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Thursday, December 12, 2013
Diabetes and sex
I know there is research about diabetes` affect on men, but is there any research on women and diabetes` affect on sexual desire and/or response? Is there any treatment being used for sexual dysfunction in women who have long term diabetes type 1? Neither my ob/gyn or endocrinologist has an idea of treatments to help...
I asked several of my colleagues for information to respond to your question so what I have here is a synthesis from them:
Dr. Mercedes Falciglia pointed out that the use of small doses of the so-called "male" hormone testosterone (which is really present in both men and women but in different amounts) has been studied in recent years as a way to improve sexual desire in women in general, not just in those with diabetes. However, this option is still controversial (or needs further investigation etc.)
Dr. Marzieh Salehi mentioned that vaginal dryness (which can cause dyspareunia or pain during intercourse), poor blood flow in the genital system and also psychological factors. An estrogen cream may be helpful for the vaginal dryness. There have been small studies on sildenafil (brand name Viagra) which raise the question whether this drug may improve sexual arousal and to some extent help with dyspareunia. There may be some mechanical means which may be helpful to improve the blood flow to the region.
Dr. David D'Alessio indicated that autonomic neuropathy (damage to the part of the nervous system controlling some parts of the sexual organs, as well as blood vessels, intestines, airways and urinary bladder) can affect sexual function in women as well as men. Anorgasmia (inability to have an orgasm) is listed in reviews of autonomic nervous system dysfunction. I would recommend that this patient have some assessment of neurologic function as a start. She might then be referred to a center where the OB/gyn folks have an interest in diabetes.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati