Can diabetes affect sexual performance?

Pain during intercourse — dyspareunia — is common, has identifiable causes, and should not be accepted as normal or endured. Causes divide roughly by where the pain is felt. Pain at entry may be due to insufficient lubrication, vaginismus (involuntary pelvic floor muscle tightening), infection, skin conditions, or scarring after childbirth. Deeper pain more often suggests endometriosis, adenomyosis, pelvic inflammatory disease, ovarian cysts, or fibroids. Deep pain with periods, or pain that has worsened over time, points particularly toward endometriosis — which is frequently diagnosed years later than it should be, partly because painful sex is under-reported and under-asked-about. For those trying to conceive, this matters practically as well as personally: pain understandably reduces frequency of intercourse, and that alone can delay conception. Assessment involves history, examination and usually a pelvic ultrasound. Treatment depends entirely on cause — pelvic floor physiotherapy is highly effective for vaginismus, and specific treatment exists for the other causes. Please raise it with a gynaecologist even if it feels awkward. It is a medical symptom and you should not have to justify wanting it addressed.