Depression, Anxiety and Sexual Dysfunction Among Jordanian Women With Type 2 Diabetes Mellitus

Type 2 diabetes mellitus, Sexual dysfunction, Depression, Anxiety


The aims of this study are to determine the prevalence of sexual dysfunction and to examine the relationships of sexual function and psychological factors of depression and anxiety and diabetes-related factors in Jordanian women with type 2 diabetes mellitus. This study employed a cross-sectional, descriptive, correlational design. All eligible participants with type 2 diabetes mellitus were consequently recruited from primary care centers. All enrolled participants were asked to complete questionnaires: Arabic version of the Female Sexual Function Index, Beck Depression Inventory-II, Beck Anxiety Inventory, and demographic questionnaires. Physical and biological measures were collected from the patient's medical records. 107 women with type 2 diabetes mellitus were recruited with a mean of age of 52.46±8.38 years. The prevalence of female sexual dysfunction was 94.4%. Regarding the mean scores of the Arabic version of the Female Sexual Function Index domains, the highest mean score was for pain (5.09±1.51), and the lowest mean score was for sexual arousal (2.44±1.28). This study found significant inverse relationships between female sexual function and age (r= -0.340, P<0.01), duration of diabetes (r= -0.211, P=0.029), fasting blood sugar (r= -0.234, P=0.015), anxiety (r= -0.375, P<0.01), and depression (r= -0.480, P<0.01). Our study found female sexual dysfunction is widely prevalent in Jordanian women with type 2 diabetes mellitus (94.4%). There were significant correlations between anxiety, depression, and female sexual function among women with type 2 diabetes mellitus.


1. WHO. Jordan: WHO statistical profile [Internet]. 2015 [cited 2016 Jun 1]. Available from:
2. Ajlouni K, Khader YS, Batieha A, Ajlouni H, El-Khateeb M. An increase in prevalence of diabetes mellitus in Jordan over 10 years. J Diabetes Complications 2008;22(5):317-24.
3. Berry MD, Berry PD. Contemporary treatment of sexual dysfunction: Reexamining the biopsychosocial model. J Sex Med 2013;10(11):2627-43.
4. Fatemi SS, Taghavi SM. Evaluation of sexual function in women with type 2 diabetes mellitus. Diab Vasc Dis Res 2009;6(1):38-9.
5. Ramalho-Santos J, Amaral S, Oliveira PJ. Diabetes and the impairment of reproductive function: possible role of mitochondria and reactive oxygen species. Curr Diabetes Rev 2008;4(1):46-54.
6. Elyasi F, Kashi Z, Tasfieh B, Bahar A, Khademloo M. Sexual dysfunction in Women with type 2 diabetes mellitus. Iran J Med Sci 2015;40(3):206-13.
7. Arrellano-Valdez F, Urrutia-Osorio M, Arroyo C, Soto-Vega E. A comprehensive review of urologic complications in patients with diabetes. Springerplus 2014;3(549):1-8.
8. Abu Ali RM, Al Hajeri RM, Khader YS, Shegem NS, Ajlouni KM. Sexual dysfunction in Jordanian diabetic women. Diabetes Care 2008;31(8):1580-1.
9. Celik S, Golbası Z, Kelleci M, Satman I. Sexual dysfunction and sexual quality of life in women with diabetes: The study based on a diabetic center. Sex Disabil 2015;33(2):233-41.
10. Cortelazzi D, Marconi A, Guazzi M, Cristina M, Zecchini B, Veronelli A, et al. Sexual dysfunction in pre-menopausal diabetic women: clinical, metabolic, psychological, cardiovascular, and neurophysiologic correlates. Acta Diabetol 2013;50(6):911-7.
11. Ziaei-Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in patients with diabetes: a study from Iran. Reprod Biol Endocrinol 2010;8(1):50.
12. Esposito K, Maiorino M, Bellastella G, Giugliano F, Romano M, Giugliano D. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res 2010;22(3):179.
13. Rutte A, Welschen LM, Van Splunter MM, Schalkwijk AA, de Vries L, Snoek FJ, et al. Type 2 diabetes patients’ needs and preferences for care concerning sexual problems: a cross-sectional survey and qualitative interviews. J Sex Marital Ther 2016;42(4):324-37.
14. Shadman Z, Akhoundan M, Poorsoltan N, Larijani B, Arzaghi SM, Khoshniat M. Factors associated with sexual function in Iranian women with type 2 diabetes mellitus: partner relationship as the most important predictor. Iran Red Crescent Med J 2014;16(3).
15. SHI YF, SHAO XY, LOU QQ, CHEN YJ, ZHOU HJ, ZOU JY. Study on female sexual dysfunction in type 2 diabetic Chinese women. Biomed Environ Sc 2012;25(5):557-61.
16. Anis TH, Aboul Gheit S, Saied HS, Al-kherbash SA. Arabic translation of Female Sexual Function Index and validation in an Egyptian population. J Sex Med 2011;8:370-3378.
17. Al-Sherbeny MF. Evaluation of impact of birth trauma on female sexual activity in primiparous women: A comparative study. J Am Sci 2012;8(7):289-96.
18. Mohammadi K, HEYDARI M, Faghihzadeh S. The female sexual function index (FSFI): validation of the Iranian version. Payesh 2008;7:269-78.
19. Rosen CB, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, D. Ferguson, R. D'Agostino, R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26(2):191-208.
20. Maamria B. Application of Beck Depression Inventory II (BDI-II) in both gender in Algerian enviroment. Journal of Arab Net of Psychology 2010;25-26:92-105.
21. Al-Shatti TS. Psychometric properties of the Arabic version of the Beck Anxiety Inventory in the State of Kuwait. Journal of Educational Psychological Science 2015:431-63.
22. Alansari BM. Gender differnces in depression among among undergradutes from seventeen Islamic countries. Soc Behav Pers 2006;34(6):729-38.
23. Humphery S, Nazareth I. GPs' views on their management of sexual dysfunction. Fam Pract 2001;18(5):516-8.
24. Rutte A, van Oppen P, Nijpels G, Snoek FJ, Enzlin P, Leusink P, et al. Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomised controlled trial. BMC Fam Pract 2015;16(1):69.
25. Wing RR, Bond DS, Gendrano IN, Wadden T, Bahnson J, Lewis CE, et al. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study. Diabetes Care 2013;36(10):2937-44.
26. Sivrikaya SK, Ünsal A, Karabulutlu EY. Sexual dysfunction and depression in Turkish women with type 2 diabetes mellitus. Sex Disabil 2014;32(1):3-13.
27. Giraldi A, Kristensen E. Sexual dysfunction in women with diabetes mellitus. J Sex Res 2010;47(2-3):199-211.
28. Yencilek F, Attar R, Erol B, Narin R, Aydın H, Karateke A, et al. Factors affecting sexual function in premenopausal age women with type 2 diabetes: a comprehensive study. Fertil Steril 2010;94(5):1840-3.
How to Cite
Alazawi Z, Alqudah O, Al-Bashaireh A. Depression, Anxiety and Sexual Dysfunction Among Jordanian Women With Type 2 Diabetes Mellitus. Acta Med Iran. 58(2):56-63.