Quality of Sexual Life and Influencing Factors in Married Diabetic Women

Quality of Sexual Life and Influencing Factors in Married Diabetic Women | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Quality of Sexual Life and Influencing Factors in Married Diabetic Women PhD Neslihan KAZAK SALTAN, Prof. Dr. Nuriye BÜYÜKKAYACI DUMAN, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7110217/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Diabetes Mellitus (DM) is a chronic systemic disease with a rapidly increasing prevalence worldwide. Vascular and neurological complications associated with DM can impair sexual function and negatively affect the overall quality of sexual life. This descriptive study aimed to assess the sexual quality of life among married women with diabetes and to identify the influencing factors. The study included 160 women with DM in Turkey. Data were collected using a 31-item Personal Information Form (PIF) and the Sexual Quality of Life-Female (SQOL-F) scale. Statistical analyses were performed using the Mann Whitney U test, Kruskal Wallis test, and Spearman’s correlation test. The mean SQOL-F score was 34.53 ± 30.36. SQOL-F scores differed significantly by age, education level, occupation, age at marriage, duration of marriage, type of marriage, and frequency of sexual intercourse (p < 0.05). A significant association was also found between SQOL-F scores and both DM type and treatment method (p 0.05). Sexual Quality of Life Diabetes Mellitus Female Sexuality Introduction Diabetes Mellitus (DM), whose prevalence has increased rapidly in recent years, is a chronic disease characterized by hyperglycemia resulting from impaired insulin secretion or action. Beyond glycemic abnormalities, DM is associated with numerous clinical symptoms and systemic complications that negatively affect quality of life [ 1 , 2 ]. Recognizing its global burden, the United Nations General Assembly declared DM a universal threat in 2006, calling for international action [ 3 ]. Similarly, the 2013 World Health Assembly included DM in the “Global Action Plan for the Prevention and Control of Noncommunicable Diseases” [ 4 ]. The number of individuals with DM has increased dramatically, from 30 million in 1980 to 463 million in 2019, and is projected to reach 700 million by 2045 [ 5 ]. According to the IDF Diabetes Atlas (2025), 11.1% of adults (20–79 years) worldwide are currently living with DM, with over 40% undiagnosed. By 2050, this proportion is expected to rise to 1 in 8 adults, representing approximately 853 million individuals [ 7 ]. DM adversely affects multiple organ systems through macrovascular complications (e.g., cardiovascular disease) and microvascular complications (e.g., retinopathy, nephropathy, neuropathy). Importantly, DM has been shown to negatively impact various aspects of sexuality in both men and women [ 7 – 11 ]. Studies consistently report higher rates of sexual dysfunction among individuals with DM compared to those without the disease [ 11 ], with depression also considered an important contributing factor in women [ 10 ]. Metabolic disturbances, elevated HbA1C levels, and neuropathy-related bladder dysfunction increase the risk of bacteriuria and recurrent genitourinary infections [ 12 ]. Microangiopathy further prolongs infection duration by impairing antibiotic absorption. In addition, hyperglycemia reduces vaginal lubrication, leading to dyspareunia [ 10 ]. Beyond these physiological mechanisms, psychological responses to chronic disease and its treatment may also contribute to sexual dysfunction and decreased sexual desire [ 10 , 13 ]. The effect of DM on sexuality was first noted by Ibn-i Sina in the 10th century as a “collapse of sexual function.” However, due to sociocultural taboos, research on this subject only gained attention after the 1950s [ 14 ]. Sexuality remains a core component of overall health, yet it continues to be a sensitive topic, especially for women, and this reluctance hinders sexual education and healthcare delivery [ 15 ]. Although research on male sexuality has long dominated the literature, studies on female sexuality have increased only in the 21st century and remain insufficient [ 14 , 16 ]. DM can impair female sexual function by affecting hormonal regulation, neural pathways, and vascular structures. Among married women, such problems may lower quality of life and strain marital relationships. Existing studies, however, often fail to capture the influence of current sociocultural dynamics. This study therefore aims to provide updated evidence on the sexual health of married women with DM, considering both individual and societal contexts. The findings are expected to guide healthcare professionals in integrating sexual health into DM care and support a more holistic approach to women’s health. Materials and Methods Type of Research The research was conducted in descriptive type. Population and Sample of the Study The population of the study consisted of married women aged between 18-45 years who were admitted to Hitit University Erol Olçok Training and Research Hospital and who had diabetes mellitus. In the sample calculation of the study, the sampling formula with known population was used. According to the calculation, the sample size to be selected was 160 and 160 women aged 18-45 years who applied to Hitit University Erol Olçok Training and Research Hospital Internal Medicine outpatient clinic were included. Data Collection Tools Personal information form (PIF). This form was developed by the researcher by reviewing the literature [17,18,19] to determine the sociodemographic characteristics of women. In this form consisting of 31 questions; in addition to some socio-demographic characteristics (such as age, height, body weight, education level, etc.), there are questions about some gynaecological and obstetric characteristics, questions about DM history and questions about sexual life history. Sexual Quality of Life Scale-Female (SQLS-F). The Turkish validity and reliability study of the scale developed by Symonds, Boolell, and Quirk (2005) to measure the quality of sexual life was conducted by Tuğut and Gölbaşı in 2010 [17, 20]. It was reported that the item-total score reliability coefficient of SQLS-F varied between r=0.32-0.67 and the Cronbach's alpha value was 0.83 [17]. The statements in the scale should be answered by considering the sexual life in the last four weeks. The scale, which has 18 items, is a six-point Likert-type scale and can be applied to all women over the age of 18. In the original scale, it is stated that each item can be scored between 0-5 or 1-6. As the total score increases, the quality of sexual life increases [20]. Data Collection The research data were collected by face-to-face interviews with women who applied to Hitit University Erol Olçok Training and Research Hospital internal medicine outpatient clinics and met the inclusion criteria of the study. Data collection took an average of 30 minutes. Analysing the Data Statistical Package fort the Social Science (SPSS) package programe was used to evaluate the data. Descriptive statistics were expressed as number (n), percentage (%) and mean ± standard deviation (x̄ ± SD). Mann Whitney U test was used to compare paired groups in non-parametric data, T test was used to compare paired groups in parametric data, Kruskal Wallis test was used to compare non-parametric groups of 3 or more, and Spearman's rho correlation test was used in correlation analysis. The results were evaluated at 95.0% confidence interval, p<0.05 significance level and p<0.01, p<0.001 advanced significance level. Limitations of the Study The results of the study were limited to 160 married women with DM between the ages of 18-45, living in Çorum province, diagnosed with DM and applying to the internal medicine outpatient clinic of Hitit University Erol Olçok Training and Research Hospital. The data on the quality of sexual life analysed within the scope of the study are limited to the qualities measured by the SQLS-F. The information obtained within the scope of this research is limited to the accuracy of the answers given by the participants to the questions asked. In addition, the answers to questions involving sexuality may be affected by cultural, religious and social norms. Findings The majority of participants were aged 40–44 years (35.6%), had completed primary school (33.8%), and were housewives (62.5%). Most women perceived their income level as moderate (69.4%). A large proportion resided in the city center and lived in nuclear families (Table 1). Table I. Sociodemographic Characteristics of the Participants and Distribution of SQOL-F Mean Scores n % SQOL-F SCORE x̄ ± SD Test/p Age 25–29 28 17,5 79,29 ± 7,80 30–34 25 15,6 59,71 ± 20,75 KW:72,765 35–39 30 18,8 49,67 ± 23,55 p: 0,000* 40–44 57 35,6 36,36 ± 21,01 Education level Illiterate 3 1,9 6,66 ± 22,54 Literate 12 7,5 2,49 ± 15,34 KW:74,919 Primary School 54 33,8 17,89 ± 24,02 p: 0,000* Middle School 19 11,9 33,27 ± 25,29 High School 39 24,3 41,96 ± 24,78 University and above 33 20,6 67,87 ± 16,89 Profession Housewife 100 62,5 24,65 ± 27,20 KW:38,338 Officer 27 16,9 63,12 ± 23,19 p: 0,000* Labourer 29 18,1 39,42 ± 28,47 Employer 4 2,5 56,66 ± 28,43 Perception of income level Bad 45 28,1 22,29 ± 26,55 KW:16,201 Centre 111 69,4 38,06 ± 30,29 p: 0,000* Good 4 2,5 74,16 ± 9,57 Family type Core 137 85,6 36,89 ± 30,29 z: -2,426 Wide 23 14,4 20,43 ± 27,37 p: 0,015* Place of residence Province 116 72,5 41,09 ± 29,74 KW:21,880 District 30 18,8 22,14 ± 24,95 p: 0,000* Village 14 8,7 6,66 ± 22,12 z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p < 0,05 A considerable proportion of participants married at a young age, with 63.8% reporting marriage between the ages of 13 and 22. In addition, 42.5% of the women had been married for 22 years or longer (Table II). Table II. Marital History Variables and Distribution of SQOL-F Mean Scores n % SQOL-F SCORE x̄ ± SD Test/p Marriage age 13–22 102 63,8 37,72 ± 22,76 KW 49,203 23–32 55 34,3 69,55 ± 22,74 p: 0,000* 33–43 3 1,9 62,67 ± 26,53 Duration of marriage (years) 1–5 36 22,5 78,17 ± 16,85 KW:73,138 6–10 19 11,9 63,58 ± 19,50 p: 0,000* 11–21 37 23,1 44,35 ± 18,21 22 and above 68 42,5 32,31 ± 22,95 Form of marriage Arranged marriage 91 56,9 18,63 ± 24,12 z:-7,632 By meeting and 69 43,1 55,50 ± 24,52 p: 0,000* agreeing z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p < 0,05 The majority of participants reported using family planning methods (FPM) (73.8%), with tubal ligation being the most common method (43.2%) (Table III). Table III. Family Planning Method Use and Distribution of SQOL-F Mean Scores n % SQOL-F Test/p FPI use status (n:160) Users 118 73,8 27,58 ± 2,56 z: -4,865 Non-users 42 26,2 54,04 ± 4,46 p: 0,000* FPI Used (n:118)* Tubal ligation 51 43,2 14,39 ± 3,28 Withdrawal 17 14,4 48,88 ± 5,73 KW 35,316 Condom 26 22,0 44,39 ± 5,11 p: 0,000* Oral contraceptive 2 1,7 65,55 ± 4,44 Intrauterine device 22 18,7 18,38 ± 4,28 (IUD) * This group consisted of women using FPI. Percentages are based on n., z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p < 0,05 Among the participants, the majority had Type 2 DM (81.9%), and almost all were receiving treatment (96.2%). The most commonly reported treatment regimens were oral antidiabetic therapy and combined oral antidiabetic plus insulin therapy (Table IV). Table IV. Diabetes History and Distribution of SQOL-F Mean Scores n % SQOL-F Test/p DM type Type 1 29 18,1 56,89 ± 27,20 z: -4,356 Type 2 131 81,9 29,58 ± 28,85 p: 0,000* DM duration (years) 1–5 77 48,1 52,48 ± 25,73 KW: 4,695 6–10 65 40,6 48,29 ± 29,60 p: 0,196 11 and above 18 11,3 37,12 ± 23,25 DM treatment status treatment 154 96,2 33,67 ± 2,43 z: -1,918 Non-treatmenr 6 3,8 56,48 ± 10,94 p: 0,055 DM treatment method* Oral antidiabetic 63 40,9 40,10 ± 3,46 KW 45,121 Insulin 29 18,8 58,65 ± 4,92 p: 0,000* Oral antidiabetic + 62 40,3 15,46 ± 2,91 insulin * This group consisted of women receiving medical treatment. Percentages are based on n = 154. z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p < 0,05 Most participants reported having sexual intercourse at intervals longer than two weeks. They also indicated that sexual and reproductive health (SH/RH) problems had increased after their DM diagnosis. Vaginal dryness was the most frequently reported problem (45.0%). Notably, a very high proportion of women (97.5%) had not received counseling for SH/RH problems (Table V). Table V. Sexual and Reproductive Health History and Distribution of SQOL-F Mean Scores n % SQOL-F Test/p Frequency of sexual intercourse Once or twice a week 46 28,7 69,27 ± 11,94 Longer than a week 49 30,6 32,35 ± 21,67 KW:99,062 Longer than two weeks 58 36,3 13,40 ± 21,16 p: 0,000* Longer than a month 7 4,4 -3,49 ± 7,99 Having Reproductive Health and Sexual Health (RH/SH) Problems Before Being Diagnosed with DM Living 10 6,3 19,01 ± 23,60 z: -8,946 Not living 150 93,7 64,15 ± 16,74 p:0,000* Current SH/RH Problem Status Living 105 65,6 23,21 ± 27,12 z: -1,241 Not living 55 34,4 35,28 ± 30,50 p: 0,212 Current SH/RH Problems * Vaginal dryness 72 45,0 45,86 ± 30,43 Vaginal itching 39 24,4 38,62 ± 31,38 x 2 : 8,011 ** Frequent recurrent 39 24,4 38,62 ± 31,38 p: 0,091 vaginal yeast infection Dyspareunia 38 23,8 40,68 ± 30,4 Sexual aversion 39 24,4 41,80 ± 29,46 Counselling Status Regarding SH/RH Counselling SH/RH 4 2,5 63,88 ± 10,44 z: -5, 144 Non-Counselling SH/RH 156 97,5 33,77 ± 30,35 p: 0,061 * More than one option is selected. ** This group consisted of women who had UC/CS problem. Percentages are based on n = 105. z : Mann Whitney U Test, KW: Kruskal Wallis Variance analysis, x 2 : Chi-Square test, *p < 0,05 Discussion In this study, the sexual quality of life among married women with diabetes was found to be low (34.53 ± 30.36). Compared with international and national studies using the same scale, our findings were lower than most reported in the literature. For example, Çelik et al. (2015) [ 21 ] reported a higher SQOL-F mean score (68.01 ± 22.22), while Köse-Tuncer et al. (2023) [ 32 ] reported moderate results (53.99 ± 10.33). Conversely, Şahin and Şahin (2015) [ 19 ] found similarly low scores in women with Type 2 DM (38.56 ± 10.89), consistent with our findings. Overall, these results suggest that DM negatively affects sexual quality of life, supporting the low mean score observed in this study. Differences between studies may be explained by variations in study location, period, and sample size. Our results also showed that sexual problems increased with advancing age, consistent with previous research [ 28 ]. Moreover, higher education levels were associated with better sexual quality of life [ 28 ]. This finding may be explained by greater self-expression, willingness to question sexual life, and openness to new experiences among more educated women. In contrast, women with lower education levels may show higher acceptance of chronic disease-related challenges and lower likelihood of seeking solutions. Occupational status also influenced outcomes. Housewives had lower mean SQOL-F scores compared with civil servants [ 24 ]. Studies of women with chronic diseases similarly report that employed women have better sexual quality of life than unemployed women [ 23 , 27 ]. Likewise, women with higher income levels reported higher quality of sexual life [ 24 ]. These findings may reflect the greater socioeconomic independence and reduced stress burden of working women, whereas economic difficulties in the family may contribute to marital discord and impaired spousal communication. In addition, women living in city centers reported better sexual quality of life compared to those residing in districts and villages. Tüzmen (2019) [ 33 ] reported similar findings in different populations. This may be related to higher socioeconomic welfare, more active social life, and easier access to healthcare services in urban areas, all of which may improve sexual health outcomes. In the literature, higher age at marriage has been associated with better sexual quality of life, which is consistent with our findings [ 27 ]. This may be explained by the fact that women who marry later are more likely to have accurate information about sexuality and easier access to reliable sources. Conversely, longer marriage duration was associated with lower sexual quality of life. Several studies have similarly reported that prolonged marriage duration negatively affects sexual life in different populations [ 23 , 24 , 27 , 28 ]. Possible explanations include aging, the development of chronic diseases, and the impact of medications on sexual function. In this study, sexual quality of life was found to increase with the number of living children. This may reflect sociocultural values in which having children is considered more important than sexual pleasure or satisfaction, and women without children may face pressure from their spouses and families. However, contrary to our findings, other studies have reported that sexual quality of life decreases as the number of children increases [ 24 , 27 ]. Regarding family planning methods, women who did not use any method had higher sexual quality of life compared with users. Among users, those who relied on oral contraceptives reported the highest scores, whereas women who had undergone tubal ligation reported the lowest. Wallwiener et al. (2010) [ 34 ] found that oral contraceptive use was associated with better sexual function, while Çöl (2019) [ 24 ] reported that tubal ligation was associated with the lowest sexual quality of life. These findings are in line with our study. A likely explanation is that oral contraceptives are commonly used by younger women, whereas tubal ligation is more frequent among multiparous and older women, which may account for the observed differences in sexual quality of life. According to treatment methods, women receiving combined oral antidiabetic and insulin therapy reported lower sexual quality of life compared with those using other treatment regimens. Derosa et al. (2023) [ 25 ] found that sexual function improved when glycemic control was achieved through treatment. Similarly, Piątkiewicz et al. (2017) [ 31 ] reported higher sexual satisfaction among patients using insulin pumps compared with those receiving injections, noting that visible injection marks may cause discomfort for partners. Erten et al. (2019) [ 26 ] also reported lower rates of sexual dysfunction among insulin users. The discrepancy between our findings and the literature may be explained by the advanced age and longer disease duration of women in our sample receiving combined therapy. Our study also confirmed findings from the literature indicating that urogenital and sexual health problems negatively affect sexual quality of life. Reported complications include genitourinary infections [ 27 ], dyspareunia [ 24 , 33 ], vaginal dryness [ 24 , 29 ], unpleasant odor [ 24 ], sexual reluctance [ 29 ], and orgasmic disorders [ 30 ]. Vaginal dryness emerged as the most common problem among our participants, consistent with Mehdipour-Rabori et al. (2020) [ 18 ], who found that dryness and itching were the most frequent dermatological findings in women with DM, while fungal infections were the most common infectious diseases. Vaginal dryness reduces lubrication, which can cause painful intercourse [ 10 , 13 ]. Similarly, Masood et al. (2021) [ 30 ] reported dyspareunia in 84.1% of their sample. Collectively, the literature indicates that DM negatively affects female sexual function [36], leading to reluctance, vaginal dryness, dyspareunia [ 22 , 30 ], reduced satisfaction [ 22 ], and overall sexual dysfunction [ 8 ]. Importantly, our findings showed that women who received counseling about their urogenital or sexual health problems had significantly higher SQOL-F scores, highlighting the potential benefit of targeted counseling interventions. Declarations Author contribution rate Idea/concept: NKS, NBD; Design: NKS, NBD; Data collection: NKS; Data processing: NKS; Analysis and/or interpretation: NKS, NBD; Literature search: NKS; Writing the article: NKS, NBD, RHA; Critical review: NBD, RHA. Conflict of interest There is no conflict of interest between the authors. Financial support No financial support was received from any institution or organisation. Author contrubition All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [NKS], [NBD] and [RHA]. The first draft of the manuscript was written by [NKS] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript Ethical Statement Prior to the study, permission was obtained from Hitit University Non-Interventional Research Ethics Committee (Decision No: 2018-222) and all participants were asked to fill out the "Informed Voluntary Consent Form". 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(2023). The relationship between marital adjustment and sexual life quality in diabetic women. Kırşehir Ahi Evran University Journal of Health Sciences, 7(3), 196-204. Tüzmen, H. (2019). Quality of sexual life and related factors in the postpartum period (Unpublished master's thesis). Necmettin Erbakan University. Wallwiener, C.W., Wallwiener, L.M., Seeger, H., Mück, A.O., Bitzer, J. ve Wallwiener, M. (2010). Prevalence of sexual dysfunction and impact of contraception in female German medical students . J Sex Med , 7(6):2139-2148. World Health Organization. (2019). Global report on diabetes. https://www.who.int/publications/i/item/global-report-on-diabetes Yenice, M. G., Danacıoğlu, Y. O., Mert, M., Karakaya, P., Seker, K. G., Akkaş, F., Şimşek, A., Şahin, S., ve Taşçı, A. I. (2020). Evaluation of factors affecting sexual dysfunction in female patients with diabetes mellitus. Archives of Endocrinology and Metabolism , 64(3), 319-325. https://doi.org/10.20945/2359-3997000000238 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7110217","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":514698291,"identity":"697aec80-7ebc-47b7-b856-c769529a823a","order_by":0,"name":"PhD Neslihan KAZAK SALTAN","email":"data:image/png;base64,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","orcid":"","institution":"Ordu University","correspondingAuthor":true,"prefix":"","firstName":"PhD","middleName":"Neslihan KAZAK","lastName":"SALTAN","suffix":""},{"id":514698292,"identity":"c7f030be-b522-4e9f-b912-6f524c757ca8","order_by":1,"name":"Prof. Dr. Nuriye BÜYÜKKAYACI DUMAN","email":"","orcid":"","institution":"Hitit University","correspondingAuthor":false,"prefix":"","firstName":"Prof.","middleName":"Dr. Nuriye BÜYÜKKAYACI","lastName":"DUMAN","suffix":""},{"id":514698293,"identity":"2b945a63-590a-4c83-8aed-97848eaa9173","order_by":2,"name":"Doç. Dr. Rukiye Höbek Akarsu","email":"","orcid":"","institution":"Bozok Universitesi","correspondingAuthor":false,"prefix":"","firstName":"Doç.","middleName":"Dr. Rukiye Höbek","lastName":"Akarsu","suffix":""}],"badges":[],"createdAt":"2025-07-12 21:38:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7110217/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7110217/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105728774,"identity":"7635e890-67cd-4729-8be1-a8f00be62d2d","added_by":"auto","created_at":"2026-03-30 11:12:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":984977,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7110217/v1/d14dc01c-c4ef-4597-8383-855d267cab15.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Quality of Sexual Life and Influencing Factors in Married Diabetic Women","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDiabetes Mellitus (DM), whose prevalence has increased rapidly in recent years, is a chronic disease characterized by hyperglycemia resulting from impaired insulin secretion or action. Beyond glycemic abnormalities, DM is associated with numerous clinical symptoms and systemic complications that negatively affect quality of life [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Recognizing its global burden, the United Nations General Assembly declared DM a universal threat in 2006, calling for international action [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Similarly, the 2013 World Health Assembly included DM in the \u0026ldquo;Global Action Plan for the Prevention and Control of Noncommunicable Diseases\u0026rdquo; [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The number of individuals with DM has increased dramatically, from 30\u0026nbsp;million in 1980 to 463\u0026nbsp;million in 2019, and is projected to reach 700\u0026nbsp;million by 2045 [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. According to the IDF Diabetes Atlas (2025), 11.1% of adults (20\u0026ndash;79 years) worldwide are currently living with DM, with over 40% undiagnosed. By 2050, this proportion is expected to rise to 1 in 8 adults, representing approximately 853\u0026nbsp;million individuals [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDM adversely affects multiple organ systems through macrovascular complications (e.g., cardiovascular disease) and microvascular complications (e.g., retinopathy, nephropathy, neuropathy). Importantly, DM has been shown to negatively impact various aspects of sexuality in both men and women [\u003cspan additionalcitationids=\"CR8 CR9 CR10\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Studies consistently report higher rates of sexual dysfunction among individuals with DM compared to those without the disease [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], with depression also considered an important contributing factor in women [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMetabolic disturbances, elevated HbA1C levels, and neuropathy-related bladder dysfunction increase the risk of bacteriuria and recurrent genitourinary infections [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Microangiopathy further prolongs infection duration by impairing antibiotic absorption. In addition, hyperglycemia reduces vaginal lubrication, leading to dyspareunia [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Beyond these physiological mechanisms, psychological responses to chronic disease and its treatment may also contribute to sexual dysfunction and decreased sexual desire [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe effect of DM on sexuality was first noted by Ibn-i Sina in the 10th century as a \u0026ldquo;collapse of sexual function.\u0026rdquo; However, due to sociocultural taboos, research on this subject only gained attention after the 1950s [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Sexuality remains a core component of overall health, yet it continues to be a sensitive topic, especially for women, and this reluctance hinders sexual education and healthcare delivery [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Although research on male sexuality has long dominated the literature, studies on female sexuality have increased only in the 21st century and remain insufficient [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDM can impair female sexual function by affecting hormonal regulation, neural pathways, and vascular structures. Among married women, such problems may lower quality of life and strain marital relationships. Existing studies, however, often fail to capture the influence of current sociocultural dynamics. This study therefore aims to provide updated evidence on the sexual health of married women with DM, considering both individual and societal contexts. The findings are expected to guide healthcare professionals in integrating sexual health into DM care and support a more holistic approach to women\u0026rsquo;s health.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003ch2\u003e\u003cem\u003eType of Research\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe research was conducted in descriptive type.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003ePopulation and Sample of the Study\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe population of the study consisted of married women aged between 18-45 years who were admitted to Hitit University Erol Olçok Training and Research Hospital and who had diabetes mellitus. In the sample calculation of the study, the sampling formula with known population was used. According to the calculation, the sample size to be selected was 160 and 160 women aged 18-45 years who applied to Hitit University Erol Olçok Training and Research Hospital Internal Medicine outpatient clinic were included.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eData Collection Tools\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003ePersonal information form (PIF).\u003c/strong\u003e This form was developed by the researcher by reviewing the literature [17,18,19] to determine the sociodemographic characteristics of women. In this form consisting of 31 questions; in addition to some socio-demographic characteristics (such as age, height, body weight, education level, etc.), there are questions about some gynaecological and obstetric characteristics, questions about DM history and questions about sexual life history.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSexual Quality of Life Scale-Female (SQLS-F).\u003c/strong\u003e The Turkish validity and reliability study of the scale developed by Symonds, Boolell, and Quirk (2005) to measure the quality of sexual life was conducted by Tuğut and Gölbaşı in 2010 [17, 20]. It was reported that the item-total score reliability coefficient of SQLS-F varied between r=0.32-0.67 and the Cronbach's alpha value was 0.83 [17]. The statements in the scale should be answered by considering the sexual life in the last four weeks. The scale, which has 18 items, is a six-point Likert-type scale and can be applied to all women over the age of 18. In the original scale, it is stated that each item can be scored between 0-5 or 1-6. As the total score increases, the quality of sexual life increases [20].\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eData Collection\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe research data were collected by face-to-face interviews with women who applied to Hitit University Erol Olçok Training and Research Hospital internal medicine outpatient clinics and met the inclusion criteria of the study. Data collection took an average of 30 minutes.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eAnalysing the Data\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eStatistical Package fort the Social Science (SPSS) package programe was used to evaluate the data. Descriptive statistics were expressed as number (n), percentage (%) and mean ± standard deviation (x̄ ± SD). Mann Whitney U test was used to compare paired groups in non-parametric data, T test was used to compare paired groups in parametric data, Kruskal Wallis test was used to compare non-parametric groups of 3 or more, and Spearman's rho correlation test was used in correlation analysis. The results were evaluated at 95.0% confidence interval, p\u0026lt;0.05 significance level and p\u0026lt;0.01, p\u0026lt;0.001 advanced significance level.\u003c/p\u003e\n\u003ch2\u003e\u003cem\u003eLimitations of the Study\u003c/em\u003e\u003c/h2\u003e\n\u003cp\u003eThe results of the study were limited to 160 married women with DM between the ages of 18-45, living in Çorum province, diagnosed with DM and applying to the internal medicine outpatient clinic of Hitit University Erol Olçok Training and Research Hospital. The data on the quality of sexual life analysed within the scope of the study are limited to the qualities measured by the SQLS-F. The information obtained within the scope of this research is limited to the accuracy of the answers given by the participants to the questions asked. In addition, the answers to questions involving sexuality may be affected by cultural, religious and social norms.\u003c/p\u003e"},{"header":"Findings","content":"\u003cp\u003eThe majority of participants were aged 40\u0026ndash;44 years (35.6%), had completed primary school (33.8%), and were housewives (62.5%). Most women perceived their income level as moderate (69.4%). A large proportion resided in the city center and lived in nuclear families (Table\u0026nbsp;1).\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable I.\u003c/b\u003e Sociodemographic Characteristics of the Participants and Distribution of SQOL-F Mean Scores\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSQOL-F SCORE\u003c/p\u003e\u003cp\u003ex̄ \u0026plusmn; SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTest/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e79,29\u0026thinsp;\u0026plusmn;\u0026thinsp;7,80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u0026ndash;34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e59,71\u0026thinsp;\u0026plusmn;\u0026thinsp;20,75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:72,765\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e35\u0026ndash;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e49,67\u0026thinsp;\u0026plusmn;\u0026thinsp;23,55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u0026ndash;44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e36,36\u0026thinsp;\u0026plusmn;\u0026thinsp;21,01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6,66\u0026thinsp;\u0026plusmn;\u0026thinsp;22,54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e2,49\u0026thinsp;\u0026plusmn;\u0026thinsp;15,34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:74,919\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e17,89\u0026thinsp;\u0026plusmn;\u0026thinsp;24,02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e33,27\u0026thinsp;\u0026plusmn;\u0026thinsp;25,29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e41,96\u0026thinsp;\u0026plusmn;\u0026thinsp;24,78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e67,87\u0026thinsp;\u0026plusmn;\u0026thinsp;16,89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProfession\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousewife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e24,65\u0026thinsp;\u0026plusmn;\u0026thinsp;27,20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:38,338\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOfficer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e63,12\u0026thinsp;\u0026plusmn;\u0026thinsp;23,19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLabourer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e39,42\u0026thinsp;\u0026plusmn;\u0026thinsp;28,47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e56,66\u0026thinsp;\u0026plusmn;\u0026thinsp;28,43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePerception of income level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22,29\u0026thinsp;\u0026plusmn;\u0026thinsp;26,55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:16,201\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCentre\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e69,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e38,06\u0026thinsp;\u0026plusmn;\u0026thinsp;30,29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e74,16\u0026thinsp;\u0026plusmn;\u0026thinsp;9,57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFamily type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCore\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e36,89\u0026thinsp;\u0026plusmn;\u0026thinsp;30,29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -2,426\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e20,43\u0026thinsp;\u0026plusmn;\u0026thinsp;27,37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,015*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProvince\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e41,09\u0026thinsp;\u0026plusmn;\u0026thinsp;29,74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:21,880\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDistrict\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e22,14\u0026thinsp;\u0026plusmn;\u0026thinsp;24,95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVillage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6,66\u0026thinsp;\u0026plusmn;\u0026thinsp;22,12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003ez : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p\u0026thinsp;\u0026lt;\u0026thinsp;0,05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eA considerable proportion of participants married at a young age, with 63.8% reporting marriage between the ages of 13 and 22. In addition, 42.5% of the women had been married for 22 years or longer (Table II).\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable II.\u003c/b\u003e Marital History Variables and Distribution of SQOL-F Mean Scores\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSQOL-F SCORE\u003c/p\u003e\u003cp\u003ex̄ \u0026plusmn; SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTest/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarriage age\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u0026ndash;22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e37,72\u0026thinsp;\u0026plusmn;\u0026thinsp;22,76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW 49,203\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e23\u0026ndash;32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e69,55\u0026thinsp;\u0026plusmn;\u0026thinsp;22,74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e33\u0026ndash;43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e62,67\u0026thinsp;\u0026plusmn;\u0026thinsp;26,53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003emarriage (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e78,17\u0026thinsp;\u0026plusmn;\u0026thinsp;16,85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:73,138\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e63,58\u0026thinsp;\u0026plusmn;\u0026thinsp;19,50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u0026ndash;21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e44,35\u0026thinsp;\u0026plusmn;\u0026thinsp;18,21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e32,31\u0026thinsp;\u0026plusmn;\u0026thinsp;22,95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eForm of marriage\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eArranged marriage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18,63\u0026thinsp;\u0026plusmn;\u0026thinsp;24,12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez:-7,632\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBy meeting and\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e55,50\u0026thinsp;\u0026plusmn;\u0026thinsp;24,52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eagreeing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003ez : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p\u0026thinsp;\u0026lt;\u0026thinsp;0,05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe majority of participants reported using family planning methods (FPM) (73.8%), with tubal ligation being the most common method (43.2%) (Table III).\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable III.