Female sexual dysfunction in premenopausal women with diabetes mellitus in northern Nigeria: A cross-sectional study from two tertiary hospitals examining associations with glycaemic control and reproductive hormones

BACKGROUND: Female sexual dysfunction (FSD) is a recognised complication of diabetes mellitus (DM), but evidence on its clinical and biological correlates in sub-Saharan Africa remains limited. FSD is defined as a disorder characterized by disturbances in sexual desire, arousal, orgasm, and/or pain that causes interpersonal difficulty or distress. This study examined associations between glycaemic control, reproductive hormonal status, and FSD among premenopausal women with diabetes in northern Nigeria. METHODS: We conducted a cross-sectional study among 180 premenopausal women aged 18-45 years attending diabetes clinics at two tertiary hospitals in Kano, Nigeria. Sexual function was assessed using the Female Sexual Function Index (FSFI), with scores ≤26 indicating FSD. Glycaemic control was measured using glycated haemoglobin (HbA1c), categorised as optimal (≤7.0%) or suboptimal (>7.0%). Reproductive hormones (FSH, LH, Oestrogen, testosterone, prolactin, and progesterone) were measured at phase-specific points of the menstrual cycle. Multivariable logistic regression models were used to assess associations with FSD, and linear regression models were used to examine associations with FSFI domain scores. RESULTS: Overall, 51.7% of participants screened positive for FSD. Suboptimal glycaemic control was associated with higher odds of FSD (adjusted odds ratio [AOR] 2.80; 95% CI 1.05-7.72). It was also associated with lower orgasm (β -0.77; p = 0.032) and satisfaction (β -0.88; p = 0.003) scores. No statistically significant associations were observed between reproductive hormonal imbalance (including FSH, LH, Oestrogen, testosterone, prolactin, and progesterone) and FSD or FSFI domain scores. CONCLUSIONS: FSD was common among premenopausal women with diabetes in this setting. Suboptimal glycaemic control was associated with FSD and with lower orgasm and satisfaction scores, while reproductive hormonal measures were not associated with FSD. These findings provide evidence on clinical correlates of FSD in a sub-Saharan African population.