The French Federation of Diabetics (FFD) has launched a public awareness campaign to break the taboo surrounding the sexual health of people with diabetes. To this end, it has made available to the public an informational brochure and an awareness video, both titled “Diabetes and Sexual Health: The Complications No One Talks About.”

Since late September, four thematic videos specifically dedicated to the sexual health issues of women living with diabetes have been available online.

Weakening of Blood Vessels

In France, where an estimated 4.5 million people are living with diabetes, the organization says about 50% will ultimately have some degree of diabetes-related sexual dysfunction. The underlying problem, it notes, is vascular: Diabetes can damage blood vessels and impair circulation. In men, this may present as erectile dysfunction; in women, it can contribute to reduced vaginal lubrication.

According to Santé publique France, erectile dysfunction affects an estimated 50% of men living with type 1 diabetes and as many as 70% of those with type 2 diabetes. The FFD warned that this problem can emerge years before other cardiovascular complications, making it an important early warning sign that should not be overlooked.

Vaginal Dryness

Among women with diabetes, vaginal dryness appears to occur about twice as often and can lead to dyspareunia as well as reduced sexual pleasure. Diabetes may also raise the risk for recurrent genitourinary infections, including yeast infections and cystitis, further affecting intimate health and quality of life.

Contraception in women with diabetes should be individualized, with decisions guided by the type of diabetes, disease duration, and the patient’s age, ideally in consultation with a diabetes specialist, gynecologist, or midwife. Pregnancy planning also requires careful discussion: Experts recommend achieving an A1c less than 6.5% before conception and maintaining stable glycemic control throughout pregnancy.

Women can also develop gestational diabetes, which affects an estimated 130,000 women and 16% of pregnancies each year. The FFD explained that this form of hyperglycemia arises during pregnancy and usually resolves after childbirth, but it requires prompt management to reduce risks for both mother and child. Although transient, gestational diabetes should not be underestimated because it can progress to type 2 diabetes later in life for both the mother and the child.

During menopause, hormonal shifts can intensify some of the sexual health effects associated with diabetes, including vaginal dryness, dyspareunia, reduced libido, fatigue, weight gain, and recurrent urinary tract infections.

Neuropathy and Mental Health

Diabetes can also lead to neuropathy. When the nerves involved in the sexual response are affected, problems may follow, including reduced sensitivity, pain during intercourse, difficulty reaching orgasm, and ejaculatory disorders. The daily burden of managing the disease, along with fear of hypoglycemia, fatigue, and other factors, can also affect self-image, strain relationships, and erode mental health. Some people may even develop a real fear of intimacy when diabetes becomes such a dominant part of daily life.

Encouraging Open Communication

Despite the harmful consequences, diabetes-related sexual health issues remain largely taboo. Clinicians often do not raise the topic on their own either because of time constraints or lack of specific training. Meanwhile, patients with diabetes may hesitate to bring it up because of embarrassment, modesty, or fear of being judged. As a result, many people live with these problems in silence for years, even though effective options for evaluation and treatment are available. 

Better education, more open discussion, and a more routine place for sexual health within the broader care pathway could help clinicians identify problems earlier, steer patients toward appropriate solutions, and ultimately improve quality of life.

This story was translated from Medscape’s French edition.