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Introducing our new SEX Column, written expert (and my friend) Janis Roszler, MSFT, RD, CDE, LD/N:

If you have diabetes, you probably know that it follows you wherever you go…even into the bedroom.  Amy recently sent me a few of your sex-related questions to address, so let’s get to them and, hopefully, put some more fun in your romantic life!

Is sex safe if your blood sugar level is above 250?

Sex may be a wonderful way to communicate with a loving partner, but it is also a form of physical activity.  So, follow the guidelines you normally use for any type of workout, or try this:

If your blood sugar level is above 250 mg/dL, check your urine for ketones.  They may appear if you don’t have enough insulin in your system. Treat your high level as directed by your health care team and don’t participate in sexual activity until the ketones are gone. If your level is above 250 mg/dL and you don’t have ketones, the physical activity may help bring your glucose level down.  Some experts caution against exercising if your blood sugar level is above 300 mg/dL, with or without ketones.  Ask your health care provider what is right for you.

Are orgasms more elusive when your blood sugar level is out of range?

Many women with diabetes have difficulty reaching orgasm when their blood sugar level is out of range.  Like Goldilocks (who certainly did some bed hopping!)…your body works best when your level isn’t too high or too low…but is just right.  For woman, achieving an orgasm involves more than just good blood flow to the pelvic area.  The mind is probably the most important sexual organ of all.  If your blood sugar level is out of range, you may have less energy available and may have a harder time concentrating, fantasizing, and enjoying intimate activity.

What about pumping?

If you wear a pump, feel free to leave it on or remove it before intimate activity. If your pump comes off in the middle, just set it aside. Check your blood sugar level after you are done, put your pump back on and take a correction bolus, if needed. If it gets yanked out, the infusion site may bleed.  That is nothing that you or your partner needs to worry about. If you use an Omnipod, the adhesive should keep it in place, regardless of its location.  Trial and error will help you decide what works best for you.

How about libido changes?

Some women with diabetes lose interest in lovemaking.  We don’t fully understand why this happens, but certain factors may play a role. Blood sugar swings can ruin your mood.  Vaginal dryness can cause you to experience pain during intercourse, so you might be more hesitant to engage in sexual activity.  Some women lose interest because they feel less attractive – they have gained weight or are embarrassed by injection bruises or pump adhesive marks.  Many women with diabetes take longer to become aroused. Hopefully, you and your partner will come to the bedroom with extra time and patience. Use a vaginal lubricant, relax and have a good time. Try to infuse your intimate moments with more fun and less pressure to perform.

For more suggestions, check out the book I co-authored with Donna Rice – Sex & Diabetes, For Him and For Her (ADA)  It is filled with great information, fun tips and aphrodisiac recipes!

Got more SEX questions? Email me at amy.mercer@comcast.net for answers in Janis’ next column.