Sexual dysfunction with women who have been diagnosed with diabetes have been shown to suffer sexual issues.

1. The Causes of Sexual Dysfunction and Women
with Diabetes
Studies have shown that 90% of diabetics are type 2 and less than 10% are diagnosed
with type 1. The patients diagnosed with either type are under an increased threat of
vascular and neurological complication and psychological issues. The women who
suffer from this may have many complications. In most cases the risk of diabetes
diagnoses especially type 2. An increased amount of cases of sexual dysfunction
correlated with the diagnosis. The research had to account for the use of contraception,
hormone replacement therapy, and pregnancy. Sexual dysfunction is a common
problem, albeit a problem that has not been studied in women with type 2 diabetes in
depth.
Diabetes type 2 diagnoses is the leading cause of sexual dysfunction. There will be an
increased amount of women diagnosed with this considered a larger proportion of the
population in increasingly growing older and becoming more and more physically
inactive. Thus, the rate of sexual dysfunction in women will also increase. It was not
until this study that the direct correlation could be substantiated. The effect of sexual
dysfunction was correlated to neurological, psychological and vascular affects and a
combination of such. However, despite the common knowledge that there is an
association in their measurements of such is hard to create. It is difficult to measure
sexual function in women. In many cases the spouses sexual performance, quality of
sexual intercourse, patients educational culture, and socioeconomic status was also a
large part of the problem. They also have a decreased sexual desire, decreased
stimulus, reduced lubrication and orgasm disorder. Thus, diabetes females are more at
risk than others. In this study several surveyors were sued to evaluate sexual function
disorders.
Sex is defined by the study as an ability to experience masculine or feminine emotions,
physical stimulation and/or mental feelings. It is also a perception that is expressed by
the sexual organs of another. The sexuality of a human being is determined by social
norms, values and taboos. This is also determined by psychological and social norms
and aspects. The nature of the disease was also defined in the study. It had to be, in
order to evaluate the nature of sexual dysfunction with patients who are diabetic.
Responses to sexual stimulation in the subjects was divided into four phases. These
included the arousal, plateau, orgasm and resolution phase. These phases were
identified as the most detrimental and prevalent issues that affected women during
sexual satisfaction.
In the first phase, the libido is accessed. This is the appearance of erotic feelings and
thoughts. Real female sexual desires begins with the first phase. Also at this point
sexual thoughts or feelings or past experiences help to create either a natural or
unnatural arousal stage in patients. There second phase identified by searchers here
was the arousal phase. In this phase the parasympathetic nervous system is involved.
With that, the phase is then characterized by erotic feelings and the formation of a
natural vaginal lubrication. The first sexual response begins with vaginal lubrication
which follows within 10-30 seconds and then follows from there. What follows is typically
a rapid breathing session or rather tachycardia that causes women to have an
increased blood pressure and a general feeling of warmth, breast tenderness, coupled
with erected nipples and a coloration of the skin. Most women experience this arousal
phase.The third phase is defined as the orgasm phase or rather the time with increased
muscular and vascular tension by sexual stimulation occurs. This is the most imperious
of the cycles and is albeit the most satisfying for women. During this period women

2. experience orgasmic responses from the sympathetic nervous system. Changes also
occur in the entire genital region these include a change in heart rate, and blood
pressure. The final phase of normal sexual stimulation is the resolution phase. During
this period women have genital changes. Basically the withdrawal of blood from the
genital region and the discharge of sexual tension as occurs after the orgasm will bring
the entire body to a period of rest.
The basis of sexual responses cycle depends on normally functioning of the endocrine,
vascular, neurological and psychological factors. Considering the brain is the center for
sexual stimulation, sexual behaviors are directly correlated to the sense of being
aroused. The study has defined sexual stimulation and peripheral stimulation. Central
stimulation is defined as the act of being aroused and sexual desire is phenomena
mainly mediated by the mesolimbic dopaminergic pathway. Dopamine is the most
important known neurotransmitter system responsible for the arousal. The process
breaks down to the fact that testosterone is responsible for both female and male desire
and it increases blood flow either directly and indirectly through estrogen.
Sexual dysfunction has been classified and defined by the inability to experience
anticipated sexual intercourse. This is a psychosocial change that complicates
interpersonal relationships and creates significant problems. Orgasm disorder usually
occurs with a recurrent delay or difficulty in achieving an orgasm after sexual
stimulation.
Several sexual disorders have been affected by diabetes, many others are blanketed
under the sexual dysfunction term. Sexual Aversion Disorder is the avoidance of all
genital contact with ones partners. The difference between the phobia and the feelings
of disgust and hatred are part of the phobia. Sexual Arousal Disorder is the inability to
establish adequate lubrication stimuli in a persistent manner. Orgasmic disorder is
defined as a persistent or recurrent delay in or lack of normal phases. Orgasm is the
sudden temporary peek feeling.
According to the data from the U.S National Healthy and Social life survey women who
are at risk for SD. In the study it was found that women with healthy problems have an
increased risk for pain during intercourse. Also women with urinary tract problems or
symptoms are at risk for problems during intercourse. The socio-economic status of
women is another risk factor as well as women who have been the victim of
harassment. Menopause has a negative impact on sexual function in women.
Sexual dysfunction was not limited to affective disorders, in fact socio-cultural and social
demographic causes effected demographic and sociological characters were
investigated. In the studies conducted sociodemographic characteristics like age,
education level and income levels. Also the use of an effective method of family
planning was related to the BMI and marriage were also factors in this decisions. The
use of alcohol and drugs was also linked to a woman’s sexual response and leads to
SD. The most prevalent use came from antidepressants received for the treatment of
depression were reported with the use of the prescription drugs. The affects included a
lack of lubrication, vaginal anesthesia, and delay in or lack of orgasm. Other drugs that
have were found to affect female SD included anthypertensives, lipid-lowering agents
and chemotheraputic agents. The study also took into account that chronic diseases like
systemic diabetes and hypertension causes psychiatric disorders, including depression,
anxiety disorders, and psychoses are attributed to chronic disease states.
Diabetes is a common chronic disease with more than 90% of diabetics having been
diagnosed with type 2 diabetes. Diabetic patients have been found to have an elevated
risk of vascular and neurological complications and psychological problem.Thus,

3. because of this it has been found that diabetics are prone to having female sexual
dysfunction. Thus, the subject of female diabetic SD was largely unrecognized until
1971. Even at that time in an article the study was the first to evaluate limited cases of
sexual dysfunction in women. Studies with females who have been diagnosed with SD.
Diabetic females with sexual problem are explained with biological, social and
psychological factors.
Hyperglycemia had been found in many diabetic women who have been diagnosed with
SD. It reduces the hydration of the mucus membranes of the vagina. It in turn reduces
the lubrication levels, leading to painful sexual intercourse. The risk of vaginal infections
increases because of that and so too does vaginal discomfort and painful intercourse. It
is clinically hard to measure sexual function in women. In many cases medical history,
physical examination, pelvic examination and hormonal profile were reviewed. The
subjects were questioned in detail regarding spouse’s sexual performance, quality of the
sexual intercourse, the patients educational level and socioeconomic status. The
several questionnaires which were used to evaluate sexual function disorders were a
substantial methodology. Sexual inventories were then classified in two groups. The
information obtained through a structured incentive allowing the discloser of terms.
There was fact to face interview and also many sexual inventories which were based
on the human sexual cycle.
There were 400 female patients that applied to the hospital or diabetes center. The test
was conducted between June 2009 and June 2013. There were first non-voluntaries or
those who met the exclusion criteria and type 1 diabetics were excluded from the study.
This study also included 329 married women, there were 213 diabetic and 116 nondatebooks. All of the women in this study were sexually active and had a spouse. Also
the survey questions were asked questions in a face to face attack. The subjects were
given questionnaires and the volunteers who were inactive or had an illness were
excluded from the study.
