Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study

Rena R Wing, Dale S Bond, Isaias Noel Gendrano 3rd, Thomas Wadden, Judy Bahnson, Cora E Lewis, Frederick Brancati, Stephen Schneider, Abbas E Kitabchi, Brent Van Dorsten, Raymond C Rosen, Sexual Dysfunction Subgroup of the Look AHEAD Research Group, Raymond C Rosen, Isaias Noel C Gendrano 3rd, Stephen H Schneider, Frederick L Brancati, Jeff Honas, Lawrence Cheskin, Jeanne M Clark, Kerry Stewart, Richard Rubin, Jeanne Charleston, Kathy Horak, Karen C Johnson, Abbas E Kitabchi, Carolyn Gresham, Stephanie Connelly, Amy Brewer, Mace Coday, Lisa Jones, Lynne Lichtermann, Shirley Vosburg, J Lee Taylor, Helen Lambeth, Debra Clark, Andrea Crisler, Gracie Cunningham, Donna Green, Debra Force, Robert Kores, Renate Rosenthal, Elizabeth Smith, Maria Sun, Judith Soberman, Thomas A Wadden, Barbara J Maschak-Carey, Stanley Schwartz, Robert I Berkowitz, Henry Glick, Shiriki K Kumanyika, Johanna Brock, Helen Chomentowski, Vicki Clark, Canice Crerand, Renee Davenport, Andrea Diamond, Anthony Fabricatore, Louise Hesson, Stephanie Krauthamer-Ewing, Robert Kuehnel, Patricia Lipschutz, Monica Mullen, Leslie Womble, Nayyar Iqbal, Rena R Wing, Renee Bright, Vincent Pera, John Jakicic, Deborah Tate, Amy Gorin, Kara Gallagher, Amy Bach, Barbara Bancroft, Anna Bertorelli, Richard Carey, Tatum Charron, Heather Cheriot, Kimberley Chula-Maguire, Pamela Coward, Lisa Cronkite, Julie Currin, Maureen Daly, Caitlin Egan, Erica Ferguson, Linda Foss, Jennifer Gauvin, Don Kieffer, Lauren Lessard, Deborah Maier, J P Massaro, Tammy Monk, Rob Nicholson, Erin Patterson, Suzanne Phelan, Hollie Raynor, Douglas Raynor, Natalie Robinson, Deborah Robles, Jane Tavares, Cora E Lewis, Sheikilya Thomas, Monika Safford, Vicki DiLillo, Charlotte Bragg, Amy Dobelstein, Stacey Gilbert, Stephen Glasser, Sara Hannum, Anne Hubbell, Jennifer Jones, Lee DeLavallade, Ruth Luketic, Karen Marshall, L Christie Oden, Janet Raines, Cathy Roche, Janet Truman, Nita Webb, Audrey Wrenn, Rena R Wing, Dale S Bond, Isaias Noel Gendrano 3rd, Thomas Wadden, Judy Bahnson, Cora E Lewis, Frederick Brancati, Stephen Schneider, Abbas E Kitabchi, Brent Van Dorsten, Raymond C Rosen, Sexual Dysfunction Subgroup of the Look AHEAD Research Group, Raymond C Rosen, Isaias Noel C Gendrano 3rd, Stephen H Schneider, Frederick L Brancati, Jeff Honas, Lawrence Cheskin, Jeanne M Clark, Kerry Stewart, Richard Rubin, Jeanne Charleston, Kathy Horak, Karen C Johnson, Abbas E Kitabchi, Carolyn Gresham, Stephanie Connelly, Amy Brewer, Mace Coday, Lisa Jones, Lynne Lichtermann, Shirley Vosburg, J Lee Taylor, Helen Lambeth, Debra Clark, Andrea Crisler, Gracie Cunningham, Donna Green, Debra Force, Robert Kores, Renate Rosenthal, Elizabeth Smith, Maria Sun, Judith Soberman, Thomas A Wadden, Barbara J Maschak-Carey, Stanley Schwartz, Robert I Berkowitz, Henry Glick, Shiriki K Kumanyika, Johanna Brock, Helen Chomentowski, Vicki Clark, Canice Crerand, Renee Davenport, Andrea Diamond, Anthony Fabricatore, Louise Hesson, Stephanie Krauthamer-Ewing, Robert Kuehnel, Patricia Lipschutz, Monica Mullen, Leslie Womble, Nayyar Iqbal, Rena R Wing, Renee Bright, Vincent Pera, John Jakicic, Deborah Tate, Amy Gorin, Kara Gallagher, Amy Bach, Barbara Bancroft, Anna Bertorelli, Richard Carey, Tatum Charron, Heather Cheriot, Kimberley Chula-Maguire, Pamela Coward, Lisa Cronkite, Julie Currin, Maureen Daly, Caitlin Egan, Erica Ferguson, Linda Foss, Jennifer Gauvin, Don Kieffer, Lauren Lessard, Deborah Maier, J P Massaro, Tammy Monk, Rob Nicholson, Erin Patterson, Suzanne Phelan, Hollie Raynor, Douglas Raynor, Natalie Robinson, Deborah Robles, Jane Tavares, Cora E Lewis, Sheikilya Thomas, Monika Safford, Vicki DiLillo, Charlotte Bragg, Amy Dobelstein, Stacey Gilbert, Stephen Glasser, Sara Hannum, Anne Hubbell, Jennifer Jones, Lee DeLavallade, Ruth Luketic, Karen Marshall, L Christie Oden, Janet Raines, Cathy Roche, Janet Truman, Nita Webb, Audrey Wrenn

Abstract

Objective: Sexual dysfunction is a prevalent problem in obese women with type 2 diabetes. This study examined the effects of intensive lifestyle intervention (ILI) in these women.

