Table 4.
Multivariable Associations Between Diabetic End-Organ Complications and Sexual Activity and Functioning Among Participants with Diabetes
| Complication | Less Than Monthly Sexual | Low Sexual Desire* | Low Sexual Satisfaction† | Low Level of Sexual Arousal¶ | Difficulty with lubrication# | Difficulty with orgasm** | Pain/discomfort with intercourse†† | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
| Heart disease‡ | 2.42 (1.17–4.98) | .02 | 1.96 (0.99–3.87) | .05 | 1.19 (0.59–2.40) | .62 | 1.97 (0.63– 6.22) | .25 | 2.12 (0.77-5.86) | 0.15 | 0.97 (0.28-3.36) | 0.96 | 2.53 (0.73-8.78) | 0.14 |
| Stroke‡ | 2.72 (0.81–9.10) | .11 | 1.49 (0.55–4.06) | .43 | 3.32 (1.08–10.21) | .04 | 2.12 (0.47– 9.63) | .33 | 0.33 (0.03-3.34) | 0.35 | 0.81 (0.11-5.88) | 0.83 | NA | |
| Renal dysfunction§ | 2.06 (1.16–3.67) | .01 | 1.07 (0.62–1.84) | .80 | 0.90 (0.51–1.60) | .73 | 1.32 (0.52– 3.33) | 0.55 | 0.95 (0.41-2.21) | 0.91 | 0.75 (0.29-1.91) | 0.54 | 0.91 (0.30-2.77) | 0.87 |
| Peripheral neuropathy|| | 1.73 (1.08–2.78) | .02 | 1.57 (1.00–2.47) | .05 | 1.16 (0.72–1.97) | .55 | 1.31 (0.58– 2.99) | 0.52 | 1.31 (0.63-2.74) | 0.47 | 1.17 (0.53-2.56) | 0.7 | 0.76 (0.30-1.96) | 0.57 |
OR, odds ratio; CI, confidence interval.
Odds ratios and confidence intervals were derived from multivariable logistic regression models that evaluated each sexual function outcome separately, adjusting for age, race or ethnicity, relationship status, history of sex with men, women or both, parity, menopause status, hysterectomy, oophorectomy, body mass index, selective serotonin reuptake inhibitor and estrogen use, and duration of diabetes.
Less than monthly sexual activity, low sexual desire, and low sexual satisfaction were assessed in all diabetic participants regardless of sexual activity status, whereas low level of sexual arousal, difficulty with lubrication, difficulty with orgasm, and pain or discomfort with intercourse were assessed only in diabetic women reporting some sexual activity in the past 3 months.
Women were considered to have low sexual desire if they reported that their level of sexual desire or interest was low, very low, or none.
Women were considered to have low sexual satisfaction if they reported their overall level of sexual satisfaction was moderately dissatisfied or very dissatisfied.
Assessed by asking participants, “Has a doctor, nurse, or other health care provider ever told you that you have: 1) Heart attack (MI), angina, or other heart disease? 2) Stroke?”
Defined as a glomerular filtration rate lower than 90, estimated by the Cockcroft-Gault equation.
Defined as a Michigan Neuropathy Screening Instrument score of 2 or higher.
Women were considered to have low sexual arousal if they reported their level of sexual arousal during sexual activity was low, very low, or none.
Women were considered to have difficulty with lubrication if they reported it was difficult, very difficult, extremely difficult, or impossible to become lubricated during sexual activity.
Women were considered to have difficulty with orgasm if they reported that is was difficult, very difficult, extremely difficult, or impossible to reach orgasm during sexual stimulation or intercourse.
Women were considered to have pain or discomfort with intercourse if they reported their level of discomfort or pain during or following vaginal penetration was moderate, high, or very high.