I am 20 years old, I’ve had diabetes for the past 11years, and I’ve been in a relationship with my boyfriend for quite a while now but haven’t had any sexual intercourse yet. Will I have any difficulties with a sexual relationship because I have diabetes?

Sexual activity is exercise so you may need extra food to avoid low blood sugars. If you plan to use birth control, keep in mind that your insulin requirements may increase if you use oral contraceptive pills, and you may be more prone to yeast (candida infections) on birth control pills (this is usually easily controlled). All people who use oral contraceptive pills have a slight increased risk of certain problems like high blood pressure and blood clots, but people with diabetes may have a slightly greater risk. There is no increased risk that I am aware of in using the diaphragm or a condom. There might be a slightly increased risk of infection with the IUD. These risks must be weighed against the risk of an unplanned pregnancy and the risk of conceiving without optimal blood sugar control.

You must make sure that your blood sugars are in the best possible control (at least three months, preferably six months) before you plan to get pregnant to avoid a small increased risk of birth defects in your child if your blood sugar is out of control at the time of conception and especially during the first trimester. You should discuss the best means of control with your endocrinologist at least six months or before you plan to conceive. You will need to constantly adjust your insulin during pregnancy to maintain excellent blood sugars to avoid complications.

I suggest you see a gynecologist, have an exam and discuss all these issues before you decide to engage in sexual activities.

TGL