Sexual Function and Endocrine Profile in Fertile Women With Type 1 Diabetes

Abstract

OBJECTIVE -Aims of this study were 1) to assess sexual function and endocrine profile among fertile type 1 diabetic women during the follicular and luteal phases of the menstrual cycle, 2) to compare these results with those obtained among healthy fertile women who served as control subjects, and 3) to explore the correlations between sexual function and endocrine milieu among patients and control subjects during the follicular and luteal phases of the menstrual cycle.RESEARCH DESIGN AND METHODS -Fifty fertile women with type 1 diabetes and 47 healthy control subjects completed a semistructured medical interview and filled in selfadministered validated instruments to evaluate sexual function, depression, and sexual distress. Venous blood samples were drawn to measure glycated hemoglobin and an endocrine profile during either the follicular or the luteal phase of the menstrual cycle.RESULTS -Type 1 diabetic women had decreased sexual function and increased sexual distress compared with control subjects during the luteal, but not the follicular, phase of the menstrual cycle. During the follicular phase, patients had lower estrogenic basal tone, lower "weak" androgen (namely ⌬ 4 -androstenedione and dehydroepiandrosterone sulfate) production, and lower free-triiodothyronine and free-thyroxine levels compared with control subjects. During the luteal phase, total testosterone levels were higher in patients than control subjects, while 17␤-estradiol and progesterone levels were lower in patients than control subjects.CONCLUSIONS -Among type 1 diabetic women, sexual function and sexual distress vary according to the phase of the menstrual cycle. This finding may have implications on the clinical assessment of sexual function in type 1 diabetic women. Diabetes Care 29:312-316, 2006A lthough sexual disorders have been extensively studied in diabetic men (1-4), the sexual function of diabetic women has only recently received attention (4 -8). The prevalence of sexual dysfunction in diabetic men approaches 50%, whereas in diabetic women it seems to be slightly lower (5,9,10). Neuropathy, vascular impairment, and psychological complaints have been implicated in the pathogenesis of decreased libido, low arousability, decreased vaginal lubrication, orgasmic dysfunction, and dyspareunia among diabetic women. However, discrepancies exist between different reports (5,8,11). This could result, at least in part, from relatively small sample size, uncontrolled study design, or inaccurate characterization of diabetes. In fact, type 1 and type 2 diabetes seem to differently influence women's sexual function (5,6,12,13). To our knowledge, correlations between sexual function and endocrine profile and phase of the menstrual cycle in type 1 diabetic women have been scarcely investigated.Aims of the present study were 1) to assess sexual function and endocrine profile among fertile type 1 diabetic women during the follicular and luteal phase of the menstrual cycle, 2) to compare these results with those obtained among healthy fertile wom...

Association of body weight with sexual function in women

“…On the other hand, decreased sexual function occurs independently of mood deflections, while the role of the endocrine milieu remains unclear. 7,18 In conclusion, we showed that in Italian otherwise healthy women with FSD obesity affects several aspects of sexuality. Interventional studies aimed at reducing body weight in women with FSD are needed to disclose a cause and effect relation between obesity and FSD.…”

“…(3) We used a validated, internationally established questionnaire (FSFI) to assess the prevalence of sexual dysfunction, which was administered during the same phase of the cycle in order to avoid interference in the assessment of sexual function. 18 However, women above 60 years were not included in the study, and hormonal and mood assessments were not performed. On the other hand, decreased sexual function occurs independently of mood deflections, while the role of the endocrine milieu remains unclear.…”

Obesity and sexual dysfunction, male and female

“…Also for diabetes mellitus, which represents an important causes of ED in men, 60 the data about the prevalence of FSD are controversial. [61][62][63] We found 64 a negative relationship between body weight and sexual function in 52 women with abnormal values of FSFI (score p23) (Figure 2). We also showed that obesity affects several aspects of sexual function in otherwise healthy women with FSD, including arousal, lubrication, satisfaction and orgasm, but not desire and pain.…”

Estrogens and the diabetic kidney

“…Several studies have suggested that circulating estradiol concentrations are decreased in women with type 1 DM, [37][38][39] suggesting that diabetes may be associated with dysregulation of sex hormone biosynthesis. Similar observations were made in experimental models of type 1 DM.…”