Relationship between diabetic microangiopathy and sexual dysfunction in women with type 2 diabetes

Female sexual dysfunction (FSD) is a frequent comorbidity in women with type 2 diabetes mellitus (T2DM), and is now increasingly considered a surrogate marker of endothelial dysfunction as well as a sentinel predictor of new-onset macroangiopathic events. Less attention, however, has been directed at the potential association of FSD and microangiopathy in hyperglycemic states. We analyzed 30 consecutive female T2DM outpatients in whom FSD was assessed by the Female Sexual Function Index (FSFI) questionnaire. A score of less than 26.55 characterizes FSD. Participants underwent a comprehensive interview, a complete eye examination and fasting blood tests. Socio-demographic and clinical characteristics were assessed during the consultation. Mean age and diabetes duration were 42.97 ± 6.6 years and 12.7 ± 6.21 years, respectively. Compared with patients without diabetic microangiopathy, those with any microangiopathy (odds ratio 12.6, P = 0.007) had an elevated risk of having sexual dysfunction. Women with diabetic nephropathy (odds ratio: 6, P = 0.045) and diabetic neuropathy (odds ratio 4, P = 0.03) had sixfold and fourfold increased odds of having sexual dysfunction, respectively, compared with those without diabetic nephropathy and neuropathy. Diabetic retinopathy, irrespective of presence or severity, was not independently associated with FSD (P = 0.141). The presence and severity of diabetic nephropathy and neuropathy but not diabetic retinopathy is independently associated with self-reported female sexual dysfunction.