Research design and methods: Look AHEAD is a 16-center, randomized, controlled trial evaluating the health effects of ILI compared with a control group (diabetes support and education [DSE]). The Look AHEAD Sexual Function Ancillary study included 375 female participants at five Look AHEAD sites. Participants completed the Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI), and assessments of weight and cardiovascular risk factors at baseline and 1 year were made.

Results: At baseline, 50% of the 229 participants who reported being sexually active met criteria for female sexual dysfunction (FSD); only BDI score was related to FSD. One-year weight losses were greater in the ILI group than in the DSE group (7.6 vs. 0.45 kg; P<0.001). Among women with FSD at baseline, those in the ILI group (N=60) compared with those in the DSE group (N=53) were significantly more likely to remain sexually active (83 vs. 64%; P<0.008), reported greater improvement in total FSFI scores and in most FSFI domains (P<0.05), and were more likely to experience remission of FSD (28 vs. 11%; P<0.04) at 1 year. No significant differences between ILI and DSE were seen in women who did not have FSD at baseline.

Conclusions: Participation in ILI appeared to have beneficial effects on sexual functioning among obese women with diabetes, particularly in those who had FSD at baseline.

Trial registration: ClinicalTrials.gov NCT00017953.

Figures

Figure 1
Figure 1
Percent of women in each category at 1 year. A: Status at 1 year of women who were sexually active and had FSD at baseline in the ILI group (N = 60) and in the DSE group (N = 53). B: Status at 1 year of women who were sexually active and did not have FSD at baseline in the ILI group (N = 56) and in the DSE group (N = 58).
Figure 2
Figure 2
FSFI scores at baseline and 1 year for women in the ILI group (N = 52) and in the DSE group (N = 47) who were sexually active and had FSD at baseline (including women who became sexually inactive at 1 year).

References

    1. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008;112:970–978
    1. Piak A, Laumann EO. Prevalence of women's sexual problems in the USA. In: Goldstein I, Meston C, Traish AM, Eds. Women's Sexual Function and Dysfunction London, Taylor & Francis, 2006, p. 23–33
    1. Bitzer J, Alder J. Diabetes and female sexual health. Womens Health (Lond Engl) 2009;5:629–636
    1. Enzlin P, Rosen R, Wiegel M, et al. DCCT/EDIC Research Group Sexual dysfunction in women with type 1 diabetes: long-term findings from the DCCT/EDIC study cohort. Diabetes Care 2009;32:780–785
    1. Esposito K, Maiorino MI, Bellastella G, Giugliano F, Romano M, Giugliano D. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res 2010;22:179–184
    1. Copeland KL, Brown JS, Creasman JM, et al. Diabetes mellitus and sexual function in middle-aged and older women. Obstet Gynecol 2012;120:331–340
    1. Wallner LP, Sarma AV, Kim C. Sexual functioning among women with and without diabetes in the Boston Area Community Health Study. J Sex Med 2010;7:881–887
    1. Esposito K, Ciotola M, Giugliano F, et al. Association of body weight with sexual function in women. Int J Impot Res 2007;19:353–357
    1. Melin I, Falconer C, Rössner S, Altman D. Sexual function in obese women: impact of lower urinary tract dysfunction. Int J Obes (Lond) 2008;32:1312–1318
    1. Bond DS, Vithiananthan S, Leahey TM, et al. Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery. Surg Obes Relat Dis 2009;5:698–704
    1. Kolotkin RL, Crosby RD, Gress RE, Hunt SC, Engel SG, Adams TD. Health and health-related quality of life: differences between men and women who seek gastric bypass surgery. Surg Obes Relat Dis 2008;4:651–658; discussion 658–659
    1. Bond DS, Wing RR, Vithiananthan S, et al. Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis 2011;7:1–7
    1. Esposito K, Ciotola M, Giugliano F, et al. Mediterranean diet improves sexual function in women with the metabolic syndrome. Int J Impot Res 2007;19:486–491
    1. Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208
    1. Ryan DH, Espeland MA, Foster GD, et al. Look AHEAD Research Group Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 2003;24:610–628
    1. Wadden TA, West DS, Neiberg RH, et al. Look AHEAD Research Group One-year weight losses in the Look AHEAD study: factors associated with success. Obesity (Silver Spring) 2009;17:713–722
    1. Wadden TA, West DS, Delahanty L, et al. Look AHEAD Research Group The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it [corrected in Obesity (Silver Spring) 2007;15:1339]. Obesity (Silver Spring) 2006;14:737–752
    1. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 2005;31:1–20
    1. Meston CM, Derogatis LR. Validated instruments for assessing female sexual function. J Sex Marital Ther 2002;28(Suppl. 1):155–164
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571
    1. Rosen RC, Wing RR, Schneider S, et al. Erectile dysfunction in type 2 diabetic men: relationship to exercise fitness and cardiovascular risk factors in the Look AHEAD trial. J Sex Med 2009;6:1414–1422
    1. Carson CC, Burnett AL, Levine LA, Nehra A. The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology 2002;60(Suppl. 2):12–27
    1. Jackson G, Rosen RC, Kloner RA, Kostis JB. The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006;3:28–36; discussion 36
    1. Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R. Help-seeking behavior of women with self-reported distressing sexual problems. J Womens Health (Larchmt) 2009;18:461–468
    1. Lutfey KE, Link CL, Rosen RC, Wiegel M, McKinlay JB. Prevalence and correlates of sexual activity and function in women: results from the Boston Area Community Health (BACH) Survey. Arch Sex Behav 2009;38:514–527

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