It was also important in the study to take into account demographics. These included
the age of the participants, their weight, and their height. Their weight circumference,
BMI and education level were also part of this study. With diabetic patients the plasma
glucose level was also reviewed. In this study the reliability of the female sexual function
index and the test-retest reliability was a .82 and a .79. The version of the validity and
reliability of the scale was performed.
Another form of measurement was the Arizona Sexual Experiences Scale, again
another form of questions used to measures the experiences that women have and how
they were able to deal with them. Patients that were treated with psychotropic drugs
were the main focus of this experiment. This is a set of five questions created to show a
minimal disturbance with patients. The scale aimed to assess sexual functions by
excluding sexual orientation and relationships with a partner. The format that was used
for most women in this study included several questions regarding sexual drive and
arousal.
Still other tests were utilized. These included the Golombuk-Rust Inventory of Sexual
Satisfaction (GRISS). The utilization of this test was yet another set of questions that
were given to males and females (28 males, 28 females) and were aimed at objectively
evaluating the heterosexual relationship of the individuals and to identify the level of
dysfunction of the subject. The results again found that women with diabetes are more
prone to suffering from dysfunctional disorders.
Of course researchers looked into the subjects BMI and found that 23 of only 7% of the
patients were in the normal range of the BMI which at the time was 18.5-24.9 kg. The

4. mean BMI was also only 33.11 in patients with diabetes. The majority of patients that
had higher BMI issues were smokers. So not only was it diabetes that attributed to SD
but smoking and drug use caused additional complications. Also, 193 were
premenopausal and 136 were postmenopausal. The average number of patients who
were diagnosed were also on oral antibiotic medications in combination with insulin and
in some cases antilipedemic medications. Many patients were not using medications at
all which may result in the reference that they were suffering from the disease because
they were unable to move through their diabetes diagnoses.
The study conducted found that there was no correlation between the age of a patient a
their FSFI. Plus, there did not seem to be a correlation between the BMI and FSFI and
the sub structures like desire, arousal, lubrication, orgasm, sexual success, and pain
with diabetic women. Some of the volunteers had children, one to three children in fact.
There again was no direct correlation with diabetic women with children or without.
However there was a correlation with women who had a more children and their ability
to reach an orgasm. Perhaps due to the multiple births and the destruction that it could
have caused neurologically.
Specifically when addressing diabetes, researchers wanted to understand the extent of
the SD disturbance. The attributes of a imbalanced hormonal system, vascular
constrictions and increased sexual problems cause the physiological and psychological
responses that were found. The differences in the mechanisms of the neurotransmitters
during sexual responses in women with diabetes and without diabetes was the leading
contributor to a decreased sexual appetite.
Women have many dimensions that lead to their diagnoses. Sexual function is affected
therefore when a woman is diagnosed with diabetes. The research also found that
female lubrication occurred only during the arousal phase. But the dysfunction was
largely affective, meaning that women were unable to become lubricated during the
arousal phase. Women who were insulin dependent had little or no evidence of
dysfunction while non-insulin dependent patient status had a negative effect on sexual
disorders. This included the ability to orgasm, lubrication during arousal, sexual
satisfaction, and sexual activity. This suggests a more comprehensive explanation that
SD might be related to the age at which the diabetes develops.
Also women who have a genital disease will also have be unable to achieve ideal
sexual arousal. Other factors besides diabetic mediations include other medications. For
instance, antibiotics used to treat urinary infections and oral contraceptives have been
attributed to an adverse sexual function in women. These medication will also heighten
a woman’s ability to reach normal sexual functioning. Again the psychological effects of
diabetes will also cause women to be unable to reach an adequate amount of sexual
ability. Typical feelings from diabetic patients that have been reported to researchers
include a feeling of isolation, feeling of being unattractive, loneliness and isolation.
These are mainly caused from the diagnoses and a lifestyle change. Women who have
these symptoms or feelings are advised to seek treatment with their medical doctor and
to seek a therapist. They should advise them of the feelings, to seek a holistic treatment
plan.
