Diabetes and sex: can we talk about it please?
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©Michael Mullan / Behance Creative Commons
Diabetes and sex: can we talk about it please?
Can improving your sex life be a fitness goal? A trainer reflects on why it was awkward for him to talk with a client about diabetes and sex.
This is a true story of why I am motivated to talk about sex, diabetes, and fitness. Like all good stories, we need to start at the beginning. When I first started as a personal trainer nine years ago, I knew I would be training people with various levels of fitness. That was my job, after all. But I never imagined I would see people with so many chronic health problems.
Very quickly I learned one of the main reasons people were unfit or didn’t exercise, was chronic health problems, not necessarily a lack of motivation. Over the years I’ve seen a fair few clients with chronic health problems. Surprisingly for me, the most prominent condition I see is diabetes.
One other thing I didn’t know about being a trainer when I first started, was how some people would get really comfortable and personal with me. I’ve heard about my client’s marriage proposals, weddings, births, divorces, and even the deaths of their loved ones. They have told me about their financial issues (which sometimes made me feel guilty because they are paying a steep price for my services), and many other things I would always keep to myself. Sometimes, I feel like I need to change my job title to: “the personal trainer who will be your therapist for free.”
Sex diabetes fitness – Dawns’ confession
One of my clients was Dawn (not her real name). Dawn was a diabetic woman in her late 50s, one of the 30 million people in the U.S who have diabetes. She came to me in January; told me she wanted to lose weight and regain her self-confidence. Apparently, it was a New Year resolution over a glass of prosecco. Her marriage was, apparently, on the brink of divorce, and she was unhappy. Very unhappy.
I learned all of this during our first training session. Plenty of my clients – male and female – had the same reasons for training with me; lose weight and regain confidence. I understood that. No big deal.
After we ended the cardio and strength session, she sat next to me on a bench to catch her breath before we finished with a cool down and stretches. I was impressed. She had pushed herself way harder than I thought she could; made it through my first workout session without complaining. Showed some grit.
We sat there, talking in low voices. I gave Dawn feedback on the workout; discussing with her what we would do in the next few sessions. She went through her training goals with me. Thinking we had finished, I started to stand up. It was at that moment she said, in a quiet voice, looking at her feet: “I just want to have sex again!”
My jaw dropped to the floor. I couldn’t believe Dawn had just said that. I wasn’t even sure she wanted me to hear it. This woman, who I didn’t know, made this sexual confession next to me like I was a priest. After a moment of awkward silence, all I could say was “Uhmmmm, nice training goals.”
We finished the session with some stretches, after which Dawn packed up her belongings and left. It was time for my next client.
Sex and Diabetes: six related complications from diabetes
In 2020 there is no escaping sex and sexual boundaries on TV, in movies, on the radio, in books, and online. Despite this, or perhaps because of it, we’re incredibly shy to talk about sex when it comes to our health and fitness.
A decrease in libido. The leading causes of reduced libido among diabetics is a lack of energy, fatigue, and hormonal changes. If the diabetic has high blood pressure, it may also be caused by antihypertensive medications. Anxiety and depression can also contribute to decreased libido.
Erectile dysfunction. Male sexual arousal is a complex process. For diabetic men, erectile dysfunction is a common problem as diabetes can damage the penile nerves and blood vessels. Psychological issues, such as anxiety, depression, and stress, can also be a cause.
Diabetic neuropathy. Experts have found that around two-thirds of males and one-third of females with diabetes experience sexual problems due to diabetic neuropathy. This is because high blood sugar levels damage the nerves, which in turn, inhibits sexual response.
Retrograde ejaculation: Men with diabetes can also face retrograde ejaculation. This results in some semen being released into the bladder. Symptoms may include noticeably less semen released during ejaculation.
Vaginal dryness. It is likely damage to blood vessels due to diabetes may be a significant contributing factor to vaginal dryness. However, the exact cause is not entirely known.
Other infections: Diabetes leads to various vaginal infections and inflammation, which can also make sexual activities more uncomfortable. Of these, urinary tract infections are most common.
Sources: diabetes and sex (www.prevention.com) and Diabetes (www.healthline.com)
“I just want to have sex again!”
That phrase echoed in my mind for the rest of the day. I could barely focus on my clients. I knew she was married, but that doesn’t necessarily mean much given how unhappy she was in her marriage. Was she referring to having sex with her husband? I assumed so.
But why would she tell me this? A total stranger, someone she had only met a few hours ago. I kept thinking: “was she trying to hit on me?” I’ve had clients flirt with me before, but never a sexual advance from a woman old enough to be my mother [not that this worried me, older woman are beautiful].
Read more: The hard truth about dating somebody with type one diabetes
We trained together for a few more sessions, never mentioning what she said. Each session, at least for me, was awkward and uncomfortable. The proverbial elephant in the gym.
For months on end, I would think about what she said. Then one day, I was doing some research on diabetes and discovered people have sex problems with diabetes and that diabetes could affect people’s sex drive. I had no clue! I knew about all the other issues, but I didn’t know it was a sex drive killer.
It then dawned on me. Maybe Dawn’s confession was linked to her diabetes. “So diabetes was making her dry!” I chortled to myself, involuntarily, laughing at my own crude pun. I then immediately felt like shit. Not only was Dawn a beautiful person, but she was also living with a chronic illness affecting her ability to be sexually intimate. And my first reaction was to make a joke; not cool, not cool at all.
"If I can improve someone's capacity for sexual intimacy by enhancing their fitness, awesome! It will also improve many other aspects of their lives, including their longevity." Marcus Wood
Credit:©Michael Mullan / Behance Creative Commons
I wish I could have talked to Dawn about it, but I couldn’t. I didn’t know-how. For some reason, I felt that talking about her sex and diabetes would cross an invisible boundary, even if it was to allow me to help her. Not just because she was the same age as my mama, but talking about sexual health in the context of personal physical training is ‘taboo.’
But it isn’t taboo to design a physical training program to help a client become more active: do more gardening, climb a mountain, take a spin class or run a marathon. That is okay. But to design, a program to improve their ability to have a more active sex life is off-limits. Why isn’t it okay? After all, sex is very much a core part of being human. Certainly more so than taking a spin class or running a marathon!
A learning experience: fitness, diabetes and sex
What have I learned from this experience? I know I need to get over being uncomfortable talking about sexual issues with my clients. I am working on this. Talking about sex and diabetes or any other sexual health issue doesn’t have to be awkward.
If I can improve someone’s capacity for sexual intimacy by enhancing their fitness, awesome! It will also improve many other aspects of their lives, including their longevity. Overall, Dawn has made me a much better personal trainer.
I know that talking “openly” with my clients about the core-thing that’s bothering them will help me help them. And that is all I really want to do.
Marcus Woods
Experienced personal trainer working in the health wellness and fitness industry.
Caption:
It isn't taboo to design a physical training program to help a client become more active: do more gardening, climb a mountain, take a spin class, or run a marathon. But to design a program to improve their ability to have a more active sex life is off-limits. Why? After all, sex is very much a core part of being human. Certainly more so than taking a spin class or running a marathon!
