Sexual Dysfunction In Diabetic Women Research Articles

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

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.

Major Sexual Function Domains Affected in the Diabetic Females: A Cross-sectional Study from North India.

Diabetes adversely affects sexual health with its negative consequences on well-being in both males and females. Literature is scanty regarding female sexual dysfunction (FSD) in diabetic women, furthermore reported literature is lacking regarding the differential impact on different domains of sexual health, especially in Indian females. In the present analysis, we aim to study the prevalence of sexual dysfunctions in diabetic women as well as different domains affected by diabetes. This cross-sectional study was carried out at a tertiary care teaching centre in North India over a duration of 6 months (January 2021 to June 2021). A total of 100 married females were enrolled including 50 diabetics and 50 healthy non-diabetic females. All the participants were subjected to a validated female sexual function index (FSFI) questionnaire for sexual function assessment. FSD was seen in 35 diabetic females (70%) with desire being the most affected domain (92%) in comparison to 15 healthy subjects (30%) with an overall mean FSFI of 23.5 in diabetics and 29.2 in the control group. Mean FSFI in diabetic females with sexual dysfunction was 21.04 ± 9. All domains of FSFI were affected significantly (P value < 0.05) in the diabetic group in comparison to the control group except for the satisfaction domain. There was no significant association of different domains of FSFI seen with the duration of diabetes and other comorbidities. A significant association of arousal and pain domain was seen with the glycaemic (HbA1C) index (P value-0.006 and 0.031, respectively). Females with diabetes mellitus (DM) have a higher prevalence of sexual dysfunction affecting all domains. Glycosylated haemoglobin is associated independently with arousal and pain domains of FSFI as well as desire being the most affected domain, although further randomized studies with larger sample sizes are needed to authenticate our findings. To improve the quality of life of diabetic females, clinicians should focus on this aspect also while treating diabetes.

Female Sexual Dysfunction in Asian Women with Diabetes

The prevalence of diabetes is increasing globally, especially in Asia. Prevalence of diabetes in Asia is increasing at a higher rate in comparison to Western countries with an increasing trend reported in the younger generation (20-39 years old). This trend has similarly been reported in our Malaysian diabetic population, of which the general prevalence is 17.5%. This population experiences longer disease duration and are at greater risk of developing complications of diabetes at an earlier stage in life. Sexual dysfunction has been established as a common long-term complication of diabetes, affecting both men and women. Evidence shows that some Asian countries experience greater rates of female sexual dysfunction compared to their Western counterparts and this is likely attributed to cultural differences and other socioeconomic factors. However, these studies are very limited and need to be investigated at a greater scale. The aim of this report is to identify gaps in the literature regarding female sexual dysfunction among Asian women with diabetes. Local cultural and religious values maintain that sexual issues should not be discussed openly, even in a clinical setting. This paper may pave the way for future studies to be carried out, as addressing sexual dysfunction is a vital part of diabetes care. In addition, various studies have identified depression as a conclusive predictor of female sexual dysfunction in diabetic women. There is a possibility of a link between diabetes distress and female sexual dysfunction, which requires further investigation.

Sexual Dysfunction in Diabetic Women: An Update on Current Knowledge

Diabetes mellitus (DM) is one of the most common chronic diseases worldwide and its prevalence is expected to increase in the coming years. Therefore, updated knowledge of all diabetic complications and their management is essential for the proper treatment of these patients. Sexual dysfunctions are one of the long-term complications of DM in both genders. However, female sexuality is still a taboo and sexual concerns are often overlooked, underdiagnosed, and untreated. The aim of this review is to summarize the current knowledge on the relationship between sexual function and DM in women. In particular, we evaluated the prevalence, etiology, diagnostic approaches, and current treatment options of female sexual dysfunction (FSD) in diabetic patients.

