Many of the risks of diabetes affect both sexes, but there are some differences.
Around one in nine adult women in the United States has diabetes, according to the Centers for Disease Control and Prevention (CDC).
This article looks at how diabetes can affect women, who is at risk, the signs and symptoms to look out for, and when to ask for testing.
Effects of diabetes in women
Many of the symptoms of diabetes are common to both men and women, but some features are specific to women.
Oral and vaginal thrush
Some symptoms of diabetes are unique to women.
Women with diabetes may be more likely to experience a yeast infection, or thrush, in the mouth and vagina.
High levels of blood sugar create an ideal breeding ground for the Candida fungus that causes the condition.
- sore skin
- vaginal discharge
- itchy sensations
- dyspareunia, or painful sex
- a white coating on the tongue, if the fungus infects the mouth
People with diabetes are more likely to develop different kinds of infections, with more severe symptoms and a higher chance of complications than people without diabetes.
High blood sugar levels in the body affect the immune system's ability to respond to pathogens such as bacteria, viruses, and fungi.
Urinary tract infections (UTIs)
Women with diabetes have a higher risk of a urinary tract infection (UTI). In a 2015 review, 12.9 percent of women studied developed a UTI within the first year of receiving a diagnosis of type 2 diabetes. Only 3.9 percent of men experienced one.
Symptoms of a UTI include:
- painful, burning urination
- cloudy urine
- blood in the urine
Anyone with diabetes who has a UTI should seek treatment as soon as possible to prevent further complications, such as a kidney infection.
A higher risk of a UTI or candidiasis can contribute to a lower sex drive, or libido. Other factors can also affect this.
Many people with diabetes develop diabetic neuropathy. This happens when high glucose levels in the blood result in damage to the body's nerve fibers.
The impact of this varies widely. It includes reduced sensations in the hands, feet, and legs and altered sexual experiences in the vagina.
There may also be:
- low lubrication of the vagina
- difficulty with arousal of the clitoris and having an orgasm
- pain during sex
All these can affect a person's interest or pleasure in sex.
Polycystic ovarian syndrome (PCOS)
There is a higher chance of having PCOS if a person has diabetes. In PCOS, a hormonal imbalance means the ovaries are unable to release eggs properly. This can affect fertility.
PCOS is not a symptom of diabetes, but a woman with diabetes is more likely to have it than one who does not have diabetes.
- irregularity in the menstrual cycle
- fertility problems
- increased body weight
- skin changes
If a person receives a diagnosis of PCOS, they should also ask their doctor about screening for diabetes.
Gestational diabetes is a temporary condition that affects some women during pregnancy.
Effects of gestational diabetes
Gestational diabetes often resolves after delivery, but a person who experiences it may have a higher risk of developing type 2 diabetes later in life.
Other problems that can arise include:
Some women experience gestational diabetes during pregnancy.
- labor difficulties
- the need for a cesarian delivery
- a risk of tearing in the vagina or between the anus and the vagina
- heavy bleeding after delivery
The baby may be born with:
- breathing problems
- low blood sugar
There may be no symptoms during pregnancy, so testing is important, especially for those who may be at risk.
If getational diabetes is present, it is important to follow the doctor's instuctions about diet, exercise, and tracking blood sugar levels.
Gestational diabetes is more likely if a person:
- is overweight before becoming pregnant
- has prediabetes, when blood sugar levels are high but not high enough for a diagnosis of diabetes
- has a family history of diabetes
- has previously had gestational diabetes
- has delivered an infant larger than 9 pounds in the past
- has PCOS
- has an African American, Asian American, Hispanic, Native American, or Pacific Island background
When a person has had gestational diabetes during pregnancy, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommend the following steps after delivery:
- screening for type 2 diabetes 6–12 weeks after delivery and every 3 years after that
- getting back to a healthy weight through regular exercise and a healthful diet
- breastfeeding the baby, if posssible, to give them the right balance of nutrients and to help you burn calories
- check with a physician about using metformin, a medication, to help prevent type 2 diabetes
What are the early signs of type 2 diabetes? Click here to find out more.
Pregnancy and the menopause
Diabetes can impact on two major aspects of female sexual and reproductive health.
Women who have diabetes before pregnancy need to take certain steps to ensure a safe pregnancy.
