Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Family planning practitioners who work with women in the perimenopausal years should educate patients about the need for contraception until 1 year past the last menstrual period, rule out contraindications to specific fertility control methods, and provide women with the opportunity to choose the method best suited for them. Women in the perimenopausal years are at increased risk of aging-related problems such as cardiovascular disease and diabetes, genetic defects in offspring, morbidity with a pregnancy, and mortality from a pregnancy. In working with these women, clinicians should evaluate the absolute and strong relative contraindications of hormonal contraception, IUDs, barriers and spermicides, natural family planning (NFP), and sterilization. Any method of combination hormonal contraception is conttraindicated for smokers aged 35 years and over. Although progestin-only pills are safer for women at risk of hypertension, possible irregular bleeding during the menstrual cycle caused by these preparations can disquise progressively involutional periods or lead women to ignore cancer warning signs. Although the IUD can be considered for perimenopausal women, it should be reconsidered if intermenstrual bleeding occurs. Barrier methods are popular among women with decreased fertility potential who are largely monogamous. Uterine and urethral changes in older women may discourage diaphragm use. However, the spermicides in contraceptive jellies and sponges can provide lubrication for women with symptoms of dry vagina. Vaginal spermicides are used heavily by women in the final 1/3 of their childbearing years. Women nearing menopause should not use NFP methods because of the irregularity of mucus and temperture patterns. Finally, the 1-time risk of tubal sterilization poses less threat to healthy women ages 35-40 years than oral contraception or a term pregnancy.
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PMID:Contraception during perimenopausal years is important issue for patients, clinicians. 1233 14

Female sexual response is a complex, nonlinear progression from desire to arousal and orgasm. Diabetes may affect all these, but it particularly affects arousal with decreased genital sensation and lubrication. Vaginal dryness and infections may lead to dyspareunia. Predictors of sexual dysfunction in women include depression. Neither age, duration of diabetes, glycemic control, nor complications predict sexual dysfunction in women as they do in men. Objective measures of decreased genital sensation or lubrication do not correlate with a subjective sense of female sexual arousal disorder. Low androgens and possibly estrogens may be etiologic, as may numerous medications used by patients with diabetes. Practitioners should recognize the high prevalence of female sexual dysfunction (up to 50%) and potential increase, in tandem with that of diabetes. In the absence of definitive treatment evidence, psychological counseling, improvised vaginal lubricants, and low doses of estrogens or androgens have been used to relieve the personal distress of female sexual dysfunction.
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PMID:Diabetes and female sexual dysfunction: moving beyond "benign neglect". 1592 71