Sexual Dysfunction in Women With Type 1 Diabetes

Long-term findings from the DCCT/ EDIC study cohort

  1. Paul Enzlin, PHD1,2,
  2. Raymond Rosen, PHD3,4,
  3. Markus Wiegel, PHD3,4,
  4. Jeanette Brown, MD5,
  5. Hunter Wessells, MD6,
  6. Patricia Gatcomb, RN, CDE7,
  7. Brandy Rutledge, PHD8,
  8. Ka-Ling Chan, MS8,
  9. Patricia A. Cleary, MS8 and
  10. the DCCT/EDIC Research Group*
  1. 1Department of Psychiatry, Katholieke Universiteit Leuven & University Hospitals Gasthuisberg, Leuven, Belgium;
  2. 2Department of Obstetrics and Gynaecology, Institute for Family and Sexuality Studies, Katholieke Universiteit Leuven & University Hospitals Gasthuisberg, Leuven, Belgium;
  3. 3New England Research Institutes, Watertown, Massachusetts;
  4. 4Robert Wood Johnson Medical School, University of Medicine & Dentistry, Piscataway, New Jersey;
  5. 5Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco Women's Health Clinical Research Center, San Francisco, California;
  6. 6Department of Urology, University of Washington, Seattle, Washington;
  7. 7Yale University School of Medicine, New Haven, Connecticut;
  8. 8The Biostatistics Center, The George Washington University, Rockville, Maryland.
  1. Corresponding author: Paul Enzlin, paul.enzlin{at}


OBJECTIVE This study aimed to investigate the prevalence and risk factors associated with sexual dysfunction in a well-characterized cohort of women with type 1 diabetes.

RESEARCH DESIGN AND METHODS The study was conducted in women enrolled in the long-term Epidemiology of Diabetes Interventions and Complications (EDIC) study, a North American study of men and women with type 1 diabetes. At year 10 of the EDIC study, 652 female participants were invited to complete a validated self-report measure of sexual function, standardized history and physical examinations, laboratory testing, and mood assessment.

RESULTS Of the sexually active women with type 1 diabetes in the EDIC study, 35% met criteria for female sexual dysfunction (FSD). Women with FSD reported loss of libido (57%); problems with orgasm (51%), lubrication (47%), and arousal (38%); and pain (21%). Univariate analyses revealed a positive association between FSD and age (P = 0.0041), marital status (P = 0.0016), menopausal status (P = 0.0019), microvasculopathy (P = 0.0092), and depression (P = 0.0022). However, in a multivariate analysis, only depression (P = 0.004) and marital status (P = 0.003) were significant predictors of FSD.

CONCLUSIONS FSD is common in women with type 1 diabetes and affects all aspects of sexual function and satisfaction. Depression is the major predictor of sexual dysfunction in women with type 1 diabetes. These findings suggest that women with type 1 diabetes should be routinely queried about the presence of sexual dysfunction and possible co-association with depression.


  • *A complete list of participants in the DCCT/EDIC Research Group can be found in Arch Ophthalmol 2008;126:1707–1715.

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received August 15, 2008.
    • Accepted February 2, 2009.
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