\u003c/b\u003e Family Planning Method Use and Distribution of SQOL-F Mean Scores\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSQOL-F\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTest/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFPI use status (n:160)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e73,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e27,58\u0026thinsp;\u0026plusmn;\u0026thinsp;2,56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -4,865\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-users\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e54,04\u0026thinsp;\u0026plusmn;\u0026thinsp;4,46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFPI Used (n:118)*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTubal ligation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e14,39\u0026thinsp;\u0026plusmn;\u0026thinsp;3,28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWithdrawal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e48,88\u0026thinsp;\u0026plusmn;\u0026thinsp;5,73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW 35,316\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCondom\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e44,39\u0026thinsp;\u0026plusmn;\u0026thinsp;5,11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOral contraceptive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e65,55\u0026thinsp;\u0026plusmn;\u0026thinsp;4,44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntrauterine device\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18,38\u0026thinsp;\u0026plusmn;\u0026thinsp;4,28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e(IUD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e* This group consisted of women using FPI. Percentages are based on n., z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p\u0026thinsp;\u0026lt;\u0026thinsp;0,05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong the participants, the majority had Type 2 DM (81.9%), and almost all were receiving treatment (96.2%). The most commonly reported treatment regimens were oral antidiabetic therapy and combined oral antidiabetic plus insulin therapy (Table IV).\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable IV.\u003c/b\u003e Diabetes History and Distribution of SQOL-F Mean Scores\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSQOL-F\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTest/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDM type\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e56,89\u0026thinsp;\u0026plusmn;\u0026thinsp;27,20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -4,356\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType 2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e81,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e29,58\u0026thinsp;\u0026plusmn;\u0026thinsp;28,85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDM duration\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e(years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48,1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e52,48\u0026thinsp;\u0026plusmn;\u0026thinsp;25,73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW: 4,695\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e48,29\u0026thinsp;\u0026plusmn;\u0026thinsp;29,60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,196\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e37,12\u0026thinsp;\u0026plusmn;\u0026thinsp;23,25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDM treatment status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003etreatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e96,2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e33,67\u0026thinsp;\u0026plusmn;\u0026thinsp;2,43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -1,918\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-treatmenr\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e56,48\u0026thinsp;\u0026plusmn;\u0026thinsp;10,94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,055\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDM treatment method*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOral antidiabetic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40,9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e40,10\u0026thinsp;\u0026plusmn;\u0026thinsp;3,46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW 45,121\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInsulin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e58,65\u0026thinsp;\u0026plusmn;\u0026thinsp;4,92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOral antidiabetic +\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e15,46\u0026thinsp;\u0026plusmn;\u0026thinsp;2,91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003einsulin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e* This group consisted of women receiving medical treatment. Percentages are based on n\u0026thinsp;=\u0026thinsp;154. z : Mann Whitney U Test, KW: Kruskal Wallis Analysis of Variance, *p\u0026thinsp;\u0026lt;\u0026thinsp;0,05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eMost participants reported having sexual intercourse at intervals longer than two weeks. They also indicated that sexual and reproductive health (SH/RH) problems had increased after their DM diagnosis. Vaginal dryness was the most frequently reported problem (45.0%). Notably, a very high proportion of women (97.5%) had not received counseling for SH/RH problems (Table V).\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable V.\u003c/b\u003e Sexual and Reproductive Health History and Distribution of SQOL-F Mean Scores\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabe\" border=\"1\"\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSQOL-F\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTest/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of sexual intercourse\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce or twice a week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e69,27\u0026thinsp;\u0026plusmn;\u0026thinsp;11,94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLonger than a week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e32,35\u0026thinsp;\u0026plusmn;\u0026thinsp;21,67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eKW:99,062\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLonger than two weeks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e13,40\u0026thinsp;\u0026plusmn;\u0026thinsp;21,16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLonger than a month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e-3,49\u0026thinsp;\u0026plusmn;\u0026thinsp;7,99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHaving Reproductive Health and Sexual Health (RH/SH) Problems Before Being Diagnosed with DM\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiving\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6,3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e19,01\u0026thinsp;\u0026plusmn;\u0026thinsp;23,60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -8,946\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot living\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e64,15\u0026thinsp;\u0026plusmn;\u0026thinsp;16,74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep:0,000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCurrent SH/RH Problem Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiving\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e65,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e23,21\u0026thinsp;\u0026plusmn;\u0026thinsp;27,12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -1,241\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot living\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e35,28\u0026thinsp;\u0026plusmn;\u0026thinsp;30,50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,212\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCurrent SH/RH Problems *\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVaginal dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e45,86\u0026thinsp;\u0026plusmn;\u0026thinsp;30,43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVaginal itching\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e38,62\u0026thinsp;\u0026plusmn;\u0026thinsp;31,38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e : 8,011 **\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequent recurrent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e38,62\u0026thinsp;\u0026plusmn;\u0026thinsp;31,38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,091\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003evaginal yeast\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003einfection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyspareunia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e40,68\u0026thinsp;\u0026plusmn;\u0026thinsp;30,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSexual aversion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e41,80\u0026thinsp;\u0026plusmn;\u0026thinsp;29,46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCounselling Status Regarding SH/RH\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCounselling SH/RH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e63,88\u0026thinsp;\u0026plusmn;\u0026thinsp;10,44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ez: -5, 144\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-Counselling SH/RH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e33,77\u0026thinsp;\u0026plusmn;\u0026thinsp;30,35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep: 0,061\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e* More than one option is selected.\u003cb\u003e**\u003c/b\u003e This group consisted of women who had UC/CS problem. Percentages are based on n\u0026thinsp;=\u0026thinsp;105. z : Mann Whitney U Test, KW: Kruskal Wallis Variance analysis, x\u003csup\u003e2\u003c/sup\u003e : Chi-Square test, *p\u0026thinsp;\u0026lt;\u0026thinsp;0,05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, the sexual quality of life among married women with diabetes was found to be low (34.53\u0026thinsp;\u0026plusmn;\u0026thinsp;30.36). Compared with international and national studies using the same scale, our findings were lower than most reported in the literature. For example, \u0026Ccedil;elik et al. (2015) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] reported a higher SQOL-F mean score (68.01\u0026thinsp;\u0026plusmn;\u0026thinsp;22.22), while K\u0026ouml;se-Tuncer et al. (2023) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] reported moderate results (53.99\u0026thinsp;\u0026plusmn;\u0026thinsp;10.33). Conversely, Şahin and Şahin (2015) [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] found similarly low scores in women with Type 2 DM (38.56\u0026thinsp;\u0026plusmn;\u0026thinsp;10.89), consistent with our findings. Overall, these results suggest that DM negatively affects sexual quality of life, supporting the low mean score observed in this study. Differences between studies may be explained by variations in study location, period, and sample size.\u003c/p\u003e\u003cp\u003eOur results also showed that sexual problems increased with advancing age, consistent with previous research [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Moreover, higher education levels were associated with better sexual quality of life [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. This finding may be explained by greater self-expression, willingness to question sexual life, and openness to new experiences among more educated women. In contrast, women with lower education levels may show higher acceptance of chronic disease-related challenges and lower likelihood of seeking solutions.\u003c/p\u003e\u003cp\u003eOccupational status also influenced outcomes. Housewives had lower mean SQOL-F scores compared with civil servants [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Studies of women with chronic diseases similarly report that employed women have better sexual quality of life than unemployed women [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Likewise, women with higher income levels reported higher quality of sexual life [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. These findings may reflect the greater socioeconomic independence and reduced stress burden of working women, whereas economic difficulties in the family may contribute to marital discord and impaired spousal communication.\u003c/p\u003e\u003cp\u003eIn addition, women living in city centers reported better sexual quality of life compared to those residing in districts and villages. T\u0026uuml;zmen (2019) [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] reported similar findings in different populations. This may be related to higher socioeconomic welfare, more active social life, and easier access to healthcare services in urban areas, all of which may improve sexual health outcomes.\u003c/p\u003e\u003cp\u003eIn the literature, higher age at marriage has been associated with better sexual quality of life, which is consistent with our findings [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. This may be explained by the fact that women who marry later are more likely to have accurate information about sexuality and easier access to reliable sources. Conversely, longer marriage duration was associated with lower sexual quality of life. Several studies have similarly reported that prolonged marriage duration negatively affects sexual life in different populations [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Possible explanations include aging, the development of chronic diseases, and the impact of medications on sexual function.\u003c/p\u003e\u003cp\u003eIn this study, sexual quality of life was found to increase with the number of living children. This may reflect sociocultural values in which having children is considered more important than sexual pleasure or satisfaction, and women without children may face pressure from their spouses and families. However, contrary to our findings, other studies have reported that sexual quality of life decreases as the number of children increases [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRegarding family planning methods, women who did not use any method had higher sexual quality of life compared with users. Among users, those who relied on oral contraceptives reported the highest scores, whereas women who had undergone tubal ligation reported the lowest. Wallwiener et al. (2010) [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] found that oral contraceptive use was associated with better sexual function, while \u0026Ccedil;\u0026ouml;l (2019) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] reported that tubal ligation was associated with the lowest sexual quality of life. These findings are in line with our study. A likely explanation is that oral contraceptives are commonly used by younger women, whereas tubal ligation is more frequent among multiparous and older women, which may account for the observed differences in sexual quality of life.\u003c/p\u003e\u003cp\u003eAccording to treatment methods, women receiving combined oral antidiabetic and insulin therapy reported lower sexual quality of life compared with those using other treatment regimens. Derosa et al. (2023) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] found that sexual function improved when glycemic control was achieved through treatment. Similarly, Piątkiewicz et al. (2017) [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] reported higher sexual satisfaction among patients using insulin pumps compared with those receiving injections, noting that visible injection marks may cause discomfort for partners. Erten et al. (2019) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] also reported lower rates of sexual dysfunction among insulin users. The discrepancy between our findings and the literature may be explained by the advanced age and longer disease duration of women in our sample receiving combined therapy.