IDF21-0027 Sexual Dysfunction in Females with Type 2 DM – An Important but Overlooked Entity

Abstract

Background: Diabetes mellitus is an important cause of sexual dysfunction (SD) both in men and women. SD is more difficult to diagnose and treat in women than it is in men because of the intricacy of the female sexual response. SD is often a neglected health issue in women with diabetes in India and there is very limited literature regarding sexual dysfunction among this important population. Aim: The aim of this study was to evaluate the prevalence of sexual dysfunction in women with Type 2 DM and its association with glycaemic control and other parameters. Method: The participants were 186 adult females with Type 2DM and attending OPD of an endocrine centre. All participants were married, age 30 years or more, having duration of diabetes five years or more and were not having any psychiatric illness. They underwent clinical examination including anthropometry, fundus examination and relevant investigations including HbA1c, ACR, Lipid profile. Sexual dysfunction was assessed using the Female Sexual Function Index-Short (FSFI-S). It has a score range 2 to 30 and the score of 18 or less indicates SD. Participants were assured regarding the confidentiality of the information and questionnaire was completed by a trained female health care worker. PHQ-9 questionnaire was used to assess depression. Data was analysed using SPSS software. Results: Out of the all participants, 49 (26.3%) had FSFI-S score of 18 or less suggesting sexual dysfunction. The mean age of participants was 42.2 ± 8.7 years and it was statistically not different in those with or without SD (P-0.23). SD was associated with FBS (p-0.01), HbA1C (p<0.01), hypertension (p-0.03), nephropathy (p-0.02) and neuropathy (p<0.01). SD was not associated with duration of diabetes, abdominal circumference and BMI. Also no association was found between diabetic retinopathy and sexual dysfunction. PHQ-9 scores were higher in females having SD, (14.4±5.9) than in normal (8.4±4.3) (P<0.001). Discussion: Sexual dysfunction (SD) continues to be under recognized and under treated entity in females because only few women seek help and it is not routinely enquired by most health care professionals. The prevalence of SD in diabetic women is estimated to be 20–80% world wide in various studies and has been reported to be variably associated with various parameters. In our study, SD was present in 26.3% of the participants and was associated with poor glycaemic control, hypertension, nephropathy, neuropathy but not with age, duration of diabetes, abdominal circumference, BMI and retinopathy. Patients with SD had higher prevalence of depression. Sexual dysfunction is a self-reported condition but it may be sometimes difficult for clinicians to talk directly to women about their sexual lives. Therefore simple questionnaire like FSFI-S which can be administered by a lady health care worker, can be a useful tool in clinical practice for the evaluation of SD and plan its appropriate management as sexual function is an important component in women’s quality of life and closely related to their psychosocial wellbeing.