Women’s sexual health is not solely a gynecologic or urologic concern. Common chronic conditions, including diabetes, can contribute to female sexual dysfunction (FSD), highlighting the need for a cross-specialty approach to its management.

A cross-sectional survey published in the Journal of Women’s Health found associations between common chronic diseases — including diabetes — and FSD, highlighting the need for routine sexual health assessments beyond traditional urogenital settings.

Hannah Ahrendt, MD, from the Case Western Reserve University School of Medicine and Urology Institute, University Hospitals Cleveland Medical Center, both in Cleveland, and colleagues wrote, “FSD is a term for sexual problems (ie, problems with desire, arousal, orgasm, or pain) so bothersome that they cause patients clinically significant distress.”

The authors emphasized that the presence of distress is crucial for the diagnosis of FSD, and in the absence of this symptom, treatment may be inappropriate. The authors noted, “A woman with decreased desire would not need treatment if she is not bothered by this decrease in desire.”

FSD remains common, yet often underdiagnosed and undertreated, with limited research. US researchers have explored the links between potential risk factors and FSD to provide useful information for clinical care.

Study Design and Measures

A study surveyed women in Ohio, Michigan, and Pennsylvania by screening for sexual dysfunction using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS).

The FSFI is a validated multidimensional tool that assesses six domains of FSF: desire, arousal, lubrication, orgasm, satisfaction, and pain.

The FSDS evaluates distress related to sexual dysfunction. Additionally, the Decreased Sexual Desire Screener was used to identify the factors contributing to reduced sexual desire.

Key Findings

Among 622 sexually active women who completed the FSFI and FSDS, 39% met the criteria for sexual dysfunction, 50% reported at least one sexual problem, 49% experienced significant distress, and 27% reported a decreased desire.

Chronic medical conditions (adjusted odds ratio [aOR], 2.50) and gynecologic disorders (aOR, 1.81) were associated with sexual dysfunction, sexual distress, and decreased desire in more than a quarter of the participants.

The most commonly reported contributors to low desire in the participants were stress and fatigue (63%); health problems (40%); other sexual disorders (36%); and medications, drugs, or alcohol (31%). Menopause and stressful life events were not significantly associated with sexual dysfunction.

The authors emphasized the need for further research in larger and more diverse populations to improve the understanding and management of FSD.

“These results suggest that statistically speaking, having one of many common, nongynecological medical problems increases the chance that patients are also experiencing FSD. Thus, clinicians in all specialties, not just those focused on the urogenital system, should be comfortable discussing FSD with patients on a regular basis,” the authors wrote.

This story was translated from Univadis Italy.