Hi Sue
I agree that women's sexual functioning is multifactorial but everything you say of women can also be applied to men.
For example, men of any age can get ED for multiple reasons including psychosexual, metabolic (diabetes/hypothyroidism), neurological, hormonal (hypogonadism), alcohol abuse etc.
Also men go through an andropause with declining levels of testosterone and DHEA as they age which has a resultant effect on sexual functioning.
Sexual dysfunction in both genders is more prevalent in the diabetic population than in the normal population.
My point is that diabetic women can suffer damage to the small blood vessels and autonomic neuropathy
as a direct complication of diabetes. These diabetic complications can serve as a
physiological cause of sexual dysfunction in women leading to clitoral numbness, lack of engorgement and decreased lubrication. This is little discussed by consultants etc. and does not appear on the NHS CHOICES website.
The fact that there are multiple reasons for sexual dysfunction should not preclude the NHS from providing information about the possible physiological complications of diabetes to diabetic women.
In mitigation I did just find this 2009 NHS document from Portsmouth NHS trust that acknowledges the links between diabetes and female sexual dysfunction.....
SEXUAL FUNCTION
It might be expected that women
with diabetes have a higher rate of
sexual problems than women without
diabetes because the tissue and nerve
supply of a woman’s sexual organs
is actually very similar to that of a
man. The available evidence plus our
own work suggests that reduced
lubrication in the vaginal area is the
major difference between diabetic
and non-diabetic women. Female
lubrication occurs during the
arousal phase of the sexual response
cycle. This is the same phase that
leads to erections in men.
The relationship between different
physical sexual problems is complex
and it seems likely that this reduced
lubrication, together with reduced
sensation in the vaginal area may
lead to more painful intercourse,
less likelihood of orgasm and a
reduced sex drive in some women.
http://www.porthosp.nhs.uk/Diabetes-Arc ... Voice9.pdf