Friday, July 17, 2009

Sex & Diabetes

Sex & Diabetes: Not Wanting It
David Spero, RN and Aisha Kassahoun
Jul 10, 2009

Dear Aisha and David: I am a 66-year-old woman who has had diabetes for over 64 years. My husband is 52. He wants sex two or more times day. I hate it. I have no sexual drive, and most of the time it is painful. It was not always like this, but he has always wanted more sex than any man I know! We talk about things, but he basically ignores a lot of what I say when it comes to sex. He is actually a very caring person and has put up with a lot considering all the complications I have after 64 years of diabetes. We have been together for 18 years (married for nine). He waits on me hand and foot. I have to tell him to let me do things myself!

I am blind from the diabetes, in stage 4 renal failure. I recently had a mild myocardial infarction. A month ago, I had to have an exploratory surgery for rectal bleeding. I do a lot of walking and other exercise, and my A1c is usually under 6%, thanks to an insulin pump.

Any suggestions?

Not Wanting Sex

Dear NWS,

Our first thought was that your husband is breaking some kind of record for insensitivity. Even without renal failure and heart attacks, nobody should have to engage in sexual behavior that is painful and unwanted just to make someone else happy. That view of women's role has been over for 40 years! Your husband has a right to get his needs met, but there are other ways that might work for both of you.

On second thought, though, we feel for both of you. Your husband is probably very scared and sad about what is happening to you. (The phrase "freaked out" comes to mind.) He may be trying to treat his anxiety with sex. He may also be using sex as a form of denial. "You can't be that sick if I can still do this to you."

You both have a tremendous amount of pain to deal with around your complications. We know, because David's MS complications cause similar problems for us. You need to talk about your feelings honestly.

Remember, words can never hurt you if they're said with love. But NOT saying what you feel CAN hurt you and damage your relationship. You two have a lot to communicate about, and you might consider professional help. Most therapists don't deal well with chronic illness OR sex, however, so finding good help might be challenging.

You told us how well you are self-managing, and it's remarkable. You should be proud of what you have accomplished. Could it be, though, that you are not showing your own pain and fear, so much so that your husband has to be afraid for both of you?

There are things you can do to maintain intimacy and meet your husband's needs. Could you say, "Look, I'm not [having intercourse] with you. That's not going to happen. But I can do some hot things to you with my hands (or mouth, or toys), and a lot of kissing and stroking."

Are you interested in that? Because you might be able to have a sex life that works for both of you that way. If even non-intercourse sex seems too much, could you just hold him or talk sexy to him while he masturbates? There are a lot of other possibilities we could share with you if kinky things don't bother you.

I know we'll get angry comments about this next suggestion, but when one partner can't be sexual, some couples stay together and thrive by allowing the sexual partner to get needs met in other ways. We're not talking about sneaking around to have an affair. But we know many couples who have broadened their relationship to include a sex partner, paid or unpaid. It takes a lot of communication and love to make this work, and there are risks. But it can be done, and it can be healing to your marriage.

So our firm advice is that your husband does have a right to have his needs met, but not at your expense. Be creative, but stand firm on the no intercourse rule unless you are really ready for it.

Please let us know how it goes. You might want to share this letter with him-it might be a start for communication.

Healthcare Reform

We all know there's more to life than sex and love. Healthcare has major effects on us, too. Right now, there's a serious struggle going on over how to change our dysfunctional healthcare system. Read David's article on how the system mistreats people with diabetes and what can be done to fix it.

David Spero RN is a nurse who has lived for 30 years with multiple sclerosis. A leading expert on self-care, he has written two books: Diabetes: Sugar-coated Crisis, and The Art of Getting Well. He has learned to maintain and even improve sex and love despite disability and illness.

Aisha Kassahoun is trained in marriage and family therapy. Aisha and David present sex and intimacy programs for people with diabetes, people with multiple sclerosis, and health professionals.

Visit David and Aisha online at or check out their coaching and counseling services. You can also read David's blog.

Categories: Columns, Community, Dating, Love, Love and Diabetes, Men\'s, Sexual, Sexual Issues, Type, Type, Type, Women\'s

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