Advertisement

Diabetes and Sexual Disorders

  • Maria Ida Maiorino
  • Giuseppe Bellastella
  • Katherine Esposito
Reference work entry
Part of the Endocrinology book series (ENDOCR)

Abstract

Sexual dysfunctions are common in diabetes mellitus, both in males than in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction is less conclusive, as female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. The main mechanisms by which diabetes may lead to sexual dysfunctions include vasculopathy, neuropathy, endothelial dysfunction, visceral adiposity, endocrinological disorders, and psychological issues. An adequate comprehensive sexual and medical history investigation is of paramount importance for the evaluation of sexual dysfunctions in diabetes. Moreover, standardized questionnaires are frequently used to confirm the diagnosis and to measure its severity. Two of the most practical and easily administered ones are the International Index of Erectile Function (IIEF) and its short version, the IIEF-5, and the Female Sexual Function Index (FSFI) and its short version, the FSFI-6. Therapeutic possibilities for sexual dysfunctions in diabetes refer to lifestyle changes, optimal diabetic control, psychotherapy, and selected medications when appropriated.

Keywords

Diabetes mellitus Erectile dysfunction Hypogonadism IIEF-5 Female sexual dysfunction FSFI Diabetic complications 

References

  1. Corona G, Jannini EA, Maggi M. Inventories for male and female sexual dysfunctions. Int J Impot Res. 2006;18:236–50.CrossRefGoogle Scholar
  2. Dandona P, Dhindsa S. Update: hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab. 2011;96:2643–51.CrossRefGoogle Scholar
  3. Esposito K, Giugliano D. Obesity, the metabolic syndrome, and sexual dysfunction in men. Clin Pharmacol Ther. 2011;90:169–73.CrossRefGoogle Scholar
  4. Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291:2978–84.CrossRefGoogle Scholar
  5. Esposito K, Ciotola M, Giugliano F, et al. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int J Impot Res. 2007;19:486–91.CrossRefGoogle Scholar
  6. Esposito K, Maiorino MI, Bellastella G, Giugliano F, Romano M, Giugliano D. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res. 2010;22:179–84.CrossRefGoogle Scholar
  7. Giugliano F, Maiorino M, Bellastella G, Gicchino M, Giugliano D, Esposito K. Determinants of erectile dysfunction in type 2 diabetes. Int J Impot Res. 2010;22:204–9.CrossRefGoogle Scholar
  8. Hatzimouratidis K, Salonia A, Adaikan G, et al. Pharmacotherapy for erectile dysfunction: recommendations from the fourth international consultation for sexual medicine (ICSM 2015). J Sex Med. 2016;13:465–88.CrossRefGoogle Scholar
  9. Isidori AM, Pozza C, Esposito K, et al. Development and validation of a 6-item version of the female sexual function index (FSFI) as a diagnostic tool for female sexual dysfunction. J Sex Med. 2010;7:1139–46.CrossRefGoogle Scholar
  10. Katz M, DeRogatis LR, Ackerman R, Hedges P, Lesko L, Garcia M Jr, Sand M, BEGONIA trial investigators. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial. J Sex Med. 2013;10:1807–15.CrossRefGoogle Scholar
  11. Lindau ST, Tang H, Gomero A, Vable A, Huang ES, Drum ML, Qato DM, Chin MH. Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes: a national, population-based study. Diabetes Care. 2010;33(10):2202–10.CrossRefGoogle Scholar
  12. Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes. 2014;7:95–105.PubMedPubMedCentralGoogle Scholar
  13. Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl. 2015;17:5–10.CrossRefGoogle Scholar
  14. Maiorino MI, Chiodini P, Bellastella G, Giugliano D, Esposito K. Sexual dysfunction in women with cancer: a systematic review with meta-analysis of studies using the female sexual function index. Endocrine. 2016;54:329–41.CrossRefGoogle Scholar
  15. McCabe MP, Sharlip ID, Atalla E, et al. Definitions of sexual dysfunctions in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med. 2016;13:135–43.CrossRefGoogle Scholar
  16. Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012;87:766–78.CrossRefGoogle Scholar
  17. Shamloul R, Ghanem H. Erectile dysfunction. Lancet. 2013;381(9861):153–65.CrossRefGoogle Scholar
  18. Vardi M, Nini A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007:CD002187.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maria Ida Maiorino
    • 1
  • Giuseppe Bellastella
    • 1
  • Katherine Esposito
    • 1
  1. 1.Department of Medical, Surgical, Neurological, Metabolic Sciences and AgingUniversity of Campania “Luigi Vanvitelli”NaplesItaly

Personalised recommendations