Sex and the diabetic woman: desire versus dysfunction

Abstract

Although it is universally appreciated that long-standing diabetes is associated with sexual dysfunction in men, the state of inquiry into sexual dysfunction in diabetic women is rudimentary A literature search of the articles published in the last 5 years on sexual dysfunction in diabetic men yields numbers in the thousands; a similar computer search directed toward diabetic women results in 13 articles. The reasons offered for this discrepancy in research related to diabetic women compared with diabetic men are only conjectures. Perhaps it is because urologists who are, in the vast majority of cases, men performed the major research in this field. Perhaps it is because women did not complain of sexual dysfunction to physicians, and therefore it was not perceived as a problem; or perhaps it is because sexual dysfunction in women masqueraded as other symptoms, such as mood swings, depression, vaginitis, cystitis, and loss of libido. Thus, the primary problem was overlooked. As changes in philosophy of health care emerge, it has become apparent that specific studies need to be performed in women, and it should not be assumed that studies in men apply equally to women. Inquiry into sexual dysfunction in diabetic women is a prime example of the need for targeted research. This review will describe the small number of articles published to date in this field, and offer an opinion as to the optimal work-up and treatment of the diabetic woman with sexual dysfunction.