Sweet blood with bitter consequences : Sexual dysfunction in diabetic women

Background: Prevalence of diabetes mellitus (DM) is on the rise. Its effect on different body systems is well known. Sexual dysfunctions (SD) in men and women may be related to DM. However, SD is more difficult to diagnose and treat in women than in men because of the intricacy of the female sexual response. Also, the literature is limited addressing female sexual dysfunction in DM, and this aspect of female health, is often ignored in clinical practice in women with DM.Objective: : To determine the frequency and types of SD and its causative factors among the diabetic women.Patients and methods: This cross sectional study used a self-report questionnaire taken from the FSFI with addition of questions suiting the purpose of the study. Participants of this study were 407 married women with regular sexual activity who attended the outpatient clinics at the National Institute of Diabetes Mellitus in Cairo during the period from September to December 2018.Results: The commonest age group of women was 40-49 years, most of them were obese and most of them can only read and write. Most participants (42%) suffered from diabetes for more than 10 years and 70.7% were of type II diabetes. Diabetic complications included peripheral neuropathy, hypertension and coronary artery disease. At least one SD was present in 66.3% of participants including dyspareunia followed by sexual dissatisfaction followed by low libido. Duration and control of diabetes, BMI, age and diabetic complications were determining factors for the occurrence of SD.Conclusion: SD are common in diabetic women. The most commonly encountered SD are dyspareunia, sexual dissatisfaction and low libido.

Sexual dysfunction in diabetic women: prevalence and differences in type 1 and type 2 diabetes mellitus.

BackgroundThe aim of this work was to evaluate the impact of diabetes on female sexuality and to highlight any differences between sexuality in the context of type 1 and type 2 diabetes mellitus (DM).MethodsThe subjects selected were 49 women with type 1 DM, 24 women with type 2 DM, and 45 healthy women as controls. Each participant was given the nine-item Female Sexual Function Index questionnaire to complete. The metabolic profile was evaluated by body mass index and glycosylated hemoglobin assay.ResultsThe prevalence of sexual dysfunction (total score ≤30) was significantly higher in the type 1 DM group (25/49, 51%; 95% confidence interval [CI] 18–31) than in the control group (4/45, 9%; 95% CI 3–5; P=0.00006); there were no significant variations in the type 2 DM group (4/24, 17%; 95% CI 3–4) versus the control group (P=0.630, not statistically significant). The mean total score was significantly lower in the type 1 DM group (30.2±6.9) versus the control group (36.5±4.9; P=0.0003), but there was no significant difference between the type 2 DM group and the control group (P=0.773). With regard to specific questionnaire items, the mean values for arousal, lubrication, dyspareunia, and orgasm were significantly lower only in the type 1 DM group versus the control group. The mean values for desire were reduced in type 1 and type 2 DM groups versus control group.ConclusionType 1 DM is associated with sexual dysfunction. This may be due to classic neurovascular complications or to the negative impact of the disease on psychosocial factors. Larger and ideally longitudinal studies are necessary to better understand the relationship between DM and sexual dysfunction.

Diabetes and sexual dysfunction: current perspectives

Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes.

Evaluation of different electrophysiological studies in the detection of urinary and sexual dysfunction in diabetic women

Evaluation of different electrophysiological studies in the detection of urinary and sexual dysfunction in diabetic women

Sexual dysfunction in diabetic women

Sexual dysfunction in diabetic women

Sexual Dysfunction in Jordanian Diabetic Women

OBJECTIVE—To estimate the prevalence of female sexual dysfunction (FSD) in diabetic and nondiabetic Jordanian women.RESEARCH DESIGN AND METHODS—Data were collected from 1,137 married women using the Arabic translation of the Female Sexual Function Index questionnaire.RESULTS—Prevalence of sexual dysfunction in diabetic women 50 years of age or older was 59.6 vs. 45.6% in nondiabetic women (P = 0.003). Diabetic women had more dysfunction of desire, arousal, lubrication, and orgasm than nondiabetic women. Glycemic control, smoking, dyslipidemia, hypertension, autonomic neuropathy, and peripheral neuropathy did not have a significant effect on FSD. Age, BMI, duration of diabetes, and the presence of coronary artery disease, nephropathy, and retinopathy had negative effects on FSD.CONCLUSIONS—Prevalence of FSD among Jordanian women was found to be significantly higher in diabetic compared with nondiabetic women.

Sexuality and women with diabetes

Health educators are ideally placed to identify sexual problems and provide sex education for women with diabetes. Important pre-requisites are for the educator to have an understanding of the human sexual response; knowledge of the evidence for sexual dysfunction in diabetic women and to be comfortable with their own sexuality. This paper aims to discuss aspects of female sexuality; the effects of diabetes on female sexuality and sexual responsiveness. The evidence for and possible causes of, sexual dysfunction in diabetic females as documented in the literature are explored and strategies for identifying sexual problems outlined.

