During the COVID-19 pandemic, people with type 2 diabetes who report decreased sexual function are more likely to have alexithymia, anxiety, and depression according to a recent study of Turkish subjects in Sexuality and Disability. 

In general, patients with diabetes are more likely to have sexual dysfunction, such as erectile dysfunction (ED) and vaginal dryness, than patients without diabetes.

The authors defined alexithymia as “a mental health trait characterized by difficulty in understanding, defining, and expressing one’s own emotions.” Past studies have suggested that the social isolation, along with stress and anxiety, has triggered alexithymia during the pandemic. However, less is known about these symptoms and sexual function in people with diabetes.

Researchers worked with 162 patients (average age 56 years) in Istanbul between May 21, 2020 and July 5, 2020. All of the participants had type 2 diabetes. Most of them (80%) were married, 83% had sexual partners, and 56% were female.

The study subjects completed several assessments, including the Hospital Anxiety and Depression Scale (HADS) and the Toronto Alexithymia Scale (TAS). They also answered questions about their diabetes and their sexual function before and during the COVID-19 pandemic.

Highlights of the results included the following:

• About 83% of the participants said their sexual function had decreased after their diabetes diagnosis, and 70% had a decrease because of the pandemic. Around 67% had decreases due to both diabetes and the pandemic. None of the patients had increases in sexual function.
• Specific sexual domains affected were desire, intercourse frequency and duration, and sexual satisfaction. These changes might have been influenced by “the obligation to share every moment during the day and the restrictions of people’s own space,” the authors said.
• The participants gave several reasons for their decrease in sexual function during the pandemic. Over three-quarters said that sex hadn’t been a priority. Over two-thirds noted that stress and anxiety affected their sexual function. About half were concerned about transmitting the virus to their partner.
• About one in five patients could find solutions to changes in sexual function. Two-thirds said their mood had been affected.
• Participants did not always feel comfortable discussing their sexual situation with a healthcare provider. About 82% said they had difficulty having such conversations.
• Average TAS and HADS scores were above the thresholds indicating alexithymia and anxiety/depression, respectively. Scores on these assessments were significantly higher (indicating more severe symptoms) in patients who reported decreased sexual functioning.

Age may have played a role in the results, as approximately 43% of the study subjects were aged 65 or older, the authors said. Older people may be more likely to experience sexual dysfunction before and during the pandemic. They may also have had diabetes for longer periods of time.

The authors added that their study subjects were Turkish and that the results might not apply to people of other cultures. Lack of a control group was another limitation to the study, they said.

They recommended that healthcare providers monitor the sexual and psychological health of patients with diabetes, especially during the pandemic.

Resources

• Sexuality and Disability via US National Library of Medicine - “Changes in Sexual Functions and Alexithymia Levels of Patients with Type 2 Diabetes During the COVID-19 Pandemic”
  Dincer, Berna, et al.
  (Full-text. Published: May 4, 2021)
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8093367/