Researchers advise that there are holistic treatments available for women who are
suffering from these diseases and including the inability to organism which can be
remedied with vibrating tools or psychosomatic techniques. Also a reduced libido may
be a form of depression and therapists will address the patients self image during the
scores of holistic treatment. This may in fact lead to a better self image and an
increased libido. The loss of genital sensations can also be attributed to diabetes. Many
patients have been advised to use entertaining vibrating tools in order to treat

5. Sexual dysfunction is mainly caused by a blanket of issues but according to recent
studies by Paul Enzlzin, MA, Chantal Mathie, MD, PHD and others the direct correlation
between medications in 90% of patients diagnosed with diabetes medication and
disease state causes sexual definition. The effects are a common problem, 20% to 80%
of women are reported as having a sexual dysfunction. The disease Diabetes Mellitis is
the leading systemic disease of sexual dysfunction. Research has found that the cause
largely forms because of psychological and physical issues. Thus leading to the inability
to stimulate during sexual intercourse.
For many researchers configuring how to asses a woman’s sexual dysfunction was
challenging. Talking about it presented a taboo and in many cases this would not lead to
a very honest or comfortable conversation for the participant. That is why researchers
utilized questionnaires and face to face interviews. This included the Female Sexual
Function Index which was created in 2000. At that time Cronbach’s coefficient testretest reliably was found to be about .82-.79. It is in essence a questionnaire that is
composed of six sections that measure desire, arousal, lubrication, satisfaction,
pleasure, and pain. The topic is also given a score system between 0-6. The 1 st, 2nd and
15th questions are then also scored between 1 and 5. The other questions are scored
between 1 and 5. This was only one of the measurements that researchers utilized to
gain a better understanding on the role of sexual dysfunction and women with diabetes.
Patients or subjects are encouraged to speak with their health care provider regarding
any issues they may begin to feel with a lack of sexual desire. There will be minor
episodes of this feeling or it may progress into something less attractive. Episodes of
depression will periodically affect the already progressing SD these too will be a point
that many should discuss with their physicians.
Patients who are diagnosed with diabetes and then depression should seek therapy. In
many cases the treatment may include antidepressants and holistic approaches.
Lifestyle changes such as the implementation of a healthy and balanced lifestyle may
help patients to improve significantly.However, that was found only in patients that made
positive lifestyle changes accordingly. The medications that affect depression however
will and may cause more complexities with SD. Moreover, only further testing will
provide conclusive evidence.
SD is a chronic and persistent problem in women diagnosed with diabetes. Until this
recent study the appearance of sexual dysfunction had not been studied enough. The
impact if studied properly will largely affect most of the population diagnosed with
diabetes. In recent years this the diagnoses has grown because the population has
increased. Research with women and sexual dysfunction is scarce and also filled with
flaws in the methodology of the research. The presence of the diabetes complications,
the adjustment that patients have to the disease, and the psychological factors
surrounding the disease affect it. The relations that they have with their partners are all
part of the complications that arise with diabetic sexual dysfunction diagnoses in
women. The study or research attempted to examine the prevalence of the dysfunction
in women, the problems that occurred with an age matched group and the influence that
diabetes had on female sexuality. The psychological factors that inhibited adequate
sexual functioning were also measured in the most recent study.
Again in these studies women reported having less satisfaction during sex, avoided it as
well. Researchers believe that these women who in particular were suffering from type 2
diabetes felt that they were less sexually attractive because of their body image.
Researchers also examined psychological aspects of older type 2 diabetes in women
who reported that they felt their bodies were less attractive then non-diabetic women.

6. 60% or more of women in this study did not have a dysfunction, other than physiological
symptoms or diabetes.
Much research has stated that if the patient is having difficulties it is important to have a
talk with a physician about the probable side effects they will be suffering from. Women
with diabetes who were suffering form the onset of menopausal symptoms could not be
correlated to SD. In fact women who reported sexual problems were not significantly
different in age though to the women who had an onset of menopause. The
overwhelming evidence however suggested that psychological dysfunction and its
accordance with diabetes was a crucial deciding factor to a rise in SD cases. The
majority of research findings have concurred with it, stating that they in fact are able to
correlate within the study.
