title: Sex steroid hormones in diabetes-induced sexual dysfunction: focus on the female gender.
abstract: BACKGROUND
  Diabetes is associated with gender-specific changes in sex steroid hormones. However, the mechanisms responsible for these associations as well as the link to sexual dysfunction are not well understood.
  
  
  OBJECTIVE
  To discuss key clinical and laboratory findings linking diabetes, sex steroid hormones, and sexual dysfunction, with particular focus on the female gender.
  
  
  METHODS
  A comprehensive literature review was conducted using the PubMed database. Search terms were used in appropriate combinations, including diabetes, insulin, insulin sensitivity, androgen, estrogen, sexual function, women, men, estrogen receptor, and androgen receptor. Over 400 citations were selected, based on topical relevance, and examined for study methodology and major findings.
  
  
  METHODS
  Data from peer-reviewed publications.
  
  
  RESULTS
  Imbalances in sex steroid hormone levels are strongly associated with diabetes and this may negatively impact upon sexual function. Although numerous factors are likely to contribute to the development of diabetes and its complications, the role of sex steroid hormones must be acknowledged.
  
  
  CONCLUSIONS
  Research related to diabetic women and sexual dysfunction is severely lacking. Identifying underlying causes for a given hormonal imbalance in diabetic patients, as well as determination of genetic and age-dependent factors, will become important in identifying the subpopulations in which hormonal replacement regimens will be most effective. Investigation into treating diabetic patients with adjunct hormonal therapies or steroid hormone receptor modulators holds much promise.
authors.affiliation: The Institute for Sexual Medicine, San Diego, CA 92121, USA. nnkim@alaginresearch.com
authors.forename: Noel N
authors.initials: NN
authors.lastname: Kim
mesh_terms: D002987:Clitoris / Q000098:blood supply; D003687:Dehydroepiandrosterone / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D004967:Estrogens / Q000502:physiology*; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D017698:Postmenopause / Q000502:physiology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D011960:Receptors, Estrogen / Q000502:physiology; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D004967:Estrogens; D011960:Receptors, Estrogen; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D003687:Dehydroepiandrosterone