Roll with It: Sex and T1
I should start this by saying—I have lots of sex. Oh wait, I should start by saying, if you’re related to me, don’t read this. You have no reason to do so since there are no other type 1s (T1s) in our family and no one is married to or dating any. Ahem—Mom and my mother-in-law—I’m talking to you two!
Okay, where was I? Yes, sex. Lots—with my husband. I have been blessed with a happy marriage of almost 10 years and if one of us isn’t traveling, it’s on! Every. Day. I’m not bragging—it wouldn’t even matter to anyone else except for the fact I have had type 1 diabetes since December of 1988. I wear a pump and a continuous glucose monitor (CGM) and that can make things kind of interesting when you add it to trying to control blood glucose levels during those hot times.
It hasn’t always been such smooth sailing. I got my first pump in 1998 as a college senior. As I was considering the transition from shots to the pump, the pump manufacturer sent a video on living with the pump. One scene showed a couple going to bed and a pump being placed on a nightstand by a rose while a voiceover talked about disconnecting while being “intimate.” I had two roommates—one female, one male. They came in while I was watching the video and we all laughed at the cheesiness of the scene. Then, it happened. My guy roomie said to me, “If I were the one with you, I’d have you take that pump tubing and swing that thing over your head like a lasso as you were rid…” I was mortified. Leave it to college boys to try to lighten the mood, but instead instill a fear in you that wouldn’t leave for quite some time. I was not experienced to begin with and was already unsure. I had been with one guy that I had dated for a total of seven years and we had just broken up a month or two before. The future was unknown. Running through my head: How would guys react? What are they going to do when they see this “thing” in my stomach? Would they be repulsed? Would they make insensitive jokes like my roommate? I know what everyone is thinking, I thought it, too, and I lived it.
Roll With It
I had nothing to worry about. Diabetes, devices and sex are an awkward tango of heat, emotion and bodies. The main thing you have to do is, roll with it. Diabetes is never convenient and that especially applies during sex. I realize that the bigger deal that is made over things happening, the less magical the moment is or the harder it will be to get back into the groove after you correct whatever diabetes has done to derail it. Don’t stress before or during about your equipment. This should be pleasurable for you and your partner, if you are stressed or if they are worried, it will decrease the enjoyment and connection for the two of you.
If you are dating someone and the time comes to take it to the next level, speak about what equipment you have on, where your sites tend to be and what happens when you get low (hopefully they already know this part). Try not to inundate them with information, be simple and succinct and try to work the conversation into a time out of bed. Talking about diabetes right before you start to get hot and heavy isn’t the best pillow talk. Finding another time, perhaps after things were heated but didn’t get to the point of sex would be better. If things just kind of happen with someone, just mention it casually as things are starting to boil, “By the way, I have a pump site that stays in for my diabetes on the back of my waist and a CGM on my arm. It won’t get in the way but I wanted to let you know in case you feel it.” Drop your purse or bag (that should contain some emergency supplies) by the bed, couch, kitchen island—hey, whatever is working for you—and proceed with your encounter.
Sex is a physical activity. Well, if you do it correctly and are having a good time, it is a physical activity. With all physical activities and T1 comes the danger of a hypo. The problem with sex is most likely you are hot and sweaty—or at least, let’s hope it’s headed that way. Your mind is in a state of euphoria that is altered from your normal cognitive process. These are some big symptoms of hypoglycemia. Many people with diabetes find themselves at a much lower blood glucose (BG) number than a normal low or sense the hypo later than they normally would during sex. It’s okay.
If you are in a relationship where you frequently have sex, keep supplies next to the bed at both people’s houses. Most T1s already keep things beside their own beds but if you have a serious partner, try to keep supplies by his/her bed as well. The world isn’t going to end if things stop for a little while for you to check your blood sugar and treat your low. And sex doesn’t have to end. Get creative to get things back going again. Incorporate the food into your experience. Treating a low with chocolate syrup is quite fun—the T1 eats it off a spoon while the partner can lick it off of the T1’s body parts. You laugh, but this keeps things less stressed, less clinical and the two partners more engaged in activities similar to what was going on before the diabetes derailment. Or you can ask your partner to talk about sexy things while you treat your hypo. If you are able to carry on a conversation, talk about fantastical things as you snack and your levels will even out. The less start and stop there is, the better. If you have a bad low, it’s fine. It happens. Just think of it as there’s more sex to be had after you’re better or at another time if you are having a hard time.
Sometimes it is best to prepare before you think things are about to go down. If you get the feeling you are about 10 minutes away from a great time, glance at your CGM and see where you are at and which way you are trending. I have taken a mini shot of juice on my way up to the bedroom more than once. If you don’t have a CGM, do a quick check with your meter. Pop a piece of candy; a glucose tab or whatever you think will hold you at a reasonable number if you are on the edge of going low. You know your body, how it may react to activity and how to address it. Again, this is only as big of a deal as you let it be. So, don’t get worked up or nervous, just make it work for you.
Pump Goes Where
That is always the question when people venture into the world of sex with a pump. First, always do what makes you comfortable. But if you don’t know where to start, start by disconnecting from your pump at a time that feels right. Sometimes I take my pump off at the beginning because I can tell that I’m ready to go and things will escalate quickly. While other times, I wait to take it off until there is a lot of foreplay and I know we aren’t quickly headed towards sex but we will get there in the near future. I simply slip my hand to my site, disconnect and lay the pump in a safe place that is within reach. I have experienced forgetting to reconnect so I don’t put it on the nightstand a lot. Mostly, I slide it under the pillow so I can tell that it is there. This way, there is no out of sight, out of mind happening. Guys, I’m not making any stereotypical assumptions here but may I point out that having to reconnect definitely cuts down on the cuddle time that so many partners are fond of having afterwards. Just sayin’. Leaving your pump on, floating about is asking to have some tubing tangles and pulled sites. I read about one T1 using a running belt to keep their pump on during sex. This is a good alternative to removing the pump, but may not work for some due to the friction the activity may cause. The belt could slide up and down or around the waist and pull your site. See what works for you, but a subtle approach to removing it before the major action starts to happen is a good approach to try.
Mishaps or Accidents
Okay—the big question about pumps and CGMs, do they get ripped out? Of course they do. Not often, but it is bound to happen if you have enough sexual encounters. How? Someone grabs your site by accident and it can pull out or the friction while wearing it on your abdomen can cause the adhesive to pull up and the cannula of your pump or wire of your CGM can slip. It is just like any other activity, there’s always the chance. So what do you do? Stay calm. You don’t have to stop right then and there and fix it. As I said earlier, it’s only as big of a deal as you make it. After you are done or if it is going to be one of those tantric-kind-of-nights, replace your site and have a little laugh about things getting so hot and aggressive. Your partner won’t feel as bad if it was something they did as well as you, and you won’t stress about it happening again as much if you keep it light-hearted. I have pulled my pump out at the gym just as often and as easily as I have in the bedroom. It can happen but rarely does and we just deal with it. Always carry extra supplies and keep them next to your bed for times like these.
I hope this helps T1s to know what to expect, what to do or just how to be. I am in no way a dia-sexologist, although that would be a really cool title. I’m just an almost 40-year-old with a voice to say, “Hey! I do this, it works and it’s all going to be okay.” Living with type 1 is a slippery slope but we have to do just that—LIVE with it. That includes being happy, healthy and hot in the bedroom!