Endocrine Abstracts

Women with CAH have decreased fertility and sexual activity because of psychological aspects and genital status. The aim of this study was to evaluate sexual function and psychological attitudes in 18 women with CAH due to 21-HD (12 with non-classical, four with salt-wasting and two with simple virilizing CAH; 20–48 yrs) under standard treatment, and 18 age-matched healthy women. Sexual function was evaluated by a validated Female Sexual Function Index (FSFI) questionnaire for the assessment of six domains of female sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain) as well as an experimental questionnaire (SIEDY), evaluating the same FSFI domains together with three more domains including body image, relationship with partner and masturbation. Psychological attitudes were investigated through the validated Middlesex Hospital Questionnaire (MHQ), evaluating six domains (anxiety, phobia, obsession, somatisation, depression, hysteria). A significantly lower FSFI score, particularly in lubrication and pain domains, was found in patients than controls (P<0.05). This evidence was confirmed by SIEDY questionnaire, which demonstrated a significant difference also in body image and relationship with partner domains (P<0.05). A significantly higher score (P<0.05) was also found in all MHQ domains except for hysteria domain. Serum testosterone, 17-OH progesterone and androstenedione levels were directly correlated with anxiety, phobia, obsession, somatisation, depression (P<0.05) and inversely correlated with desire, arousal, lubrication, orgasm, satisfaction, and pain (P<0.05). Conversely, DHEA-S was not correlated with MHQ domains, but inversely correlated with arousal, lubrication, orgasm and satisfaction (P<0.05).

In conclusion, this study demonstrated that women with CAH are affected not only by disturbed psychological balance but also to a pathological sexual function, as demonstrated by both a standard and an experimental questionnaire, despite an appropriate treatment.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.