Sexual Dysfunction in Diabetes Mellitus – An Observational Cohort Study

Abstract

The objectives of the study are to assess the prevalence and type of sexual dysfunction (SD) in males and females living with diabetes mellitus and to further assess erectile dysfunction in males who score more than 10 points in the Arizona Sexual Experience (ASEX) scale with help of the International Index of Erectile Function-5 (IIEF-5) scale. An observational cohort study was conducted on 153 diabetic patients visiting SGRDIMSR hospital, Vallah, Sri Amritsar in the Punjab region of North India. Patients aged between 18 and 50 years who were sexually active and in a healthy sexual relationship with their partner were included in the study after an informed consent. ASEX score was used for the assessment of SD and males who score more than 10 points were further assessed for erectile dysfunction with the help of IIEF-5 scale. SPSS Statistics for Windows, Version 23.0. Armonk, NY, USA: IBM Corp., Chicago, was used for data analysis. SD was prevalent in 64.05% (n = 98) of study participants overall, 65.9% (n = 5) in female and 61.5% (n = 40) in male groups, respectively. Mean scores of each sexual domain were drive (3.85 ± 1.10) > overall satisfaction (3.34 ± 1.06) > orgasm (3.14 ± 0.96) > arousal (3.11 ± 0.84) > erection/lubrication (2.65 ± 0.82) in that order. 69.84% of male diabetic had some degree of erectile dysfunction as assessed further by IIEF-5 score. The prevalence of SD was found to be higher in patients belonging to elderly age group (P = 0.001), longer duration of diabetes (P = 0.001), and deteriorating glycemic control (P = 0.001). Diabetes-related SD is quite prevalent in diabetic patients with 6 out of every 10 patients experiencing this problem. Thus, sexuality needs to be discussed frequently and openly with diabetic patients. In our study, factors such as elderly age of the patient, longer duration of diabetes, and worsening glycemic control of the patient are found to increase the prevalence of SD. Furthermore, the prevalence is higher in patients who already have existing complications of diabetes such as neuropathy, retinopathy, or albuminuria.