Women's Health Clinical Research Center and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94115, USA.
Obstet Gynecol. 2012 Aug;120(2 Pt 1):331-40. doi: 10.1097/AOG.0b013e31825ec5fa.
Diabetes mellitus is an established risk factor for sexual dysfunction in men, but its effect on female sexual function is poorly understood. We examined the relationship of diabetes to sexual function in middle-aged and older women.
Sexual function was examined in a cross-sectional cohort of ethnically diverse women aged 40-80 years using self-administered questionnaires. Multivariable regression models compared self-reported sexual desire, frequency of sexual activity, overall sexual satisfaction, and specific sexual problems (difficulty with lubrication, arousal, orgasm, or pain) among insulin-treated diabetic, non-insulin-treated diabetic, and nondiabetic women. Additional models assessed relationships between diabetic end-organ complications (heart disease, stroke, renal dysfunction, and peripheral neuropathy) and sexual function.
Among the 2,270 participants, mean±standard deviation age was 55±9.2 years, 1,006 (44.4%) were non-Latina white, 486 (21.4%) had diabetes, and 139 (6.1%) were taking insulin. Compared with 19.3% of nondiabetic women, 34.9% of insulin-treated diabetic women (adjusted odds ratio [OR] 2.04, 95% confidence interval [CI] 1.32-3.15) and 26.0% of non-insulin-treated diabetic women (adjusted OR 1.42, 95% CI 1.03-1.94) reported low overall sexual satisfaction. Among sexually active women, insulin-treated diabetic women were more likely to report problems with lubrication (OR 2.37, 95% CI 1.35-4.16) and orgasm (OR 1.80, 95% CI 1.01-3.20) than nondiabetic women. Among all diabetic women, end-organ complications such as heart disease, stroke, renal dysfunction, and peripheral neuropathy were associated with decreased sexual function in at least one domain.
Compared with nondiabetic women, diabetic women are more likely to report low overall sexual satisfaction. Insulin-treated diabetic women also appear at higher risk for problems such as difficulty with lubrication and orgasm. Prevention of end-organ complications may be important in preserving sexual activity and function in diabetic women.
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糖尿病是男性性功能障碍的既定危险因素，但它对女性性功能的影响知之甚少。我们研究了糖尿病与中年和老年女性性功能之间的关系。
我们使用自我管理问卷，对年龄在 40-80 岁之间、种族多样的女性进行了一项横断面队列研究，以评估她们的性功能。多变量回归模型比较了接受胰岛素治疗的糖尿病患者、未接受胰岛素治疗的糖尿病患者和非糖尿病患者之间报告的性欲、性活动频率、整体性满意度以及特定性问题（润滑困难、唤起、性高潮或疼痛）。另外的模型评估了糖尿病终末器官并发症（心脏病、中风、肾功能不全和周围神经病变）与性功能之间的关系。
在 2270 名参与者中，平均年龄为 55±9.2 岁，1006 名（44.4%）是非拉丁裔白人，486 名（21.4%）患有糖尿病，139 名（6.1%）正在服用胰岛素。与 19.3%的非糖尿病女性相比，34.9%接受胰岛素治疗的糖尿病女性（调整后的优势比[OR]2.04，95%置信区间[CI]1.32-3.15）和 26.0%未接受胰岛素治疗的糖尿病女性（调整后的 OR 1.42，95% CI 1.03-1.94）报告整体性满意度较低。在有性行为的女性中，与非糖尿病女性相比，接受胰岛素治疗的糖尿病女性更有可能报告润滑问题（OR 2.37，95% CI 1.35-4.16）和性高潮问题（OR 1.80，95% CI 1.01-3.20）。在所有糖尿病女性中，心脏病、中风、肾功能不全和周围神经病变等终末器官并发症与至少一个领域的性功能下降有关。
与非糖尿病女性相比，糖尿病女性更有可能报告整体性满意度较低。接受胰岛素治疗的糖尿病女性似乎更容易出现润滑和性高潮困难等问题。预防终末器官并发症可能对保持糖尿病女性的性行为和性功能很重要。
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