Impact of age, obesity, testosterone, and patient education on the prevalence, incidence, and remission of sexual dysfunction in women with newly diagnosed and uncomplicated type 2 diabetes.

PURPOSE

Female sexual dysfunction (FSD) is a common but underexplored complication in women with type 2 diabetes (T2D). This longitudinal study assessed the prevalence, incidence, and remission of FSD in women with newly diagnosed, uncomplicated T2D, and identified associated predictors.

METHODS

We enrolled 388 women (mean follow-up: 60.5 ± 20.4 months) from a larger cohort of 937 newly diagnosed T2D patients. FSD was assessed using the Female Sexual Function Index (FSFI), with a cut-off score < 26.55 defining FSD. Baseline and follow-up evaluations included anthropometric, metabolic, hormonal, and therapeutic parameters, including participation in therapeutic patient education (TPE). Multivariate logistic regression was used to identify predictors of FSD prevalence, incidence, and remission.

RESULTS

At baseline, FSD prevalence was 42.8%. During follow-up, 30.2% of initially unaffected women developed FSD (6.0% annual incidence), while 28.9% of women with baseline FSD achieved remission (5.8% annual remission). Baseline FSD was independently associated with age > 50 years and BMI > 30 kg/m². FSD incidence was inversely associated with total testosterone > 28.5 ng/dL and TPE. FSD remission was predicted by TPE participation and a ≥ 3-point BMI reduction. At follow-up, FSD prevalence rose to 47.7%.

CONCLUSION

FSD is common in early-stage T2D, with identifiable predictors of both its onset and remission. Age, obesity, testosterone levels, and TPE significantly influence FSD dynamics. These findings support early FSD screening and integration of sexual health into comprehensive diabetes care.