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

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.