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Diabetic women and sexual dysfunction

June 4th, 2006

Dr Petra

Recent research published in the journal Fertility and Sterility suggests Viagra could improve the sex lives of diabetic women. Women with diabetes often experience problems with arousal, desire, and orgasm due to vaginal dryness and discomfort. It isn’t clear whether this is purely an effect of diabetes, or whether it is more an effect of women living with a life changing illness.

The study selected 32 women with type 1 diabetes who reported a good sex life in the past but who currently had sexual difficulties. Participants were either given Viagra or a placebo drug for 8 weeks, then the treatments were swapped for a further 8 weeks. Women were instructed to take the medication (placebo or Viagra) one hour before intercourse.

Those who were taking Viagra as opposed to placebo reported more arousal, orgasm and enjoyment. However no effect was found on desire or frequency of having sex.

This is a tiny study of only 32 women that isn’t representative of diabetic women generally. Whilst it does show that orgasm or arousal may have improved, it’s interesting that taking the drug didn’t lead women to have any more sex and nor did it influence desire – so women didn’t want more sex either.

If you look at the press coverage this study has received, you’d have thought the opposite though since headlines are implying the drug “boosts” women’s sex lives or comes to their “rescue”. In fact neither of these things happened.

The study appears to have missed some crucial aspects required for any research on sexual functioning. It is not enough to report a lack of sexual activity or problems that could be labelled a ‘dysfunction’, for a woman to truly require any medication she also needs to be distressed by her condition. Frequently when women are studied about sexual behaviour they report not having sex much but this does not distress them. The research in Fertility and Sterility didn’t mention whether participants were distressed by their condition or not.

It’s also slightly concerning that participants were asked to take their medication (or placebo) one hour before intercourse. Aside from this making it a very artificial environment to be having sex, it also will affect participant behaviour since they know they’re having sex to report back on in a study and have to record everything about each encounter. Hardly an aphrodisiac. More importantly the focus on this research was about intercourse and women reporting satisfaction from that. Why not focus on other aspects of sex women also enjoy – oral sex, masturbation or other sexual activities we sometimes erroneously call ‘foreplay’? Those are activities more likely to result in orgasm yet this research reinforced the idea of orgasm through intercourse being the pinnacle of female pleasure. It is that stereotype that leads so many women to have sexual problems in the first place.

Whilst women who find it difficult to orgasm could see opportunities from this research, it’s worth coming back to the key finding that it neither increased frequency of sex or desire. For most women problems are around a lack of desire – either because stress or physical or psychological factors make it difficult for them to become aroused, or because problems in their relationship or their understanding of sex make it hard to become excited. For many diabetic women solutions need to be found to reduce pain and discomfort – lubricants can do a wonderful job here. Other more practical solutions around physical and psychological well-being and improving their relationship would also be necessary. Something that medication can’t fix.

We need to be careful with studies like this since when they’re misrepresented in the media it can be misleading to those affected by medical conditions. If you have diabetes and have questions about your sex life you can speak to your GP (doctor) about it, or the practice nurse at your surgery. Often people with diabetes aren’t told about the effects of the disease on their sex lives or feel they shouldn’t discuss this issue. There are a number of help groups at the end of this blog who can offer you advice, as well as your diabetes clinic.

Whilst the study does offer an interesting opportunity for further study, and does importantly put diabetic women’s needs on the public agenda, it isn’t accurate to claim these women’s sex lives were ‘saved’. We need to do a whole lot more work before we can say that with any authority.

If you are a woman affected by sexual problems you can get support and advice at:
Sexual Dysfunction Association includes information about different sexual problems affecting women.
Patient.co.uk links to advice sheets and support groups on various health issues.
Women’s Health (includes useful advice about pain, vaginal dryness, thrush etc).
V-group enables women with disabilities discuss their sex lives.
Diabetes UK has a guide especially for women.

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