Female sexual dysfunction covers disorders of the different phases of the sexual response, including sexual desire, arousal, orgasm or the presence of pain, which can lead to distress, with a negative effect on women’s health and quality of life. Decreased sexual desire is one of the most common sexual disorders in women. It occurs more often in postmenopausal women – in up to 40-50% of cases. The etiology of sexual disorders is complex and multifactorial, being associated with both somatic (physical) and mental illnesses and disorders. Diabetes mellitus has long been associated with sexual dysfunction in both men and women. Hyperglycemia can reduce the hydration of the mucous membrane in the vagina, which is associated with reduced lubrication and dyspareunia – pain during intercourse. An increased risk of vaginal infections also increases the risk of vaginal discomfort and dyspareunia. Vascular damage and autonomic neuropathy can lead to reduced genital blood flow, which impairs genital arousal. Not to be neglected are the psychosocial factors – such as acceptance of the diagnosis and the often resulting depression, which is essential for a decrease in libido. Studies have found significant differences between type 1 and type 2 diabetes patients in terms of arousal and lubrication disorders, up to 18% and up to 42%, respectively, which is associated with a higher number of complications in type 2 diabetes. Important role in sexual disorders in diabetes mellitus type 2, the accompanying metabolic syndrome, including arterial hypertension, overweight and obesity, as well as dyslipidemia, also play a role. Non-pharmacological treatment includes changes in diet and physical activity. The medical treatment of sexual dysfunction in women includes the use of hormonal preparations in different forms when there is a proven hormonal deficiency, during menopause, as well as when there is a mixed etiology of the sexual problem. Treatment with vasoactive medications has been conducted in numerous studies, but is currently not approved by the appropriate authority. Atherosclerosis of the small vessels of the vagina and clitoris can cause a violation of sexual arousal, and studies with the use of the same drugs show an increase in vaginal blood filling and lubrication, a reduction in the symptoms of sexual dysfunction in women with diabetes mellitus. Sources: https://pubmed.ncbi.nlm.nih.gov/20358461/ https://pubmed.ncbi.nlm.nih.gov/12150499/
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