Sexual Dysfunction and Sexual Quality of Life in Women with Diabetes: The Study Based on a Diabetic Center

Improving the sexual health of couples with diabetes: study protocol of an action research study

BACKGROUND

One of the most serious problems that threatens the sexual health of couples is diabetes. Diabetes is a global public health crisis affecting more than 0.5 billion adults worldwide. Inefficiency in implementing family planning or childbearing, sexually transmitted infections and sexual disorders in these patients can lead to psychological problems such as feelings of inadequacy, despair, loss of self-esteem and psychological consequences. Action research has the dual purpose of action, to bring about change in society or an organization or program, and research to increase the understanding of the researcher or the people involved with the problem, or both, in the wider community. Therefore, this study was designed with the aim of improving the sexual health of couples with diabetes with an action research approach.

METHODS

This study will be done with an action research approach in four phases and several steps. In the first phase (planning), which includes 4 steps, during which the needs and challenges of sexual health of couples with diabetes are explained ([with a qualitative and quantitative approach), the literature review of databases, the explanation of suitable and practical solutions, the prioritization of strategy improve sexual health Diabetic couples and development of sexual health promotion program for diabetic couples and Identifying sexual function and sexual satisfaction before implementing the program [before action]will be done. In the second phase (action), the program resulting from the first phase will be implemented, and in the third and fourth phases, the program will be continuously observed and reflected in order to adjust and improve the program. Qualitative data analysis using conventional content analysis method, quantitative data analysis will be done with SPSS 27 statistical software.

CONCLUSION

Since diabetes affects the sexual health and marital satisfaction of couples, and considering that providing sexual health is one of the duties of reproductive health practitioners, and considering that the study of strategic action research is accepted to change attitudes, behavior and performance in the system. It seems that the application of the technical action research method opens the field for the entry of a research team consisting of various relevant experts to implement the plan resulting from It is the participants' own needs and strategy open.

The relationship between sexual health literacy and sexual function of women with diabetes mellitus: a cross-sectional study

BACKGROUND

Sexual dysfunction (SD) is a complication of poorly managed diabetes mellitus (DM). To prevent SD, patients should develop sexual health literacy (SHL).

OBJECTIVE

This study investigated the relationship between SHL and SD in women with DM.

METHODS

This cross-sectional study was performed between 1 October 2023 and 1 June 2024. The sample comprised 400 participants. The inclusion criteria were (1) being 18-65 years of age, (2) having been diagnosed with DM, and (3) having a sex partner. Data were collected using a personal information form, the Female Sexual Function Index (FSFI), and the Sexual Health Literacy Scale (SHLS).

OUTCOMES

The data were analyzed using the Mann-Whitney test, Kruskal-Wallis H test, Spearman correlation coefficients, and binary logistic regression.

RESULTS

Over half of the participants experienced SD (68,2%). Participants with higher education, those whose partners had higher education, those who did not have any chronic disease other than DM, and those who did not take hormone replacement therapy had a lower rate of SD (P < 0.05). Participants with higher income, those who used family planning, those with DM I, and non-menopausal participants had lower SD and higher SHL (P < 0.05). Insulin-only participants had higher SD and lower SHL than those who were on other types of medications (P < 0.05). There was a significant negative correlation between scale scores (FSFI and SHLS) and age (r = -0.388; P < 0.001 r = -0.326; P < 0.001, respectively), age of partner (r = -0.383; P < 0.001, r = -0.274; P < 0.001, respectively), duration of romantic relationship (r = -0.326; P < 0.001, r = -0.328; P < 0.001, respectively), number of children (r = -0.109; P < 0.001, r = -0.290; P < 0.001, respectively), and duration of DM (r = -0.254; P < 0.001, r = -0.125; P < 0.013, respectively). There was a significant positive correlation between scale scores (FSFI and SHLS) and number of sexual intercourse (r = 0,493; P < 0.001, r = 0.127; P < 0.011, respectively). A one-unit increase in DM duration resulted in a 3.7% increase in SD rate (OR = 1.037). A one-unit increase in the number of sexual intercourses reduced the SD rate by 35.5% (OR = 0.645).

