Chronic conditions such as diabetes can have a severe impact on a person’s physical and mental health, but can they damage our ability to be intimate with our partners, as well as ourselves?
My body image has drastically changed since being diagnosed with type 1 diabetes last year.
Insulin injections have made my weight yo-yo up and down and produced bruises and bumps all over my body, while my hair has thinned, and my sleeping pattern has fallen to pieces.
Low self-esteem does not do wonders for our desire to have sex, but is it just that alone that is destroying my capacity to be intimate – or could my condition also be physically harming my libido?
Sexual desire, what feeds and what kills it
Gaia Polloni, a clinical psychologist, psychotherapist, and clinical sexologist based in Milan, describes libido as the overall drive for sexual activity, which can include having sexual thoughts, fantasies, and the impulse to masturbate or engage in sexual activity with others.
Most people will begin developing such a drive between the ages of 10 and 12, despite most not yet having developed a full sexual awareness – who they are attracted to, for example, she says.
Exercising regularly, sleeping enough and taking care of ourselves mentally are all key to a good amount of libido. But self-confidence is also an important element, which can include having a dose of ‘healthy selfishness’, according to Polloni.
To be able to enrich a sexual desire with someone else, having a mental and physical connection with a partner such as through feeling loved and stable is essential. Meanwhile, some may feel a higher sex drive when they are less vulnerable to possible judgments such as with strangers in one-night stands, she says.
Unfortunately, hormonal issues – including testosterone deficiency in men – depression, anxiety, stress, major life changes such as getting fired or divorced, as well as getting diagnosed with cancer, heart diseases and other conditions can all negatively impact our sex drives, Polloni notes.
More immediate, remote causes of a decline in sex drive can also include not feeling sexually attracted to your partner, being in an unpleasant environment, and having negative thoughts about your body, she adds.
So pretty much everything affects our desire for sex. It therefore might not come as a surprise that getting diagnosed with type 1 diabetes could have such an effect.
Liz Wagner-Hoadley, a type 1 diabetic, says she felt very unattractive when she was first diagnosed. ‘I remember feeling broken somehow,’ she recalls.
But after splitting up with her husband five years ago, she started dating a type 1 diabetic friend she had met online. The two are now married.
‘Diabetes is now just part of the furniture in our lives, and doesn’t have the same kind of negative impact on self-esteem,’ she says.
Over time, you became able to separate your condition from your sexuality, Wagner-Hoadley adds. ‘It will just be another part of your personal care routine, I hope.’
Andy Slowey notes the importance of partners recognising diabetics’ needs. It’s daunting getting near us these days with many of us having tech stuck to us, he says. ‘But it’s a minefield from all sides.’
Unfortunately, the issue of self-confidence is one that many diabetics suffer from after diagnosis. With insulin causing weight gain, devices stuck to all sorts of weird places and bruises and bumps covering our stomachs and legs – it’s not a ‘pretty’ condition to live with.
Tegan Olivia Skye Wentworth says that she has not felt like her body was her own since she was diagnosed with type 1 diabetes just over nine years ago.
‘I found it hard to separate myself from diabetes itself so it felt like that’s all I was,’ she says.
The 18-year-old adds that, for a long time, she felt as though she deserved to get diabetes – she hated herself for it. ‘It definitely changed how I saw myself and in some parts, made me feel I was nothing but my diagnosis.’
Meanwhile, Laura Chapman, also a type 1 diabetic, says that a man has never been put off or bothered by her continuous glucose monitor – a device that provides blood sugar data to its user in real time.
While diabetes also affected her ability to feel like she could be intimate, she claims it was all in her head. ‘If it is an issue for others it’s their issue, not yours,’ Chapman adds.
The physical and psychological side effects
But Polloni explains that type 1 diabetes can impose a huge burden on our mental health, triggering depression, anxiety, and eating disorders.
People with the condition are required to face several daily stressors, including tracking blood glucose levels, dosing insulin, and planning meals, and these routines can make diabetics feel disadvantaged, limited, unappealing, or unattractive.
‘If we feel sick then we will hardly be able to feel sexy and live a free sexuality,’ she says.
The diagnosis itself can also be very stressful, whether it comes earlier or later in life, Polloni notes. For younger people, such diagnoses can impact their social lives or school performance, whereas in adulthood it can interfere with work, social life, relationships, and sexuality.
Adapting to diabetes can be particularly hard during adolescence, when kids are more vulnerable, as they are afraid of being judged or marginalised because of their condition and may feel inferior to peers, she says.
Type 1 does not just affect one’s mental health, however. According to Polloni, it can have devastating effects on a person’s physical capacity to be intimate too.
Complications of the chronic condition include atherosclerosis – a narrowing of the arteries – which can progressively damage the nerves and cause erectile dysfunction which, in turn, impacts the desire for sex.
She notes that as diabetic men age, they become more at risk of developing erectile dysfunction, which starts with a progressive reduction of blood flow inside the penis.
Neuropathy, when severe, can also cause some individuals to experience decreased penile sensation. Men with diabetes can also develop premature ejaculation, as a consequence of the penile discomfort linked to phimosis and genital infections, Polloni says.
Meanwhile, as diabetic women age, they could suffer from vaginal dryness. Pregnancy can also be very stressful, due to the strict glycemic control needed and the fear of possible complications, she adds.
Regaining our sex drives
For diabetics like Wagner-Hoadley, starting afresh with a fellow diabetic was a good way to regain her confidence and feel like she could be intimate again. I don’t know if I would necessarily take the same approach myself, but remembering to embrace diabetes as ‘part of the furniture’ is certainly a lesson to learn from that.
Polloni believes that people with chronic conditions should embrace them, but remember that they are not their disease. ‘Therefore, they shouldn’t let the disease define them and limit their lives,’ she says.
To regain our sex drives, Polloni says it is vital that we feel good about ourselves and love and take care of our bodies. Therapy can help with past traumas, as can being in touch with ourselves and our partners about our sexual needs.
One way of getting to know what we need is through masturbation, she says. But those who binge on pornography should reduce its consumption and cultivate the ability to create sexual fantasies, she says, noting that too much can create a distorted view of reality and also contribute to lowering a couple’s sexual desire.
Most importantly though, Polloni says we need to make sure we feel pleasure. ‘Knowing that you will enjoy sex and you will orgasm will increase your desire to do it again.’
Hi, I’m Olivia (She/Her). I am a news reporter for a specialist law publication, Global Competition Review. I have a degree in Journalism from City, University of London and previously worked at vegan and climate change publications. I grew up in Italy, but now call London my home. View my Twitter and LinkedIn.
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