Managing Intimacy with Type 1 Diabetes

Diabetes can be troublesome on a good day and can get in the way… especially during moments that are more intimate. There is no doubt that date night with diabetes can get a little tricky. Keeping the “magic” alive with Type 1 comes down to preparation and communication.  

Diabetes can be affected by sex and sex can be affected by diabetes.  Talk with your partner about how you manage your diabetes, what kind of tools and technology you use, where you wear them, what causes a low blood sugar, how to recognize signs of a low blood sugar and what needs to be done to treat it.

Before intimate moments happen it’s important to prepare yourself and your partner so that you both know what to expect and look out for. With a little bit of planning ahead, you can avoid the stress and worry about how diabetes may dampen the mood. 

Dealing with Devices

If you wear an insulin pump, map out your plan in advance to limit “technical difficulties”.  If you wear a tubed pump, will you suspend insulin delivery and disconnect from your pump? Or will you find a spot to tuck your pump away that won’t cause it to get tangled up during intimate moments? You don’t have to disconnect, but you may feel more free without anything attached to you in the moment. If you think you might forget to reconnect after, consider trying longer tubing when you order your next box of infusion sites or set an alarm on your phone to remind you to reconnect.

There’s always a chance you might have a site or sensor pop off during your intimate moments. If you experience a lot of friction and sweat, consider using over-the-counter adhesive products like SkinTac or SkinPrep wipes to give your sites a little extra stick. If you are worried about insulin pump or CGM device beeping ruining the mood, play some background music to drown out the alerts and alarms or set your alerts and alarms to vibrate. Chances are you will still hear them, but they won’t be as distracting for your partner with your favourite music enhancing the mood.  Stay calm, keep extra supplies nearby and replace the site when the time is right.

Remember that having sex usually increases your movement and raises your heart rate, which can increase your chance of having a low blood sugar. Get creative about how to manage blood sugars during sex and always keep low treatment supplies, water and snacks within an arm’s reach so you can react to changes in your blood sugar quickly and conveniently.

Having light-hearted conversations with your partner about these hiccups after the fact can be helpful, too, so they know you weren’t hurt and everything is okay. A little pillow talk while you cuddle afterwards can help any mishaps from being a problem in the future.

How Type 1 Diabetes Can Impact Your Experience

FOR THE LADIES:

Sexual dysfunction can affect 35-70% of women managing diabetes. High blood sugars can cause an increase in urinary tract infections, vaginal dryness and discomfort during sex, a lack of sex drive or difficulty reaching sexual climax. Nerve damage over time can also reduce sexual response. Weight-gain, anxiety and depression can also contribute to a decreased sex drive. Some tips to help make things more enjoyable include: using lubricants, practicing daily Kegel exercises to strengthen the muscles and improve sensitivity, and/or trying couples therapy to help you communicate your needs.

Another factor to consider for women is pregnancy.  Preparing for pregnancy with diabetes is very important to both mom and baby. Be sure to speak to your doctor about pregnancy planning well in advance if you are thinking of having a baby.

FOR THE MEN:

The ability to have or keep an erection affects approximately 35-45% of men with diabetes. Higher blood sugars can lead to nerve and small blood vessel damage that impacts blood flow to the penis over time. This can lead to erectile dysfunction and may cause problems with ejaculation.  Prescribed medications can be effective.  Approximately 70-80% of men who take prescribed medications find them helpful.

Hormones are also affected in men managing Type 1. Lower testosterone levels, specifically, tend to cause a drop in libido. There are medications, injections, gels and specialized equipment available to help you through these challenges. Speak to your doctor or diabetes educator for more information.

What Can Your Partner Do for You?

It’s important for both people in the relationship to understand that when you are intimate with someone living with Type 1, there may be challenges and unique situations. Communicate your needs and help your partner understand more about how you manage your diabetes.  

Many aspects of Type 1 and blood sugar management are trial and error. It’s natural for you or your partner to be curious, concerned, anxious, excited or everything at once. Different approaches may need to be tried to discover what works best for your positive intimate moments.

It’s important that your partner does not take any of it personally and understands how diabetes and sex fit together.  Encourage your partner to learn more about Type 1 and ask questions about things they don’t understand. When the partner of someone living with Type 1 has a better understanding of the day-to-day needs and challenges of diabetes and how best to offer patience, support and space to handle health issues, this will lead to a more enjoyable experience overall.

References:

Diabetes Canada: https://www.diabetes.ca/managing-my-diabetes/stories/sex—diabetes%E2%80%94what-you-need-to-know

Diabetes UK: https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/sex-and-diabetes#:~:text=High%20blood%20sugar%20levels%20can,some%20feeling%20to%20your%20genitals.

American Diabetes Association (PubMed): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671088/

Beyond Type 1: https://beyondtype1.org/sex-drugs-diabetes/ 

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