The natural history of sexual dysfunction in diabetic women. A 6-year follow-up study

The natural history of sexual dysfunction in diabetic women was evaluated in a 6-year prospective study. Fifty type I, insulin-treated diabetic women, aged 26-45 years, were assessed and re-evaluated 6 years later. Measures included psychological, physiological and social parameters. The frequency of sexual dysfunction was similar in 1977 and 1983. Diabetic women did not differ in sexual function from their healthy controls. None of the physiologic measures studied were predictive of sexual function. Six out of 14 women who were sexually dysfunctional in 1977 recovered normal function, some of them in spite of objective evidence of neuropathy. None of the women had been on psychotherapy for their sexual problem. The most important factor in the spontaneous remission rate seemed to be improvement in the overall marital and social situation. The women's acceptance of illness, as judged by the interviewer, and data from the questionnaires concerning psychological distress, were strong predictors of sexual function. Sexual dysfunction in diabetic women is thus an index of psychological adjustment to chronic illness. Family and marital counseling should be routinely offered as part of the medical care of the diabetic patient.