Mediators of Sexual Functions in Women with Diabetes

Abstract

Introduction Sexual disorders in women with diabetes mellitus (DM) may not necessarily have only the biological etiology. Aims To establish the mediators of sexual functions in the population of women with DM. Methods Five hundred seventeen females, aged 18–55 years old, were included in a questionnaire-based, cross-sectional study. This is the second part of the study on sexual functions in females with DM where only females with DM (n = 242) were analyzed. Sexual functions were compared between women with type 1 (n = 109) and type 2 DM (N = 133). Main Outcome Measures To assess reported female sexual functions by using the Female Sexual Function Index (FSFI) in women with type 1 and type 2 DM. To establish the risk factors of female sexual dysfunction (FSD) in women with DM by using multivariate logistic regression model. Results Sexual dysfunction was diagnosed in 32.65% (n = 64) of women with DM. Women with type 2 DM had a significantly lower number of points scored in all FSFI domains except pain compared to type 1 respondents. The only variables associated with DM significantly influencing sexual functioning were: type 2 diabetes in desire, arousal, as well as in global FSD (odds ratio [OR] = 1.40; 2.70 and 3.31, respectively), the presence of retinopathy in lubrication (OR = 7.8), and treatment with insulin in satisfaction domain (OR = 0.29). Neither the presence of comorbidities, the duration of diabetes, the presence of diabetes complications nor the glycemic control was a moderator of FSD. The strongest significant predictors of FSD were: the presence of depressive symptoms, the importance of sex to the respondent, and satisfaction with the partner as a lover. Conclusions Women with DM, especially type 2, are at risk of sexual dysfunctions. Diabetes-related factors have little impact on sexual functions in women with DM. Depressive symptoms, partner-related factors, and individual perception of sexuality should be evaluated when counseling females with DM.

Sexual dysfunction in diabetic patients — an important and overlooked complication

“…These results are difficult to relate to other research because the publications are characterized by significant methodological divergence. The incidence of sexual dysfunction in women with diabetes is estimated to amount 14-85% [14,25,26]. According to Jackson's research [27], persistent erectile dysfunction was observed in 34% of patients and in 24% they appeared from time to time.…”

“…More than half of the patients included in the study had been diagnosed with type 2 diabetes. This can have a significant impact on the emergence of a broad spectrum of disorders of sex life [25,26,28]. The combination of mature age of a patient with the diagnosis of diabetes, strongly multiplies the risk of emergence of various types of sexual problems.…”

“…The results of published studies are often contradictory. The literature contains reports indicating no difference in the incidence of sexual dysfunction between type 1 and type 2 [26,31]. According to other research, people suffering from type 2 diabetes more often experience problems in sex life [18,29,[32][33][34][35].…”

“…For example, erectile dysfunction, according to research of Jackson [27] and Lindau [28] applies to 24-36% of patients. Problems with lubrication occur in 14-76% of patients with diabetes, and the problem of feeling pain in 1-66% of women [14,26,34]. Vaginal dryness and pain are related phenomena, and pain in a sexual context is considered on multi-dimensional level [20].…”

Comparison of sexual dysfunction between diabetic and non-diabetic women

“…Enzlin et al .,[3] discussed that poor control of patients, older age, and longer diabetes duration do not have a significant association with SD Different studies conducted by Doruk et al . [27] Wallner et al .,[8] and Nowosielski et al .,[28] indicated that there is no special risk-factors related to SD in diabetic women. They concluded that higher prevalence of SD in diabetic women can be related to probable confounder variables.…”