CLINICAL IMPLICATION

The data show that the prevalence of SD in diabetic women is directly affected by the number of sexual intercourses per week, menopausal status, and duration of DM.

STRENGTHS AND LIMITATIONS

This is the first study to examine the relationship between SHL and SD in women with DM. Second, the results are sample-specific and cannot be generalized to all women with DM.

CONCLUSION

Healthcare professionals should ensure that women with DM have high levels of SHL to prevent SD and improve their quality of sexual life.

Depression scores and its relationship with sexual quality of life in women with type 1 and type 2 diabetes: A cross-sectional study

Diabetes is an important public health problem with increasing prevalence worldwide. However, the prevalence of diabetes in women is increasing. Women with diabetes have many physical and psychological complications. It has been reported that complications experienced by women with diabetes negatively affect both their sexual and mental health. This study aimed to determine the sexual quality of life (SQoL) and depression scores in women with type 1 diabetes (T1D) and type 2 diabetes (T2D), the relationship between them, and to examine the factors predicting the SQoL. This study was analytical and cross-sectional. This study was conducted with 440 women with diabetes (206 women with type 1 and 234 women with type 2 diabetes) who came to the endocrine policlinic of a university hospital in Izmir, western Türkiye, between April and October 2023. Data were collected using the "Individual Description Form," "Sexual Quality of Life Questionnaire" and "Beck Depression Inventory." Correlation and multiple regression analyses were conducted to investigate the relationship between SQoL and depression scores. When women with T1D and T2D were compared, it was determined that women with T2D had worse SQoL and higher depression scores (P < .05). Both T1D and T2D women were found to have a strong negative correlation between SQoL and depression scores (r = -0.753; -0.837; P < .05). Age (B = -0.291), body mass index (BMI; B = -2.747), type 2 diabetes (B = -3.074), and depression scores (B = -1.898) were predictive factors of SQoL in women with diabetes (R2 = 0.670; P < .05). In our study, it was determined that depression scores were increased in women with diabetes mellitus with decreased SQoL. When T1D and T2D were compared, T2D had worse SQoL and higher depression scores. It also revealed that age, BMI, T2D, and depression scores affected SQoL. Healthcare professionals especially nurses should provide education and counseling to women with T1D and T2D about sexual life and mental health.

Sexual life experiences of women with diabetes: A systematic review and synthesis of qualitative studies

This study aims to systematically interpret and synthesize the data obtained from qualitative research about the sexual lives of women with diabetes. A thorough literature review was conducted between May and July 2023 across five electronic databases: PubMed, Web of Science, CINAHL, EBSCO, and Science Direct Embase. Eight studies published in English since 2000, which explored the sexual experiences of women with diabetes, were included in this assessment. The sexual experiences of women with diabetes were summarized under five main themes: perception of sexuality, changes in sexual life, adapting to the new normal, unmet care needs, and expectations. This review underlines the intricate nature of diabetic women's sexual experiences, acknowledging the substantial impact of diabetes-related complications and the associated emotional stress on their quality of life and intimate relationships. The study finds that awareness varies among women, with some adapting to the changes brought on by diabetes, while others remain uninformed about its impact on their sexual health. There is a pronounced need for integrating sexual health into diabetes care routines. Many women face unaddressed sexual health concerns and require education and empathetic care from knowledgeable health professionals.

Prevalence and associated factors of female sexual dysfunction among type 2 diabetes patients in Indonesia: A systematic review and meta-analysis

BACKGROUND AND AIMS

Female sexual dysfunction (FSD) is a neglected chronic complication of diabetes. However, there is a scarcity of data in Indonesia, which is currently ranked as the 5th in the world for the number of people with Type 2 Diabetes (T2D). Our study aims to analyze the prevalence and factors of FSD among T2D patients in Indonesia.

METHOD

Literature searching was performed in PubMed/Medline®, CINAHL®, Embase®, Proquest®, Scopus®, local journals and libraries. All studies in searching keywords "sexual", "diabetes" and "Indonesia" with Medical Subject Headings (MeSH) terms were included, without time or language restriction. Pooled prevalence and odds ratio of associated factors of FSD were analyzed using STATA.

