Abstract
Female sexual response is a complex, nonlinear progression from desire to arousal and orgasm. Diabetes may affect all these, but it particularly affects arousal with decreased genital sensation and lubrication. Vaginal dryness and infections may lead to dyspareunia. Predictors of sexual dysfunction in women include depression. Neither age, duration of diabetes, glycemic control, nor complications predict sexual dysfunction in women as they do in men. Objective measures of decreased genital sensation or lubrication do not correlate with a subjective sense of female sexual arousal disorder. Low androgens and possibly estrogens may be etiologic, as may numerous medications used by patients with diabetes. Practitioners should recognize the high prevalence of female sexual dysfunction (up to 50%) and potential increase, in tandem with that of diabetes. In the absence of definitive treatment evidence, psychological counseling, improvised vaginal lubricants, and low doses of estrogens or androgens have been used to relieve the personal distress of female sexual dysfunction.
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References and Recommended Reading
Richardson D, Vinik A: Etiology and treatment of erectile failure in diabetes mellitus. Curr Diab Rep 2002, 2:501–509.
Enzlin P, Mathieu C, Vanderschueren D, Demyttenaere K: Diabetes mellitus and female sexuality: a review of 25 years' research. Diabet Med 1998, 15:809–815.
Morano S: Pathophysiology of diabetic sexual dysfunction. J Endocrinol Invest 2003, 26(3 suppl):65–69.
Laumann EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999, 281:537–544. Epidemiologic assessment: high prevalence of FSD.
Schiel R, Muller UA: Prevalence of sexual disorders in a selection-free diabetic population (JEVIN). Diabetes Res Clin Pract 1999, 44:115–121.
Basson R: Recent advances in women's sexual dysfunction. Menopause 2004, 11:714–725. Recent review of newer concepts in FSD.
Basson R: The female sexual response: a different model. J Sex Marital Ther 2000, 26:51–65.
Cain VJ, Johannes CB, Avis NE, et al.: Sexual functioning and practices in a multiethnic study of women in the mid life years: baseline results from SWAN. J Sex Res 2003, 40:266–276.
Basson R, Berman J, Burnett A, et al.: Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 2000, 163:888–893.
American Psychiatric Association, ed: Female sexual arousal disorder. In Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: 2004:500–502. American Psychiatric Association definition of FSAD.
American Psychiatric Association, ed: Female orgasmic disorder. In Diagnostic and Statistical Manual of Mental Disorders, edn 4. Washington, DC: 2004:505–506. American Psychiatric Association definition of female orgasmic disorder.
Kolodny RC: Sexual dysfunction in diabetic females. Diabetes 1971, 20:557–559.
Erol B, Tefekli A, Sanli O, et al.: Does sexual dysfunction correlate with deterioration of somatic sensory system in diabetic women? Int J Impot Res 2003, 15:198–202.
Enzlin P, Mathieu C, Van Den Bruel A, et al.: Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes. Diabetes Care 2003, 26:409–414.
Jensen SB: Diabetic sexual dysfunction: a comparative study of 160 insulin treated diabetic men and women and an agematched control group. Arch Sex Behav 1981, 10:493–504.
Schreiner-Engel P, Schiavi RC, Vietorisz D, Smith H: The differential impact of diabetes type on female sexuality. J Psychosom Res 1987, 31:23–33.
Campbell LV, Redelman MJ, Borkman M, et al.: Factors in sexual dysfunction in diabetic female volunteer subjects. Med J Aust 1989, 151:550–552.
Leedom L, Feldman M, Procci W, Zeidler A: Symptoms of sexual dysfunction and depression in diabetic women. J Diabetes Complications 1991, 5:38–41.
Tyrer G, Steel JM, Ewing DJ, et al.: Sexual responsiveness in diabetic women. Diabetologia 1983, 24:166–171.
Wincze JP, Albert A, Bansal S: Sexual arousal in diabetic females: physiological and self-report measures. Arch Sex Behav 1993, 22:587–601.
Sarkadi A, Rosenqvist U: Intimacy and women with type 2 diabetes: an exploratory study using focus group interviews. Diabetes Educ 2003, 29:641–652.
Humphery S, Nazareth I: GPs' views on their management of sexual dysfunction. Fam Pract 2001, 18:516–518.
Erol B, Tefekli A, Ozbey I, et al.: sexual dysfunction in type II diabetic females: a comparative study. J Sex Marital Ther 2002, 28(suppl 1):55–62.
