Diabetes Mellitus and Sexual Function in Middle-Aged and Older Women

Copeland, Kelli L. BA; Brown, Jeanette S. MD; Creasman, Jennifer M. MSPH; Van Den Eeden, Stephen K. PhD; Subak, Leslee L. MD; Thom, David H. MD, PhD; Ferrara, Assiamira MD, PhD; Huang, Alison J. MD, MAS

Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e31825ec5fa
Original Research
Abstract

OBJECTIVE: Diabetes mellitus is an established risk factor for sexual dysfunction in men, but its effect on female sexual function is poorly understood. We examined the relationship of diabetes to sexual function in middle-aged and older women.

METHODS: Sexual function was examined in a cross-sectional cohort of ethnically diverse women aged 40–80 years using self-administered questionnaires. Multivariable regression models compared self-reported sexual desire, frequency of sexual activity, overall sexual satisfaction, and specific sexual problems (difficulty with lubrication, arousal, orgasm, or pain) among insulin-treated diabetic, non–insulin-treated diabetic, and nondiabetic women. Additional models assessed relationships between diabetic end-organ complications (heart disease, stroke, renal dysfunction, and peripheral neuropathy) and sexual function.

RESULTS: Among the 2,270 participants, mean±standard deviation age was 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 nondiabetic women, 34.9% of insulin-treated diabetic women (adjusted odds ratio [OR] 2.04, 95% confidence interval [CI] 1.32–3.15) and 26.0% of non–insulin-treated diabetic women (adjusted OR 1.42, 95% CI 1.03–1.94) reported low overall sexual satisfaction. Among sexually active women, insulin-treated diabetic women were more likely to report problems with lubrication (OR 2.37, 95% CI 1.35–4.16) and orgasm (OR 1.80, 95% CI 1.01–3.20) than nondiabetic 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 domain.

CONCLUSION: Compared with nondiabetic women, diabetic women are more likely to report low overall sexual satisfaction. Insulin-treated diabetic women also appear at higher risk for problems such as difficulty with lubrication and orgasm. Prevention of end-organ complications may be important in preserving sexual activity and function in diabetic women.

LEVEL OF EVIDENCE: II

In Brief

Diabetes is associated with worse overall sexual satisfaction and greater problems with lubrication and orgasm in middle-aged and older women, especially for insulin-treated diabetic women.

Author Information

From the Women's Health Clinical Research Center and the Departments of Obstetrics, Gynecology, and Reproductive Sciences, Family and Community Medicine, and Medicine, University of California, San Francisco, San Francisco, California; and the Division of Research, Kaiser Permanente Northern California, Oakland, California.

Funded by the National Institutes Diabetes, Digestive and Kidney Diseases (NIDDK) Grant DK53335 and the NIDDK/Office of Research on Women's Health Specialized Center of Research Grant P50 DK064538. Dr Huang is supported by a Paul B. Beeson Career Development Award in Aging Research from the National Institute on Aging (1K23AG038335-01A1) and the American Federation for Aging Research.

Presented as an abstract at the Society of General Internal Medicine Annual Meeting, May 4–7, 2011, Phoenix, Arizona.

Corresponding author: Alison J. Huang, MD, MAS, UCSF Women's Health Clinical Research Center, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115; e-mail: ahuang@ucsfmed.org mailto.

Financial Disclosure Dr. Huang has received research grants from Pfizer through the University of California San Francisco to conduct research unrelated to the study discussed in this article. The other authors did not report any potential conflicts of interest.

© 2012 The American College of Obstetricians and Gynecologists