Associate Professor of Urology University of Michigan
Introduction: Female sexual dysfunction (FSD) has been reported to be more common in women with T2D. However, detailed risk profiles are lacking. We sought to determine the burden and correlates of FSD in a well characterized cohort of women with Prediabetes (PreD) and T2D enrolled in the DPPOS. Methods: Between 1996-1999, 3,234 adults with PreD were randomized to intensive lifestyle intervention, masked metformin, or placebo in the DPP. In 2001, open-label metformin was continued for those originally randomized to it and modified lifestyle intervention offered to all. In 2016-2017, 1320 of 1464 participants completed the Female Sexual Function Index (FSFI). 426 women were sexually active and included in the current report. FSD was defined as FSFI=26.55. A backwards selection multivariable logistic regression model estimated odds of FSD for sociodemographic, clinical, and diabetes-related covariates significant in bivariate analysis. Results: Overall, 185 (43%) women met the criteria for FSD. After adjustment for treatment arm, age and race, depression (defined by the Beck Depression inventory or antidepressant use) and weekly urinary incontinence were both associated with over a two-fold (OR=2.81, 95%CI=1.57, 5.02; and OR=2.14, 95%CI=1.31, 3.51) increase in odds of FSD, respectively. Women who reported hysterectomy were 1.95 times more likely (95%CI=1.07, 3.54) to report FSD. Mean study BMI was slightly protective for FSD (OR=0.93, 95%CI=0.89, 0.96). Neither DPP treatment group nor any diabetes-related factors were associated with FSD. Conclusions: FSD is highly prevalent in this population of women with PreD and T2D. Our findings suggest that FSD in this cohort is most strongly associated with depression. The lack of association between any measures of diabetes or glycemic control suggests that the sexual response in women is more likely to be affected by psychosocial aspects than by metabolic control or complications of diabetes. SOURCE OF Funding: National Institute of Diabetes and Digestive and Kidney Diseases (UDK048489, UDK048339, UDK048377, UDK048349, UDK048381, UDK048468, UDK048434, UDK048485, UDK048375, UDK048514, UDK048437, UDK048413, UDK048411, UDK048406, UDK048380, UDK048397, UDK048412, UDK048404, UDK048387, UDK048407, UDK048443, and UDK048400)
