Female Sexual Dysfunction in type 1 diabetes

Two published studies report presence of female sexual dysfunction (FSD) in women with type 1 diabetes (T1D).  Each of the studies found that FSD is more common in women with T1D than healthy women without diabetes.  One of the studies found a strong link between coexisting thyroid autoimmune disease which may exacerbate FSD in women with T1D.

While diabetes-induced erectile dysfunction is reported and well-established among men with type 1 and type 2 diabetes, sexual dysfunction is less explored in women with diabetes.

The first and earlier study conducted in Poland and published online in May consisted of 230 women, including 70 healthy and 160 with T1D. All of the participants voluntarily filled out an anonymous questionnaire.  Results regarding sexual function were obtained using a Female Sexual Function Index (FSFI).

Out of the total, 180 declared sexual active status for which statistical analysis was performed. Women with T1D (118) in comparison with healthy women (62) were older, had a higher BMI, weight and had more pack-years of cigarette smoking. Researchers found FSD more common in women with T1D; they had lower results in FSFI independent of age, duration of T1D, body weight and presence of angiopathy.

In the study conducted in the Czech Republic and published this month, 40 women completed the FSFI, Female Sexual Distress Scale-revised (FSDS-R) and Beck’s Depression Inventory-II (BDI-II).

The median age of the women was 32. T1D duration ranged from 1-32 years; HbA1c ranged from 5.5-12.4%. Blood samples were used for metabolic and endocrine analysis.  Details of participants (personal information, diabetes related data and sex history), sexual performance, and levels of depression were measured.

Researchers found FSD present in 58% of the women, and 38% declared significant sexual distress. A strong association between levels of depression and FSD were found although only four women fulfilled criteria for depression. Depression levels also correlated to higher HbA1c. Again, neither age nor microvascular complications were associated with FSD. What was found was a strong link between hypothyroidism and FSD, even if the condition was successfully treated.  Hypothyroidism seemed to exacerbate FSD.

Additional findings included responses from women who use insulin pump therapy. (n=25) Three women reported never detaching their insulin pump during sexual intercourse and 22 of the 25 pump users considered the device to be intrusive and disruptive during intercourse, especially with respect to the partner.

Only 8 women (20%) reported that they had had the opportunity to discuss their sexual life and associated problems with their diabetologist.

While some research has suggested that depression is a major risk-factor for FSD in women with diabetes, further research is needed. Both studies found that women with T1D have much higher rates of sexual dysfunction than healthy women of the same age.

Both studies concluded that women treated for type 1 diabetes should be actively screened for FSD by their diabetologist and healthcare teams, who should be paying more attention to this aspect of health and quality of life.