Issue 98 item 9 Sexual Dysfunction in Women With Type 1 Diabetes

Women with diabetes are clearly at risk for decreased desire and dyspareunia and that especially the arousal phase can be affected. This study aimed to 1) examine the prevalence of sexual problems in women with type 1 diabetes, 2) compare this prevalence rate with that of an age-matched control group, 3) study the influence of diabetes-related somatic factors on female sexuality, and 4) study the influence of psychological variables on the sexual functioning of both groups.

A total of 120 women with diabetes visiting the outpatient diabetes clinic completed questionnaires evaluating psychological adjustment to diabetes, marital satisfaction, depression, and sexual functioning. Medical records were used to obtain data on HbA1c, use of medication, BMI, and early-onset microvascular complications. An age-matched control group of 180 healthy women attending an outpatient gynecological clinic for preventive routine gynecological assessment also completed the non–diabetes-related questionnaires.

RESULTS —More women with diabetes than control subjects reported sexual dysfunction (27 vs. 15%; P = 0.04), but a significant difference was found only for decreased lubrication. No association was found between sexual dysfunction and age, BMI, duration of diabetes, HbA1c, use of medication, menopausal status, or complications. Women with more complications, however, reported significantly more sexual dysfunctions, and the presence of complications altered treatment satisfaction. Both diabetic and control women with sexual dysfunction mentioned lower overall quality of the marital relation and more depressive symptoms than their respective counterparts without sexual problems. Depression was a significant predictor for sexual dysfunction in both women with diabetes and control subjects.

CONCLUSIONS— This study revealed that sexual dysfunction was related to general psychological factors in both women with diabetes and control women. Sexual dysfunction was associated with lower overall quality of marital relation and more depressive symptoms in both groups. This is not surprising because the relation between marital relation, depression, and sexual dysfunction is well established in the literature. Our attempt to find significant predictors of sexual dysfunction showed only depression to be a significant predictor of sexual dysfunction. This suggests that, in both women with diabetes and control women, sexual dysfunction seems to be related to psychological rather than other factors.

The results of this study confirm that women with diabetes are clearly at risk for decreased desire and dyspareunia and that especially the arousal phase can be affected. Our results also suggest that psychological and not diabetes-related somatic factors are related to sexual dysfunction in women with diabetes. The sexual problems of women with diabetes deserve more attention in clinical research and practice. Sexual problems are frequent in women with diabetes. Diabetes Care 25:672-677, 2002