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

ObjectiveTo verify whether sildenafil is effective in type 1 premenopausal women affected by sexual arousal disorder (SAD).DesignDouble-blind, crossover, placebo-controlled study.SettingGynecological diabetic outpatient clinic and sexual clinic.Patient(s)Thirty-six type 1 premenopausal diabetic women affected by SAD.Intervention(s)Two 8-week periods of sildenafil 100 mg, washout, and placebo, by two possible sequences.Main Outcomes Measure(s)Each woman submitted blood samples to measure HbA1c, 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.Result(s)Thirty-two women completed the study. The mean HbA1c 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.Conclusion(s)Sildenafil seems to improve subjective sexual aspects and can be used to treat objectively genital arousal disorder of premenopausal women with type 1 diabetes.