Studies have shown that 90% of diabetics are type 2 and less than 10% are diagnosed with type 1. The patients diagnosed with either type are under an increased threat of vascular and neurological complication and psychological issues. The women who suffer from this may have many complications. In most cases the risk of diabetes diagnoses especially type 2. An increased amount of cases of sexual dysfunction correlated with the diagnosis. The research had to account for the use of contraception, hormone replacement therapy, and pregnancy. Sexual dysfunction is a common problem, albeit a problem that has not been studied in women with type 2 diabetes in depth.
Diabetes type 2 diagnoses is the leading cause of sexual dysfunction. There will be an increased amount of women diagnosed with this considered a larger proportion of the population in increasingly growing older and becoming more and more physically inactive. Thus, the rate of sexual dysfunction in women will also increase. It was not until this study that the direct correlation could be substantiated. The effect of sexual dysfunction was correlated to neurological, psychological and vascular affects and a combination of such. However, despite the common knowledge that there is an association in their measurements of such is hard to create. It is difficult to measure sexual function in women. In many cases the spouses sexual performance, quality of sexual intercourse, patients educational culture, and socioeconomic status was also a large part of the problem. They also have a decreased sexual desire, decreased stimulus, reduced lubrication and orgasm disorder. Thus, diabetes females are more at risk than others. In this study several surveyors were sued to evaluate sexual function disorders.
Sex is defined by the study as an ability to experience masculine or feminine emotions, physical stimulation and/or mental feelings. It is also a perception that is expressed by the sexual organs of another. The sexuality of a human being is determined by social norms, values and taboos. This is also determined by psychological and social norms and aspects. The nature of the disease was also defined in the study. It had to be, in order to evaluate the nature of sexual dysfunction with patients who are diabetic. Responses to sexual stimulation in the subjects was divided into four phases. These included the arousal, plateau, orgasm and resolution phase. These phases were identified as the most detrimental and prevalent issues that affected women during sexual satisfaction.
In the first phase, the libido is accessed. This is the appearance of erotic feelings and thoughts. Real female sexual desires begins with the first phase. Also at this point sexual thoughts or feelings or past experiences help to create either a natural or unnatural arousal stage in patients. There second phase identified by searchers here was the arousal phase. In this phase the parasympathetic nervous system is involved. With that, the phase is then characterized by erotic feelings and the formation of a natural vaginal lubrication. The first sexual response begins with vaginal lubrication which follows within 10-30 seconds and then follows from there. What follows is typically a rapid breathing session or rather tachycardia that causes women to have an increased blood pressure and a general feeling of warmth, breast tenderness, coupled with erected nipples and a coloration of the skin. Most women experience this arousal phase.The third phase is defined as the orgasm phase or rather the time with increased muscular and vascular tension by sexual stimulation occurs. This is the most imperious of the cycles and is albeit the most satisfying for women. During this period women experience orgasmic responses from the sympathetic nervous system. Changes also occur in the entire genital region these include a change in heart rate, and blood pressure. The final phase of normal sexual stimulation is the resolution phase. During this period women have genital changes. Basically the withdrawal of blood from the genital region and the discharge of sexual tension as occurs after the orgasm will bring the entire body to a period of rest.
The basis of sexual responses cycle depends on normally functioning of the endocrine, vascular, neurological and psychological factors. Considering the brain is the center for sexual stimulation, sexual behaviors are directly correlated to the sense of being aroused. The study has defined sexual stimulation and peripheral stimulation. Central stimulation is defined as the act of being aroused and sexual desire is phenomena mainly mediated by the mesolimbic dopaminergic pathway. Dopamine is the most important known neurotransmitter system responsible for the arousal. The process breaks down to the fact that testosterone is responsible for both female and male desire and it increases blood flow either directly and indirectly through estrogen.
Sexual dysfunction has been classified and defined by the inability to experience anticipated sexual intercourse. This is a psychosocial change that complicates interpersonal relationships and creates significant problems. Orgasm disorder usually occurs with a recurrent delay or difficulty in achieving an orgasm after sexual stimulation.
Several sexual disorders have been affected by diabetes, many others are blanketed under the sexual dysfunction term. Sexual Aversion Disorder is the avoidance of all genital contact with ones partners. The difference between the phobia and the feelings of disgust and hatred are part of the phobia. Sexual Arousal Disorder is the inability to establish adequate lubrication stimuli in a persistent manner. Orgasmic disorder is defined as a persistent or recurrent delay in or lack of normal phases. Orgasm is the sudden temporary peek feeling.
According to the data from the U.S National Healthy and Social life survey women who are at risk for SD. In the study it was found that women with healthy problems have an increased risk for pain during intercourse. Also women with urinary tract problems or symptoms are at risk for problems during intercourse. The socio-economic status of women is another risk factor as well as women who have been the victim of harassment. Menopause has a negative impact on sexual function in women.
Sexual dysfunction was not limited to affective disorders, in fact socio-cultural and social demographic causes effected demographic and sociological characters were investigated. In the studies conducted sociodemographic characteristics like age, education level and income levels. Also the use of an effective method of family planning was related to the BMI and marriage were also factors in this decisions. The use of alcohol and drugs was also linked to a woman’s sexual response and leads to SD. The most prevalent use came from antidepressants received for the treatment of depression were reported with the use of the prescription drugs. The affects included a lack of lubrication, vaginal anesthesia, and delay in or lack of orgasm. Other drugs that have were found to affect female SD included anthypertensives, lipid-lowering agents and chemotheraputic agents. The study also took into account that chronic diseases like systemic diabetes and hypertension causes psychiatric disorders, including depression, anxiety disorders, and psychoses are attributed to chronic disease states.
