blood glucose (something we see mentioned a bit more now that people have CGM and are learning how to decrease that variability) . . . and there is evidence that improved glucose control is an important aspect of sexual health.

The endocrinologist that I work with tells women that sexual interest and sex drive are a sign of health . . . which of course includes the integration of mind, body, soul . . . or balance. Good nutrition is an aspect of health that is often neglected with diabetes. . . with so much emphasis on taking the right amount of insulin and BG management. . . many women do not realize the importance of proper nutritional intake.

This is one of the areas where I believe proper education and support is of utmost importance. Even though surveys and research may show that women with diabetes often experience a decrease in libido . . . it is important to recognize that a decrease in sexual desire is not an inherent outcome of diabetes. We can be as healthy, if not healthier, than woman who do not have diabetes. Sexual desire is a sign of health, and sensuality, a state of mind that is nurtured when we find balance in care of our body-mind-soul.

Understanding Our Bodies

Janis Roszler, RD, CDE, LD/N, the 2008-2009 Diabetes Educator of the Year (American Association of Diabetes Educators [AADE]), said that women need to understand their bodies. She has written several books about relationships and diabetes and gives talks to increase education about diabetes and sexuality.

Understanding the anatomy of our bodies includes more than knowing if we are high or low. We also need to know how our bodies work in order to achieve pleasure. Too many women think it is their fault when they can't achieve orgasm through sex with a partner, when in fact, statistics show that for all women, the percentage of achieving orgasm through plain, old-fashioned sex is low.

Part of understanding our body is understanding our menstrual cycle. Janis says arousal is affected for women with type 1 diabetes during the "luteal phase." From the day after ovulation until the day before the next period expect:

■ Decreased arousal

■ Impaired ability to achieve orgasm

■ Increased discomfort/pain during sexual penetration

■ Decreased sexual function independent of mood, not influenced by glycemic control

Orgasms are hard to achieve for many women, including women with diabetes. Rachel Garlinghouse says:

I know, without a doubt, that diabetes impacts every area of my life. If my sugars are too high, I'm dry all over, including vaginally. That's obviously not pleasant. If I'm low, sex isn't enjoyable. It's hard to be spontaneous when my number one priority has to be diabetes, not spur of the moment sex.

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