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Sexual Function and Endocrine Profile in Fertile Women With Type 1 Diabetes

¹ Departments of Urology, University Vita-Salute San Raffaele, Milano, Italy
² Department of Internal Medicine, University Vita-Salute San Raffaele, Milano, Italy
³ Department of Biochemical Chemistry, University Vita-Salute San Raffaele, Milano, Italy
⁴ Department of Obstetrics and Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo, University of Pavia, Pavia, Italy

Address correspondence and reprint requests to Andrea Salonia, MD, U.O. di Urologia, Ospedale San Raffaele, Via Olgettina 60, 20132 Milano, Italy. E-mail: salonia.andrea{at}hsr.it

OBJECTIVE—Aims of this study were 1) to assess sexual function and endocrine profile among fertile type 1 diabetic women during the follicular and luteal phases of the menstrual cycle, 2) to compare these results with those obtained among healthy fertile women who served as control subjects, and 3) to explore the correlations between sexual function and endocrine milieu among patients and control subjects during the follicular and luteal phases of the menstrual cycle.

RESEARCH DESIGN AND METHODS—Fifty fertile women with type 1 diabetes and 47 healthy control subjects completed a semistructured medical interview and filled in self-administered validated instruments to evaluate sexual function, depression, and sexual distress. Venous blood samples were drawn to measure glycated hemoglobin and an endocrine profile during either the follicular or the luteal phase of the menstrual cycle.

RESULTS—Type 1 diabetic women had decreased sexual function and increased sexual distress compared with control subjects during the luteal, but not the follicular, phase of the menstrual cycle. During the follicular phase, patients had lower estrogenic basal tone, lower "weak" androgen (namely ₄-androstenedione and dehydroepiandrosterone sulfate) production, and lower free-triiodothyronine and free-thyroxine levels compared with control subjects. During the luteal phase, total testosterone levels were higher in patients than control subjects, while 17ß-estradiol and progesterone levels were lower in patients than control subjects.

CONCLUSIONS—Among type 1 diabetic women, sexual function and sexual distress vary according to the phase of the menstrual cycle. This finding may have implications on the clinical assessment of sexual function in type 1 diabetic women.

Abbreviations: BDI, Beck’s Inventory for Depression • DHEAS, dehydroepiandrosterone sulfate • FSDS, Female Sexual Distress Scale • FSFI, Female Sexual Function Index • fT3, free-triiodothyronine • fT4, free-thyroxine • SHBG, sex hormone–binding globulin

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