Signs and Symptoms of Diabetes in Women

Diabetes occurs when your blood glucose (sugar) levels are too high due to problems with insulin. Insulin is a hormone your pancreas makes that helps control how your body uses glucose (sugar) for energy. Common symptoms include intense thirst, frequent urination, and unexplained weight loss.

Currently, over 199 million women have diabetes, and this number will likely reach 313 million by 2040. Women face unique challenges due to their anatomy, hormones, and reproductive health, and they are also at a higher risk for complications like heart disease. Recognizing these signs and seeking early treatment can help reduce these risks.

Types of Diabetes

There are three main types of diabetes:

• Type 1: Type 1 diabetes occurs when your pancreas does not produce enough insulin. Symptoms typically develop quickly over a few weeks.
• Type 2: Type 2 diabetes accounts for 90% of adult diabetes cases. It occurs when your body does not use insulin effectively. Symptoms develop gradually over time. 
• Gestational: Gestational diabetes occurs during pregnancy and typically resolves after delivery. People who have gestational diabetes are at higher risk of developing type 2 diabetes later on. Experts recommend diabetes screening at least every three years after delivery. 

Common Symptoms

Regardless of your gender or age, early signs and symptoms of diabetes often include:

• Increased thirst or dry mouth
• Frequent urination (peeing)
• Extreme hunger, even after eating
• Unexplained weight loss

As diabetes progresses, symptoms may also include:

• Acanthosis nigricans (darkening skin under the arms or neck)
• Blurred vision
• Dry skin or mouth
• Fatigue 
• Frequent infections
• Numbness or tingling in hands or feet
• Slow-healing sores

Signs and Symptoms in Females

Initial symptoms may intensify as diabetes advances. New symptoms may emerge over the coming months or years, especially without treatment and blood glucose (sugar) control. At this stage, the following female-specific diabetes signs might develop.

Vaginal Dryness

Continuous high blood glucose can damage nerves and blood vessels, including those in the vaginal area. This can reduce lubrication, leading to dryness and discomfort, especially during sex.

Nerve damage can also affect sensation, making sex less enjoyable and causing difficulty in achieving orgasm. 

Genitourinary Infections

People with diabetes are more likely to get infections because of nerve damage, high blood sugar, or a weakened immune system. More specifically, people with diabetes are four times more likely to get genitourinary (genital or urinary) infections. Women are at an even higher risk due to their anatomy and hormonal changes.

Frequent Urinary Tract Infections (UTIs)

A urinary tract infection (UTI) happens when germs infect the urethra (the tube that carries urine out of the body) or bladder. UTI symptoms include:

• Burning when you pee
• Cloudy or strong-smelling pee
• Discomfort in the pelvic area (between the hips) 
• Frequent urge to pee

In a study of 3,552 people with diabetes, 3.8% of men and 31.8% of women had UTIs. Women are more likely to get UTIs because their urethra is shorter and closer to the anus (where poop exits the body), making it easier for germs to enter.

Recurrent Vaginal Yeast Infections

People with diabetes are more likely to get yeast infections because high blood sugar makes it easier for yeast to grow. Hormonal changes, frequent antibiotic use, and vaginal environment can also increase the risk.

Signs of a yeast infection include:

• Pain during urination or sex
• Thick, white vaginal discharge that may look like cottage cheese
• Vaginal itching, burning, redness, or swelling 

Bacterial Vaginosis

Bacterial vaginosis (BV) occurs when the pH (acid-base) balance of bacteria in the vagina is off track. People with diabetes are more likely to get BV because high blood sugar can upset this balance.

Symptoms of BV include a thin, gray, or white discharge and a fishy smell, especially after sex.

Irregular Menstrual Cycles

High blood sugar, low insulin, weight fluctuations, or insulin injections are examples of factors that can alter female hormones like estrogen, causing irregular periods. Menstrual irregularities are more common in type 1 diabetes but can also happen with type 2. Common changes include:

• No periods (amenorrhea)
• Heavy bleeding
• Shorter or longer time between periods
• Later menarche (first period)
• Earlier menopause (end of menstruation)

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormone-related condition that causes many small cysts on the ovaries and high levels of male hormones called androgens. Symptoms include:

• Acne
• Dark, thick skin on the neck, armpits, or groin
• Excess facial or body hair
• Thinning hair on the scalp
• Irregular periods
• Unexplained weight gain
• Difficulty getting pregnant

PCOS and diabetes have a bidirectional link, meaning each can increase the risk of getting the other. People who have PCOS and clinical obesity are eight times more likely to get type 2 diabetes. About 50-80% of people with PCOS have insulin resistance, leading to a higher risk of diabetes. On the other hand, diabetes increases the risk of PCOS due to hormonal imbalances.

