Sexual dysfunction, an invisible complication of diabetes – an exploratory study of the experiences of premenopausal women with Type 1 diabetes
DOI:
https://doi.org/10.57177/idn.v15.11Keywords:
Type 1 diabetes, sexual dysfunction, psychological health, qualitative researchAbstract
Background: Survey data suggest that women with Type 1 diabetes mellitus have a higher prevalence of sexual dysfunction (SD) compared with women with Type 2 diabetes or without diabetes. However, little is known about how women with Type 1 diabetes experience SD or its impact on their lives. This exploratory study sought to elicit women with Type 1 diabetes’s experiences of SD and identify their ideas on how SD could be better addressed in diabetes care.
Method: A qualitative study using semi-structured interviews was conducted at a diabetes centre in South West of England hospital. A purposeful sample of six women with Type 1 diabetes (<50 years of age) and experience of SD were interviewed. The interviews lasted 20–30 min and were analysed using Interpretive Phenomenological Analysis.
Findings: The study identified four superordinate themes: barriers to sex, impact of SD, personal support and ideas for improving support with SD. The majority of the themes were underpinned by diabetes specific factor such as hypoglycaemia, body image and diabetes management (technology and glucose regulation). This study found that women’s perspectives on their sexual identities and behaviours were mediated by emotional and interpersonal issues. This study also highlighted the lack of support provided by healthcare professionals (HCPs) in addressing SD.
Conclusion: The findings indicate that SD is a complex issue that needs to be given more attention by HCPs, so that the women can approach sex positively in their lives. HCPs need to be enabled to initiate conversations around SD in their consultations.
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References
Maiorino M, Bellastella G, Esposito K. Diabetes and sexual dysfunction, current perspectives. Diabetes Metab Syndr Obes 2014; 7: 95–105. doi: 10.2147/DMSO.S36455
Enzlin P, Mathieu C, Van den Bruel A, Bosteels J, Vanderschueren D, Demyttenaere K. Sexual dysfunction in women with type 1 diabetes: a controlled study. Diabetes Care 2002; 25: 672–7. doi: 10.2337/diacare.25.4.672
Stechova K, Mastikova L, Urbaniec K, Hylmarova S, Kvapil M, Pastos Z. Sexual dysfunction in women treated for type 1 diabetes and the impact of coexisting thyroid disease. J Int Soc Sex Med 2019; 7(2): 217–26. doi: 10.1016/j.esxm.2019.03.001
Basson R. Women’s sexual dysfunction; revised and expanded definition. CMAJ 2005; 172(10): 1327–33. doi: 10.1503/cmaj.1020174
Gupta L, Prakash S, Khandelwal D, Kalra B, Kalra S. Diabetes and female sexual dysfunction. Touch Endocrinol 2018; 14(1): 35–8. doi: 10.17925/USE.2018.14.1.35
Rahmanian E, Salari N, Mohammedi M, Jalali R. Evaluation of sexual dysfunction indicators in women with type 2 diabetes: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11: 73. doi: 10.1186/s13098-019-0469-z
Erten Z, Zincir H, Ozkan F, Selcuk A, Elmail F. Sexual lives of women with diabetes mellitus (type 2) and impact of culture and solution for problems related to sexual life. J Clin Nurs 2013; 23: 995–1004. doi: 10.1111/jocn.12273
Phillips A, Phillips S. Recognising female sexual dysfunction as an essential aspect of effective diabetes care. Appl Nurs Res 2015; 28(3): 235–8. doi: 10.1016/j.apnr.2015.04.007
Parnan A, Tafazolim M, Azmoude E. Comparison of sexual function among women with and without diabetes. J Midwifery Reprod Health 2017; 5(4): 1090–7.
Patton M. Qualitative research and evaluation methods. 3rd ed. UK: Sage; 2002.
Palinkas L, Horwitz S, Green C, Wisdome J, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in implementation and mixed method research. Adm Policy Ment Health 2015; 42(5): 533–44. doi: 10.1007/s10488-013-0528-y
Smith JA, Flowers P, Larkin M. Interpretive phenomenological analysis: theory method and research. London: Sage; 2012.
