Enzlin et al. (1) outline the high frequency of female sexual dysfunction (FSD) in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) cohort. However, their data need further clarification. They say that the prevalence of FSD, at 35%, is moderately high for a population with a mean age of 43 years. However, this depends on what constitutes a “normal” rate of FSD. Previous studies suggest that up to 43% of otherwise normal women with no comorbidity between 18 and 75 years of age have some form of sexual difficulty (2,3). Thus, if approximately half of the “normal” female population has a degree of FSD, is that population “abnormal”? These data suggest that the rates of FSD in the female population with type 1 diabetes are not different from those of the general population.
In addition, other work has shown that there is a correlation between serum androgen levels in young women without diabetes who have a decreased libido and absent sexual desire (4). These hormone levels have been shown to vary with menstrual cycle and are important determinants of sexual function in premenopausal women with type 1 diabetes (5). Enzlin et al. do not comment on the levels of the sex hormones estrogen, testosterone, or dehydroepiandrosterone nor on what proportion of the cohort was postmenopausal. Furthermore, it would be important to know at what stage of the menstrual cycle the questionnaires were filled out.
Acknowledgments
No potential conflicts of interest relevant to this article were reported.