Diabetes is a common chronic disease with more than 90% of diabetics having been diagnosed with type 2 diabetes. Diabetic patients have been found to have an elevated risk of vascular and neurological complications and psychological problem.Thus, because of this it has been found that diabetics are prone to having female sexual dysfunction. Thus, the subject of female diabetic SD was largely unrecognized until 1971. Even at that time in an article the study was the first to evaluate limited cases of sexual dysfunction in women. Studies with females who have been diagnosed with SD. Diabetic females with sexual problem are explained with biological, social and psychological factors.
Hyperglycemia had been found in many diabetic women who have been diagnosed with SD. It reduces the hydration of the mucus membranes of the vagina. It in turn reduces the lubrication levels, leading to painful sexual intercourse. The risk of vaginal infections increases because of that and so too does vaginal discomfort and painful intercourse. It is clinically hard to measure sexual function in women. In many cases medical history, physical examination, pelvic examination and hormonal profile were reviewed. The subjects were questioned in detail regarding spouse’s sexual performance, quality of the sexual intercourse, the patients educational level and socioeconomic status. The several questionnaires which were used to evaluate sexual function disorders were a substantial methodology. Sexual inventories were then classified in two groups. The information obtained through a structured incentive allowing the discloser of terms. There was fact to face interview and also many sexual inventories which were based on the human sexual cycle.
There were 400 female patients that applied to the hospital or diabetes center. The test was conducted between June 2009 and June 2013. There were first non-voluntaries or those who met the exclusion criteria and type 1 diabetics were excluded from the study. This study also included 329 married women, there were 213 diabetic and 116 non-datebooks. All of the women in this study were sexually active and had a spouse. Also the survey questions were asked questions in a face to face attack. The subjects were given questionnaires and the volunteers who were inactive or had an illness were excluded from the study.
It was also important in the study to take into account demographics. These included the age of the participants, their weight, and their height. Their weight circumference, BMI and education level were also part of this study. With diabetic patients the plasma glucose level was also reviewed. In this study the reliability of the female sexual function index and the test-retest reliability was a.82 and a.79. The version of the validity and reliability of the scale was performed.
Another form of measurement was the Arizona Sexual Experiences Scale, again another form of questions used to measures the experiences that women have and how they were able to deal with them. Patients that were treated with psychotropic drugs were the main focus of this experiment. This is a set of five questions created to show a minimal disturbance with patients. The scale aimed to assess sexual functions by excluding sexual orientation and relationships with a partner. The format that was used for most women in this study included several questions regarding sexual drive and arousal.
Still other tests were utilized. These included the Golombuk-Rust Inventory of Sexual Satisfaction (GRISS). The utilization of this test was yet another set of questions that were given to males and females (28 males, 28 females) and were aimed at objectively evaluating the heterosexual relationship of the individuals and to identify the level of dysfunction of the subject. The results again found that women with diabetes are more prone to suffering from dysfunctional disorders.
Of course researchers looked into the subjects BMI and found that 23 of only 7% of the patients were in the normal range of the BMI which at the time was 18.5-24.9 kg. The mean BMI was also only 33.11 in patients with diabetes. The majority of patients that had higher BMI issues were smokers. So not only was it diabetes that attributed to SD but smoking and drug use caused additional complications. Also, 193 were premenopausal and 136 were postmenopausal. The average number of patients who were diagnosed were also on oral antibiotic medications in combination with insulin and in some cases antilipedemic medications. Many patients were not using medications at all which may result in the reference that they were suffering from the disease because they were unable to move through their diabetes diagnoses.
The study conducted found that there was no correlation between the age of a patient a their FSFI. Plus, there did not seem to be a correlation between the BMI and FSFI and the sub structures like desire, arousal, lubrication, orgasm, sexual success, and pain with diabetic women. Some of the volunteers had children, one to three children in fact. There again was no direct correlation with diabetic women with children or without. However there was a correlation with women who had a more children and their ability to reach an orgasm. Perhaps due to the multiple births and the destruction that it could have caused neurologically.
Specifically when addressing diabetes, researchers wanted to understand the extent of the SD disturbance. The attributes of a imbalanced hormonal system, vascular constrictions and increased sexual problems cause the physiological and psychological responses that were found. The differences in the mechanisms of the neurotransmitters during sexual responses in women with diabetes and without diabetes was the leading contributor to a decreased sexual appetite.
Women have many dimensions that lead to their diagnoses. Sexual function is affected therefore when a woman is diagnosed with diabetes. The research also found that female lubrication occurred only during the arousal phase. But the dysfunction was largely affective, meaning that women were unable to become lubricated during the arousal phase. Women who were insulin dependent had little or no evidence of dysfunction while non-insulin dependent patient status had a negative effect on sexual disorders. This included the ability to orgasm, lubrication during arousal, sexual satisfaction, and sexual activity. This suggests a more comprehensive explanation that SD might be related to the age at which the diabetes develops.