Diabetic sexual dysfunction: a comparative study of 160 insulin treated diabetic men and women and an age-matched control group.

Abstract

Sexual dysfunction is a well-known complication in diabetic men, though only a few studies concern sexual dysfunction in diabetic women. Most previous studies are noncomparative. This study reports results from a comparative study of 160 consecutive insulin-treated diabetic outpatients (80 men and 80 women) and a control group (40 men and 40 women) seeing their general practitioner. The age range was 26–45. Results indicate that nearly 44% of the diabetic men, compared to 12.5% of the controls, experienced sexual dysfunction. Diabetic women and controls showed no significant difference in reported sexual dysfunction (27.5% and 25%, respectively). The most common symptoms in diabetic men were erectile dysfunction and reduced libido, often in combination; ejaculatory dysfunctions were rare. In women diabetics as well as in controls, reduced libido was the most common symptom. Significantly more diabetic men than women reported sexual dysfunction. A subdivision of sexual function into three components (libido-vasocongestion-orgasm) showed an equal effect on each of these phases in both sexes. Among the diabetic factors, peripheral neuropathy was correlated with sexual dysfunction in diabetic men as well as women, but none of the other complications present were found to be correlated with sexual dysfunction. A further analysis (Venn diagram) showed two major groups of diabetes in both sexes reporting sexual dysfunction: those having peripheral neuropathy, retinopathy, and reduced pulse beat-to-beat variation and those having none of these complications. Open dynamic descriptions added further factors such as being chronically ill, having reduced bodily self-esteem, fear and depression. An etiological review is given and some therapeutic consequences mentioned.