RESULTS

Ten studies comprised 572 females with T2D were included in this review. The pooled prevalence of FSD reached 52% (95% CI = 0.49-0.56; I2 93.9%, p < 0.001). After removing one study that was conducted with an unstandardized questionnaire cut-off value, the pooled prevalence of FSD was 62% (95% CI = 0.58-0.66; I2 68.7%, p = 0.001). Age more than 45 years old and or menopause, and the use of antihypertensives were associated with FSD. While Hemoglobin A1c (HbA1c) is only correlated with a desire for sexual dysfunction.

CONCLUSION

FSD was prevalent among T2D patients in Indonesia and was associated with age more than 45 years old, menopause, and the use of antihypertensive medications.

Comparison of sexual functions in women with and without type 1 diabetes

OBJECTIVE

This study aimed to investigate female sexual function in patients with type 1 diabetes by comparing female sexual function index scores between women with and without type 1 diabetes.

METHODS

A total of 62 women with type 1 diabetes and 69 age-matched women without diabetes but with similar backgrounds were enrolled in the patient and control groups, respectively. All participants were sexually active and had no systemic diseases other than diabetes in the patient group.

RESULTS

The frequency of female sexual dysfunction was significantly higher, and the mean female sexual function index score was significantly lower in women with diabetes compared to the control group (p=0.01). There was a significant relationship between sexual dysfunction and duration of diabetes, glycosylated hemoglobin test, and body mass index (p<0.05).

CONCLUSION

This study demonstrates that female sexual dysfunction is more common among women with type 1 diabetes than among women without type 1 diabetes. Patients with type 1 diabetes should be evaluated in terms of sexual health. Health professionals should give more attention to and provide guidance regarding sexual function in women with type 1 diabetes.

Quality of Life, Sexual Functioning and Chronic Disease: A Comparative Study with Portuguese Women without Chronic Disease, and Women with Diabetes Type 1 and 2, and Arterial Hypertension

Aims: Previous research has focused on the impact of chronic diseases on men's sexual functioning and quality of life; however, little is known about the association between chronic disease and women's sexual functioning and quality of life. Current study aimed at exploring the differences in quality of life and sexual functioning between women without chronic disease, and women with type 1 diabetes, with type 2 diabetes, and with arterial hypertension. Methods: A web-survey was completed by 313 Portuguese women (167 without chronic disease, 48 with type 1 diabetes, 48 with type 2 diabetes, and 50 with arterial hypertension). Results: Women without chronic disease scored significantly higher than women with chronic disease in quality of life and sexual functioning, adjusting for age. Conclusions: Quality of life and sexual functioning in women with chronic diseases is impaired.

Sexual Function and Sexual Quality of Life in Premenopausal Women with Controlled Type 1 and 2 Diabetes-Preliminary Study

Sexual dysfunction is more common in women with diabetes than in women without diabetes. The aim of the study was to determine sexual function and the level of the quality of sex life in premenopausal women with controlled, uncomplicated type 1 and type 2 diabetes taking into account the stages of the menstrual cycle and mood level. The study included 163 women with type 1 and type 2 diabetes and 115 controls without diabetes. Questionnaire studies were conducted using the following surveys: Demographic and Clinical Data Survey, Female Sexual Function Index, Sexual Quality of Life—Female, and Beck Depression Inventory. Both phases of the menstrual cycle—follicular and luteal—were included. It was shown that, in women with type 1 diabetes, sexual function decreased during the luteal phase in comparison with the follicular phase (p < 0.001). In the women with type 2 diabetes and in the controls, sexual function was comparable during both phases of the cycle (p > 0.05). In the women with uncomplicated controlled type 1 diabetes, sexual function and the sexual and relationship satisfaction changed depending on the phase of the menstrual cycle with a decrease during the luteal phase. Sexual function and the quality of the sex life of premenopausal women with controlled type 2 diabetes were comparable during both the follicular and the luteal phases. Sexual function in menstruating women with controlled type 2 diabetes decreased with age and a worsening mood.

Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes.