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Sexual Health in Women with Diabetes

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Diabetes in Women

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Women’s sexual dysfunction (SD) is defined as a disorder of sexual desire, arousal, orgasm, and/or sexual pain, which results in significant personal distress and may have a negative effect on a woman’s health and quality of life. Although previously published data suggest that sexual complaints are highly prevalent among women with diabetes mellitus (DM), the scientific community has scarcely investigated the potential correlation between diabetes mellitus and women’s SD. In case-control studies, SD was reported at a significantly greater rate in women with DM type 1 (DM1) than among controls – arousal difficulties being most common. Interestingly, sexual complaints were not isolated in occurrence, because women with DM often reported at least two sexual problems. Sexual disorders are also highly prevalent in women with DM type 2 (DM2), with low sexual desire being most commonly reported. Few treatment options and no specific compounds have been investigated to address the various types of SD in women with diabetes.

Therefore, additional medical research, education and training are needed to improve the identification and management of SD in diabetic women. In this context, it is of paramount importance that both researchers and clinicians address the issue of sexuality and sexual health among diabetic women in well-designed longitudinal studies that have sufficient statistical power and are free of bias.

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References

  1. Bachmann G. Female sexuality and sexual dysfunction: are we stuck on the learning curve? J Sex Med 2006;3:639–645

    Article  PubMed  Google Scholar 

  2. Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med 2006;3:589–595

    Article  PubMed  Google Scholar 

  3. Basson R, Schultz WW. Sexual sequelae of general medical disorders. Lancet 2007;369:409–424

    Article  PubMed  Google Scholar 

  4. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537–544

    Article  CAS  PubMed  Google Scholar 

  5. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T for the GSSAB Investigators’ Group. 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

    Article  CAS  PubMed  Google Scholar 

  6. Ponholzer A, Roehlich M, Racz U, Temml C, Madersbacher S. Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors. Eur Urol 2005;47:366–374

    Article  PubMed  Google Scholar 

  7. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Definitions of women’s sexual dysfunction reconsidered: advocating expansion and revision. J Psychosom Obstet Gynaecol 2003;24:221–229

    Article  CAS  PubMed  Google Scholar 

  8. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Revised definitions of women’s sexual dysfunction. J Sex Med 2004;1:40–48

    Article  PubMed  Google Scholar 

  9. Clayton AH. Epidemiology and neurobiology of female sexual dysfunction. J Sex Med 2007;4(Suppl 4):260–268

    Article  CAS  PubMed  Google Scholar 

  10. Basson R. Clinical practice: sexual desire and arousal disorders in women. N Engl J Med 2006;354:1497–1506

    Article  CAS  PubMed  Google Scholar 

  11. Basson R, Brotto LA, Laan E, Redmond G, Utian WH. Assessment and management of women’s sexual dysfunctions: problematic desire and arousal. J Sex Med 2005;2:291–300

    Article  PubMed  Google Scholar 

  12. Cayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E. The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women. Urol Int 2004;72:52–57

    PubMed  Google Scholar 

  13. Graziottin A. Prevalence and evaluation of sexual health problems: HSDD in Europe. J Sex Med 2007;4(Suppl 3):211–219

    Article  PubMed  Google Scholar 

  14. Eplov L, Giraldi A, Davidsen M, Garde K, Kamper-Jørgensen F. Sexual desire in a nationally representative Danish population. J Sex Med 2007;4:47–56

    Article  PubMed  Google Scholar 

  15. Dennerstein L, Koochaki P, Barton I, Graziottin A. Hypoactive sexual desire disorder in menopausal women: a survey of Western European women. J Sex Med 2006;3:212–222

    Article  PubMed  Google Scholar 

  16. Hayes R, Dennerstein L. The impact of ageing on sexual function and sexual dysfunction in women: a review of population-based studies. J Sex Med 2005;2:317–330

    Article  PubMed  Google Scholar 

  17. Fedele D, Coscelli C, Santeusanio F, Bortolotti A, Chatenoud L, Colli E, Landoni M, Parazzini F. Gruppo Italiano Studio Deficit Erettile nei Diabetici. Erectile dysfunction in diabetic subjects in Italy. Diabetes Care 1998;21:1973–1977

    Article  CAS  PubMed  Google Scholar 

  18. Penson DF, Latini DM, Lubeck DP, Wallace KL, Henning JM, Lue TF, Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database. Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database. Diabetes Care 2003;26:1093–1099

    Article  PubMed  Google Scholar 

  19. Enzlin P, Mathieu C, Van den Bruel A, Vanderschueren D, Demyttenaere K. Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes. Diabetes Care 2003;26:409–414

    Article  PubMed  Google Scholar 

  20. Sarkadi A, Rosenqvist U. Intimacy and women with type 2 diabetes: an exploratory study using focus group interviews. Diabetes Educ 2003;29:641–652

    Article  PubMed  Google Scholar 

  21. Rutherford D, Collier A. Sexual dysfunction in women with diabetes mellitus. Gynecol Endocrinol 2005;21:189–192

    Article  PubMed  Google Scholar 

  22. Grandjean C, Moran B. The impact of diabetes mellitus on female sexual well-being. Nurs Clin N Am 2007;42:581–592

    Article  Google Scholar 

  23. Bhasin S, Enzlin P, Coviello A, Basson R. Sexual dysfunction in men and women with endocrine disorders. Lancet 2007;369:597–611

    Article  CAS  PubMed  Google Scholar 

  24. Thomas A, Lo Piccolo J. Sexual functioning in persons with diabetes: issues in research, treatment and education. Clin Psychol Rev 1994;14:61–86

    Article  Google Scholar 

  25. Enzlin P, Mathieu C, Vanderschueren D, Demyttenaere K. Diabetes mellitus and female sexuality: a review of 25 years’ research. Diabet Med 1998;15:809–815

    Article  CAS  PubMed  Google Scholar 

  26. Enzlin P, Mathieu C, Van den Bruel A, Bosteels J, Vanderschueren D, Demyttenaere K. Sexual dysfunction in women with type 1 diabetes. Diabetes Care 2002;25:672–677

    Article  PubMed  Google Scholar 

  27. Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K. The UKU side effect rating scale: a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl 1987;334:1–100

    Article  CAS  PubMed  Google Scholar 

  28. Jensen S. Diabetic sexual dysfunction: a comparative study of 160 insulin treated diabetic men and women and an age-matched control group. Arch Sex Behav 1981;10:493–504

    Article  CAS  PubMed  Google Scholar 

  29. Jensen S. Sexual relationships in couples with a diabetic partner. J Sex Marital Ther 1985;11:259–270

    CAS  PubMed  Google Scholar 

  30. Diemont WL, Vruggink PA, Meuleman EJH, Doesburg WH, Lemmens WAJG, Berden JHM. Sexual dysfunction after renal replacement therapy. Am J Kidney Dis 2000;35:845–851

    Article  CAS  PubMed  Google Scholar 

  31. Levine SB, Yost MA. Frequencies of sexual dysfunction in a general gynaecological clinic: an epidemiological approach. Arch Sex Behav 1976;5:229–238

    Article  CAS  PubMed  Google Scholar 

  32. Bachman GA, Leiblum SR, Grill J. Brief sexual inquiry in gynaecologic practice. Obstet Gynecol 1989;73:425–427

    Google Scholar 

  33. Schreiner-Engel P, Schiavi R, Vietorisz D, Smith H. The differential impact of diabetes type on female sexuality. J Psychosom Res 1987;31:23–33

    Article  CAS  PubMed  Google Scholar 

  34. Tyrer G, Steel J, Ewing D, Bancroft J, Warner P, Clarke B. Sexual responsiveness in diabetic women. Diabetologia 1983;24:166–171

    Article  CAS  PubMed  Google Scholar 

  35. Taylor JF, Rosen RC, Leiblum SR. Self-report assessment of female sexual function: psychometric evaluation of the Brief Index of Sexual Functioning for Women. Arch Sex Behav 1994;23:627–643

    Article  CAS  PubMed  Google Scholar 

  36. Derogatis LR. The Derogatis Interview for Sexual Functioning (DISF/DISF-SR): an introductory report. J Sex Marital Ther 1997;23:291–304

    CAS  PubMed  Google Scholar 

  37. Basson RJ, Rucker BM, Laird PG, Conry R. Sexuality of women with diabetes. J Sex Reprod Med 2001;1:11–20

    Google Scholar 

  38. Doruk H, Akbay E, Cayan S, Akbay E, Bozlu M, Acar D. Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl 2005;51:1–6

    Article  CAS  PubMed  Google Scholar 

  39. Rosen RC, Brown C, Heiman J, Leiblum S, Meston CM, Shabsigh R, Ferguson D, D’Agostino R Jr. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208

    Article  CAS  PubMed  Google Scholar 

  40. Erol B, Tefekli A, Ozbey I, Salman F, Dincag N, Kadioglu A, Tellaloglu S. Sexual dysfunction in type II diabetic females: a comparative study. J Sex Marital Ther 2002;28(Suppl 1):55–62

    Article  PubMed  Google Scholar 

  41. Olarinoye J, Olarinoye A. Determinants of sexual function among women with type 2 diabetes in a Nigerian population. J Sex Med 2007;5(4):878–876

    Article  PubMed  Google Scholar 

  42. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–774

    Article  CAS  PubMed  Google Scholar 

  43. Arshag D, Mooradian MD, Greiff V. Sexuality in older women. Arch Intern Med 1990;150:1033–1038

    Article  Google Scholar 

  44. Erol B, Tefekli A, Sanli O, Ziylan O, Armagan A, Kendirci M, Eryasar D, Kadioglu A. Does sexual dysfunction correlate with deterioration of somatic sensory system in diabetic women? Int J Impot Res 2003;15:198–202

    Article  CAS  PubMed  Google Scholar 

  45. Duby JJ, Campbell RK, Setter SM, White JR, Rasmussen KA. Diabetic neuropathy: an intensive review. Am J Health Syst Pharm 2004;61:160–173

    CAS  PubMed  Google Scholar 

  46. Wincze JP, Albert A, Bansal S. Sexual arousal in diabetic females: physiological and self-report measures. 1. Arch Sex Behav 1993;22:587–601

    Article  CAS  PubMed  Google Scholar 

  47. Park K, Ryu SB, Park YI, Ahn K, Lee SN, Nam JH. Diabetes mellitus induces vaginal tissue fibrosis by TGF-beta 1 expression in the rat model. J Sex Marital Ther 2001;27:577–587

    Article  CAS  PubMed  Google Scholar 

  48. Kim NN, Stankovic M, Cushman TT, Goldstein I, Munarriz R, Traish AM. Streptozotocin-induced diabetes in the rat is associated with changes in vaginal hemodynamics, morphology and biochemical markers. BMC Physiol 2006;6:4

    Article  PubMed  CAS  Google Scholar 

  49. Ferrini MG, Nolazco G, Vernet D, Gonzalez-Cadavid NF, Berman J. Increased vaginal oxidative stress, apoptosis, and inducible nitric oxide synthase in a diabetic rat model: implications for vaginal fibrosis. Fertil Steril 2006;86(Suppl 4):1152–1163

    Article  CAS  PubMed  Google Scholar 

  50. Park K, Ahn K, Chang JS, Lee SE, Ryu SB, Park YI. Diabetes induced alteration of clitoral hemodynamics and structure in the rabbit. J Urol 2002;168:1269–1272

    Article  PubMed  Google Scholar 

  51. Park JK, Kim SZ, Kim SH, Kim YG, Cho KW. Renin angiotensin system of rabbit clitoral cavernosum: interaction with nitric oxide. J Urol 2000;164:556–561

    Article  CAS  PubMed  Google Scholar 

  52. Park JK, Kim SZ, Kim JU, Kim YG, Kim SM, Cho KW. Comparison of effects of angiotensin peptides in the regulation of clitoral cavernosum smooth muscle tone. Int J Impot Res 2002;14:72–80

    Article  CAS  PubMed  Google Scholar 

  53. Park JK, Lee SO, Cui WS, Kim SZ, Koh GY, Cho KW. Activity of angiotensin peptides in clitoral cavernosum of alloxan induced diabetic rabbit. Eur Urol 2005;48:1042–1050

    Article  CAS  PubMed  Google Scholar 

  54. Giraldi A, Persson K, Werkström V, Alm P, Wagner G, Andersson KE. Effects of diabetes on neurotransmission in rat vaginal smooth muscle. Int J Impot Res 2001;13:58–66

    Article  CAS  PubMed  Google Scholar 

  55. Haffner SM. Sex hormones, obesity, fat distribution, type 2 diabetes and insulin resistance: epidemiological and clinical correlation. Int J Obes Relat Metab Disord 2000;24(Suppl 2):S56–S58

    CAS  PubMed  Google Scholar 

  56. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2006;295:1288–1299

    Article  CAS  PubMed  Google Scholar 

  57. Golden SH, Dobs AS, Vaidya D, Szklo M, Gapstur S, Kopp P, Liu K, Ouyang P. Endogenous sex hormones and glucose tolerance status in postmenopausal women. J Clin Endocrinol Metab 2007;92:1289–1295

    Article  CAS  PubMed  Google Scholar 

  58. Korytkowski MT, Krug EI, Daly MA, Deriso L, Wilson JW, Winters SJ. Does androgen excess contribute to the cardiovascular risk profile in postmenopausal women with type 2 diabetes? Metabolism 2005;54:1626–1631

    Article  CAS  PubMed  Google Scholar 

  59. Joffe HV, Ridker PM, Manson JE, Cook NR, Buring JE, Rexrode KM. Sex hormone-binding globulin and serum testosterone are inversely associated with C-reactive protein levels in postmenopausal women at high risk for cardiovascular disease. Ann Epidemiol 2006;16:105–112

    Article  PubMed  Google Scholar 

  60. Golden SH, Ding J, Szklo M, Schmidt MI, Duncan BB, Dobs A. Glucose and insulin components of the metabolic syndrome are associated with hyperandrogenism in postmenopausal women: the atherosclerosis risk in communities study. Am J Epidemiol 2004;160:540–548

    Article  PubMed  Google Scholar 

  61. Rexrode KM, Manson JE, Lee IM, Ridker PM, Sluss PM, Cook NR, Buring JE. Sex hormone levels and risk of cardiovascular events in postmenopausal women. Circulation 2003;108:1688–1693

    Article  CAS  PubMed  Google Scholar 

  62. Phillips GB, Tuck CH, Jing TY, Boden-Albala B, Lin IF, Dahodwala N, Sacco RL. Association of hyperandrogenemia and hyperestrogenemia with type 2 diabetes in Hispanic postmenopausal women. Diabetes Care 2000;23:74–79

    Article  CAS  PubMed  Google Scholar 

  63. Hak AE, Westendorp IC, Pols HA, Hofman A, Witteman JC. High-dose testosterone is associated with atherosclerosis in postmenopausal women. Maturitas 2007;56:153–160

    Article  CAS  PubMed  Google Scholar 

  64. Bachmann G, Bancroft J, Braunstein G, Burger H, Davis S, Dennerstein L, Goldstein I, Guay A, Leiblum S, Lobo R, Notevolitz M, Rosen RC, Sarrel P, Sherwin B, Simon J, Simpson E, Shifren J, Spark R, Traish A. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment. Fertil Steril 2002;77:660–665

    Article  PubMed  Google Scholar 

  65. Wierman ME, Basson R, Davis SR, Khosla S, Miller KK, Rosner W, Santoro N. Androgen therapy in women: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2006;91:3697–3710

    Article  CAS  PubMed  Google Scholar 

  66. Kingsberg S. Testosterone treatment for hypoactive sexual desire disorder in postmenopausal women. J Sex Med 2007;4(Suppl 3):227–234

    Article  CAS  PubMed  Google Scholar 

  67. Miller KK, Rosner W, Lee H, Hier J, Sesmilo G, Schoenfeld D, Neubauer G, Klibanski A. Measurement of free testosterone in normal women and women with androgen deficiency: comparison of methods. J Clin Endocrinol Metab 2004;89:525–533

    Article  CAS  PubMed  Google Scholar 

  68. Cameron DR, Braunstein GD. Androgen replacement therapy in women. Fertil Steril 2004;82:273–289

    Article  CAS  PubMed  Google Scholar 

  69. Shifren JL, Davis SR, Moreau M, Waldbaum A, Bouchard C, DeRogatis L, Derzko C, Bearnson P, Kakos N, O’Neill S, Levine S, Wekselman K, Buch A, Rodenberg C, Kroll R. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 Study. Menopause 2006;13:770–779

    Article  PubMed  Google Scholar 

  70. Shifren JL, Braunstein GD, Simon JA, Casson PR, Buster JE, Redmond GP, Burki RE, Ginsburg ES, Rosen RC, Leiblum SR, Caramelli KE, Mazer NA. Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. N Engl J Med 2000;343:682–688

    Article  CAS  PubMed  Google Scholar 

  71. Simon J, Braunstein G, Nachtigall L, Utian W, Katz M, Miller S, Waldbaum A, Bouchard C, Derzko C, Buch A, Rodenberg C, Lucas J, Davis S. Testosterone patch increases sexual activity and desire in surgically menopausal women with hypoactive sexual desire disorder. J Clin Endocrinol Metab 2005;90:5226–5233

    Article  CAS  PubMed  Google Scholar 

  72. Miller KK, Biller BM, Beauregard C, Lipman JG, Jones J, Schoenfeld D, Sherman JC, Swearingen B, Loeffler J, Klibanski A. Effects of testosterone replacement in androgen-deficient women with hypopituitarism: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 2006;91:1683–1690

    Article  CAS  PubMed  Google Scholar 

  73. Braunstein GD, Sundwall DA, Katz M, Shifren JL, Buster JE, Simon JA, Bachman G, Aguirre OA, Lucas JD, Rodenberg C, Buch A, Watts NB. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial. Arch Intern Med 2005;165:1582–1589

    Article  CAS  PubMed  Google Scholar 

  74. North American Menopause Society. The role of testosterone therapy in postmenopausal women: position statement of The North American Menopause Society. Menopause 2005;12:496–511

    Article  Google Scholar 

  75. Kingsberg S, Shifren J, Wekselman K, Rodenberg C, Koochaki P, Derogatis L. Evaluation of the clinical relevance of benefits associated with transdermal testosterone treatment in postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4:1001–1008

    Article  CAS  PubMed  Google Scholar 

  76. Lazarou S, Reyes-Vallejo L, Morgentaler A. Wide variability in laboratory reference values for serum testosterone. J Sex Med 2006;3:1085–1089

    Article  CAS  PubMed  Google Scholar 

  77. Rivera-Woll LM, Papalia M, Davis SR, Burger HG. Androgen insufficiency in women: diagnostic and therapeutic implications. Hum Reprod Update 2004;10:421–432

    Article  CAS  PubMed  Google Scholar 

  78. Bell RJ, Donath S, Davison SL, Davis SR. Endogenous androgen levels and well-being: differences between premenopausal and postmenopausal women. Menopause 2006;13:65–71

    Article  PubMed  Google Scholar 

  79. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2006;91:1995–2010

    Article  CAS  PubMed  Google Scholar 

  80. Maggi M, Schulman C, Quinton R, Langham S, Uhl-Hochgraeber K. The burden of testosterone deficiency syndrome in adult men: economic and quality-of-life impact. J Sex Med 2007;4:1056–1069

    Article  PubMed  Google Scholar 

  81. Santoro N, Torrens J, Crawford S, Allsworth JE, Finkelstein JS, Gold EB, Korenman S, Lasley WL, Luborsky JL, McConnell D, Sowers MF, Weiss G. Correlates of circulating androgens in mid-life women: the study of women’s health across the nation. J Clin Endocrinol Metab 2005;90:4836–4845

    Article  CAS  PubMed  Google Scholar 

  82. Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA 2005;294:91–96

    Article  CAS  PubMed  Google Scholar 

  83. Labrie F, Luu-The V, Labrie C, Bélanger A, Simard J, Lin SX, Pelletier G. Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003;24:152–182

    Article  CAS  PubMed  Google Scholar 

  84. Labrie F, Bélanger A, Bélanger P, Bérubé R, Martel C, Cusan L, Gomez J, Candas B, Castiel I, Chaussade V, Deloche C, Leclaire J. Androgen glucuronides, instead of testosterone, as the new markers of androgenic activity in women. J Steroid Biochem Mol Biol 2006;99:182–188

    Article  CAS  PubMed  Google Scholar 

  85. Salonia A, Lanzi R, Scavini M, Pontillo M, Gatti E, Petrella G, Licata G, Nappi RE, Bosi E, Briganti A, Rigatti P, Montorsi F. Sexual function and endocrine profile in fertile women with type 1 diabetes. Diabetes Care 2006;29:312–316

    Article  PubMed  Google Scholar 

  86. Kolodny RC. Sexual dysfunction in diabetic females. Diabetes 1971;20:557–559

    CAS  PubMed  Google Scholar 

  87. Zrustova M, Rostlapid J, Kabshelova A. Sexual disorders in diabetic women. Ches Gunekol 1978;43:277–280

    CAS  Google Scholar 

  88. Widom B, Diamond MP, Simonson DC. Alterations in glucose metabolism during menstrual cycle in women with IDDM. Diabetes Care 1992;15:213–220

    Article  CAS  PubMed  Google Scholar 

  89. Bestetti G, Locatelli V, Tirone F, Rossi GL, Muller EE. One month of streptozotocin-diabetes induces different neuroendocrine and morphological alterations in the hypothalamo-pituitary axis of male and female rats. Endocrinology 1985;117:208–216

    Article  CAS  PubMed  Google Scholar 

  90. Djursing H, Haan C, Nylholm HC, Carstensen L, Andersen A. Gonadotropin responses to gonadotropin-releasing hormone and prolactin responses to thyrotropin-releasing hormone and metoclopramide in women with amenorrhea and insulin-treated diabetes mellitus. J Clin Endocrinol Metab 1983;46:1016–1021

    Article  Google Scholar 

  91. Valimaki M, Liewendahl K, Nikkanen P, Peldkonen R. Hormonal changes in severely uncontrolled type 1 (insulin-dependent) diabetes mellitus. Scand J Clin Lab Invest 1991;51:385–393

    Article  CAS  PubMed  Google Scholar 

  92. Kjaer K, Hagen C, Sando SH, Eshoj O. Epidemiology of menarche and menstrual disturbances in an unselected group of women with insulin-dependent diabetes mellitus compared with controls. J Clin Endocrinol Metab 1992;75:524–529

    Article  CAS  PubMed  Google Scholar 

  93. Rosenfield RL. Evidence that idiopathic functional adrenal hyperandrogenism is caused by dysregulation of adrenal steroidogenesis and that hyperinsulinemia may be involved. J Clin Endocrinol Metab 1996;81:878–880

    Article  CAS  PubMed  Google Scholar 

  94. Cara JF, Rosenfield RL. Insulin-like growth factor-I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian theca-interstitial cells. Endocrinology 1988;123:733–739

    Article  CAS  PubMed  Google Scholar 

  95. O’Hare JA, Eichold BH, II, Vignati L. Hypogonadotropic secondary amenorrhea in diabetes: effects of central opiate blockade and improved metabolic control. Am J Med 1987;83:1080–1084

    Article  PubMed  Google Scholar 

  96. Schwab J, Bialow M, Clemmons R, Martin P, Holzer G. The Beck Depression Inventory with medical inpatients. Acta Psychiatr Scand 1967;43:255–266

    Article  CAS  PubMed  Google Scholar 

  97. Beck A, Beamersderfer A. Assessment of depression: the depression inventory. Mod Probl Pharmacopsychiatry 1974;7:151–169

    CAS  PubMed  Google Scholar 

  98. Erickson GF, Magoffin DA, Dyer CA, Hofeditz C. The ovarian androgen producing cells: a review of structure/function relationships. Endocr Rev 1985;6:371–399

    Article  CAS  PubMed  Google Scholar 

  99. Escobar-Morreale HF, Roldan B, Barrio R, Alonso M, Sancho J, de la Calle H, Garcia-Robles R. High prevalence of the polycystic ovary syndrome and hirsutism in women with type 1 diabetes mellitus. J Clin Endocrinol Metab 2000;85:4182–4187

    Article  CAS  PubMed  Google Scholar 

  100. Couch RM. Dissociation of cortisol and adrenal androgen secretion in poorly controlled insulin-dependent diabetes mellitus. Acta Endocrinol 1992;127:115–117

    CAS  PubMed  Google Scholar 

  101. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001;63:619–630

    CAS  PubMed  Google Scholar 

  102. Newman A, Bertelson A. Sexual dysfunction in diabetic women J Behav Med 1986;9:261–270

    Article  CAS  PubMed  Google Scholar 

  103. Leedom L, Feldman M, Warner P, Zeidler A. Symptoms of sexual dysfunction and depression in diabetic women. J Diabetes Complicat 1991;5:38–41

    Article  CAS  Google Scholar 

  104. Apaydin KC, Akar Y, Akar ME, Zorlu GC, Ozer HO. Menstrual cycle dependent changes in blue-on-yellow visual field analysis of young diabetic women with severe non-proliferative diabetic retinopathy. Clin Experiment Ophthalmol 2004;32:265–269

    Article  PubMed  Google Scholar 

  105. Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther 2002;28:317–330

    Article  PubMed  Google Scholar 

  106. Gragasin FS, Michelakis ED, Hogan A, Moudgil R, Hashimoto K, Wu X, Bonnet S, Haromy A, Archer SL. The neurovascular mechanism of clitoral erection: nitric oxide and cGMP-stimulated activation of BKCa channels. FASEB J 2004;18:1382–1391

    Article  CAS  PubMed  Google Scholar 

  107. Garcia S, Talakoub L, Maitland S, Dennis A, Goldstein I, Munarriz R. Genital duplex Doppler ultrasonography before and after sexual stimulation in women with sexual dysfunction: gray scale, volumetric, and hemodynamic findings. Fertil Steril 2005;83:995–999

    Article  PubMed  Google Scholar 

  108. Yang CC, Cao YY, Guan QY, Heiman JR, Kuffel SW, Peterson BT, Maravilla KR. Influence of PDE5 inhibitor on MRI measurement of clitoral volume response in women with FSAD: a feasibility study of a potential technique for evaluating drug response. Int J Impot Res 2008;20:105–110

    Article  PubMed  CAS  Google Scholar 

  109. Levin RJ, Wylie K. Vaginal vasomotion: its appearance, measurement, and usefulness in assessing the mechanisms of vasodilatation. J Sex Med 2008;5:377–386

    PubMed  Google Scholar 

  110. Laan E, Everaerd W. Physiological measures of vaginal vasocongestion. Int J Impot Res 1998;10(Suppl 2):S107–S110

    PubMed  Google Scholar 

  111. Prause N, Cerny J, Janssen E. The labial photoplethysmograph: a new instrument for assessing genital hemodynamic changes in women. J Sex Med 2005;2:58–65

    Article  PubMed  Google Scholar 

  112. McCall KM, Meston CM. The effects of false positive and false negative physiological feedback on sexual arousal: a comparison of women with or without sexual arousal disorder. Arch Sex Behav 2007;36:518–530

    Article  PubMed  Google Scholar 

  113. Khalifé S, Binik YM, Cohen DR, Amsel R. Evaluation of clitoral blood flow by color Doppler ultrasonography. J Sex Marital Ther 2000;26:187–189

    Article  PubMed  Google Scholar 

  114. Paulus WE, Strehler E, Zhang M, Jelinkova L, El-Danasouri I, Sterzik K. Benefit of vaginal sildenafil citrate in assisted reproduction therapy. Fertil Steril 2002;77:846–847

    Article  PubMed  Google Scholar 

  115. Park K, Moreland RB, Goldstein I, Atala A, Traish A. Sildenafil inhibits phosphodiesterase type 5 in human clitoral corpus cavernosum smooth muscle. Biochem Biophys Res Commun 1998;249:612–617

    Article  CAS  PubMed  Google Scholar 

  116. Perelman MA. Clinical application of CNS-acting agents in FSD. J Sex Med 2007;4(Suppl 4):280–290

    Article  CAS  PubMed  Google Scholar 

  117. Caruso S, Rugolo S, Mirabella D, Intelisano G, Di Mari L, Cianci A. Changes in clitoral blood flow in premenopausal women affected by type 1 diabetes after single 100-mg administration of sildenafil. Urology 2006;68:161–165

    Article  PubMed  Google Scholar 

  118. Caruso S, Rugolo S, Agnello C, Intelisano G, Di Mari L, Cianci A. Sildenafil improves sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder: a double-blind, crossover, placebo-controlled pilot study. Fertil Steril 2006;85:1496–1501

    Article  CAS  PubMed  Google Scholar 

  119. Caruso S, Intelisano G, Lupo L, Agnello C. Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double-blind, cross-over, placebo-controlled study. BJOG 2001;108:623–628

    Article  CAS  PubMed  Google Scholar 

  120. Caruso S, Intelisano G, Farina M, Di Mari L, Agnello C. The function of sildenafil on female sexual pathways: a double-blind, cross-over, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 2003;110:201–206

    Article  CAS  PubMed  Google Scholar 

  121. Burnett AL, Calvin DC, Silver RI, Peppas DS, Docimo SG. Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. J Urol 1997;158:75–78

    Article  CAS  PubMed  Google Scholar 

  122. D’Amati G, di Gioia CR, Bologna M, Giordano D, Giorgi M, Dolci S, Jannini EA. Type 5 phosphodiesterase expression in the human vagina. Urology 2002;60:191–195

    Article  PubMed  Google Scholar 

  123. Munarriz R, Kim SW, Kim NN, Traish A, Goldstein I. A review of the physiology and pharmacology of peripheral (vaginal and clitoral) female genital arousal in the animal model. J Urol 2003;170:S40–S44

    Article  CAS  PubMed  Google Scholar 

  124. Gragasin FS, Michelakis ED, Hogan A, Moudgil R, Hashimoto K, Wu X, Bonnet S, Haromy A, Archer SL. The neurovascular mechanism of clitoral erection: nitric oxide and cGMP-stimulated activation of BKCa channels. FASEB J 2004;18:1382–1391

    Article  CAS  PubMed  Google Scholar 

  125. Mayer M, Stief CG, Truss MC, Uckert S. Phosphodiesterase inhibitors in female sexual dysfunction. World J Urol 2005;23:393–397

    Article  CAS  PubMed  Google Scholar 

  126. Nappi RE. New attitudes to sexuality in the menopause: clinical evaluation and diagnosis. Climacteric 2007;10(Suppl 2):105–108

    Article  PubMed  Google Scholar 

  127. Alexander JL, Kotz K, Dennerstein L, Kutner SJ, Wallen K, Notelovitz M. The effects of postmenopausal hormone therapies on female sexual functioning: a review of double-blind, randomized controlled trials. Menopause 2004;11:749–765

    Article  PubMed  Google Scholar 

  128. Dennerstein L, Lehert P, Burger H. The relative effects of hormones and relationship factors on sexual function of women through the natural menopausal transition. Fertil Steril 2005;84:174–180

    Article  CAS  PubMed  Google Scholar 

  129. Dennerstein L, Hayes RD. Confronting the challenges: epidemiological study of female sexual dysfunction and menopause. J Sex Med 2005;2(Suppl 3):118–132

    Article  PubMed  Google Scholar 

  130. Alexander JL, Dennerstein L, Woods NF, Kotz K, Halbreich U, Burt V, Richardson G. Neurobehavioral impact of menopause on mood. Expert Rev Neurother 2007;7(11 Suppl):S81–S91

