While diabetic men have long been known to be extra prone to sexual problems, particularly impotence, less is known about the intimate lives of women with the disease.

"It's an area that is very understudied, particularly in older women," said Dr. Alison Huang of the University of California, San Francisco, who led the new work.

Based on a survey of nearly 2,300 California women aged 40 to 80 years, Huang and her colleagues found that more than a third of those on insulin treatment said they were "moderately" or "very" sexually dissatisfied.

About a quarter of diabetic women who weren't on insulin reported similar levels of dissatisfaction, whereas less than one in five women without the disease did so. The gap remained after the researchers accounted for a variety of factors, including age, race, relationship status, overweight and estrogen treatment.

"It's not that diabetic women are not interested in sexual activity," said Huang, whose findings are published in the journal Obstetrics & Gynecology.

"The diabetic women in the study had more sexual problems, but they were just as interested in sexual activities and had a similar level of sexual activity as women without diabetes," she told Reuters Health.

About six percent of the women in the study were treated for diabetes with insulin, whereas 15 percent had the disease but did not get insulin. The rest did not have diabetes.

Among women who were sexually active, those who took insulin complained more often of problems with lubrication and orgasm than did non-diabetic women.

And women with diabetes complications such as heart and kidney disease were less likely than others to have sex at least once a month.

"I think these results do suggest that if you are a diabetic woman, preventing complications may help prevent development of sexual problems," said Huang. She said following a diabetic diet and getting regular exercise will lower the risk of complications.

There could be many reasons why diabetic women would have more sexual problems. While the issues in diabetic men are often believed to be tied to cholesterol buildup in the arteries that supply blood to the penis, Huang said, blood flow problems are less likely to be at work in women.

Instead, according to Huang, who specializes in women's urogenital problems, the overall burden of living with a chronic disease might be taking a toll on women's sex lives as might nerve damage caused by elevated blood sugar levels.

Huang added that her team did find one perplexing result, in that women with elevated blood sugar levels were less likely to report low sexual satisfaction.

It could be a chance result, or it could be that women with higher blood sugar are more impulsive, less concerned about their blood sugar and more interested in sex, Huang speculated.

Whatever the reason, she said, "I don't think it's likely that very poorly controlled blood sugar leads to better sexual function in women."

More than a quarter of Americans over 65 have diabetes.

SOURCE: bit.ly/QyV0PL Obstetrics & Gynecology, August 2012.

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