Higgins A, Lynch A, Nash M. Antidepressants-associated sexual dysfunction: impact, effects and treatment. Drug Healthc Patient Saf 2010; 2: 141–50. doi: 10.2147/DHPS.S7634
Santos A, Pascoal P, Barros L. Sexuality in emerging adults with type 1 diabetes mellitus: an exploratory study using thematic analysis. J Sex Marital Ther 2020; 46(3): 234–45. doi: 10.1080/0092623X.2019.1682730
Dimitropoulos K, Bargiota A, Mouzas O, Melekos M, Tzortzis V, Koukoulis G. Sexual functioning and distress among premenopausal women with uncomplicated type 1 diabetes. J Sex Med 2012; 9: 1374–81. doi: 10.1111/j.1743-6109.2012.02664.x
Polland A, Davis M, Zeymos A, Iglesia C. Association between comorbidities and female sexual dysfunction: findings from the 3rd national survey of sexual attitudes and lifestyle. Int Urogynaecol J 2019; 3(30): 377–83. doi: 10.1007/s00192-018-3739-7
Robertson C, Lin A, Smith G. The impact of externally worn diabetes technology on sexual behaviours and activity, body image and anxiety in type 1 diabetes. J Diabetes Sci Technol 2019; 14(2): 303–8. doi: 10.1177/1932296819870541
Tagiliabue M, Gottero C, Zufferaniere M, Negro M, Carletto S, Picci RL, et al. Sexual function in women with type 1 diabetes matched with a controlled group: depressive and psychosocial aspects. J Sex Med 2012; 8(6): 1694–700. doi: 10.1111/j.1743-6109.2011.02262.x
Salonia A, Lanzi R, Scavini M, Pontillo M, Gatti E, Petrella G, et al. Sexual function and endocrine profile in fertile women with type 1 diabetes. Diabetes Care 2006; 29(2): 312–16. doi: 10.2337/diacare.29.02.06.dc05-1067
Bak E, Marcisz C, Krzeminska S, Dobrzyn-Matuisiak D, Foltyn A, Drosdzol-Cop A. Does type of diabetes modify sexuality and mood of women and men? Int J Environ Res Public Health 2018; 15(5): 958. doi: 10.3390/ijerph15050958
Fritschi C, Quinn L. Fatigue in patients with diabetes: a review. J Psychosom Res 2010; 69(1): 33–41. doi: 10.1016/j.jpsychores.2010.01.021
Czajkowska KB, Lew-Starowicz Z, Szymańska M. The prevalence of sexual activity, and sexual dysfunction and behaviours in postmenopausal woman in Poland. Prz Menopauzalny 2016; 15(3): 156–64. doi: 10.5114/pm.63495
Ahmed MR, Shaaban MM, Sedik WF, Mohamed TY. Prevalence and differences between type 1 and type 2 diabetes mellitus regarding female sexual dysfunction: a cross-sectional Egyptian study. J Psychosom Obstet Gynaecol 2017; 39(3): 176–81. doi: 10.1080/0167482X.2017.1318123
Flotynska J, Uruska A, Michalska A, Araszkiewicz A. Sexual dysfunction I a more common problem in young women with type 1 diabetes than healthy women. J Sex Marital Ther 2019; 45(7): 643–51. doi: 10.1080/0092623X.2019.1610121
Yadav J, Genarrelli L, Ratakonda U. Female sexuality and common sexual dysfunction: evaluation and management in a primary care setting. Prim Care Update OB/GYNS 2001; 8(1): 5–11. doi: 10.1016/S1068-607X(00)00062-7
Gagan P, Bharti K, Emmy G, Inderpreet KD. Remarriage counselling in type 1 diabetes. Indian J Endocrinol Metab 2018; 22: 1.
Feldhaus-Dahir M. Female sexual dysfunction: barriers to treatment. Urol Nurs 2009; 29(2): 81–5.
Kingsberg S, Brook JS, Fought J, Pinkerton S, Parish S, Iglesia C, et al. Female sexual health. Barriers to optimal outcomes and a roadmap for improved patient-clinician communications. J Womens Health 2019; 28(4): 432–43. doi: 10.1089/jwh.2018.7352
Sarkadi A, Rosenqvist U. Contradictions in the medical encounter: female sexual dysfunction in primary care contacts. Fam Pract 2001; 18: 161–6. doi: 10.1093/fampra/18.2.161
Gott M, Hinchliff S. Barriers to seeking treatment for sexual problems in primary care: a qualitative study with older people. Fam Pract 2003; 6: 690–5. doi: 10.1093/fampra/cmg612
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