ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Cardiovascular Endocrinology and Lipid Metabolism (29 abstracts)
Cardiometabolic risk and female sexuality: focus on clitoral vascular resistance
Elisa Maseroli 1 , Egidia Fanni 1 , Sarah Cipriani 1 , Irene Scavello 1 , Francesca Pampaloni 1 , Cesare Battaglia 2 , Massimiliano Fambrini 1 , Edoardo Mannucci 1 , Emmanuele A Jannini 3 , Mario Maggi 1, & Linda Vignozzi 1,
1University of Florence, Florence, Italy; 2University of Bologna, Bologna, Italy; 3Tor Vergata University of Rome, Rome, Italy; 4Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy.
The relation between sexual and cardiovascular health in women is not well defined. Clitoral colour Doppler ultrasound (CDU) with assessment of the pulsatility index (PI), reflecting resistance to blood flow, has been proposed as an objective measurement of sexual functioning. We aimed to investigate the associations between clitoral PI and cardiometabolic risk factors. Seventy-one adult heterosexual women attending our clinic for sexual dysfunction were consecutively recruited. Clitoral PI was positively correlated with BMI (P<0.0001), waist circumference (WC; P<0.0001), glycaemia (P=0.029), insulin (P=0.002), homeostatic model assessment index (P=0.005), triglycerides (P=0.011), total cholesterol (P=0.010), and LDL-cholesterol (P=0.016). All relations, with the exception of glycaemia, retained statistical significance after adjusting for age, smoking habit, and years since menopause (P<0.0001 for BMI, WC and triglycerides; P<0.05 for all other associations). Analysis of covariance, after adjusting for confounders, showed that women with obesity or metabolic syndrome (MetS) showed significantly higher PI values (obesity: P=0.001; MetS: P=0.019). In particular, a stepwise increase of PI was found as a function of increasing MetS components (P=0.007). Clitoral PI was negatively associated with Female Sexual Function Index arousal (P=0.014) and satisfaction (β=−0.289, P=0.026) scores and positively associated with Middlesex Hospital Questionnaire somatized anxiety symptoms, even after adjusting for confounders (P=0.011). A positive association also was observed between PI and the Body Uneasiness Test (BUT) positive symptom distress index (P=0.039) and BUT for dislike of the womb, genitals, and breast (P<0.0001; P<0.0001; P<0.0001, respectively). After introducing WC as another covariate, the associations between clitoral PI and the BUT positive symptom distress index and BUT dislike of the womb, genitals, and breast retained statistical significance (P=0.038 for positive symptom distress index; P<0.0001 for dislike of womb, genitals, and breast). Clitoral vascular resistance is positively associated with MetS (in particular insulin resistance), decreased sexual arousal, body image concerns, and increased somatized anxiety symptoms. Further studies are needed to establish whether treatment of metabolic abnormalities might improve clitoral CDU indices and sexual outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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