Sexual Dysfunction in Young Women with Type 1 Diabetes
Abstract
:1. Introduction
Aim of the Study
2. Material and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- International Diabetes Federation IDF. Diabetes Atlas 9th ed. Available online: https://diabetesatlas.org/en/resources/ (accessed on 13 March 2020).
- Gandhi, J.; Dagur, G.; Warren, K.; Smith, N.L.; Sheynkin, R.Y.; Zumbo, A.; Khan, A.S. The role of diabetes mellitus in sexual and reproductive health: An overview of pathogenesis, evaluation, and management. Curr. Diabetes Rev. 2017, 13, 573–581. [Google Scholar] [CrossRef]
- Hylmarova, S.; Stechova, K.; Pavlinkova, G.; Peknicova, J.; Peknicova, J.; Macek, M.; Kvapil, M. The impact of type 1 diabetes mellitus on male sexual functions and sex hormone levels. Endocr. J. 2020, 67, 59–71. [Google Scholar] [CrossRef] [PubMed]
- Enzlin, P.; Mathieu, C.; Van den Bruel, A.; Vanderschueren, D. Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes. Diabetes Care 2003, 26, 409–414. [Google Scholar] [CrossRef] [Green Version]
- Bak, E.; Marcisz, C.; Krzeminska, S.; Dobrzyn-Matusiak, D.; Foltyn, A.; Drosdzol-Cop, A. Does type 1 diabetes modify sexuality and mood of women and men? Int. J. Environ. Res. Public Health 2018, 15, 958. [Google Scholar] [CrossRef] [Green Version]
- Maiorino, M.I.; Bellastella, G.; Castaldo, F.; Petrizzo, M.; Giugliano, D.; Esposito, K. Sexual function in young women with type 1 diabetes: The METRO study. J. Endocrinol. Invest. 2017, 40, 169–177. [Google Scholar] [CrossRef] [PubMed]
- Gupta, L.; Swarnima, P.; Deepak, K.; Bharti, K.; Sanjay, K. Diabetes and Female Sexual Dysfunction. US Endocrinol. 2018, 14, 35–38. [Google Scholar] [CrossRef]
- Enzlin, P.; Mathieu, C.; Van den Bruel, A.; Bosteels, J. Sexual dysfunction in women with type 1 diabetes. Diabetes Care 2002, 25, 672–677. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bąk, E.; Marcisz, C.; Krzemińska, S.; Dobrzyn-Matusiak, D.; Foltyn, A.; Drosdzol-Cop, A. Relationships of sexual dysfunction with depression and acceptance of illness in women and men with type 2 Diabetes mellitus. Int. J. Environ. Res. Public Health. 2017, 14, 1073. [Google Scholar] [CrossRef] [PubMed]
- Kouidrat, Y.; Pizzol, D.; Cosco, T.; Thompson, T.; Carnaghi, M.; Bertoldo, A.; Solmi, M.; Stubbs, B.; Veronese, N. High prevalence of erectile dysfunction in diabetes: A systematic review and meta-analysis of 145 studies. Diabet. Med. 2017, 34, 1185–1192. [Google Scholar] [CrossRef] [PubMed]
- Laumann, E.O.; Paik, A.; Rosen, R.C. Sexual dysfunction in the United States: Prevalence and predictors. JAMA 1999, 281, 537–544. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pontiroli, A.E.; Cortelazzi, D.; Morabito, A. Female sexual dysfunction and diabetes: A systematic review and meta-analysis. J. Sex. Med. 2013, 10, 1044–1051. [Google Scholar] [CrossRef]
- Haduch-Pietruszka, I.; Brudkowska, Z.; Moczulski, D. Patients with type 1 diabetes in the context of social and psychological support-analysis of own research results. Medycyna Rodzinna 2017, 3, 188–191. [Google Scholar] [CrossRef]
- Filip, N.; Flotyńska, J.; Uruska, A.; Araszkiewicz, A.; Zozulińska-Ziółkiewicz, D. Aktywność fizyczna chroni kobiety z cukrzycą typu 1 przed dysfunkcjami seksualnymi. Clin. Diabetol. 2019, 8 (Suppl. A8), 8. [Google Scholar]
- Stanton, A.M.; Handy, A.B.; Meston, C.M. The Effects of Exercise on Sexual Function in Women. Sex. Med. Rev. 2018, 6, 548–557. [Google Scholar] [CrossRef] [PubMed]
- Choy, C.L.; Sidi, H.; Koon, C.S.; Ming, O.S.; Mohamed, I.N.; Guan, N.C.; Alfonso, C.A. Systematic Review and Meta-Analysis for Sexual Dysfunction in Women with Hypertension. J. Sex. Med. 2019, 16, 1029–1048. [Google Scholar] [CrossRef] [PubMed]
