OBJECTIVE -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. RESEARCH DESIGN AND METHODS-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 HbA 1c , 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 ϭ 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, HbA 1c , 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 -Sexual problems are frequent in women with diabetes. They affect the overall quality of life and deserve more attention in clinical practice and research. Diabetes Care 25:672-677, 2002D iabetes is known to cause multiple medical, psychological, and sexual problems (1-5). Erectile dysfunction is a well-established complication of diabetes (6). The sexual functioning of women with diabetes has received much less attention in clinical research (7). However, a recent review about diabetes and female sexuality indicated that diabetes slightly increases the risk of female sexual dysfunction (8). The most common sexual dysfunction in women with diabetes is decreased sexual arousal with slow and/or inadequate lubrication. Women with diabetes may, however, also experience a decreased sexual desire and more pain on sexual intercourse, whereas problems with orgasm are not more frequent (8).Research on diabetes and female sexual dysfunction is not only scarce, it also has been plagued by methodological flaws such as small sample size, absence of a control group, and noncharacterization as to diabetes type, presence and number of diabetic complications, psychological adjustment to diabetes, quality of the partner relation, and depression (5,8).The present study aimed to 1) examine the prevalence of sexual problems in women with type...

OBJECTIVE -This study aimed to 1) measure the prevalence of sexual dysfunction in patients with diabetes; 2) describe how descriptive variables, psychological variables, diabetic complications, and sexual dysfunction relate in patients with diabetes; and 3) describe the predictors of sexual dysfunction in patients with diabetes. RESEARCH DESIGN AND METHODS-A total of 240 adult type 1 diabetic patients visiting the outpatient diabetes clinic of a university hospital completed questionnaires evaluating psychological adjustment to diabetes and sexual functioning. Medical records were used to obtain HbA 1c values as well as information on microvascular diabetic complications.RESULTS -Sexual dysfunction was reported by 27% of women and 22% of men. No differences were found between sexes in type of reported sexual dysfunction. In men, but not in women, sexual dysfunction was related to age, BMI, duration of diabetes, and diabetic complications. No correlation with HbA 1c was found in either sex. In women, but not in men, sexual dysfunction was related to depression and the quality of the partner relationship. Binary logistic regression demonstrated that, in men, the significant predictors of sexual dysfunction were higher age and presence of complications, whereas, in women, sexual dysfunction was related to depression.CONCLUSIONS -Both women and men with diabetes are at increased risk for sexual dysfunction. This study suggests that in men with diabetes, sexual dysfunction is related to somatic and psychological factors, whereas in women with diabetes, psychological factors are more predominant. Diabetes Care 26:409 -414, 2003D iabetes is known to cause multiple medical (1), psychological (2), and sexual (3) dysfunctions. Impaired sexual function in men is a welldocumented complication of diabetes. Several studies have shown that men with diabetes are at increased risk for erectile dysfunction, that it occurs at an earlier age (4 -8), and that it is related to longer duration of diabetes, poor metabolic control, and the presence and number of diabetic complications (9).Although women run the same risk to develop diabetic complications, the sexual problems of women with diabetes have received much less attention in research and clinical practice (10). Although it has often been suggested that diabetes has no influence on female sexual functioning, in a review, we formulated the hypothesis that women with diabetes (compared with men) are also at increased risk for sexual dysfunction (3,11). Moreover, in a recent controlled study, comparing women with diabetes and control subjects, we demonstrated that significantly more women with diabetes (27%) than control subjects (15%) reported sexual dysfunction and that a significant difference was found only for decreased lubrication (12). Furthermore, no association was found between sexual dysfunction and age, BMI, diabetes duration, diabetic complications, HbA 1c , medication use, or menopausal status (12).The debate about the etiology of sexual dysfunction of patients with d...

OBJECTIVE -This study aimed to investigate the prevalence and risk factors associated with sexual dysfunction in a well-characterized cohort of women with type 1 diabetes.RESEARCH DESIGN AND METHODS -The study was conducted in women enrolled in the long-term Epidemiology of Diabetes Interventions and Complications (EDIC) study, a North American study of men and women with type 1 diabetes. At year 10 of the EDIC study, 652 female participants were invited to complete a validated self-report measure of sexual function, standardized history and physical examinations, laboratory testing, and mood assessment.RESULTS -Of the sexually active women with type 1 diabetes in the EDIC study, 35% met criteria for female sexual dysfunction (FSD). Women with FSD reported loss of libido (57%); problems with orgasm (51%), lubrication (47%), and arousal (38%); and pain (21%). Univariate analyses revealed a positive association between FSD and age (P ϭ 0.0041), marital status (P ϭ 0.0016), menopausal status (P ϭ 0.0019), microvasculopathy (P ϭ 0.0092), and depression (P ϭ 0.0022). However, in a multivariate analysis, only depression (P ϭ 0.004) and marital status (P ϭ 0.003) were significant predictors of FSD.CONCLUSIONS -FSD is common in women with type 1 diabetes and affects all aspects of sexual function and satisfaction. Depression is the major predictor of sexual dysfunction in women with type 1 diabetes. These findings suggest that women with type 1 diabetes should be routinely queried about the presence of sexual dysfunction and possible co-association with depression. Diabetes Care 32:780-785, 2009