title: Sexual dysfunction is frequent in premenopausal women with diabetes, obesity, and hypothyroidism, and correlates with markers of increased cardiovascular risk. A preliminary report.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  These data indicate an increased prevalence of sexual dysfunction in diabetic, in obese, and in hypothyroid women, associated with markers of cardiovascular risk.
authors.affiliation: Università degli Studi di Milano-Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;; Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Veronelli
authors.affiliation: Università degli Studi di Milano-Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mauri
authors.affiliation: Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zecchini
authors.affiliation: Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Peca
authors.affiliation: Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Olivia
authors.initials: O
authors.lastname: Turri
authors.affiliation: Università degli Studi di Milano-Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;; Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Valitutti
authors.affiliation: Università degli Studi di Milano-Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;; Ospedale San Paolo-Medicina 2a, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Dall'Asta
authors.affiliation: Università degli Studi di Milano-Dipartimento di Medicina, Chirurgia e Odontoiatria, Milano, Italy;; Ospedale San Paolo-Medicina 2a, Milano, Italy. Electronic address: antonio.pontiroli@unimi.it.
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Pontiroli
mesh_terms: D000328:Adult; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015815:Cell Adhesion Molecules; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D019040:E-Selectin / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D019007:P-Selectin / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017697:Premenopause / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019007:P-Selectin; D017395:Plasminogen Activator Inhibitor 1; D018799:Intercellular Adhesion Molecule-1