Diabetes and female sexual health: an ongoing challenge

Female sexual health remains a much-neglected area in diabetes clinical medicine; however, it is important for psychological and social well-being as well as reproductive function. We aimed to explore the views of women regarding the impact of diabetes on sexual health beyond pregnancy and reproduction. We conducted an online survey distributed via social media platforms including Twitter, Facebook and LinkedIn; the survey remained open for four weeks. Questions addressed a range of medical and psychological factors including body image, self-esteem and confidence. A total of 258 participants, aged 18–73 years, completed the survey. Results show a significant deterioration over the past 20 years, with issues including negative impact on self-esteem (68.6%) and relationships (61.6%), feeling less attractive (57.8%), feeling lonely/isolated (66.3%), worries about fertility (52.7%) and pregnancy (69.4%), and worry about diabetes being passed on to children (79.5%). Medical factors included vaginal infections (77.9%), dyspareunia (51.2%), and general orgasmic problems (57.4%). Almost half (49.2%) were unaware that these problems were more common in women with diabetes. Shorter duration of diabetes was negatively associated with self-esteem (p<0.002), loneliness (p<0.001), and impact on relationships (p<0.017). Those without children and those aged under 35 years were more worried about fertility (p=0.000) and pregnancy (p=0.000). It was concluded that sexual health issues continue to pose challenges for women with diabetes in terms of medical and psychological challenges. The psychosocial aspects of diabetes and sexuality, including feeling unattractive both physically and emotionally are widely reported by participants, demonstrating the very damaging and distressing personal consequences. Copyright © 2019 John Wiley & Sons. Practical Diabetes 2019; 36(5): 165–169.