Background and AimsFemale sexual dysfunction (FSD) remains a very little studied subject in Madagascar, despite the resulting alteration of quality of life. Our study aims to determine the prevalence and risk factors for sexual dysfunction in Malagasy women with and without type 2 diabetes (T2DM).MethodsThis was a descriptive and analytical cross‐sectional study, carried out in the Endocrinology department of the Joseph Raseta Befelatanana University Hospital Center over a period of 18 months. FSD was assessed using the Female Sexual Function Index questionnaire in women with and without T2DM.ResultsWe retained 122 patients with T2DM and 127 without T2DM. The prevalence of FSD was 47.5% in diabetics and 44.1% in non‐diabetics. In patients with T2DM, factors associated with FSD were age [50–59 years] (OR = 2.03 [1.03–4.51]), nephropathy (OR = 2.18 [1.09–3.98]), ischemic stroke (p = 0.0483), ischemic heart disease (p = 0.005), carotid atherosclerosis (OR = 2.64 [1.09–7.85]), obesity (OR = 3.64 [1.22–12.3]), calcium channel blocker use (OR = 4.71 [1.35–21.0]), history of genitourinary infections (OR = 2.06 [1.07–4.28]). In patients without T2DM, they were age [50 – 59 years] (OR = 4.86 [2.16–11.3]), age of first sexual intercourse < 18 years (OR = 2.06 [1.04–4.57]), irregular menstrual cycle (OR = 2.02 [1.00–6.37]), number of gestations ≥ 4 (OR = 1.99 [1.00–5.41]), abortion (OR = 3.15 [1.21–29.1]) and number of children ≥ 4 (OR = 2.17 [1.01–4.81]).ConclusionFSD was more common in diabetics than non‐diabetics. Its early management and associated risk factors are necessary to improve the quality of life of patients.