With health concerns such as obesity and diet at the forefront of our consciousness these days, diabetes and the diseases associated with it are also of great concern, albeit sometimes with an incomplete understanding. When people hear the word “diabetes,” they often think of hypoglycemia and hyperglycemia, or the long-term effects such as renal failure or coronary artery disease. The effects of diabetes on women’s health and female fertility are not commonly known among most folks.
Type 2 Diabetes, or Non-Insulin-Dependent Diabetes Mellitus is associated with polycystic ovarian syndrome (PCOS). In Type 2 diabetes, the tissues of the body are resistant to insulin, so despite normal pancreatic function, the cells within the body do not utilize it properly. Increased insulin also increases the level of androgens – male hormones that further throw the delicate hormonal balance into disarray.
Androgens also exacerbate the symptoms of PCOS, a disorder where the ovarian follicles form cysts that do not rupture, which in turn results in anovulation. It is one of the most common causes of female infertility.
Diabetes also makes women more likely to contract urinary tract infections. Illnesses such as yeast infections or tuberculosis of the urogenital tract affect women with diabetes more often than other women. Urogenital infections can affect and damage the fallopian tubes and uterus by causing scarring in these structures, and also by occlusion. This in turn prevents fertilization of the egg, and also implantation of an embryo.
More Trouble Along the Way
If the embryo manages to make it to implantation, diabetes can still make the pregnancy difficult. High blood glucose levels are teratogenic, causing congenital defects to occur in the growing fetus, which puts it at risk of a miscarriage. Diabetes also provides excess, unnecessary nutrition for the growing fetus, which causes macrosomia. This complicates the process of labor and delivery, sometimes requiring a forceps delivery or cesarean section.
Even if the baby is delivered through a normal delivery, he may sustain injury while passing through the birth canal. A large baby can also damage the mother’s birth canal and other internal structures, which is detrimental to her chances of having another child.
Women who are diabetic often feel tired more often than they would if they were healthy. This leads to a decreased libido, as well as depression and anxiety. They may also experience decreased lubrication, vaginal dryness, as well as pain and discomfort during sexual intercourse, which does nothing to help sexual desire at all.
On the bright side, some medications used to treat diabetes, such as thiazolidinediones (THY-a-ZO-li-deen-DYE-owns) have been found to promote fertility by inducing ovulation. They are an integral component in the treatment of PCOS for obvious reasons.