title: The Study of Gonadal Hormonal Abnormalities and Sexual Dysfunction in HIV Positive Females: An Exploratory Study.
abstract: BACKGROUND
  Every endocrine gland has been reported to be affected at varying rates in HIV. HIV is a highly stigmatized chronic disease with a substantial co-occurrence of mental and sexual health problems; however the sexual health problems in women have not been extensively studied.
  
  
  OBJECTIVE
  To study the gonadal hormonal abnormalities and sexual dysfunction in HIV positive female patients and its possible association.
  
  
  METHODS
  This descriptive/exploratory study was conducted in the Department of General Medicine at a tertiary care hospital from September 2013 to August 2015. The study group included 50 diagnosed HIV-positive patients. They were also subjected to specific questions regarding sexual dysfunction by female counselors using female sexual function index. Visits of the subjects were scheduled independent of the menstrual cycle. Hormonal levels (free testosterone, FSH, LH) were measured.
  
  
  RESULTS
  Out of 50 patients, 26 patients in our study had sexual dysfunction (52%). Patients with age group between 30-39 years had the maximum sexual dysfunction compared to the other groups (<0.001). Patients with a CD4 count between 200 and 499 had the maximum sexual dysfunction (<0.02). Mean duration of HIV in the study was 30 months in sexual dysfunction group which was significant (p<0.005). Hormonal levels were found to be in normal range. All the study patients reported desire, arousal and lubrication problems whereas orgasm and satisfaction problems were noted in 60% patients with pain reported in 52%.
  
  
  CONCLUSIONS
  We identified that although the hormonal levels were in the normal range, they were comparatively in the lower range in the dysfunction group than the non-dysfunctional group. Both free testosterone and FSH levels were low indicating involvement of the pituitary rather than the gonads. We also conclude that duration of HIV and also level of CD4 count is related to sexual dysfunction.
authors.affiliation: Associate Professor, Department of General Medicine, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
authors.forename: Bhanukumar
authors.initials: B
authors.lastname: Muthiah
authors.affiliation: Post Graduate, Department of General Medicine, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
authors.forename: Abithraj
authors.initials: A
authors.lastname: Kallikadavil
authors.affiliation: Assistant Professor, Department of General Medicine, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
authors.forename: Rajendraprasad
authors.initials: R
authors.lastname: Shivaswamy
authors.affiliation: Research Scholar, Department of Clinical Pharmacy, JSS Medical College and Hospital , SS Nagar, Mysore, Karnataka, India .
authors.forename: Vineetha Bharathan
authors.initials: VB
authors.lastname: Menon
keywords: AIDS; CD4 count; Female sexual function index; Follicle-stimulating hormone; Free testosterone; Luteinizing hormone