Middle-aged and older patients with type 2 diabetes are often not sexually active, but they may still have sexual concerns, according to Danish researchers.
Assessments of sexual health may not provide enough information on sexually inactive patients, they added.
Type 2 diabetes can have a huge impact on one’s sexual health. Erectile dysfunction (ED) is common in diabetic men, who may develop the condition earlier than men without diabetes. For women, poor lubrication may lead to painful intercourse. Both men and women may experience diminished sex drive and trouble with arousal or orgasm.
However, not much is known about the sexual concerns on sexually inactive patients, as clinical assessments tend to focus on recently sexually active patients.
To learn more, the research team collected information from the Danish arm of the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION) study. The Danish participants, who were between the ages of 40 and 69, underwent a physical examination and filled out questionnaires, including the Female Sexual Function Index (FSFI-R) and the International Index of Erectile Function (IIEF-5).
Participants also responded to the following:
• Does your sexual life meet your sexual needs?
• How important is it for you to have a good sexual life?
• My sexual life gives me a lot of distress. (agree/disagree)
Men and women were considered sexually active if they had engaged in any sexually-arousing activity, including masturbation, in the previous 12 months.
Five hundred eighty-three men and 377 women provided information about sex during that time period. Of these, 17% of the men and 54% of the women were sexually inactive.
Among sexually inactive participants, over half of the men and over 40% of the women said their sexual needs were not fulfilled. Almost a third of the men and 11% of the women reported sexual distress.
Common sexual concerns among the sexually inactive participants included low interest, physical problems that made sex difficult or unpleasant, and lack of a partner.
The researchers also aimed to determine the prevalence of sexual dysfunction. However, because the assessment tools used addressed only activity during the prior four weeks, about half of the participants were excluded. Of the remaining participants, 54% of the men and 12% of the women had some degree of sexual dysfunction.
High exclusion rates made it “difficult to draw any conclusions regarding the prevalences,” the authors wrote.
The 4-week time frame would exclude patients who are sexually active, but less frequently. This is common as people get older, the researchers explained.
“Instruments for assessing [sexual dysfunction] should be modified to include people who are more rarely sexually active, especially in older populations,” they wrote, suggesting that a 12-month time frame “may give a more realistic picture.”
They recommended that healthcare providers address sexual health concerns in both sexually active and inactive patients with type 2 diabetes.
The study was first published online in October in Sexual Medicine.
Resources
Sexual Medicine
Bjerggaard, Mette, MD, et al.
“Prevalence of Sexual Concerns and Sexual Dysfunction among Sexually Active and Inactive Men and Women with Screen-Detected Type 2 Diabetes”
(Full-text. First published online: October 28, 2015)
http://onlinelibrary.wiley.com/doi/10.1002/sm2.91/full