Taking a Look at Sexual Dysfunction in Females with T1D
Females with type 1 diabetes have many hormonal shifts to navigate throughout their life. The unfortunate thing is that most are not educated on the natural course of the change in these hormones as we age. When you add type 1 diabetes to this it can mean a host of things are happening without definition or acknowledgement that these are normal changes. Also lacking is information about how to adjust to maintain healthy glucose levels.
Lack of healthy management of glucose levels can lead to complications in various areas of the body such as eyes, kidneys, blood vessels and in nerves around the body. With this as a consideration, I have found working with many people that the topic of sexual dysfunction (SD) is poorly discussed.
This is more commonly brought up by males rather than females as erectile dysfunction is a known complication of diabetes. Females however have similar complications which are more complex in many ways.
Did you know that even without diabetes, 43% of women and 31% of men report some degree of sexual dysfunction.
It is classified into 4 categories – desire, arousal, orgasm and pain disorders and most commonly impacts those over the age of 40.
Recent research on this topic was published in Diabetic Medicine Journal and comes from a review of literature and data from four electronic databases. Researchers wanted to estimate how common SD occurs in premenopausal women with type 1 diabetes compared to those without diabetes.
Paring the research down to just a few eligible studies showed that a female with T1D is THREE times more likely to experience SD compared to those without diabetes.
The fact that females struggle with this, yet it is not addressed well indicates that there may be psychosocial factors influencing the discussion but also a lack of information or assessment from the clinician. When changes happen as we age there could be the addition of stress, relationship issues, body changes that add a layer to SD. If there is a problem that appears medical, most people will bring it up with their PCP. If there is something related to diabetes, it is brought to the attention of the Endocrinologist or CDCES. The issue of SD is a bit of a harder topic. Discussion related to something that is still considered very private and personal needs to be done with a trusted clinician. If a female doesn’t feel a comfort level with a provider, then symptoms that might be there may never be brought up and the problem persists.
Who should be the one to bring up this issue?
First, we need to focus on information provided from the clinical angle. If a female is educated from the start about shifts in hormones through life as well as the potential for SD and its relation to diabetes, then when a woman starts to see some things change, she will be more informed from the start. She may also be able to address the issue sooner than later which could prevent many of the mental health struggles that go along with SD.
Who should the person with diabetes feel confident in discussing this personal topic with?
Your PCP may be able to provide a referral but lack the ability to provide more in-depth discussion. Endocrine providers may be able to provide more context for reasons, but still won’t help navigate the plan of care. As the person with this concern, you may have to be the one to ask for a specialist. SD in women is multilayered due to hormonal influence as shifts through stages of life happen. Considering diabetes, the issue may be influenced by fluctuating glucose levels, which over time may damage nerves and leads to a decrease in sensation and reaction in an intimate setting. This part needs to be navigated well and will take a multi-level approach to managing. There are Women’s SD clinics and specialists to assist but it takes a village to manage T1D.
I have had the wonderful privilege to work with females through many stages of life.
As I dig a bit more to really learn about the under-discussed pieces to managing diabetes as a female, I have found many things that need to be brought into the spotlight.
- Education for hormone changes early on to be ready for a shift.
- How to adjust as needs change through growth, puberty and into the time a woman may want to plan a pregnancy.
- As we age things change again and hormones shift, and stress or energy levels will add a layer to navigate.
- Not to mention the adjustments to appetite and weight management!
As I noted, it takes a multilayered approach to managing T1D well as a female. If you feel you need some adjustment or a more defined approach to managing life as a female with T1D please reach out. Integrated Diabetes Services provides education that spans all ages and we’d be happy to help!
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