Muniyappa Ranganath, Norton Margaret, Dunn Marian E, Banerji Mary Ann
SUNY Downstate Medical Center and Kings County Hospital, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
Curr Diab Rep. 2005 Jun;5(3):230-6. doi: 10.1007/s11892-005-0014-3.
Female sexual response is a complex, nonlinear progression from desire to arousal and orgasm. Diabetes may affect all these, but it particularly affects arousal with decreased genital sensation and lubrication. Vaginal dryness and infections may lead to dyspareunia. Predictors of sexual dysfunction in women include depression. Neither age, duration of diabetes, glycemic control, nor complications predict sexual dysfunction in women as they do in men. Objective measures of decreased genital sensation or lubrication do not correlate with a subjective sense of female sexual arousal disorder. Low androgens and possibly estrogens may be etiologic, as may numerous medications used by patients with diabetes. Practitioners should recognize the high prevalence of female sexual dysfunction (up to 50%) and potential increase, in tandem with that of diabetes. In the absence of definitive treatment evidence, psychological counseling, improvised vaginal lubricants, and low doses of estrogens or androgens have been used to relieve the personal distress of female sexual dysfunction.
女性的性反应是一个从欲望到唤起再到高潮的复杂、非线性过程。糖尿病可能会影响所有这些方面，但它对唤起的影响尤为明显，会导致生殖器感觉减退和润滑减少。阴道干燥和感染可能会导致性交困难。女性性功能障碍的预测因素包括抑郁症。年龄、糖尿病病程、血糖控制情况以及并发症均不像在男性中那样可预测女性的性功能障碍。生殖器感觉减退或润滑减少的客观指标与女性性唤起障碍的主观感受并无关联。雄激素水平低以及可能存在的雌激素水平低可能是病因，糖尿病患者使用的众多药物也可能是病因。从业者应认识到女性性功能障碍的高患病率（高达50%），并且其患病率可能会随着糖尿病患病率的增加而升高。在缺乏确凿治疗证据的情况下，心理咨询、临时使用的阴道润滑剂以及低剂量的雌激素或雄激素已被用于缓解女性性功能障碍带来的个人困扰。
