The emergence of Viagra on the drug market has spurned several studies directed at sexual function in men with diabetes.

Much less, however, is known about sexual dysfunction in women with diabetes.

According to a study that was published in the September 1998 issue of Practical Diabetes International, women with diabetes may have a range of sexual health concerns. In research conducted by Darryl Meeking, MRCP, and Jackie Fosbury, UMDS, it was revealed that there are many dimensions, both physical and psychological, that play into sexual dysfunction in women with diabetes.

According to Meeking and Fosbury, sexual function is one element of bodily function that is affected when a woman has diabetes. Unpublished research that was conducted on 160 women with diabetes (in addition to a nondiabetic control group) revealed that vaginal lubrication was the major functional difference between the two groups. The research indicated that female lubrication occurs during the arousal phase of the sexual response cycle, much like the erectile phase in men. Evidence suggests that females with diabetes, much like males with diabetes, have more arousal phase dysfunction than their healthy spouses.

It has also been found that women with insulin-dependent diabetes show little or no evidence of psychosexual dysfunction, while non-insulin-dependent diabetes has more of a negative side effect on sexual desire, orgasmic capacity, lubrication, sexual satisfaction and sexual activity. Meeking and Fosbury suggest that a more comprehensive explanation might be related to the age at which the diabetes develops.

It should be noted that genito-urinary diseases in women with diabetes could very well affect sexual function. Such diseases include candidiasis, systitis and genito-urinary infection.

Another factor might be medications or antibiotics used to treat urinary tract infections. Meeking and Fosbury suggest that certain medications might necessitate women making alterations in their contraceptive therapy.

Psychological effects of diabetes may manifest themselves through problems of self-image, loss of self-esteem, feelings of unattractiveness, loneliness and isolation.

Fosbury suggests that women with diabetes who suffer from these problems should talk freely about them so that a holistic approach to treating the problem can be addressed. Some of the recommendations that Meeking and Fosbury suggest are:

Sexual Problem - Available Treatments

Reduced vaginal lubrication - Water-based vaginal lubricants

Loss of genital sensation - Penetrative vibrating tools

Pain during intercourse - Lubricants or treatment of underlying genito-urinary disease

Inability to orgasm - Vibrating tools or psychosexual techniques

Reduced libido - Treatment of any depressive illnesses; addressing self-image issues or correcting sexual problems