Many older adults with diabetes are sexually active but have problems


Many older adults with diabetes are sexually active but have problems

New research from the University of Chicago found that many middle-aged and older Americans with diabetes are sexually active but more likely to experience sexual problems compared with counterparts without diabetes.

Lead author Stacy Lindau, associate professor of obstetrics and gynecology and of medicine at the University of Chicago, and colleagues, wrote about their findings in a paper published 27 August in an online advanced issue of Diabetes Care.

Lindau told the media that:

"Patients and doctors need to know that most middle age and older adults with partners are still sexually active despite their diabetes."

"However, many people with diabetes have sexual problems that are not being addressed," she added.

Senior author Dr Marshall Chin, a professor of medicine at the University of Chicago, said:

"Failure to recognize and address sexual issues among middle-age and older adults with diabetes may impair quality of life and adaptation to the disease."

For their study, Lindau and colleagues examined data from a survey of nearly 2,000 people aged 57 to 85 years, that was performed between July 2005 and March 2006 as part of the National Social Life, Health and Aging Project.

1,993 participants were interviewed at home, completed questionnaires, underwent assessment of medication and gave blood samples so researchers could assess their diabetes status..

From the survey and blood samples, using a diabetes test that measures glycosolated hemoglobin (HbA1c), the researchers were able to categorize the participants according to diabetes status: those with diagnosed diabetes, those with undiagnosed diabetes and those with no sign of diabetes.

The results showed that 47 per cent of the men had diabetes, with about 25 per cent aware and 22 per cent not aware that they had the disease (ie undiagnosed). For the women, the blood test showed that nearly 40 per cent had diabetes, with 20.5 per cent aware of it and 19 per cent unaware of it.

The authors noted that these figures were in line with previous studies of people over 60 and estimates that suggest around 12 million Americans over the age of 60 are living with diabetes (many of whom are unaware of it).

When the researchers examined the sexual activity data, they found that nearly 70 per cent of partnered men with diabetes and 62 per cent of partnered women with diabetes were sexually active: they engaged in sexual activity two or three times a month, which is about the same as older people who do not have diabetes.

" Partnered sexual behaviors did not differ by gender or diabetes status," wrote the authors, but they found that the disease did exact a toll on both the desire and rewards of sexual activity.

While the proportion of men with diagnosed and undiagnosed diabetes who reported experiencing orgasm problems was about the same as the proportion of men without diabetes, erectile difficulty and lack of interest in sex was more common among the men with diagnosed diabetes.

Also, women with undiagnosed diabetes were less likely to talk about sex with their doctor (only 11 per cent said they did), compared to women with diagnosed diabetes (19 per cent), men with undiagnosed diabetes (28 per cent), and men with diagnosed diabetes (47 per cent).

Lindau said that nearly half of women in this age group don't have a partner, and that "women with diabetes are far less likely than women without diabetes to have a partner".

"Those who have partners were more likely than men to avoid sex because of a problem, and were far less likely than men to discuss a sexual problem with their doctors," she explained.

Before this study, not much was known about sexual behavior and problems among people with undiagnosed diabetes.

Lindau explained that perhaps not knowing they have diabetes protects people not yet diagnosed with the disease (probably because it is still in the early stages) from the psychological burden of the stigma that often follows the diagnosis.

"The elevated prevalence of orgasm difficulties in people unaware of their diabetes suggests that these are predominantly physical," she said, adding that:

"The erectile dysfunction and loss of interest among men with a diagnosis may be due in part to the psychological burden of diabetes."

The researchers suggest that diabetes may reduce sexual drive, given that just over 60 per cent of the men without diabetes reported having masturbated in the prior 12 months compared to only 47 per cent of men with both diagnosed and undiagnosed diabetes.

A similar pattern was observed among the women: although fewer overall reported having masturbated in the previous 12 months (22.5 per cent), the proportion of women without diabetes who reported doing so was 29 per cent compared with only 15 per cent of women with diagnosed and undiagnosed diabetes.

Also, as with the men, the women with diagnosed and undiagnosed diabetes reported a higher rate of orgasm difficulties.

Chin said:

"Sexual problems are common in patients with diabetes, and many patients are not discussing these issues with their physicians."

The study was supported by funds from the National Institutes of Health's National Social Life, Health and Aging Project.

"Sexuality Among Middle Age and Older Adults with Diagnosed and Undiagnosed Diabetes: A National, Population-Based Study."

Stacy Tessler Lindau, Hui Tang, Ada Gomero, Anusha Vable, Elbert S. Huang, Melinda L. Drum, Dima M. Qato, and Marshall H. Chin.

Diabetes Care, published ahead of print 27 August 2010.

DOI:10.2337/dc10-0524

Additional source: University of Chicago Medical Center.

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Section Issues On Medicine: Disease