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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.

Caruso S, Rugolo S, Agnello C, Intelisano G, Di Mari L, Cianci A

Department of Microbiological Science and Gynaecological Science, School of Medicine, University of Catania, Catania, Italy. scaruso@unict.it

OBJECTIVE: To verify whether sildenafil is effective in type 1 premenopausal women affected by sexual arousal disorder (SAD). DESIGN: Double-blind, crossover, placebo-controlled study. SETTING: Gynecological 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 HbA(1c), 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 HbA(1c) 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.

Published 1 May 2006 in Fertil Steril, 85(5): 1496-501.
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