Rockliffe-Fidler C, Kielmle G: Sexual function in diabetic women: a psychological perspective. Sex Relationship Ther 2003, 18:143–159.
Laan E, Everaerd W: Physiological measures of vaginal vasocongestion. Int J Impot Res 1998, 10(suppl 2):S107-S110; discussion S124-S105.
Slob AK, Koster J, Radder JK, et al.: Sexuality and psychophysiological functioning in women with diabetes mellitus. J Sex Marital Ther 1990, 16:59–69.
Zrustova M, Rostlapil J, Kabshelova A: Sexual disorders in diabetic women. Cesk Gynekol 1978, 43:277–280.
Newman AS, Bertelson AD: Sexual dysfunction in diabetic women. J Behav Med 1986, 9:261–270.
Bachmann G, Bancroft J, Braunstein G, et al.: Female androgen deficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002, 77:660–665. Review of evidence and definition of androgen deficiency; algorithms for a clinical approach to the problem.
Zumoff B, Strain GW, Miller LK, Rosner W: Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995, 80:1429–1430.
Salonia A, Licata G, Pontillo M, et al.: Sexual function and endocrine profile in fertile women with diabetes mellitus type 1: results of a case-controlled study [abstract 44]. Paper presented at the annual meeting of the International Society for the Study of Women's Sexual Health. Atlanta, GA; October 28-31, 2004.
Crenshaw TL, Goldberg JP, eds: Sexual Pharmacology: Drugs That Affect Sexual Function. New York: W.W. Norton & Co.; 1996.
House WC, Pendleton L: Sexual dysfunction in diabetes. A survey of physicians' responses to patients' problems. Postgrad Med 1986, 79:227–235.
Annon JS, ed: Behavioral Treatment of Sexual Problems: Brief Therapy. Hagerstown, MD: Harper & Row; 1976.
Rosen R, Brown C, Heiman J, et al.: The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000, 26:191–208. Useful, validated instrument to assess FSD.
Lustman P, Clouse R, Griffin L, et al.: Screening for depression using the Beck Depression Inventory. Psychosom Med 1997, 59:24–31.
Derogatis LR, Rosen RC, Leiblum S, et al.: The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther 2002, 28:317–330. Useful instrument to assess female sexual distress.
Kaplan HS: Hypoactive sexual desire. J Sex Marital Ther 1979, 3:3–9.
Billups KL, Berman L, Berman J, et al.: A new non-pharmacological vacuum therapy for female sexual dysfunction. J Sex Marital Ther 2001, 27:435–441.
Wilson SK, Delk JR 2nd, Billups KL: Treating symptoms of female sexual arousal disorder with the Eros-Clitoral Therapy Device. J Gend Specif Med 2001, 4:54–58.
Foster DC, Palmer M, Marks J: Effect of vulvovaginal estrogen on sensorimotor response of the lower genital tract: a randomized controlled trial. Obstet Gynecol 1999, 94:232–237. Topical estrogen improves vulvovaginal sensation.
Davis SR: The clinical use of androgens in female sexual disorders. J Sex Marital Ther 1998, 24:153–163.
Shifren JL, Braunstein GD, Simon JA, et al.: Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. N Engl J Med 2000, 343:682–688. Important primary data, although limited to women with surgical menopause.
Kaplan SA, Reis RB, Kohn IJ, et al.: Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction. Urology 1999, 53:481–486.
Caruso S, Intelisano G, Lupo L, Agnello C: Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double-blind, cross-over, placebo-controlled study. BJOG 2001, 108:623–628.
Rosen RC, Phillips NA, Gendrano NC 3rd, Ferguson DM: Oral phentolamine and female sexual arousal disorder: a pilot study. J Sex Marital Ther 1999, 25:137–144.
Basson R: Female sexual response: the role of drugs in the management of sexual dysfunction. Obstet Gynecol 2001, 98:350–353.
Sarkadi A, Rosenqvist U: Contradictions in the medical encounter: female sexual dysfunction in primary care contacts. Fam Pract 2001, 18:161–166. A practical primary care approach to FSD.
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Muniyappa, R., Norton, M., Dunn, M.E. et al. Diabetes and female sexual dysfunction: Moving beyond "benign neglect". Curr Diab Rep 5, 230–236 (2005). https://doi.org/10.1007/s11892-005-0014-3
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DOI: https://doi.org/10.1007/s11892-005-0014-3