Infertility

Diabetes can make it harder to get pregnant by affecting the hormones that control ovulation and your menstrual cycle. Poor blood sugar control may also lower egg quality, which reduces your chances of getting pregnant. Females who develop type 1 diabetes before their first period may face even more significant reproductive challenges.

Complications

Women and children are at higher risk of diabetes complications such as:

• Heart disease
• Eye damage or blindness
• Nerve damage (neuropathy)
• Kidney disease
• Stroke

Pregnancy Complications

Pregnancy can be more complicated for people with diabetes because poor blood sugar control increases the risk of:

• A larger-than-average baby 
• Congenital disabilities (present at birth)
• Hypoglycemia (low blood sugar) for the baby after birth 
• Miscarriage or stillbirth
• Preeclampsia (high blood pressure during pregnancy)
• Premature (early) delivery
• Shoulder dystocia (the baby's shoulder getting stuck inside the pelvis during delivery)

Pregnancy can also increase the risk of diabetic complications like kidney or eye disease.

Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis (DKA), an accumulation of acids (ketones) in your blood, is a dangerous complication of diabetes. While children with diabetes are more likely to develop it, adults can experience it too.

Signs of severe diabetes are an emergency and include:

• Confusion 
• Deep, rapid breaths
• Dehydration (dark pee, not peeing enough)
• Stomach cramps
• Sweet or fruity breath
• Throwing up
• Unconsciousness

Symptoms in Children 

Children experience the same common diabetes symptoms as adults. However, type 1 diabetes is most common in children. A type 1 diagnosis often occurs between ages 5 and 7 or during puberty. It's more likely if you have a parent or sibling with diabetes, and it's slightly more common in children assigned male at birth.

Type 2 diabetes, once seen primarily in adults, is now more common in children due to obesity and lifestyle factors. One in three new childhood diabetes cases is type 2. Risk factors include:

• African American, Hispanic, Native American, Pacific Islander, or Asian American descent
• A family member with diabetes
• A mother who had gestational diabetes
• Being overweight
  
• Being assigned female at birth, especially during puberty

Symptoms in Men

In addition to common diabetes symptoms, people with male reproductive organs may also experience: 

• Erectile dysfunction (from nerve damage or poor blood flow)
• Infections and inflammation of the genitals and urinary tract
• Lower muscle mass 
• Lower sex drive
• Retrograde ejaculation (semen goes into the bladder rather than out of the penis during sexual climax)

Is Diabetes Contagious?

Diabetes isn't contagious because the underlying cause involves genetics and environmental factors, not germs.

However, people with diabetes often get genitourinary infections. These infections may share similar symptoms with sexually transmitted infections (STIs). Therefore, getting a proper diagnosis and treatment for these infections is important.

When to Contact a Healthcare Provider 

Signs of diabetes that require a visit to a healthcare provider include:

• Excessive thirst 
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Blurred vision
• Dry skin or mouth
• Fatigue 
• Numbness or tingling in hands or feet
• Slow-healing sores

Other signs that may indicate diabetes and require medical attention are:

• Vaginal dryness or painful sex
• Low sex drive
• Recurrent vaginal or urinary infections
• Irregular periods
• Difficulty getting pregnant
• Frequent miscarriages

Some symptoms require emergency care, as they could indicate severe complications like diabetic ketoacidosis (DKA). These symptoms include:

• Confusion
• Deep, rapid breathing
• Loss of consciousness
• Severe dehydration (extreme thirst, very dark pee, not peeing enough)
• Stomach pain or cramps
• Sweet or fruity breath
• Vomiting

A Quick Review 

Common diabetes symptoms include frequent urination, excessive thirst or hunger, or unexplained weight loss. Women may also experience signs like recurrent vaginal or urinary infections, vaginal dryness, period irregularities, infertility, or pregnancy complications.

Women are also at a higher risk of diabetes complications like heart, kidney, or eye-related conditions. Understanding these signs and symptoms can help you take steps to manage your blood sugar and prevent possible complications.