title: Clitoral blood flow in systemic sclerosis women: correlation with disease clinical variables and female sexual dysfunction.
abstract: OBJECTIVE
  The objectives of this study were to investigate clitoral blood flow in SSc women compared with healthy controls and to correlate it with microvascular damage and disease clinical variables. We also evaluated the correlation between clitoral blood flow and sexual dysfunction.
  
  
  METHODS
  Twenty-two SSc women and 20 healthy controls matched for sex and age were enrolled in this study. Baseline Doppler indices of the clitoral artery were measured. Peak systolic velocity, end diastolic velocity, resistive index (RI), pulsatile index (PI) and systolic/diastolic (S/D) ratio were measured. The female sexual function index (FSFI) was used to assess sexual function.
  
  
  RESULTS
  The RI and S/D ratio were higher (P < 0.0001) in SSc women compared with healthy controls. The PI, RI and S/D ratio increased with progression of capillaroscopic damage. The RI and S/D ratio were higher (P < 0.01) in women with digital ulcers than in women without digital ulcers. No correlation exists between Doppler indices of the clitoral artery and age or clinical variables of disease. The FSFI was reduced in 7 (32%) of 22 SSc women. A negative correlation was observed between both the FSFI and RI (R = -0.74, P < 0.0001) and the S/D ratio (R = -0.68, P < 0.0001). A negative correlation exists between the RI and all domains of the FSFI score except for desire.
  
  
  CONCLUSIONS
  Clitoral blood flow was reduced in SSc women compared with healthy controls. Clitoral blood flow was reduced in SSc women with digital ulcers and it correlated with capillaroscopic damage progression. A negative correlation exists between the RI and S/D ratio and all domains of the FSFI score except for desire.
authors.affiliation: Clinical Immunology Unit, Department of Clinical Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy. edoardo.rosato@uniroma1.it.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosato
authors.forename: Antonietta
authors.initials: A
authors.lastname: Gigante
authors.forename: Biagio
authors.initials: B
authors.lastname: Barbano
authors.forename: Fabiola
authors.initials: F
authors.lastname: La Marra
authors.forename: Ilenia
authors.initials: I
authors.lastname: Molinaro
authors.forename: Silvia
authors.initials: S
authors.lastname: Quarta
authors.forename: Maria Anna
authors.initials: MA
authors.lastname: Digiulio
authors.forename: Rossi
authors.initials: R
authors.lastname: Carmelina
authors.forename: Rosario
authors.initials: R
authors.lastname: Cianci
authors.forename: Simonetta
authors.initials: S
authors.lastname: Pisarri
authors.forename: Felice
authors.initials: F
authors.lastname: Salsano
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D002987:Clitoris / Q000098:blood supply*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D012595:Scleroderma, Systemic / Q000503:physiopathology*; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*; D018616:Ultrasonography, Doppler, Duplex
keywords: clitoral blood flow; female sexual dysfunction; systemic sclerosis