Many of us want to enjoy a healthy sex life as we get older. However, diabetes can make this goal difficult to attain. In this Health Alert, Johns Hopkins endocrinologists discuss two common complaints of women with diabetes.

If you have diabetes, over time, high blood glucose can damage the nerves and blood vessels essential to a natural sexual response. In men with diabetes, this can mean problems with erections. In women with diabetes, it can lead to poor vaginal lubrication and infections as well as decreased sexual desire.

Researchers have studied men more extensively than women, but there's little doubt that controlling blood glucose is the best way to prevent diabetes-related sexual problems regardless of your gender. And when improved blood glucose control is not enough, help is available to overcome the ways that diabetes can take the joy out of sex.

Decreased Lubrication – A recent survey found that poor vaginal lubrication was the most common cause of sexual difficulty in women with type 1 diabetes. Women with type 2 diabetes also appear to have a higher risk of vaginal dryness, which can cause irritation and discomfort, especially during sexual intercourse.

• Why it occurs. Nerve damage from diabetes can reduce or block the production of lubricating fluids in the vagina. Poor blood flow due to blocked arteries can worsen the problem.
• What you can do. Personal lubricants, such as K-Y Jelly, can reduce the friction that causes painful intercourse. Vaginal moi turizers such as Replens or Lubrin can provide longer relief. These lubricants and moisturizers are available without a prescription at your local pharmacy.

Vaginal Infections -- Women with diabetes have an unusually high risk of vaginal yeast infections.

• Why it occurs. -- Vaginal yeast infections are caused by an overgrowth of a fungus called Candida albicans. High blood glucose levels feed the spread of this fungus and weaken the immune system's ability to destroy it. Symptoms of a yeast infection include vaginal itching or burning, pain during intercourse, and vaginal discharge resembling cottage cheese.
• What you can do. Yeast infections are treated with antifungal medicine, which may be applied topically as a cream or lotion, or taken in the form of a pill or liquid. Some of these treatments, such as clotrimazole (Gyne-Lotrimin and other brands) and miconazole (Monistat and others) are available over the counter. Others, such as fluconazole (Diflucan), require a prescription.