Determinants of Sexual Function among Women with Type 2 Diabetes in a Nigerian Population

Abstract

Introduction Sexual health is an important but often neglected component of diabetes care. Unlike erectile dysfunction, female sexual dysfunction has not been well studied among Nigerian diabetics. Aims To assess the sexual function of women with diabetes, and to determine its clinical correlates. Methods The sexual performances of 51 women with type 2 diabetes mellitus attending the Diabetes Clinic, University of Ilorin Teaching Hospital were assessed using the Female Sexual Function Index (FSFI) questionnaire. The Female Sexual Function (FSF) scores in each domain of sexual function were then compared with those of 39 nondiabetic controls. The associations between the FSF scores and certain clinical variables, as well as some diabetic complications, were also determined. Main Outcome Measures Sexual performance of the women as measured by the FSF scores using the FSFI questionnaires. Results The FSF score in the diabetic women was 20.5 (±8.3) compared with a score of 31.2 (±8.8) in the control (P value=0.00). The FSF scores in the arousal, pain, orgasm, and overall satisfaction domains were all lower in the diabetic women (P value<0.05). There was no significant difference in the scores for “desire” domain in the two groups (P value > 0.05). Women with diabetes attempted sex less frequently (P <0.05). There was a negative correlation between the ages of the women and all the domains of sexual function (P value<0.05). Duration of diabetes correlated negatively with comfort (P value=0.04), lubrication (P =0.03), frequency (P value=0.05), as well as orgasm (P value=0.04) domains. There was no significant relationship between the FSF score and body mass index, blood pressure, and glycemic control. There was no significant difference between the FSF scores of diabetic women with complications and those without (P value > 0.05). Conclusions Diabetes significantly impairs the sexual performance of the Nigerian women afflicted with the disease. Determinants of FSF include age, duration of diabetes illness, and presence of menopause.

Determinants of female sexual dysfunction in type 2 diabetes

“…It is noteworthy that the prevalence of FSD in the diabetic sample aged o50 years was around 41%; mean FSFI score was 20.8. The FSFI scores recorded in other studies were 29.3 (72 women), 13 20.5 (51 women), 14 23.6 (23 women) 16 31 These findings are in line with our results.…”

“…19 However, and in apparent contrast with diabetic men, no association was found between sexual dysfunction and cardiovascular, metabolic, and other risk factors, such as age, body mass index (BMI), menopause and use of hormone replacement therapy. 7 It seems that in type 1 diabetes sexual dysfunction is related more directly to psychological factors, 14 an interpretation recently confirmed by the results of a large prospective study of 625 women with type 1 diabetes (Epidemiology of Diabetes Interventions and Complications study), in which depression was found to be the major predictor of sexual dysfunction. 17 A somewhat different picture seems to emerge from the results of studies evaluating sexual dysfunction in type 2 diabetic women: although the findings may be considered preliminary given the paucity of studies and the small samples analyzed, determinants of sexual function in type 2 diabetic women may include age, duration of diabetes, vascular complications and menopause.…”

“…The overall FSD prevalence rate in our study was approximately 54%, which is higher than that reported in younger women with type 1 diabetes (up to 35%). 12 The studies that until now addressed FSD in women with type 2 diabetes suffer most from small sample size: 13,14,16,30,31 in all these studies sample size was well below 100 diabetic patients (range 30-72 women), and all studies reported a higher prevalence of FSD in diabetic women as compared with matched nondiabetic women. In the largest study so far published, Abu Ali et al 15 evaluated 613 diabetic women and 524 nondiabetic women in Jordan, and found a prevalence of FSD of 59.6% in diabetic women 50 years of age or older as compared with 45.6% found in the age-matched nondiabetic women (Po0.05).…”

“…In spite of these limitations, most studies have found a higher prevalence of FSD in diabetic women as compared with nondiabetic women. [12][13][14][15][16] Recent studies focused the attention on type 1 diabetic women, probably because type 1 diabetes may be free, at least for many years of its natural history, of metabolic risk factors that are associated with FSD, 17,18 this might have offered the unique opportunity to examine the role of diabetes per se, independent of associated comorbidities, on sexual function. So far, a high prevalence of sexual dysfunction has been reported in type 1 diabetic women, including loss of desire, lubrication difficulties, dyspaurenia and loss of the ability to reach orgasm.…”

“…17 A somewhat different picture seems to emerge from the results of studies evaluating sexual dysfunction in type 2 diabetic women: although the findings may be considered preliminary given the paucity of studies and the small samples analyzed, determinants of sexual function in type 2 diabetic women may include age, duration of diabetes, vascular complications and menopause. [13][14][15][16] This study was designed to evaluate the prevalence and correlates of female sexual function in a population of diabetic women. The Campanian Post-Prandial Hyperglycemia Study 20,21 provided the opportunity to evaluate FSD in the context of a large observational study of type 2 diabetic patients.…”