Exp Clin Endocrinol Diabetes 2017; 125(01): 42-48
DOI: 10.1055/s-0042-116594
Article
© Georg Thieme Verlag KG Stuttgart · New York

Sexual Functioning and Depressive Symptoms in Women with Diabetes and Prediabetes Receiving Metformin Therapy: A Pilot Study

Robert Krysiak
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland, Medyków, Katowice, Poland
,
Agnieszka Drosdzol-Cop
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland, Medyków, Katowice, Poland
,
Violetta Skrzypulec-Plinta
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland, Medyków, Katowice, Poland
,
Bogusław Okopień
1   Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland, Medyków, Katowice, Poland
› Author Affiliations
Further Information

Publication History

received 19 July 2016
first decision 02 September 2016

accepted 05 September 2016

Publication Date:
06 October 2016 (online)

Abstract

Aim: Metformin is a drug of choice for the management of type 2 diabetes mellitus. Very little is known about its effect on human sexual function.

Methods: The study included 3 age- and weight-matched groups of premenopausal women: individuals with type 2 diabetes, women with prediabetes and healthy controls. All women with diabetes and 50% of those with prediabetes were then treated with metformin and complied with lifestyle modification. The remaining individuals, not receiving pharmacotherapy, only complied with dietary recommendations. Apart from measuring plasma glucose and assessing insulin sensitivity, all enrolled women completed questionnaires evaluating sexual function (Female Sexual Function Index - FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition – BDI-II) initially and after 6 months.

Results: Women with diabetes had a lower total FSFI score, as well as lower scores for all domains: sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction and dyspareunia, and these scores correlated with a degree of insulin resistance. Women with prediabetes had lower scores for sexual desire and sexual satisfaction. Moreover, women with diabetes and prediabetes were characterized by a higher total BDI-II score. Metformin treatment not only normalized sexual desire and sexual satisfaction in both studied groups, but also normalized or improved the remaining domains of FSFI in patients with diabetes, and these effects correlated with an improvement in insulin resistance.

Conclusions: Metformin treatment provides a beneficial effect on female sexual function and the strength of this effect depends on the degree of insulin resistance.

 
  • References

  • 1 American Diabetes Association . Approaches to glycemic treatment. Diabetes Care 2016; 39 (Suppl. 01) S52-S59
  • 2 Genuth S. The UKPDS and its global impact. Diabet Med 2008; 25 (Suppl. 02) 57-62
  • 3 Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403
  • 4 Scarpello JH, Howlett HC. Metformin therapy and clinical uses. Diab Vasc Dis Res 2008; 5: 157-167
  • 5 Mahmood K, Naeem M, Rahimnajjad NA. Metformin: the hidden chronicles of a magic drug. Eur J Intern Med 2013; 24: 20-26
  • 6 Hahn S, Benson S, Elsenbruch S et al. Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality. Hum Reprod 2006; 21: 1925-1934
  • 7 Rey-Valzacchi GJ, Costanzo PR, Finger LA et al. Addition of metformin to sildenafil treatment for erectile dysfunction in eugonadal nondiabetic men with insulin resistance. A prospective, randomized, double-blind pilot study. J Androl 2012; 33: 608-614
  • 8 Krysiak R, Okrzesik J, Okopień B. The effect of short-term metformin treatment on plasma prolactin levels in bromocriptine-treated patients with hyperprolactinaemia and impaired glucose tolerance: a pilot study. Endocrine 2015; 49: 242-249
  • 9 Krysiak R, Kowalcze K, Szkrobka W et al. The effect of metformin on prolactin levels in patients with drug-induced hyperprolactinemia. Eur J Intern Med 2016; 30: 94-98
  • 10 Banaszewska B, Pawelczyk L, Spaczynski RZ et al. Effects of simvastatin and metformin on polycystic ovary syndrome after six months of treatment. J Clin Endocrinol Metab 2011; 96: 3493-3501
  • 11 Barba M, Schünemann HJ, Sperati F et al. The effects of metformin on endogenous androgens and SHBG in women: a systematic review and meta-analysis. Clin Endocrinol (Oxf) 2009; 70: 661-670
  • 12 Krysiak R, Okopień B. The effect of metformin on androgen production in diabetic women with non-classic congenital adrenal hyperplasia. Exp Clin Endocrinol Diabetes 2014; 122: 568-571
  • 13 Krysiak R, Drosdzol-Cop A, Skrzypulec-Plinta V et al. Sexual function and depressive symptoms in young women with elevated macroprolactin content: a pilot study. Endocrine 2016; 53: 291-298
  • 14 Pluchino N, Carmignani A, Cubeddu A et al. Androgen therapy in women: for whom and when. Arch Gynecol Obstet 2013; 288: 731-737
  • 15 Pontiroli AE, Cortelazzi D, Morabito A. Female sexual dysfunction and diabetes: a systematic review and meta-analysis. J Sex Med 2013; 10: 1044-1051
  • 16 Nowosielski K, Skrzypulec-Plinta V. Mediators of sexual functions in women with diabetes. J Sex Med 2011; 8: 2532-2545
  • 17 Shi YF, Shao XY, Lou QQ et al. Study on female sexual dysfunction in type 2 diabetic Chinese women. Biomed Environ Sci 2012; 25: 557-561
  • 18 Martelli V, Valisella S, Moscatiello S et al. Prevalence of sexual dysfunction among postmenopausal women with and without metabolic syndrome. J Sex Med 2012; 9: 434-441
  • 19 Wiegel M, Meston C, Rosen R. The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cut-off scores. J Sex Marital Ther 2005; 31: 1-20
  • 20 Ferenidou F, Kapoteli V, Moisidis K et al. Presence of a sexual problem may not affect women’s satisfaction from their sexual function. J Sex Med 2008; 5: 631-639
  • 21 Beck AT, Steer RA, Brown GK. BDI-II: Beck Depression Inventory Manual. 2nd ed. San Antonio: Psychological Corporation; 1996
  • 22 American Psychiatric Association . Diagnostic and statistical manual of mental disorders – DSM-IV-TR. 4th ed. Washington: American Psychiatric Publishing; 1994
  • 23 Krysiak R, Okopień B. The effect of fenofibrate on lymphocyte cytokine release in patients with impaired fasting glucose and impaired glucose tolerance: a preliminary report. Atherosclerosis 2010; 213: 325-328
  • 24 Krysiak R, Gdula-Dymek A, Bachowski R et al. Pleiotropic effects of atorvastatin and fenofibrate in metabolic syndrome and different types of pre-diabetes. Diabetes Care 2010; 34: 2266-2270
  • 25 Krysiak R, Gdula-Dymek A, Okopień B. Hemostatic effects of simvastatin in subjects with impaired fasting glucose. Pharmacol Rep 2010; 62: 1090-1098
  • 26 Krysiak R, Okopień B. Haemostatic effects of simvastatin in subjects with impaired glucose tolerance. Intern Med J 2011; 41: 473-481
  • 27 Krysiak R, Gdula-Dymek A, Okopień B. Effect of simvastatin and fenofibrate on cytokine release and systemic inflammation in type 2 diabetes mellitus with mixed dyslipidemia. Am J Cardiol 2011; 107: 1010.e1-1018.e1
  • 28 Alzahrani SH, Ajjan RA. Coagulation and fibrinolysis in diabetes. Diab Vasc Dis Res 2010; 7: 260-273
  • 29 Albers JW, Pop-Busui R. Diabetic neuropathy: mechanisms, emerging treatments, and subtypes. Curr Neurol Neurosci Rep 2014; 14: 473
  • 30 Papanas N, Ziegler D. Prediabetic neuropathy: does it exist?. Curr Diab Rep 2012; 12: 376-383
  • 31 Kim C. Halter JB. Endogenous sex hormones, metabolic syndrome, and diabetes in men and women. Curr Cardiol Rep 2014; 16: 467
  • 32 Moulana M, Lima R, Reckelhoff JF. Metabolic syndrome, androgens, and hypertension. Curr Hypertens Rep 2011; 13: 158-162
  • 33 Chau-Van C, Gamba M, Salvi R et al. Metformin inhibits adenosine 5′-monophosphate-activated kinase activation and prevents increases in neuropeptide Y expression in cultured hypothalamic neurons. Endocrinology 2007; 148: 507-511
  • 34 Duntas LH, Orgiazzi J, Brabant G. The interface between thyroid and diabetes mellitus. Clin Endocrinol 2011; 75: 1-9
  • 35 Wen JP, Liu C, Bi WK et al. Adiponectin inhibits KISS1 gene transcription through AMPK and specificity protein-1 in the hypothalamic GT1-7 neurons. J Endocrinol 2012; 214: 177-189
  • 36 Skorupskaite K, George JT, Anderson RA. The kisspeptin-GnRH pathway in human reproductive health and disease. Hum Reprod Update 2014; 20: 485-500
  • 37 Miranda-Massari JR, Gonzalez MJ, Jimenez FJ et al. Metabolic correction in the management of diabetic peripheral neuropathy: improving clinical results beyond symptom control. Curr Clin Pharmacol 2011; 6: 260-273
  • 38 Twigg SM, Kamp MC, Davis TM et al. Australian Diabetes Society; Australian Diabetes Educators Association . Prediabetes: a position statement from the Australian Diabetes Society and Australian Diabetes Educators Association. Med J Aust 2007; 186: 461-465
  • 39 Petersen JL, McGuire DK. Impaired glucose tolerance and impaired fasting glucose – a review of diagnosis, clinical implications and management. Diab Vasc Dis Res 2005; 2: 9-15