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Sexual Function Variable in Women With Type 1 Diabetes

Women with type 1 diabetes have decreased sexual function and increased sexual distress during the luteal phase of the menstrual cycle, according to researchers.

A group of Italian researchers lead by Dr. Andrea Salonia, of University Vita-Salute San Raffaele, Milano, evaluated the sexual function and endocrine profile in 50 fertile women with type 1 diabetes, noting the follicular and luteal phases of the menstrual cycle, and compared the findings with those of 47 controls.

The subjects completed a semistructured medical interviews and self-administered assessments of sexual function, depression and sexual distress. Along with laboratory tests, the researchers reviewed the patients’ medical records to assess contraception, comorbidities and medication use, body mass index and diabetes complications.

Compared with the controls, women with diabetes had decreased sexual function and increased sexual distress during the luteal, but not the follicular phase of the menstrual cycle. During the luteal phase, patients had higher total testosterone levels and lower 17-beta-estradiol and progesterone levels compared with the controls.

The diabetic women had lower estrogenic basal tone, lower "weak" androgen production, and lower free-triiodothyronine and free-thyroxine levels during the follicular phase.

"Decreased sexual function occurs independently of mood deflections and does not seem to be influenced by glycemic control," lead author Dr. Salonia and colleagues write.

"The role of endocrine milieu remains unclear," they note. The variability of sexual function with different phases of the menstrual cycle may have implications on the clinical assessment in diabetics, they conclude.

Diabetes Care 2005;29:312-316.