Stephanie Ejegi-Memeh, a PhD student at University of Sheffield considers the sexual health and wellbeing of older women with Type 2 diabetes
In May 2016, Diabetes UK added “the right to talk about any sexual problems” to their list of 15 Healthcare Essentials. While this demonstrates recognition of the increased likelihood of sexual problems in people living with diabetes, the issues surrounding their sexual health and well-being remain largely unexplored. What we do know is that diabetes increases the risks of many sexual problems in both men and women, yet existing health literature tends to focus primarily on erectile dysfunction. In order to address this imbalance in the health literature, I began thinking about what the wider conceptions of sexual health and well-being in older adults are and what sexual health and well-being means to women? In order to answer these questions, I explored the sexual health and well-being literature around older women with Type 2 diabetes.
The search revealed that many women with diabetes experience feelings of guilt, shame and embarrassment due to the perception that diabetes is a self-inflicted disease caused by poor eating habits or being overweight. These perceptions have been found to impact on the self-confidence of women and in turn affect their feelings towards how they viewed themselves sexually.
The diabetes-related infections that women are more likely to have, such as cystitis and thrush, were found to affect sexual health and well-being through women being reluctant to disclose them to potential sexual partners, and fear of pain during sexual intercourse. In addition to these issues, women with Type 2 diabetes were also found to enjoy sex less, feel “unable to let go” and be more tired than women without diabetes. Women encountering these concerns may find that it has an impact on their intimate relationships and quality of sexual life.
Women frequently mentioned relationship issues as being important to their sexual health and well-being. These varied widely from fear of becoming hypoglycaemic during sex, to disclosing their diabetic status, to having sex to please a partner. This suggests that perhaps a greater focus on relationships and the dynamics between sexual partners could make a significant contribution to current sexual health and well-being agendas and future research.
An exploration of the literature highlighted some key areas that this population consider important to their sexual health and well-being but the level of importance that they attribute to their sexual health and well-being was not something that was discussed in detail.
Is sexual health and well-being important to older women with Type 2 diabetes?
This question is not easy to answer and nor should it be. As in younger populations, it depends very much on the individual, their personal circumstances and perceptions of sexual health and well-being in general. In society, older adults, and older women in particular, tend to be perceived as asexual but there is mounting evidence to show that this is not the case. However, it is important to recognise that evidence does exist suggesting that older women consider sex as less important than men do but how this is measured and what implications it has is complicated. What is their definition of sex? Do they feel that it’s a taboo for women, and particularly older women, to be interested in sex? Meaning that they are just less likely to express a lack of satisfaction with their sex lives? If so, we need to know more about the role that health care professionals play in the sexual health and well-being care of older women, especially those more likely to encounter sexual problems such as women with diabetes.