Symptoms of sexual dysfunction and depression in diabetic women

Studies of sexual dysfunction in diabetic women have been less conclusive than those of sexual dysfunction in diabetic men. We examined the relationship between symptoms of sexual dysfunction, neuropathy, and depression in diabetic women. Diabetic women with neuropathy experienced significantly more symptoms of sexual dysfunction and depression than diabetic women without neuropathy. Furthermore, among women with neuropathy, there was a significant positive correlation between the degree of sexual dysfunction experienced and the degree of depression. These results indicate that depressive symptoms should be examined in studies of sexual dysfunction in diabetic women, and that a biopsychosocial approach is best for assessing sexual dysfunction in diabetic women.

Factors in sexual dysfunction in diabetic female volunteer subjects.

The aetiology and management of diabetic impotence is well-documented; the effects of diabetes on female sexuality are not so clear. In this study, 48 diabetic women were assessed clinically and answered detailed sexual questionnaires during a semistructured interview with a sexual counsellor. Twenty-four of the women reported one-or-more sexual dysfunctions: decreased libido, slow arousal, inadequate lubrication, anorgasmia or dyspareunia. There was no significant relationship between the presence of dysfunction and recent glycaemic control, the duration of diabetes, the presence of clinical complications or of neuropathy alone, or the attitude to sexuality. The sexual dysfunction(s) were present at the onset of diabetes in the majority of those so affected (17 of 24 patients), or were attributed to other causes in the remainder. It is suggested that sexual dysfunction in diabetic women should be treated actively as in "normal" women, since diabetes is not the major aetiological factor.

Sexual dysfunction in diabetic women.

This study examined sexual dysfunction in diabetic women. Eighty-one insulin-treated diabetic women were interviewed and administered standardized questionnaires. Using criteria derived from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III; American Psychiatric Association, Washington, D.C., 1980), 38 (47%) of the women were diagnosed with sexual dysfunction and 43 (53%) did not report sexual problems. The more frequently reported sexual problems were inhibited sexual excitement, inhibited sexual desire, and dyspareunia. Diabetic women with sexual dysfunction were more depressed, more stereotyped in their sex-role definitions, and less satisfied in their sexual relationships than those without sexual dysfunction. The two groups did not differ in metabolic control, insulin dose, duration of diabetes, or frequency of diabetic complications (e.g., neuropathy, etc.). Results suggest that diabetes may be associated with inhibited sexual excitement and dyspareunia in women. Both psychological and physiological concomitants of sexual dysfunction in diabetic women should be considered in diagnostic and treatment programs.

The natural history of sexual dysfunction in diabetic women. A 6-year follow-up study.

The natural history of sexual dysfunction in diabetic women was evaluated in a 6-year prospective study. Fifty type I, insulin-treated diabetic women, aged 26-45 years, were assessed and re-evaluated 6 years later. Measures included psychological, physiological and social parameters. The frequency of sexual dysfunction was similar in 1977 and 1983. Diabetic women did not differ in sexual function from their healthy controls. None of the physiologic measures studied were predictive of sexual function. Six out of 14 women who were sexually dysfunctional in 1977 recovered normal function, some of them in spite of objective evidence of neuropathy. None of the women had been on psychotherapy for their sexual problem. The most important factor in the spontaneous remission rate seemed to be improvement in the overall marital and social situation. The women's acceptance of illness, as judged by the interviewer, and data from the questionnaires concerning psychological distress, were strong predictors of sexual function. Sexual dysfunction in diabetic women is thus an index of psychological adjustment to chronic illness. Family and marital counseling should be routinely offered as part of the medical care of the diabetic patient.

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

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.

Sexual dysfunction in diabetic females.

Problems of sexual function in male diabetics are well-known, but studies have not been previously published documenting the incidence of such distress in diabetic females. One hundred and twenty-five diabetic women and 100 nondiabetic women between the ages of eighteen and forty-two were interviewed to determine the incidence of sexual dysfunction in these two groups. Forty-four of the 125 diabetic women (35.2 per cent) and six of the 100 nondiabetic women (6 per cent) reported complete nonorgasmic function in the preceding year, a difference significant at the P &amp;lt; .01 level. The appearance of sexual dysfunction in diabetic women correlated strongly with duration of diabetes, but there was little association with age, insulin dose, or such complications of diabetes as neuropathy, retinopathy, nephropathy or vaginitis. The term “secondary orgasmic dysfunction” is proposed for cases where impaired sexual response is felt to be on an organic basis, but appears only after a phase of normal sexual functioning.