Ask Joslin: Sexual Health

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How does diabetes affect sexual health?

Not much is known about female sexual dysfunction, for women with or without diabetes. We know that men with diabetes have high rates of erectile dysfunction and it is believed that women have similar levels of dysfunction, but because the problem is not as obvious for women, it is not brought up as often in medical visits nor is it asked about as much.

In the medical field over the past several years there has been a good deal of emphasis placed on asking about sexual dysfunction in men with diabetes, but not so much with women. Part of the problem may be that there are very specific tests that can be done (testosterone levels) in men and treatments (testosterone replacements and drugs to promote erection such as Viagra and Cialis) whereas with women there are not really any tests that can be easily done to determine possible causes of the dysfunction.

Testosterone levels can be checked in women and if low sometimes testosterone replacement can be given, but there are some risks associated with this and the cut off points for what “normal” is at a certain age is still not well understood.

Also, because sexual dysfunction for women can occur during the hormonal changes associated with menopause, it is often difficult to know whether it is the diabetes or other hormonal imbalances that are causing the problem. The erectile dysfunction drugs that are used in men have not been found to be very helpful in women and are not recommended. If dryness is a problem, vaginal lubricants can be tried. If a woman with diabetes is having problems with arousal or with dryness they should first speak to their gynecologist about it and find out if there is someone near where they live who specializes in this field.

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