ECE2021 Audio Eposter Presentations Late Breaking (114 abstracts)
Physical activity and female sexual dysfunction: too much of a good thing?
Elisa Maseroli 1 , Giulia Rastrelli 1 , Vincenza Di Stasi 1 , Sarah Cipriani 1 , Irene Scavello 1 , Tommaso Todisco 1 , Veronica Gironi 2 , Giovanni Castellini 2 , Valdo Ricca 2 , Flavia Sorbi 3 , Massimiliano Fambrini 3 , Felice Petraglia 3 , Mario Maggi 4 & Linda Vignozzi 1
1Department of Experimental Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy; 2Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy; 3Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy; 4Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy
Background
Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.
Aim
To investigate the clinical, psychological, and sexual correlates of PA in women with FSD.
Methods
A non-selected series of n = 322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (<1 hour/week: sedentary, 1–3 hours/week: active, 4–6 hours/week: very active, >6 hours/week: extremely active) were investigated with a specific question.
Outcomes
FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Uneasiness Test (BUT), and Middlesex Hospital Questionnaire (MHQ).
Results
At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several FSFI domains - including desire, arousal and lubrication - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (BUT Global severity index), psychopathological symptoms (MHQ total score) and sexual distress (FSDS-R score). These latter two factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i.e. sexual satisfaction and histrionic/hysterical symptoms), even compared to a sedentary lifestyle.
Clinical Implications
Women consulting for FSD may gain benefits on desire, arousal, lubrication and sex-related distress from regular PA; however, physicians should remain alert to the downsides of excessive exercise.
Strengths & Limitations
The main strength lies in the novelty of the findings. The main limitations are the cross-sectional nature, the clinical setting, the small sample size of the different PA groups, and the use of self-reported instruments for the evaluation of PA.
Conclusion
In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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