Sildenafil improves sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder: a double-blind, crossover, placebo-controlled pilot study.
OBJECTIVE
To verify whether sildenafil is effective in type 1 premenopausal women affected by sexual arousal disorder (SAD).


METHODS
Double-blind, crossover, placebo-controlled study.


METHODS
Gynecological diabetic outpatient clinic and sexual clinic.


METHODS
Thirty-six type 1 premenopausal diabetic women affected by SAD.


METHODS
Two 8-week periods of sildenafil 100 mg, washout, and placebo, by two possible sequences.


METHODS
Each woman submitted blood samples to measure HbA(1c), and T, free T (FT), and PRL. Efficacy was assessed [1] subjectively by the Personal Experiences Questionnaire based on the 5-point Likert scale, quantifying arousal, desire, orgasm, enjoyment of sexual activities, and frequency of sexual relationships; and [2] objectively by translabial color Doppler ultrasound to measure the resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end diastolic velocity of clitoral arteries.


RESULTS
Thirty-two women completed the study. The mean HbA(1c) value was 8.0% +/- 1.8%, and plasma concentrations of T, FT, and PRL were normal. Sildenafil seems to improve arousal, orgasm and sexual enjoyment, and dyspareunia in women affected by type 1 diabetes. However, by flowmetric measurements, the mean RI was significantly lower and both the mean PI and PSV of the clitoral arteries were significantly higher compared with baseline and placebo.


CONCLUSIONS
Sildenafil seems to improve subjective sexual aspects and can be used to treat objectively genital arousal disorder of premenopausal women with type 1 diabetes.
Department of Microbiological Science and Gynaecological Science, School of Medicine, University of Catania, Catania, Italy. scaruso@unict.it
Salvatore
S
Caruso
Salvatore
S
Rugolo
Carmela
C
Agnello
Giorgia
G
Intelisano
Lucia
L
Di Mari
Antonio
A
Cianci
D000328:Adult; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D015990:Placebo Effect; D017697:Premenopause / Q000187:drug effects*; D011687:Purines; D012725:Sexual Behavior / Q000187:drug effects*; D020018:Sexual Dysfunctions, Psychological / Q000150:complications* / Q000188:drug therapy*; D000068677:Sildenafil Citrate; D013450:Sulfones; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate