Diabetes and Intimacy – Navigating Sexual Health Together

Living with diabetes means more than just managing blood sugar – it can affect many aspects of life, including your sex life. Though often difficult to talk about, sexual challenges are common for both men and women with diabetes. With the right information, support and communication, couples can navigate this sensitive issue together.

How diabetes affects sexual function

Diabetes can impact sexual health through several physical and emotional pathways:

• Vascular and nerve damage caused by prolonged high blood sugar levels can interfere with genital sensation and arousal in both sexes. In men, this commonly results in erectile dysfunction and in women, it can cause reduced sensitivity and pain during intercourse.
• Hormonal imbalances, especially insulin resistance, may disrupt sex hormones like testosterone and estrogen, reducing libido and energy levels.
• Psychological factors, including anxiety, depression and stress related to diabetes, can lower desire and affect intimacy.

How common is sexual dysfunction in diabetes?

Sexual dysfunction is a widespread, but underdiscussed complication of diabetes:

• Studies show a global prevalence of 65.9% of men with diabetes experiencing some form of sexual dysfunction, including erectile dysfunction and premature ejaculation.
• Similarly, 58.8% of women with diabetes report challenges, including reduced libido, difficulty reaching orgasm and vaginal dryness.

These numbers highlight how common these issues are and that you’re not alone.

For men: what to expect

Men with diabetes most commonly face:

• Erectile dysfunction, due to damage to blood vessels and nerves controlling erection. Diabetes is a common cause of ED in men under 45.
• Retrograde ejaculation, a condition where semen enters the bladder instead of exiting through the penis.
• Premature ejaculation occurs when ejaculation occurs faster than you or your partner would like.
• Anejaculation (dry orgasm) is when you climax during sex without ejaculating.

The first line of treatment for ED is phosphodiesterase type 5 (PDE5) inhibitors like sildenafil, followed by injectables and other treatments. Weight management, especially for those who are obese, also plays a role in reversing ED in diabetic men.

For women: what to expect

Women with diabetes may experience:

• Reduced desire and arousal, often related to hormone changes, emotional strain or nerve damage.
• Vaginal dryness, due to poor circulation and hormonal disruption, which can make intercourse uncomfortable.
• Higher risk of vaginal infections. Common symptoms may include itching, changes in discharge and pain when urinating.
• More frequent urinary tract infections – an infection in the organs of the urinary tract, which include the bladder and kidneys.

In addition to monitoring blood sugar levels, trying water-based lubricants, maintaining blood sugar levels and engaging in open discussions with healthcare providers can greatly improve comfort and satisfaction.

Advice for couples

If you or your partner is living with diabetes, there are ways to support one another:

1. Talk openly: Honest, compassionate conversations about changes in desire, comfort and needs can ease tension and increase intimacy.
2. Manage your diabetes: Good glycaemic control is not only vital for your overall health, but also improves circulation, nerve function and hormonal balance – all essential for a healthy sex life.
3. Address mental health: Therapy or counselling can help with diabetes-related anxiety, depression and self-esteem challenges that affect intimacy.
4. Consider lifestyle adjustments: Regular exercise, sleep and a balanced diet can improve both physical and emotional health, enhancing your sex life.
5. See your doctor: Don’t be afraid to raise sexual concerns with your healthcare provider. These issues are common and treatable.

Diabetes-related sexual challenges are more common than you might think, but with patience, communication and medical support, couples can maintain and even deepen intimacy. It starts with recognising that this is a health issue, not a personal failure and approaching it as a team.

References

1. Connell, K. (2025). Diabetes and Sexual Health. Healthline. Available from https://www.healthline.com/health/type-2-diabetes/sex-health (Accessed 3 July 2025).
2. Diabetes UK. (2025). Sex and Diabetes. Available from https://www.diabetes.org.uk (Accessed 17 July 2025).
3. Edwards, D., & Panay, N. (2016). Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric. 19(2): 151–161. https://doi.org/10.3109/13697137.2015.1124259
4. Gebeyehu, N. A., et al (2023). Global prevalence of sexual dysfunction among diabetic patients from 2008 to 2022. Metabolism Open. 18, 100247. https://doi.org/10.1016/j.metop.2023.100247
5. Navriya S.C., Jain, M., Yadav, O., et al. Sexual Dysfunction in Female Patients with Diabetes. In: Endotext. Available from: https://www.ncbi.nlm.nih.gov/books/NBK612823/
6. Shindel AW, & Lue TF. (2021). Sexual Dysfunction in Diabetes. In: Endotext. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279101/
7. Zadra, J. (n.d.) The Hidden Impacts of Blood Sugar Imbalances and Insulin Resistance. California Center for Functional Medicine. Available from: https://www.ccfmed.com (Accessed: 16 June 2025)