Does Type 1 Diabetes Kill Your Sex Drive?

One topic that stood out in particular at the conference was an emphasis on T1D “killing the mood.” So what is its real impact on your sex drive? Kersti Spjut, PhD, Licensed Psychologist and Certified Sex Therapist, explained during her DMH Conference session, “When Diabetes Kills the Mood: A Sexual Health Primer for People Living with Diabetes.”

Why Is It Awkward to Talk About Sex and Diabetes?

As a person living with type 1 diabetes, it can be awkward to talk about intimacy with your doctor, especially if you’re newly entering this phase of your adulthood. It’s equally unlikely that they’ll bring it up unprompted.

Thoughts and anxieties about sex and diabetes may swirl around your head like:

• What if I go low during sex?
• How do I safely take my tubed insulin pump off during sex?
• How do I talk to my new sexual partner about my T1D?
• How do I make sure my experience doesn’t become all about T1D?

Sex for the first time or your first time with a new partner can be awkward already, then throwing T1D on top of it can make it feel like the threesome you never asked for. It can take attention away from the moment or from your ability to be present. And that sort of anxiety? Well, it can most certainly be a mood killer for lots of people with T1D.

But there are ways to work around that! Understanding the challenges may be the first step toward solving them effectively, and seeking support when needed.

The Intersection of Sexual Health and Chronic Illness

Spjut works in private practice in Utah, specializing in sexual health, perfectionism, and body image. Spjut has firsthand experience with adult-onset T1D. Outside of work, she loves baking and trashy reality TV—fitting for Utah culture right now with the rise in popularity of “The Secret Lives of Mormon Wives.”

Spjut was already a psychologist when diagnosed with Latent Autoimmune Diabetes in Adults (LADA) at the age of 32. She was also already specializing in the aforementioned. When T1D got added to her personal picture, Spjut’s whole world “turned upside down.”

“It’s been a huge personal change for me,” Spjut noted. “I got diagnosed on the anniversary of D-Day. That felt fitting for diabetes. I think it has influenced a lot of how I practice. For personal reasons, of course, I have to learn more about health connections to mental health.”

Spjut started working with folks who wanted to work with someone who had lived experience. Through her work and personal life, she began to understand how all aspects of health influence chronic illness. 

Many people don’t always understand what sex therapy is. Essentially, it’s talk therapy focused on sexual issues, whether someone needs to discuss sexual dysfunction, low desire, difficulty achieving orgasm, mismatched desires with a partner, or healing from sexual trauma.

“A big part of sex therapy is unpacking the messages you’ve gotten about sex,” Spjut said. “Whether that’s from broader culture, your religious upbringing, your identities, or the way the organizations you’re a part of think or talk about sex. And of course, how that overlaps with gender identity.”

When you throw chronic illness into the mix, that can add a whole other level of complexity.

“These have a lot of overlap with mental and physical health,” Spjut concluded. “A lot of it ties back to sex.”

Clinical Gaps in Sex Education with Diabetes

When Spjut was first diagnosed, she acknowledged that no provider ever talked to her about sexual health.

“Most people get information from the internet,” Spjut said. “And a lot of it is about dysfunction, which makes sense because people want to fix those problems. But there’s a huge proportion of people with diabetes (PWD) who have some sort of sexual dysfunction.”

Spjut attributed a study of 20% to 80% of women with diabetes having a form of sexual dysfunction. 

Spjut noted that PWD may struggle with:

• Erectile dysfunction
• Ejaculation disorder
• Loss of sexual desire
• Painful intercourse
• Orgasmic disorder

“There’s also a potentially higher risk for genital and urinary infections,” Spjut said. “Sexually transmitted infections (STIs) can also sometimes spread more easily among PWD. For most of these, the risk is higher when blood glucose management is difficult—just like any diabetes complication.”

Diabetes can also make pregnancies high-risk, which can make contraception use emotionally loaded for PWD.

Even with the right partner, the desire to have children can feel heavy because it’s important to be in your target range to ensure a healthy pregnancy. So, unexpected pregnancies can feel chaotic or troubling, even if they’re what you want.

When women, in particular, were asked what made sex more difficult with diabetes, Spjut shared that common themes among interviewees included:

1. Diabetes is always present: it’s a burden and affects relationships.‍
2. Diabetes affects sexual health: reduced desire, physical challenges, effects on partnered sex, etc.‍
3. Diabetes affects sexual function: glucose levels and diabetes tech directly affect sexual function. 

