WOMEN'S HEALTH
KEY POINTS
Decreased vaginal lubrication (leading to discomfort during intercourse) is commonly reported by women with diabetes.
Women with diabetes may also experience more frequent bouts of vaginitis and yeast infections.
Contraceptive pills are safe for women with diabetes but may very slightly increase blood glucose levels in some women. This is usually very manageable by making slight adjustments to your diabetes medication.
Women with diabetes may have a risk of infection with IUDs.
Very little is known about how diabetes affects a woman’s sexuality. Most research on sexual matters and diabetes has focussed on male issues (in particular, impotence). Unfortunately, the findings of male-oriented research can seldom be applied to women, so there are lots of unanswered questions and uncertainty about both the cause and frequency of diabetes-related sexual problems for women.
Vaginitis
This is a general term for inflammation of the vagina. The vagina is the muscular canal extending from the cervix to the outside of the body. Vaginitis is often caused by a fungus. If you have this condition you may have itching or burning and you may notice a discharge. Vaginitis is a common condition. When you have diabetes you are more likely to get vaginitis than women who don't have diabetes. If you think you have vaginitis visit your doctor or sexual health clinic for advice.
Vaginal infections
When you have diabetes there are times when your vaginal secretions may contain more glucose than is normal. This is usually if your blood glucose levels are high. Unfortunately extra glucose in your vaginal secretions means that fungal or bacterial infections will thrive. This means you will be more at risk of getting these infections.
Symptoms of vaginal infection are itching of the vagina and vulva, often associated with a discharge from the vagina onto your underpants.
This can be treated by pessaries and creams. Occasionally a course of tablets taken orally by both you and your sexual partner is also needed. If your blood glucose levels are high, bringing them into a more healthy range will help.
Contraception
When you have diabetes it is very important that you plan your pregnancies. This is because conceiving a child during a period when your blood glucose levels are very high puts that child much more at risk of developing a malformation. Planning a pregnancy should be done well in advance so as to work on improving your blood glucose levels for the period around conception and pregnancy.
For this reason contraception is an important issue for women with diabetes. You should choose a form of contraception that is safe and effective and try hard not to take any risks. Visit your doctor for advice immediately if you have had unprotected sex.
The risks associated with taking the oral contraceptive pill are the same for women with diabetes as those without diabetes, although some women do experience a slight increase in their blood glucose levels when they first start using this method of contraception. If this happens you can usually manage it very successfully by a slight increase in your diabetes medications.
Now and to the future
As there has not been a lot of research done into women’s sexual problems in relation to diabetes there is also not a lot clearly understood about treatment options if you do have a problem. It is best to work closely with a doctor you feel comfortable with if you are experiencing issues you feel unable to resolve.
Your diabetes specialist may be a good person to consult if you are experiencing sexual issues that you think may be related to your diabetes.
It is thought that some women may experience issues with arousal and libido that are related to autonomic neuropathy. If you fell this may be an issue for you, consult your doctor.