Women who maintain better control of their diabetes enjoy better sexual health. The reason? In general, controlling blood glucose decreases risks for specific symptoms that can lead to sexual problems.

How Diabetes Affects Sexual Health

New studies on the link between diabetes and sexual health have shown that nearly 20 percent of women with type 1 diabetes and over 40 percent of women with type 2 diabetes experience sexual dysfunction. These problems may include:

• Decreased vaginal lubrication or vaginal dryness
• Pain or discomfort during intercourse
• Little to no desire for sexual activity
• Minimal or absent sexual response

Diabetes can cause these problems because of the many issues that result from poor glucose control, such as:

• Nerve damage
• Reduced blood flow to genitals
• Hormonal changes
• Bladder problems
• Urinary tract infections

In addition, women with diabetes face a higher risk for yeast infections because vaginal secretions contain more sugar, which encourages yeast cells to multiply.

Risks for sexual problems go up for diabetic women who have high cholesterol or high blood pressure; are overweight or over 40; and those who smoke. Exercising, controlling weight and blood sugar, and quitting smoking can all help improve sexual health.

Birth Control and Diabetes

Birth control options for women with diabetes are the same as other women. If your birth control method affects hormone concentrations, such as the pill, know that it can also affect your blood glucose levels. Talk with your doctor about birth control options that won't hamper your diabetes control.

Types of birth control methods include:

Hormonal methods—prevent pregnancy by preventing ovulation and are about 95 to 99 percent effective. Some options:

The pill — choose from two types: pills that contain estrogen and progesterone, or pills that contain only progesterone.
The patch and the ring — contain both estrogen and progesterone.
The injection — called Depo-Provera, the injection contains only progesterone.
IUDs — prevent sperm from reaching the egg or from implanting in the uterus. Some contain copper, while others contain progesterone.

Generally, hormonal methods are safe for diabetic women. If your insulin sensitivity varies at certain times of the month, you may find that the pill, patch, ring or injections help balance your blood glucose levels by providing a steady flow of hormones.

For some women, oral contraceptives can increase insulin resistance. Physicians can adjust your dose of insulin or oral diabetes medication to help.

Non-Hormonal Methods—prevent pregnancy without altering hormones. Choices include:

Barrier Methods — the diaphragm, sponge, cervical cap and condoms, all of which prevent the sperm from reaching the egg. Overall, barrier methods are 80 to 94 percent effective.
Spermicides — inserted vaginally, these substances kill sperm and are roughly 70 to 90 percent effective. Combining spermicides with barrier methods can increase effectiveness.