“Seeing yourself in the mirror, trying to be sexy, and seeing this thing in the mirror—your diabetes tech—can make you not feel so sexy,” Spjut reflected. “And you might want to remove it, but that could affect your sexual health as well.”

Some other things that may impact your sexual experience with diabetes that don’t feel obviously connected may include:

• The financial burden of diabetes
• Partner dynamics: jealousy of non-disabled partners or caregiver vs. caretaker roles
• Internalized stigma
• Diet culture
• A lack of body trust: feeling like your body has betrayed you

At the end of the day, diabetes tends to make everything more challenging. But a little preparation and awareness can go a long way in easing the complicated feelings you may have around intimacy and T1D.

Alice Wong, a powerful disability advocate who recently passed, acknowledged that people with chronic illnesses who rely on technology might actually feel empowered by wearing tech. Like “superhuman cyborgs.”

“We’re kind of like cool, bionic people,” Spjut said. 

Improving Your Sexual Health with Diabetes

To begin to address some of the challenges of your sex life while navigating diabetes, Spjut recommended some important steps:

1. Start with educating yourself: “Not everything has to have a reason,” Spjut said. “There are ways you can still feel empowered and feel joy, growth, and pleasure while experiencing those challenges.”‍
2. Identify what you’re really asking: “Am I okay? Am I broken? Do I belong? Am I to blame? Is there hope for my sex life?” Normal looks different for PWD. Everyone’s normal is different, regardless of chronic illness, because we each have our own standards, expectations, desires, and goals. That’s okay! Knowing ourselves and giving ourselves grace and compassion helps us be more present during sexual experiences. 

“Complications from diabetes don’t have to control your sex life,” Spjut added. “You can still have an awesome sex life. What will ruin it is how you think about your complications related to your sex life. You’re allowed to feel how you feel and want what you want.”

Most things are normal. There are way more commonalities people experience during sex. You’re not the only one, even if you believe you are.

“Of course, non-consent is not normal or okay,” Spjut said. “Or unwanted pain during sex. We want to stop, in that case, and figure out the pain.”

Your entire well-being and awareness of it are critical for all aspects of health. If you take care of yourself, you can enjoy yourself and others better.

“The biggest predictor of sexual wellbeing is overall wellbeing,” Spjut concluded. “Ask yourself if you’re okay. Don’t focus on whether you’re normal. There could be a lot of other things going on—financial components to make ends meet, not eating enough, etc. Once you’ve established a better way of being, you can identify sex-specific things.”

The Role of Shame in Sex and Diabetes

“It’s messy,” said Spjut. “Figuring it out can be relief and growth. For a lot of people, it can even be rooted in using the term disability.” 

Even though diabetes is a disability, acknowledging it this way can influence personal stigma, especially if you’ve had to disclose it at work or school. 

Shame can inhibit a person’s sex drive. This is especially true for people with chronic illnesses like T1D. Identity work can be very important for PWD who may confuse their personalities with their conditions—T1D can overtake a lot of who we are.

“You’re not the only one dealing with this,” Spjut said. “It’s common with chronic illness to feel at odds with our bodies. Like our bodies are the enemies. But when we distance ourselves from our bodies, we also distance ourselves from our pleasure, our emotions, and our connections.”

Spjut said divorcing yourself from your body can be the culprit of sexual shame or a loss of sexual desire for many PWD.

“The reality is, your body is your home,” Spjut noted. “If you’re going to experience sexual pleasure, it’s going to be in your body in some regard.”

Get Support for Your Unique Diabetes Needs

These insights just touch the surface when it comes to sexual drive and health in relation to our lived experiences with diabetes. Individuals seeking personal support from certified sex therapists like Spjut can search the American Diabetes Association’s (ADA) psychologist directory or use their insurance portal to find someone who can support their unique needs.

Spjut offered even more insights and information during the full session, which are worth a watch if you relate to any of the subject matter mentioned within this article.

If you would like to replay this session and many others from this year's conference, on-demand tickets are available for purchase until July 19, 2026. After purchasing the on-demand sessions, you can access the replays here. If you attended the live event, you should have received a code to access the on-demand features afterward.