198 Associations Between Domains of Urinary Symptoms and Female Sexual Dysfunction in Women with Type 1 Diabetes

Abstract

The prevalence of female sexual dysfunction (FSD) in women with type 1 diabetes mellitus (T1DM) is significant, but the etiology remains poorly understood. Our objective was to determine the influence of urinary symptoms on FSD in women with T1DM. Sexually active women with T1DM participating in the urological ancillary study of the Epidemiology of Diabetes Interventions and Complications Study (UroEDIC) completed an abbreviated version of the Female Sexual Function Index measuring FSD, the American Urological Association Symptom Index measuring lower urinary tract symptoms (LUTS), the Sandvik Severity Index and other validated questionnaires measuring urinary incontinence (UI). Women were deemed to be symptomatic or non-symptomatic in each condition overall and in domains within each condition using standard cutpoints. Associations between symptoms of UI and LUTS and FSD were examined using logistic regression models adjusting for hemoglobin A1c, body mass index, age, and marital status. Among sexually active women (N=499) in the study the prevalence of FSD was 46.5% (N=232), of UI was 25.1% (N=125), and of LUTS was 19.2% (N=96). UI was not associated with FSD, whereas LUTS were significantly associated with FSD overall (OR=1.74, 95% CI 1.09, 2.77) and lower scores within the orgasm (OR=1.88, 95% CI 1.15, 3.07) and satisfaction domains (OR=2.09, 95% CI 1.13, 3.87). Incomplete emptying was the urinary symptom most strongly associated with FSD (OR=2.69, 95% CI 1.36, 5.30), primarily via the satisfaction (OR=2.74, 95% CI 1.25, 6.01) and pain (OR=4.81, 95% CI 2.14, 10.81) domains. Of the women with FSD, 75% were symptomatic in the interest domain, 57% in the orgasm domain, 45% in the lubrication domain, 34% in the arousal domain, 25% in the satisfaction domain and 23% in the pain domain.