A poor self image in women with diabetes leads to a loss of self esteem, feelings of
unattractiveness, concern about weight gain and negative body images. The occur
largely around the issue of weight gain, which follows with anxiety. There is evidence
that these problems are common in older women who have been diagnosed according
to several questionnaires that were used to evaluate women in the studies from 20092010. Research could suggest that it is because older women may be without a sexual
partner and their diabetes could add to feelings of inadequacy. Younger women tend to
worry about the effects that the disease and what it will have on their physical
appearance especially with insulin therapy. If women begin healthy eating patterns then
the main cause will have not issue on the physical appearance on women with proper
nutrition. A woman has to be able to communicate with her partner and others around
her in order to make sure that everyone understand the problems she is facing.
However diabetes coupled with poor self images will lead a woman to become and
introvert and therefore keep her feelings to herself. Thereby causing SD and a loss of
social experiences by the woman in fact who has been battling these disease states.
A woman’s sexual desire has been found to be low, painful and absent. Thus, of this
issue women will not be able to have healthy relationship. Unfortunately there has not
been much research conducted with women because the variables have been to hard to
control. But recently in this recent study conducted in 2009-2010 the questionnaire
gave insight into the mind of women suffering form this disease. The limited study has
prevented women from seeking out help and having a renewed interest in the problem.
Limited studies have found that this problem affects largely about 50 % or more of
women diagnosed with the disease. Most women who have type 2 and 1 diabetes are
statistically going to stop having sex as much as their male counterparts because of
their lack of a valued self image. In fact there are many sociological risks to not having
adequate support systems to help minimize the impact the diabetes has on a lifestyle.
The changes that take place in a woman’s body who has been diagnosed with diabetes
type 2 have largely been ignored. There are a plethora of issues at play here including
detrimental issues affecting the central nervous system.Therefore, a woman’s sexual
desire is largely affected by not only the CNS, but many other factors. In some cases
these may include a hormonal imbalance caused by pre-menopause. Regardless there
is a correlation between female diabetics and the changes in estrogen and sexual
arousal stimulation. In the study the decreased sexual function and diabetes was also
found to have a direct correlation in women who were overweight. This correlation was
diminished in women who were average.

7. However of all of the contributors that will and do cause dysfunctions with women in
sexual dysfunctions a poor self image was the leading cause. Depression was
established in many women with a poor self image. Studies have shown that there is a
direct link with diabetes and SD which is linked to a psychological disorder within
women. Also diabetic women with this dysfunction were at least two times more likely to
have sexual dysfunction than women without diabetes. In many cases depression
caused a lack of sexual arousal or desire and a lack of physical performance when
initiating the act. Therefore, a woman who is diagnosed with diabetes is at a higher risk
of complications that harm her self confidence, her physiological health and her social
interactions. Her daily routine will even be affected due or her lack of sexual arousal.
Specifically when addressing diabetes, researchers wanted to understand the extent of
the SD disturbance. The attributes of a imbalanced hormonal system, vascular
constrictions and increased sexual problems cause the physiological and psychological
responses that were found. The differences in the mechanisms of the neurotransmitters
during sexual responses in women with diabetes and without diabetes was the leading
contributor to a decreased sexual appetite. Several risk factors were associated with
sexual dysfunction including health problems which affected sexual intercourse, mainly
in the form of pain associated with penetration. There are also several other causes that
can be attributed to sexual dysfunction including urinary tract symptoms and arousal
issues. However not necessarily in direct correlation to diabetes, but it becomes a
symptom of the sexual dysfunction that may be attributed to diabetes as an after effects.
Women who were diagnosed with type 2 diabetes had a direct correlation with sexual
dysfunction. It was only with this research that many methodologies were proven useful
in capturing the information.