Decreased Vaginal Lubrication

Nerve damage to cells that line the vagina can result in dryness, which in turn may lead to discomfort during sexual intercourse. Discomfort is likely to decrease sexual response or desire.

Decreased or Absent Sexual Response

Diabetes or other diseases, blood pressure medications, certain prescription and over-the-counter drugs, alcohol abuse, smoking, and psychological factors such as anxiety or depression can all cause sexual problems in women. Gynecologic infections or conditions relating to pregnancy or menopause can also contribute to decreased or absent sexual response.

As many as 35 percent of women with diabetes may experience decreased or absent sexual response. Decreased desire for sex, inability to become or remain aroused, lack of sensation, or inability to reach orgasm can result.

Symptoms include

• decreased or total lack of interest in sexual relations
• decreased or no sensation in the genital area
• contant or occasional inability to reach orgasm
• dryness in the vaginal area, leading to pain or discomfort during sexual relations

If you experience sexual problems or notice a change in your sexual response, talking to your doctor about it is the first step in getting help. Your doctor will ask you about your medical history, any gynecologic conditions or infections, the type and frequency of your sexual problems, your medications, your smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may also help pinpoint causes. Your blood glucose control will be discussed. The doctor may ask whether you might be pregnant or have reached menopause and whether you are depressed or have recently experienced upsetting changes in your life.

Prescription or over-the-counter vaginal lubricant creams may be useful for women experiencing dryness.

Techniques to treat decreased sexual response include changes in position and stimulation during sexual relations. Psychological counseling, as well as Kegel exercises to strengthen the muscles that hold urine in the bladder, may be helpful. Studies of drug treatments are under way.

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