5 tips for safe sex when you have diabetes

Living with diabetes doesn't mean that you need to avoid sex. Here are some important tips so your sex life can be enjoyable, fun and safe.

If your blood sugar tends to drop during physical activity or at nighttime, having sex in the evening can present a challenge. Before things get too heated up, check your blood sugar so that you're sure of your status.

• If your blood sugar is at a normal level or is already on the low side, you may need to adjust your insulin or eat something before or after sex — a robust session could make you hypoglycemic.
• If you have an insulin pump, consider unhooking it during sex.

Alcohol and vigorous sex both lower blood sugar, and combining the two could cause a dangerous low.

• Be sure to monitor your blood glucose if you're having a glass of wine or more.

Women who have diabetes are more susceptible to vaginal infections and should take special care to avoid them.

Higher glucose levels in the vaginal lining, combined with moisture and warmth, encourages the growth of bacteria and yeast. The problem is particularly bad for older women because levels of protective estrogen drop around menopause.

What to do

• Bathe regularly and keep fecal matter away from the vagina.
• Keep the vaginal area dry, and avoid clothing that will hold moisture against you.
• Avoid harsh feminine products that invite infection, including douches, feminine sprays and strong soaps.

Regardless of gender, get your blood sugar under control and talk to your doctor about medicated ointments and creams that will clear up the problem.

If you're a woman with damage to the nerves controlling your bladder (neurogenic bladder), urinate just before sex and within 30 minutes after having sex.

• This will reduce your chances of developing a bladder infection.

Your menstrual cycle might be complicating your efforts to manage your diabetes. Women build up high levels of estrogen and progesterone about a week before menstruation.

Some scientists believe that these hormones interfere with insulin sensitivity in many women, most often making blood sugar run high, but sometimes causing it to drop.

What to do

Take out your record of blood glucose readings for the last three months and mark the dates when your last three periods began.

Were your blood sugar levels high a week before each period? If so, experiment with some countermeasures.

• Exercise more around this time and cut back on carbs, for instance.
• If you use insulin, ask your doctor if it's okay to slowly increase your dose a touch and back off again when your period starts.
• If your blood sugar tends to drop a week before your period, do the reverse; temporarily exercise less, consume more carbs and lower your insulin dose slightly if your doctor says it's okay.

By taking these precautions you can help ensure you don't leave yourself susceptible to infections and hypoglycemia, while still enjoying a satisfying sex life.