Disfunção sexual feminina na diabetes mellitus tipo 2
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2017
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A Diabetes Mellitus (DM) é uma doença metabólica crónica de elevada prevalência,
afetando 422 milhões de indivíduos em todo o mundo. Em Portugal, a prevalência estimada é
de 13,6%, sendo a Diabetes Mellitus tipo 2 (DM2) responsável por 90% dos casos.
Nas mulheres com DM, a prevalência da disfunção sexual feminina (DSF) varia
entre 25-71% mas a génese da doença é ainda mal compreendida. Apesar dos trabalhos
existentes sugerirem que as repercussões da doença na saúde sexual diferem consoante o tipo
de DM, os estudos que avaliam o funcionamento e a satisfação sexual feminina na DM2 são
em pequena quantidade, apresentam metodologias díspares e resultados contraditórios.
Este trabalho visa determinar a prevalência de DSF nas utentes com DM2 de um
centro de saúde da região de Lisboa, avaliar o impacto da DM2 nos vários domínios da
sexualidade e analisar a influência de características biopsicossociais no funcionamento e
satisfação sexual.
Trata-se de um estudo transversal realizado num único centro clínico. Amostra de
conveniência, constituída por 285 mulheres com idades entre os 45 e os 70 anos, 112 com o
diagnóstico de DM2 e 173 sem DM.
Utilizou-se os seguintes instrumentos de auto-preenchimento: questionário clínico,
Índice de Funcionamento Sexual Feminino (IFSF), Nova Escala de Satisfação Sexual (NSSS)
e Inventário de Sintomas Psicopatológicos (BSI).
A taxa de resposta foi de 42,7%. A prevalência de DSF na amostra foi de 55,7%,
sendo de 70,9% nas mulheres com DM2 e de 46,5% nas mulheres sem DM.
Os preditores do funcionamento sexual na amostra estudada foram a idade, a autopercepção
do estado de saúde, a presença de perturbação emocional e a terapêutica com
psicofármacos e antidiabéticos orais. Os preditores da satisfação sexual foram o IFSF, a autopercepção
do estado de saúde e a presença de dislipidemia.
A DM2 associou-se a pontuações significativamente mais baixas no IFSF, nos
domínios do desejo, excitação, orgasmo, lubrificação, satisfação e dor e também na NSSS.
Nas mulheres com DM2 verificou-se uma relação significativa negativa da idade
com o domínio do desejo e excitação. A duração da doença, o nível de controlo metabólico e
a presença de complicações da doença não teve impacto na função sexual.
Persiste a necessidade de realizar investigação orientada para a multiplicidade de
factores implicados na DSF na DM2.
Diabetes Mellitus (DM) is a chronic metabolic disease with high prevalence, affecting 422 million individuals worldwide. In Portugal, the estimated prevalence is 13.6%, with type 2 DM (DM2) accounting for 90% of the cases. The prevalence of female sexual dysfunction (FSD) in women with DM varies between 25-71%, but the genesis of the disease is still poorly understood. Although the existing studies suggest that the repercussions of the disease on sexual health differ according to the type of DM, the studies assessing female sexual function and satisfaction in DM2 are few and present different methodologies and contradictory results. This study aims to determine the prevalence of FSD in patients with DM2 from a clinical center in the Lisbon region, to evaluate the impact of DM2 in various domains of sexuality and to assess the influence of biopsychosocial characteristics on female sexual function and satisfaction. This is a cross-sectional study conducted at a single clinical center. Convenience sample consisting of 285 women between the ages of 45 and 70, of which 112 have DM2 and 173 do not have DM. The following self-completion instruments where used: clinical questionnaire, Female Sexual Function Index (FSFI), New Sexual Satisfaction Scale (NSSS) and Brief Symptom Inventory (BSI). The response rate was 42.7%. The prevalence of FSD in the sample was 55.7%, being 70.9% in women with DM2 and 46.5% in women without DM. The sexual function predictors in the studied sample were age, self-perception of health status, presence of emotional disturbance, and treatment with psychotropic and oral antidiabetic drugs. The sexual satisfaction predictors were FSFI, self-perception of health status and presence of dyslipidemia. DM2 was associated with significantly lower scores on FSFI in the domains of desire, arousal, orgasm, lubrication, satisfaction and pain, and also on NSSS. In women with DM2 there was a significant negative relationship between age and the domains of desire and arousal. Duration of the disease, level of metabolic control and presence of disease complications had no impact on sexual function. There remains a need for further research oriented to the multiplicity of factors implicated in FSD in DM2.
Diabetes Mellitus (DM) is a chronic metabolic disease with high prevalence, affecting 422 million individuals worldwide. In Portugal, the estimated prevalence is 13.6%, with type 2 DM (DM2) accounting for 90% of the cases. The prevalence of female sexual dysfunction (FSD) in women with DM varies between 25-71%, but the genesis of the disease is still poorly understood. Although the existing studies suggest that the repercussions of the disease on sexual health differ according to the type of DM, the studies assessing female sexual function and satisfaction in DM2 are few and present different methodologies and contradictory results. This study aims to determine the prevalence of FSD in patients with DM2 from a clinical center in the Lisbon region, to evaluate the impact of DM2 in various domains of sexuality and to assess the influence of biopsychosocial characteristics on female sexual function and satisfaction. This is a cross-sectional study conducted at a single clinical center. Convenience sample consisting of 285 women between the ages of 45 and 70, of which 112 have DM2 and 173 do not have DM. The following self-completion instruments where used: clinical questionnaire, Female Sexual Function Index (FSFI), New Sexual Satisfaction Scale (NSSS) and Brief Symptom Inventory (BSI). The response rate was 42.7%. The prevalence of FSD in the sample was 55.7%, being 70.9% in women with DM2 and 46.5% in women without DM. The sexual function predictors in the studied sample were age, self-perception of health status, presence of emotional disturbance, and treatment with psychotropic and oral antidiabetic drugs. The sexual satisfaction predictors were FSFI, self-perception of health status and presence of dyslipidemia. DM2 was associated with significantly lower scores on FSFI in the domains of desire, arousal, orgasm, lubrication, satisfaction and pain, and also on NSSS. In women with DM2 there was a significant negative relationship between age and the domains of desire and arousal. Duration of the disease, level of metabolic control and presence of disease complications had no impact on sexual function. There remains a need for further research oriented to the multiplicity of factors implicated in FSD in DM2.
Descrição
Orientação: Jorge Manuel dos Santos Cardoso
Palavras-chave
MESTRADO EM TRANSDISCIPLINAR DE SEXOLOGIA, SEXOLOGIA, DISFUNÇÕES SEXUAIS, SEXUALIDADE FEMININA, DIABETES, SATISFAÇÃO SEXUAL, SEXOLOGY, SEXUAL DYSFUNCTIONS, FEMALE SEXUALITY, DIABETES, SEXUAL SATISFACTION