Sexual dysfunctions common in adults with diabetes
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About one-third of adults with diabetes have sexual dysfunction, and sexual dysfunction is associated with greater diabetes distress and worse emotional well-being and anxiety for women, according to a study published in Diabetic Medicine.
“This study showed that men and women with diabetes differ in the type of sexual dysfunction,” Jolijn Van Cauwenberghe, of the department of endocrinology, diabetology and metabolism at Antwerp University Hospital in Belgium, and colleagues wrote. “Moreover, in men, sexual dysfunctions were independently associated with older age, higher waist circumference and longer diabetes duration. More women with sexual dysfunction had impaired well-being, diabetes distress and moderate to severe anxiety symptoms compared to women without sexual dysfunction.”
Researchers analyzed data from the Diabetes Management and Impact for Long-Term Empowerment and Success (MILES) observational study in Belgium, conducted to investigate psychosocial aspects of living with diabetes. Adults with diabetes were invited to complete a 60-minute online survey. The Short Sexual Functioning Scale was used to measure sexual dysfunction and its severity. The WHO-5 Well-Being Index was conducted to measure general emotional well-being, the Generalized Anxiety Disorder 7-item scale measured anxiety and the Problem Areas In Diabetes scale assessed diabetes distress. Of 1,935 participants who completed the survey, 756 who reported being sexually active in the past 4 weeks and completed the Short Sexual Functioning Scale were included in the analysis.
Sexual dysfunction was reported by 36% of men and 33% of women. Erectile dysfunction and orgasmic dysfunction were the two most common sexual dysfunctions for men, whereas women were most likely to report decreased sexual desire, lubrication problems and orgasmic dysfunction.
After adjusting for type of diabetes, retinopathy and neuropathy, men were more likely to have sexual dysfunction if they were older (OR = 1.05; 95% CI, 1.01-1.09; P = .022), had a higher waist circumference (OR = 1.04; 95% CI, 1.02-1.06; P < .001) and a longer diabetes duration (OR = 1.04; 95% CI, 1.01-1.06; P = .007).
A higher proportion of women with sexual dysfunction had impaired well-being (36% vs. 25%; P = .036), elevated diabetes distress (36% vs. 21%; P = .003) and moderate to severe anxiety (20% vs. 11%; P = .026) compared with women without sexual dysfunction. More women with sexual dysfunction reported low emotional well-being compared with men with sexual dysfunction (36% vs. 20.7%; P = .006). More men with sexual dysfunction had elevated diabetes distress compared with men without sexual dysfunction (20% vs. 12%; P = .026).
“Further research is needed to better understand the biological, psychological and social mechanisms that underlie sexual dysfunctions in people with diabetes,” the researchers wrote. “To better unravel the link between sexual dysfunctions and biological data, studies should rely on objectively measured clinical data covering anthropometry, glucose metabolism, microvascular dysfunction, other endocrine disorders, short-term and long-term diabetic complications,” the researchers wrote. “This should be combined with more validated instruments or standardized diagnostic psychiatric interviews to measure mental health problems and quality of the partner relation.”
Perspective
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Janis Roszler, PhD, LMFT, RDN, CDCES, FAND
This excellent study offers a fresh and expanded look at diabetes-related sexual complications. I appreciate the researchers’ decision to include diabetes distress in their analysis as it impacts so many areas of our clients’ lives.
Especially helpful is their suggestion to use the Brief Sexual Symptom Checklist, or other tool, to help initiate this sensitive conversation. Many providers don’t discuss sexual topics unless clients bring them up. The Brief Sexual Symptom Checklist makes it possible for us to validate the importance of sexual expression, to create space for clients to voice their concerns and to discuss effective treatment options, which are numerous.
As medical professionals, we often rely on supportive family members to help our clients successfully complete diabetes health care tasks. If an intimate partner misunderstands troublesome events that happen in the bedroom, they may withdraw their valued support.
One couple I know were at odds because of the husband’s erectile dysfunction. The wife misinterpreted his erection challenges as evidence that he was having an affair. Sadly, no one told the couple that his erectile dysfunction was related to his diabetes and could be helped.
Make time for this important annual chat. Your clients will thank you for it.
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