Pain during sexual intercourse (dyspareunia) is more commonly reported by women but can also affect men. High blood sugar levels as a result of diabetes may increase the risk of certain causes of pain.
Lack of lubrication
Vaginal dryness will most likely lead to pain during intercourse. Insufficient lubrication may be caused by a number of factors.
Arousal can be inhibited either by a lack of foreplay, psychological reasons or as a side effect of certain medications including some blood pressure medications and antidepressants.
Autonomic neuropathy may prevent arousal and lubrication. High blood glucose levels at the time of sex may further lead to vaginal dryness.
Use of a lubricant may help to relieve the pain. If the problem is psychological, you may be offered sexual and relationship therapy.
Genital thrush (yeast infections)
Genital thrush can affect both men and women and is more likely to occur when blood glucose levels are higher than normal. Yeast infections can cause soreness of the genitals which may cause sex to be painful.
Thrush is not a sexually transmitted infection but it is possible to pass on a yeast infection to your partner whilst having sex.
For this reason, it is advisable to allow the infection to clear up before having sex.
Thrush may be treated with oral medication or with anti-thrush creams. Maintaining good control of blood sugar levels can also help thrush to clear up.
Vaginismus is the name for involuntary contraction of the muscles around the vagina in response to an attempt at penetration.
Vaginismus may occur if previous attempts at sex have been painful but may be a psychological response for other reasons. If the cause is psychological, sexual therapy may help you to gain control of the muscles.
Tight foreskin – phimosis
Phimosis describes having tight foreskin that prevents a man from being able to retract the foreskin over the glans (head of the penis). Phimosis may cause pain during sex.
Phimosis is caused by an infection and high blood sugar levels as a result of diabetes may provide a breeding ground for infection. Treatment for phimosis will typically involve a topical steroid cream which can help to reduce the tightness.
Inflamed head of the penis – balanitis
Balanitis is swelling of the glans (head of the penis). Balanitis may occur as a result of phimosis if tight foreskin causes irritation of the glans or difficulty in cleaning the glans. Balanitis may also be caused by allergic reactions to soaps or detergents or prolonged contact of the glans with urine.
As with phimosis, balanitis may be treated by use of a topical steroid cream. Depending on the cause of balanitis, it may be treated with antibiotics. Traditionally circumcision was a common treatment for balanitis but these days this will usually only be considered for serious or recurrent cases.