Sexual Health

Thrush

Lots of things that you deal with on a daily basis don’t seem to be related to your diabetes, but they actually are. That annoying thrush you keep getting? Yep, it’s almost certainly caused by the high levels of glucose in your urine because ‘candida albicans’, the fungus that causes thrush to grow, just thrives on all that sugar. 

Thrush mainly occurs in the genitals, but it can be sexually transmitted. It can also occur in the mouth and sometimes in the armpits and even between the fingers.

You’ll know that you have oral thrush (in your mouth) if you can see redness and you have white spots coating the surface of your tongue. You may also experience other symptoms like cracks in the skin around your mouth, pain inside the mouth, difficulty eating or drinking or not being able to taste properly.

Thrush does not discriminate. Males and females get similar symptoms. Females usually notice a whitish discharge in their pants and they will feel itchy and sore when they pee.

Males will find that the head of their penis gets red and inflamed (this inflammation is often referred to as balanitis) and it can also feel itchy and sore. They may also notice small red spots on the penis and will get a similar discharge.

The good news is that thrush can usually be treated with over-the-counter creams, ointments, tablets, or suppository which are very effective.

If an infection persists, or you can’t afford to buy medication privately, talk to your GP or your Diabetes Team about getting a prescription.

Keeping your blood sugar in range is the best way to prevent yeast infections but if you get thrush regularly, wearing cotton underwear, avoiding tight trousers, changing out of wet swimsuits immediately, changing tampons and sanitary towels frequently and steering clear of hot baths, hot tubs and vaginal douches or sprays is also a good idea.  

Urinary Tract Infections (UTI)

Urinary Tract Infections (UTI’s) such as cystitis are more common in females, especially if your blood sugar is higher than it should be for long periods of time. You’ll know if you have cystitis if it hurts to pee, and you need to pee all the time. It can also cause pain low down in your tummy and is generally a pretty miserable experience. 

The best way to avoid getting UTI’s is to keep your blood sugar in range, to drink plenty of water and always go for a pee when you need to.  Check out our ‘Your Rights at School” section if teachers get on your case about needing the toilet.

If you do have cystitis, you can treat it by taking paracetamol or ibuprofen and by drinking plenty of water and cranberry juice. Cranberries contain substances called proanthocyanidins, which are thought to prevent bacteria from sticking to the wall of the bladder, but it contains sugar so make sure you bolus appropriately.

Although UTI’s aren’t sexually transmitted, having sex is a great way for gut bacteria to get into your urinary tract and if you already have cystitis, having sex can put pressure on your bladder, which can be very painful. Sex is also a common cause of bladder infections so it is best to avoid sex until you feel better.

If your cystitis lasts longer than a few days, talk to your GP because it can develop into something called vaginitis if it is not treated promptly.

Sexually Transmitted Infections (STI’s)

Your risk of contracting a sexually transmitted infection is no different if you are diabetic, but having diabetes can impact your capacity to heal. That means that all infections, including sexually transmitted infections (STIs), can be a bit trickier and it can take longer to get rid of them when you have type 1 diabetes. Using condoms or femidoms is the only way to prevent getting a sexually transmitted infection so be prepared. You can get free condoms by post in most parts of the country. Google your nearest service and they will send them to you in a discrete brown envelope. Most parts of the country also offer young people a C card which means you can get condoms free at pharmacies. If you think you might have an STI you can get a testing kit and treatment from your GP. For more information visit the NHS website.

Sexual Difficulties

Obviously, you don’t need anyone else telling you to do more to control your blood sugar, but thinking about what happens if you don’t, can help you to understand why so many people nag you about it. When you are young, it is difficult to think about the future because it seems so far away, but the way you manage your diabetes now has an impact on how well your body will function in the future.

One of the most important reasons to keep your blood sugar in a normal range is to help prevent  damage to the blood vessels (vascular) and nerves (Neuropathic). Damage to the nerves and blood vessels impacts the amount of blood flowing to your sexual organs and that can make it harder to feel aroused, to have an erection or to achieve an orgasm.  There are things you can do to help yourself if you experience sexual dysfunction but the best way to avoid having these issues is to keep your blood sugar in range to prevent them happening in the first place.

On a more positive note….

Now that every young person in the UK is legally entitled to get a closed loop pump, sexual difficulties caused by high blood sugars should, hopefully, become a thing of the past. It has taken a long time but the National Institute for Health and Care Excellence (NICE) have finally agreed that all young people in England  aged 0-18 with type 1 diabetes will be eligible for a hybrid closed loop system and those over the age of 18 who have a HbA1c that is greater than 7.5% or who are experiencing disabling hypos, or planning to have a baby, will also be eligible. Talk to your Diabetes team if they have not offered this to you.