    Article  PubMed  Google Scholar 

  131. Dennerstein L, Lehert P, Guthrie JR, Burger HG. Modeling women’s health during the menopausal transition: a longitudinal analysis. Menopause 2007;14:53–62

    Article  PubMed  Google Scholar 

  132. Sarrel PM. Sexuality and menopause. Obstet Gynecol 1990;75:26S–35S

    CAS  PubMed  Google Scholar 

  133. Nappi R, Salonia A, Traish AM, van Lunsen RH, Vardi Y, Kodiglu A, Goldstein I. Clinical biologic pathophysiologies of women’s sexual dysfunction. J Sex Med 2005;2:4–25

    Article  PubMed  Google Scholar 

  134. Sherwin BB. The impact of different doses of estrogen and progestin on mood and sexual behavior in postmenopausal women. J Clin Endocrinol Metab 1991;72:336–343

    Article  CAS  PubMed  Google Scholar 

  135. Bachmann GA. The hyperandrogenic woman: pathophysiologic overview. Fertil Steril 2002;77:S72–S76

    Article  PubMed  Google Scholar 

  136. Sarrel PM. Androgen deficiency: menopause and estrogen-related factors. Fertil Steril 2002;77:S63–S67

    Article  PubMed  Google Scholar 

  137. Sarrel PM. Effects of hormone replacement therapy on sexual psychophysiology and behaviour in postmenopause. J Womens Health Gend Based Med 2000;9:S25–S32

    Article  PubMed  Google Scholar 

  138. Cayan F, Dilek U, Pata O, Dilek S. Comparison of the effects of hormone therapy regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women. J Sex Med 2008;5:132–138

    CAS  PubMed  Google Scholar 

  139. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J; Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321–333

    Article  CAS  PubMed  Google Scholar 

  140. Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, Bonds D, Brunner R, Brzyski R, Caan B, Chlebowski R, Curb D, Gass M, Hays J, Heiss G, Hendrix S, Howard BV, Hsia J, Hubbell A, Jackson R, Johnson KC, Judd H, Kotchen JM, Kuller L, LaCroix AZ, Lane D, Langer RD, Lasser N, Lewis CE, Manson J, Margolis K, Ockene J, O’sullivan MJ, Phillips L, Prentice RL, Ritenbaugh C, Robbins J, Rossouw JE, Sarto G, Stefanick ML, Van Horn L, Wactawski-Wende J, Wallace R, Wassertheil-Smoller S; Women’s Health Initiative Steering Committee. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA 2004;291:1701–1712

    Article  CAS  PubMed  Google Scholar 

  141. Vickers MR, MacLennan AH, Lawton B, Ford D, Martin J, Meredith SK, DeStavola BL, Rose S, Dowell A, Wilkes HC, Darbyshire JH, Meade TW; WISDOM group. Main morbidities recorded in the women’s international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women. BMJ 2007;335:239

    Article  CAS  PubMed  Google Scholar 

  142. Heiss G, Wallace R, Anderson GL, Aragaki A, Beresford SA, Brzyski R, Chlebowski RT, Gass M, LaCroix A, Manson JE, Prentice RL, Rossouw J, Stefanick ML; WHI Investigators. Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin. JAMA 2008;299:1036–1045

    Article  CAS  PubMed  Google Scholar 

  143. Kublickiene K, Fu XD, Svedas E, Landgren BM, Genazzani AR, Simoncini T. Effects in postmenopausal women of estradiol and medroxyprogesterone alone and combined on resistance artery function and endothelial morphology and movement. J Clin Endocrinol Metab 2008;93:1874–1883

    Article  CAS  PubMed  Google Scholar 

  144. Braunstein GD. Management of female sexual dysfunction in postmenopausal women by testosterone administration: safety issues and controversies. J Sex Med 2007;4:859–866

    Article  CAS  PubMed  Google Scholar 

  145. Kenemans P, Speroff L, International Tibolone Consensus Group. Tibolone: clinical recommendations and practical guidelines. A report of the International Tibolone Consensus Group. Maturitas 2005;51:21–28

    Article  CAS  PubMed  Google Scholar 

  146. World Health Organization. Education and treatment in human sexuality: the training of health professionals. Available at: http://www.who.int/reproductive-health/gender/sexualhealth.html Accessed 27 January 2008

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Salonia, A., Lanzi, R., Bosi, E., Rigatti, P., Montorsi, F. (2009). Sexual Health in Women with Diabetes. In: Tsatsoulis, A., Wyckoff, J., Brown, F. (eds) Diabetes in Women. Contemporary Diabetes. Humana Press. https://doi.org/10.1007/978-1-60327-250-6_8

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