Blood sugar levels: If possible, keeping blood sugar levels under control before pregnancy is vital. High blood sugar levels can harm the fetus and may result in congenital anomalies.
This is especially true early in pregnancy, when a person might not yet know they are pregnant.
Medication: The person may need to change their use of medication during pregnancy.
Diet and lifestyle factors: Diabetes can increase the risk of complications during pregnancy, so a person should work closely with their healthcare team to establish:
- a safe diet
- an exercise plan
- a schedule for testing blood sugar at home
- the need for other tests and monitoring
Menopause can worsen diabetes symptoms, but exercise and a healthful diet will help.
Menopause and the years leading up to it involve a variety of changes that can trigger diabetes or make it worse.
Hormonal changes alter how cells respond to insulin. Blood sugar levels might become less predictable and require more frequent monitoring.
Menopause leads to a drop in estrogen levels as the ovaries stop producing eggs. A person may be more prone to UTIs and vaginal infections at this time if they have diabetes.
Many women experience weight gain during menopause. Women with diabetes may need to change their insulin doses or oral diabetes medications to adapt to these changes.
A study published in 2018 concluded that women with type 2 diabetes who experience hot flashes and other symptoms of menopause may benefit from hormone therapy.
However, the authors note that treatment will depend on the individual.
Symptoms of diabetes
The most common signs and symptoms of high blood sugar levels include:
- increased thirst
- frequent urination
- extreme tiredness
- increased hunger
- unexplained weight loss, even when increasing food intake
- lack of energy
- blurred vision
- frequent or recurring infections, such as an infection of the gum, skin, or vagina
- cuts and bruises that are slow to heal
- sexual difficulties
People who have any of these symptoms should see a doctor, as early diagnosis can help prevent complications.
How do diabetes symptoms differ according to age?
Type 1 diabetes is most likely to develop during childhood or adolescence, and the risk of having type 2 diabetes increases after the age of 45 years. However, it is possible for either type to affect a person at any age.
There has been an increase in the onset of type 2 diabetes in younger people in recent years. Studies show that these people are more likely to develop complications faster and at a younger age, compared with people with type 1 diabetes and those who develop type 2 at a later stage.
Effective blood sugar control and healthful lifestyle habits can help reduce the risk of complications for people with type 1 and type 2 diabetes at any age.
The blood flows to all parts of the body, and high blood sugar can cause damage in many areas for both men and women.
Diseases of the heart and blood vessels are key complications of diabetes. Over time, high blood sugar levels cause damage to blood vessels and nerves.
High blood sugar levels lead to inflammation in the blood vessels. The blood vessels stiffen, and the blood does not flow through them as well as before.
Low blood flow can lead to a range of problems, including:
Nerve damage can lead to many complications, including problems in the extremities.
In severe cases, these can lead to complications that can make an amputation necessary.
A person with diabetes also has an increased risk of other mental and physical health issues, including a loss of mobility and depression.
Learn more here about the symptoms and complications of diabetes.
Risk factors for women
Many risk factors for diabetes are the same for men and women, but some are different.
A study of data for nearly 100,000 men and women found, for example, that men tend to have a lower body mass index than women when they develop type 2. The results were published in 2011.
The CDC list the following as risk factors for women to develop type 2 diabetes:
- a history gestational diabetes during a past pregnancy
- giving birth to a baby weighing more than 9 pounds (lb)
- having a history of PCOS
- having a family history of diabetes
- having high blood pressure or 140/90 mmhg or above
- having high cholesterol or 240 mg/dL or above
- getting less than 150 minutes of moderate intensity activity, such as walking, a week
- having an African American, American Indian or Alaska Native, Asian American, Hispanic or Latino, Native Hawaiian or Pacific Island background
Anyone with these risk factors should ask their doctor about screening for diabetes.
Diabetes can affect both men and women, but women can have some specific symptoms.
Current guidelines from the American Diabetes Association recommend regular screening for diabetes from the age of 45 years, or earlier if a person has other risk factors. Women should ask about screening if they have PCOS or if they are or plan to become pregnant.
Women should talk to their healthcare team about any special requirements if they have a diagnosis of PCOS, before and during pregnancy, and around the time of menopause.
Is diabetes treatment any different for women?
The only difference is that women of childbearing age need to consider the side effects of any treatment that could have an effect on a developing fetus.Suzanne Falck, MD, FACP Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.