\u003c/p\u003e\u003cp\u003eOur study also confirmed findings from the literature indicating that urogenital and sexual health problems negatively affect sexual quality of life. Reported complications include genitourinary infections [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], dyspareunia [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], vaginal dryness [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], unpleasant odor [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], sexual reluctance [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], and orgasmic disorders [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Vaginal dryness emerged as the most common problem among our participants, consistent with Mehdipour-Rabori et al. (2020) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], who found that dryness and itching were the most frequent dermatological findings in women with DM, while fungal infections were the most common infectious diseases. Vaginal dryness reduces lubrication, which can cause painful intercourse [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Similarly, Masood et al. (2021) [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] reported dyspareunia in 84.1% of their sample. Collectively, the literature indicates that DM negatively affects female sexual function [36], leading to reluctance, vaginal dryness, dyspareunia [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], reduced satisfaction [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], and overall sexual dysfunction [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eImportantly, our findings showed that women who received counseling about their urogenital or sexual health problems had significantly higher SQOL-F scores, highlighting the potential benefit of targeted counseling interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contribution rate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIdea/concept:\u0026nbsp;NKS, NBD;\u0026nbsp;Design:\u0026nbsp;NKS, NBD;\u0026nbsp;Data\u0026nbsp;collection:\u0026nbsp;NKS;\u0026nbsp;Data\u0026nbsp;processing: NKS;\u0026nbsp;Analysis and/or interpretation: NKS, NBD; Literature search: NKS; Writing the article: NKS, NBD, RHA; Critical review: NBD, RHA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict\u0026nbsp;of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere\u0026nbsp;is\u0026nbsp;no\u0026nbsp;conflict\u0026nbsp;of\u0026nbsp;interest\u0026nbsp;between\u0026nbsp;the\u0026nbsp;authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo\u0026nbsp;financial\u0026nbsp;support\u0026nbsp;was\u0026nbsp;received\u0026nbsp;from\u0026nbsp;any\u0026nbsp;institution\u0026nbsp;or organisation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contrubition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [NKS], [NBD] and [RHA]. The first draft of the manuscript was written by [NKS] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrior to the study, permission was obtained from Hitit University Non-Interventional Research Ethics Committee (Decision No: 2018-222) and all participants were asked to fill out the \u0026quot;Informed Voluntary Consent Form\u0026quot;. The scales were filled out individually by the researchers by going to the relevant outpatient clinics. The women participating in the study were informed about the research and written and verbal consent was obtained. This study was performed in line with the principles of the Declaration of Helsinki.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOlgun, N., Aslan, E., Coşansu, G., ve \u0026Ccedil;elik, S. (2020). Diabetes Mellitus. Karadakovan, A. ve Eti Aslan, F. (Eds.), \u003cem\u003eCare in Internal and Surgical Diseases\u003c/em\u003e in (pp. 787\u0026ndash;824). Academician Bookstore\u003c/li\u003e\n\u003cli\u003eTurkish Society of Endocrinology and Metabolism (TEMD). (2014). \u003cem\u003eDiagnosis, treatment, and monitoring guidelines for diabetes mellitus and its complications.\u003c/em\u003e http://www.turkendokrin.org/files/file/DIYABET_TTK_web.pdf\u003c/li\u003e\n\u003cli\u003eUnited Nations Resolution 61/225: World Diabetes Day. http://www.idf.org/sites/default/files/UNResolutiononWorldDiabetesDayof Dec2006.pdf. 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The relation of diabetes type 2 with sexual function among reproductive age women in iran, a case- control study. \u003cem\u003eHindawi Advances in Medicine\u003c/em\u003e, 4838923, https://doi.org/10.1155/2017/4838923. \u003c/li\u003e\n\u003cli\u003eBaşkan, B. (2015). Evaluation of sexual life quality in women with inflammatory bowel disease (Unpublished master\u0026apos;s thesis). Marmara University.\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;\u0026ouml;l, D. (2019). Examination of married women in primary care in terms of sexual dysfunction and quality of sexual life and investigation of the affecting factors (Unpublished medical specialization thesis). Health Sciences University.\u003c/li\u003e\n\u003cli\u003eDerosa, G., Romano, D., Angelo, A., ve Maffioli, P. (2023). 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(2019). \u003cem\u003eGlobal report on diabetes.\u003c/em\u003e https://www.who.int/publications/i/item/global-report-on-diabetes\u003c/li\u003e\n\u003cli\u003eYenice, M. G., Danacıoğlu, Y. O., Mert, M., Karakaya, P., Seker, K. G., Akkaş, F., Şimşek, A., Şahin, S., ve Taş\u0026ccedil;ı, A. I. (2020). Evaluation of factors affecting sexual dysfunction in female patients with diabetes mellitus. \u003cem\u003eArchives of Endocrinology and Metabolism\u003c/em\u003e, 64(3), 319-325. https://doi.org/10.20945/2359-3997000000238 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sexual Quality of Life, Diabetes Mellitus, Female Sexuality","lastPublishedDoi":"10.21203/rs.3.rs-7110217/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7110217/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eDiabetes Mellitus (DM) is a chronic systemic disease with a rapidly increasing prevalence worldwide. Vascular and neurological complications associated with DM can impair sexual function and negatively affect the overall quality of sexual life. This descriptive study aimed to assess the sexual quality of life among married women with diabetes and to identify the influencing factors. The study included 160 women with DM in Turkey. Data were collected using a 31-item Personal Information Form (PIF) and the Sexual Quality of Life-Female (SQOL-F) scale. Statistical analyses were performed using the Mann Whitney U test, Kruskal Wallis test, and Spearman\u0026rsquo;s correlation test. The mean SQOL-F score was 34.53\u0026thinsp;\u0026plusmn;\u0026thinsp;30.36. SQOL-F scores differed significantly by age, education level, occupation, age at marriage, duration of marriage, type of marriage, and frequency of sexual intercourse (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). A significant association was also found between SQOL-F scores and both DM type and treatment method (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However, disease duration and the presence of sexual or reproductive health problems were not statistically significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e","manuscriptTitle":"Quality of Sexual Life and Influencing Factors in Married Diabetic Women","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-27 15:47:10","doi":"10.21203/rs.3.rs-7110217/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c9f2ff7b-4044-4a6b-808e-03c07e3b357e","owner":[],"postedDate":"October 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-29T23:24:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-27 15:47:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7110217","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7110217","identity":"rs-7110217","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}