- Dimitropoulos, K.; Bargiota, A.; Mouzas, O.; Melekos, M.; Tzortzis, V.; Koukoulis, G. Sexual functioning and distress among premenopausal women with uncomplicated type 1 diabetes. J. Sex. Med. 2012, 9, 1374–1381. [Google Scholar] [CrossRef] [PubMed]
- Laumann, E.O.; Nicolosi, A.; Glasser, D.B.; Paik, A.; Gingell, C.; Moreira, E.; Wang, T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int. J. Impot. Res. 2005, 17, 39–57. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Schram, M.T.; Baan, C.A.; Pouwer, F. Depression and quality of life in patients with diabetes: A systematic review from the European depres-sion in diabetes (EDID) research consortium. Curr. Diabetes Rev. 2009, 5, 112–119. [Google Scholar] [CrossRef] [Green Version]
- Rockliffe-Fidler, C.; Kiemle, G. Sexual function in diabetic women: A psychological perspective. Sex. Relation. Ther. 2003, 18, 143–159. [Google Scholar] [CrossRef]
- Leeman, L.M.; Rogers, R.G. Sex After Childbirth. Obstet. Gynecol. 2012, 119, 647–655. [Google Scholar] [CrossRef] [PubMed]
Variable | n | % | Mean | ±SD | |
---|---|---|---|---|---|
Education | Primary | 4 | 2.4 | ||
Secondary | 67 | 39.6 | |||
Higher | 99 | 58.0 | |||
Professional situation | Worker | 124 | 73.4 | ||
Non-worker | 45 | 26.6 | |||
Is your financial situation satisfactory? | Yes | 119 | 69.93 | ||
No | 50 | 29.6 | |||
Marital status | Married | 85 | 50.3 | ||
Single | 74 | 43.8 | |||
Divorced | 10 | 5.9 | |||
Stable relationship | Yes | 148 | 87.6 | ||
No | 21 | 12.4 | |||
Physical activity | Yes | 96 | 55 | ||
No | 76 | 45 | |||
Frequency of physical activity per week | 2.06 | 0.99 | |||
Mean physical activity per week [h] | 3.72 | 1.43 | |||
Smoking | Yes | 34 | 20.1 | ||
No | 135 | 79.5 | |||
Alcohol | None | 50 | 29.6 | ||
Once per week | 27 | 16.0 | |||
2–3 times per week | 9 | 5.3 | |||
Once per month | 22 | 13 | |||
2–3 times per month | 30 | 17.8 | |||
Once every 3 months | 31 | 18.3 |
Variable | n | Median | Q1 | Q3 | Mean | ±SD |
---|---|---|---|---|---|---|
Age | 169 | 31.00 | 26.00 | 36.00 | ||
Weight [kg] | 169 | 65.00 | 60.00 | 73.00 | ||
Height [cm] | 169 | 167.00 | 162.00 | 170.00 | ||
BMI [kg/m2] | 169 | 23.81 | 21.48 | 26.45 | ||
Duration of diabetes | 169 | 14.47 | 8.63 | |||
HbA1c [%] | 169 | 7.31 | 1.25 | |||
MDI/CCII [%] | 80 (47.3%)/89 (52.7%) | |||||
HbA1c [%]- MDI group | 80 | 7.50 | 1.53 | |||
HbA1c [%]- CCII group | 89 | 7.10 | 0.83 | |||
Continuous glycemic control | 35(20.7%) | |||||
Diabetes-related complications: | 43(25.5%) | |||||
Diabetic retinopathy Diabetic retinopathy requiring laser therapy | 21 (12.4%) 10 (5.9%) | |||||
Nephropathy | 2(1.1%) | |||||
Diabetic nephropathy | 9(5.3%) | |||||
Visible hypertrophy of the subcutaneous tissue | 24(14.2%) | |||||
Other diseases: | 86 (50.9%) | |||||
Arterial hypertension | 16 (9.4%) | |||||
Hypothyroidism | 27(15.9%) | |||||
Hashimoto thyroiditis | 29 (17.1%) | |||||
Hyperthyroidism | 3 (1.7%) | |||||
Polycystic ovary syndrome (PCOS) | 4 (2.3%) | |||||
Mean score of the FSFI | 169 | 27.96 | 5.00 | |||
I—desire | 3.94 | 1.05 | ||||
II—arousal | 4.58 | 1.06 | ||||
III—lubrication | 4.97 | 1.05 | ||||
IV—orgasm | 4.62 | 1.34 | ||||
V—satisfaction | 5.05 | 0.95 | ||||
VI—pain | 4.81 | 1.13 | ||||
Mean score of the AIS | 169 | 29.67 | 8.29 | |||
(Past or present) mood disorders | 112 (66.3%) | |||||
(Past or present) depressive disorders | 27 (16%) | |||||
Influence of diabetes on sex life: Positive | 16 (9.5%) | |||||
Negative | 45 (26.6%) | |||||
no influence | 108 (63.9%) |
Variable | n | % | Mean | ||
---|---|---|---|---|---|
Contraception: | |||||
