Sexual Dysfunction Is Frequent in Premenopausal Women with Diabetes, Obesity, and Hypothyroidism, and Correlates with Markers of Increased Cardiovascular Risk. A Preliminary Report

Authors

  • Annamaria Veronelli MD,

    1. Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;
    2. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Chiara Mauri MD,

    1. Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;
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  • Barbara Zecchini BSC,

    1. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Maria Grazia Peca MD,

    1. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Olivia Turri MD,

    1. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Maria Teresa Valitutti BSC,

    1. Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;
    2. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Chiara Dall'Asta MD,

    1. Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;
    2. Ospedale San Paolo—Medicina 2a, Milano, Italy
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  • Antonio E. Pontiroli MD

    Corresponding author
    1. Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;
    2. Ospedale San Paolo—Medicina 2a, Milano, Italy
      Antonio E. Pontiroli, MD, Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy. Tel: 390281844559; Fax: 390281844576; E-mail: antonio.pontiroli@unimi.it
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Antonio E. Pontiroli, MD, Università degli Studi di Milano—Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy. Tel: 390281844559; Fax: 390281844576; E-mail: antonio.pontiroli@unimi.it

ABSTRACT

Introduction.  Female sexual dysfunction (FSD) is characterized by reduced sexual appetite and altered psychologic and physiologic response to sexual intercourse; it is reported to be frequent in diabetes mellitus, but no data have been reported in thyroid disorders.

Aims.  To compare the prevalence of FSD in diabetic, in obese, and in hypothyroid women vs. healthy women, and to correlate FSD with endocrine and metabolic profiles.

Methods.  We evaluated, through a questionnaire (Female Sexual Function Index [FSFI]), the prevalence of FSD in 91 women affected by diabetes mellitus, obesity, or hypothyroidism, and in 36 healthy women, all aged 22–51 years and in premenopausal state.

Main Outcome Measures.  FSFI score, endocrine and metabolic parameters (triglycerides, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol, free-triiodothyronine (FT3), free-thyroxine (FT4), thyroid stimulating hormone [TSH], 17-beta-estradiol, testosterone, glycated hemoglobin 1c (HbA1c), thyroid autoantibodies, E-selectin, P-selectin, intercellular adhesion molecule-1 [ICAM-1], plasminogen-activator inhibitor-1 [PAI-1]), and anthropometric parameters (body mass index, waist, blood pressure [BP]).

Results.  A reduced FSFI score was more frequent in diabetic, obese, and hypothyroid women vs. healthy women (P < 0.01). In the different groups of women, FSFI score was inversely correlated (pairwise correlation) with at least one of the following: HbA1c, TSH, LDL-cholesterol, PAI-1, diastolic BP, presence of thyroid Ab, and directly correlated with HDL-cholesterol (always P < 0.05 or less). At stepwise regression analysis, HDL-cholesterol (protective) and HbA1c, LDL-cholesterol, PAI-1, and diastolic BP (negatively) predicted reduced FSFI score.

Conclusion.  These data indicate an increased prevalence of sexual dysfunction in diabetic, in obese, and in hypothyroid women, associated with markers of cardiovascular risk. Veronelli A, Mauri C, Zecchini B, Peca MG, Turri O, Valitutti MT, dall'Asta C, and Pontiroli AE. Sexual dysfunction is frequent in premenopausal women with diabetes, obesity, and hypothyroidism, and correlates with markers of increased cardiovascular risk. A preliminary report. J Sex Med 2009;6:1561–1568.

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