Your Guide To Sex + Type 1 Diabetes

Sex is a unique form of physical exercise that most of us look forward to. Like any other activity that requires physical exertion, having sex will probably affect your blood sugar levels. 

In this guide, we walk you through the unique experience of managing type 1 while being intimate, sharing practical tips and words of wisdom to boost your confidence, comfort and presence during these very human experiences.

Know your blood sugars before, during and after sex

If you find yourself dripping with sweat and can hear your own heartbeat, you might be really into your partner, but there’s also a chance your blood sugar has spiked and then dropped. It’s good practice to check your blood sugar levels before, during and after sex. Get creative and think about incorporating this into foreplay and post-coital cuddling.

Stocking your nightstand with low blood sugar supplies is always a good idea for this reason. T1D and sex can both be unpredictable. While you may not be able to plan everything, you can plan for the unexpected! If you’re at your partner’s home for the moment and don’t live there, keeping your low blood sugar stash nearby is helpful. 

Part of what makes sex fun is its unpredictability, of course. While T1D often requires planning for optimal support, don’t worry about putting it on the back burner for the moment. If it needs to be addressed during sex, clearly communicate that to your partner, pause, treat and then get back into it if you so choose.

It’s only as dramatic as you make it. It could help you bond with your partner and even be a way to deepen your relationship as you get their mental or physical support during low blood sugar episodes that may happen during sex.

Take breaks during intimacy

It may sound odd or unsexy, but it’s totally reasonable and natural. People without diabetes need breaks sometimes too. We all have something! You are humans sharing one of the most intimate and vulnerable experiences. Realness is essential to these life moments.

It’s totally reasonable to hit pause in the middle of sex if you feel fatigued and/or notice a drop in your blood sugar. Listen to your body and let your partner know if you need a moment to refuel.

Alcohol, sex and T1D

Alcohol can play a role in dramatic drops in blood sugar levels. If you choose to mix drinking and sex, T1D community members often recommend sticking to white wine, champagne or other beverages with slightly higher sugar contents to keep your blood sugar in check.

While high blood sugars during sex aren’t ideal, they’re not as scary or urgent as lows.

Alcohol can increase the risk of high or low blood sugar, depending on what’s in it. Sometimes, keeping your alcohol intake low or not drinking at all before or during sex with T1D can help improve clarity and peace of mind, so you’re not worrying about your blood sugar levels any more than you have to. At the end of the day, it’s up to you whether you combine alcohol, sex and T1D. Trust your gut. Do what makes you feel the safest.

Wear a CGM during sex (and always)

If you’re not already wearing a continuous glucose monitor (CGM), it can be especially helpful for thinking less about your diabetes and focusing more on the present.

CGMs are FDA-approved devices that automatically track blood sugar levels every one to five minutes and sound an alarm if levels drop too low or climb too high. While these monitors help with planning or keeping sex spontaneous, a 30-second blood sugar test can be done discreetly wherever you happen to be.

CGMs improve the quality of life for so many people living with diabetes.

T1D and sex: technical difficulties

Keeping tabs on your blood sugar levels is an important practice to prevent potential roadblocks that might happen during any stage of sexual play.

What women with T1D should know

Many women with T1D experience vaginal dryness due to high blood sugar levels, which can lead to pain or discomfort during sex, a lower sex drive, difficulty reaching climax and a generally reduced sexual response. 

Whether you’re all about foreplay or aiming for “The Big O,” keep lubricants nearby. Remember that blood sugar levels can spike depending on what products you apply to your skin, so be sure the one on your nightstand is sugar-free. In addition, practicing daily Kegel exercises will strengthen the muscles in your pelvic region and improve your body’s sensitivity to stimulation.

What men should know

High blood sugar levels may lead to potential obstacles in the bedroom for men with T1D, possibly leading to erectile dysfunction and a variety of problems with ejaculation. Poor blood glucose management can cause nerve damage, a catalyst for retrograde ejaculation, which is what happens when semen travels to the bladder instead of through the penis during ejaculation. 

If you’re experiencing either of these issues, talk to your healthcare provider. There are many options you can explore to address these technical difficulties, such as Viagra or Cialis, testosterone injections, gels or maybe even vacuum pumps.

What transgender and nonbinary people should know

If you are nonbinary or transgender and are exploring sex while managing T1D, intimate moments may trigger gender dysphoria. Fluctuations in hormones may also feel heightened during sex. If you are experiencing gender dysphoria during sex, it’s important to be open and communicate that with your partner so you can enjoy the time together. By having a conversation, you can set boundaries and expectations better.

Before sex, transgender people may consider gender-affirming hormone therapy (GAHT). This therapy can affect hormones in different ways, so it’s important to understand how it interacts with your T1D medications and day-to-day mental state. The best way to know is to talk with your doctor as you progress on your GAHT journey. Community support can also be helpful if doctors are unwilling or poorly versed in this topic.

Communication leads to more pleasure

And remember, whether you have T1D or not, better communication means better sex! Talking to your partner about potential roadblocks before things get hot and heavy is always a good idea. Sex should feel good for everyone involved. For that to happen, there has to be open dialogue. 

Use this guide as your jumping-off point. It can be nerve-wracking, but it can also bring relief that helps you feel sexy and in the moment.

Are you newly diagnosed with diabetes, or do you want to empower yourself more in managing it? It’s time to thrive out loud! Download our Beyond Diagnosis guides to start soaring in your management and inner confidence.