None | 54 | 31.9 | |||
natural methods of contraception (calendar method, interrupted intercourse) | 34 | 20.1 | |||
mechanical contraceptives (condoms, vaginal rings) | 70 | 41.2 | |||
intrauterine contraceptive device | 2 | 1.1 | |||
hormonal contraceptives (pills, patches) | 34 | 20.1 | |||
chemical contraceptives (gels, creams) | 5 | 2.9 | |||
Deliveries: | YES | 92 | 54.4 | ||
NO | 77 | 45.6 | |||
1 delivery | 47 | 51 | |||
2 deliveries | 33 | 35.8 | |||
Natural delivery | 38 | 41.3 | |||
C-section | 54 | 58.7 | |||
mean age of sexual initiation | 19.16 | 3.07 | |||
mean number of sexual partners | 169 | 3.69 | 2.03 | ||
mean duration of a stable relationship [years] | 148 | 8.63 | 6.48 | ||
Gynecological complaints: | 108 | 63.9 | |||
irregular menstruation (>±7 days) | 51 | 30.1 | |||
recurrent urinary tract infections | 29 | 17.1 | |||
recurrent fungal infections of the genital tract | 39 | 23.0 | |||
vaginal dryness/decreased lubrication | 44 | 26.0 | |||
vaginal pain | 15 | 8.8 | |||
itching in the genital area | 36 | 21.3 |
Parameter | Total Score of the FSFI | Total Score of the AIS |
---|---|---|
education | p = 0.16 | p = 0.36 |
marital status | p = 0.65 | p = 0.11 |
work | p = 0.06 | p = 0.05 |
BMI > 25 kg/m2 | p = 0.54 | p = 0.74 |
smoking | p = 0.87 | p = 0.05 |
alcohol | p = 0.69 | p = 0.33 |
physical activity | p = 0.23 | p = 0.002 |
physical activity—VI-FSFI-pain complaints | p = 0.01 | |
disease duration >10 years | p = 0.17 | p = 0.72 |
type of therapy | p = 0.49 | p = 0.87 |
use of continuous glucose monitoring system | p = 0.47 | p = 0.38 |
glycemic control HbA1c > 7% | p = 0.15 | p = 0.04 |
glycemic control HbA1c > 8% | p = 0.03 | p = 0.88 |
chronic complications of diabetes | p = 0.79 | p = 0.26 |
visible hypertrophy of the subcutaneous tissue | p = 0.87 | p = 0.14 |
Hashimoto thyroiditis | p = 0.45 | p = 0.30 |
arterial hypertension | p = 0.08 | p = 0.81 |
past or present history of depression | p = 0.39 | p = 0.0015 |
gynecological complaints | p = 0.03 | p = 0.87 |
irregular menstruation | p = 0.36 | p = 0.97 |
recurrent urinary tract infections | p = 0.03 | p = 0.65 |
recurrent fungal infections | p = 0.06 | p = 0.76 |
fungal infections/domain V-FSFI— satisfaction | p = 0.06 | |
fungal infections/domain VI-FSFI-pain | p = 0.02 | |
Item 8 (AIS)—embarrassment of people around the patient due to diabetes | p = 0.0033 | |
mechanical contraception | p = 0.72 | p = 0.40 |
delivery | p = 0.89 | p = 0.88 |
delivery/domain I-FSFI—desire | p = 0.02 | |
delivery/domain IV-FSFI—satisfaction | p = 0.06 | |
C-section delivery | p = 0.89 | p = 0.76 |
number of partners | p = 0.62 | p = 0.55 |
negative impact of diabetes on sex life | p = 0.0001 | p = 0.00001 |
negative impact of diabetes on sex life/FSFI domains: | ||
I-desire | 0.0046 | |
II-arousal | 0.0029 | |
III-lubrication | 0.0018 | |
IV-orgasm | 0.0014 | |
V-satisfaction | 0.0005 | |
VI-pain | 0.16 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Cichocka, E.; Jagusiewicz, M.; Gumprecht, J. Sexual Dysfunction in Young Women with Type 1 Diabetes. Int. J. Environ. Res. Public Health 2020, 17, 4468. https://doi.org/10.3390/ijerph17124468
Cichocka E, Jagusiewicz M, Gumprecht J. Sexual Dysfunction in Young Women with Type 1 Diabetes. International Journal of Environmental Research and Public Health. 2020; 17(12):4468. https://doi.org/10.3390/ijerph17124468
Chicago/Turabian StyleCichocka, Edyta, Michał Jagusiewicz, and Janusz Gumprecht. 2020. "Sexual Dysfunction in Young Women with Type 1 Diabetes" International Journal of Environmental Research and Public Health 17, no. 12: 4468. https://doi.org/10.3390/ijerph17124468