According to the Los Angeles County Department of Public Health, diabetes is a major healthcare concern Angelenos. Since 1977, it has been the sixth leading cause of death in the county; since 1999, it has become an important cause of premature death (before age 75). Diabetics are more susceptible to a host of medical problems including cardiovascular disease and impaired vision. Another complication for diabetic women was reported in the August 2012 edition of the journal Obstetrics and Gynecology. Researchers affiliated with the University of California (San Francisco) and Kaiser Permanente Northern California (Oakland) reported on the impact of diabetes on sexual satisfaction in women.
The researchers noted that diabetes mellitus is an established risk factor for sexual dysfunction in men; however, its effect on female sexual function is poorly understood. Therefore, they examined the relationship of diabetes to sexual function in middle-aged and older women. Sexual function was examined in a group of ethnically diverse women aged 40–80 years using self-administered questionnaires. The questionnaires covered the following topics: sexual desire, frequency of sexual activity, overall sexual satisfaction, and specific sexual problems (difficulty with lubrication, arousal, orgasm, or pain). The study participants included insulin-treated diabetic women, non–insulin-treated diabetic women, and non-diabetic women. In addition, the relationships between diabetic end-organ complications (heart disease, stroke, renal dysfunction, and peripheral neuropathy) and sexual function were evaluated.
The study group included 2,270 participants (age: 55 ± 9.2 years); 1,006 (44.4%) were non-Latina white, 486 (21.4%) had diabetes, and 139 (6.1%) were taking insulin. Compared with 19.3% of non-diabetic women, 34.9% of insulin-treated diabetic women had a 2.04-fold decrease in overall sexual satisfaction; 26.0% of non–insulin-treated diabetic women had a 1.42-fold decrease in overall sexual satisfaction. Among sexually active women, insulin-treated diabetic women were more likely to report problems with lubrication (2.37 times more likely) and orgasm (1.80 times more likely) than non-diabetic women. Among all diabetic women, end-organ complications such as heart disease, stroke, renal dysfunction, and peripheral neuropathy were associated with decreased sexual function in at least one area.
The authors concluded that, compared with non-diabetic women, diabetic women are more likely to report low overall sexual satisfaction. Insulin-treated diabetic women also appeared to be at higher risk for problems such as difficulty with lubrication and orgasm. They noted that prevention of end-organ complications may be important in preserving sexual activity and function in diabetic women.
Take home message:
End-organ complications are more common in diabetics with poor control; thus, this study points to one more problem that can occur in diabetic women. Good control of diabetes plus appropriate lifestyle choices (i.e., avoidance of obesity, healthy diet, and exercise) will facilitate a longer and more satisfactory life.