Endocrine Abstracts

Introduction: Female sexual dysfunctions (FSD) are complex conditions characterized by impairment of the female sexual cycle. Higher prevalence of FSD has been found in women with diabetes, as compared with matched healthy controls. Endothelial progenitor cells (EPCs) are circulating mononuclear cells participating in the neo-angiogenesis. There is evidence that circulating levels of EPCs are reduced in diabetic patients compared with age-matched subjects. The relationship between EPCs and sexual function during menses in women with diabetes has never been investigated.

Aim: The aim of this study is to assess circulating levels of EPCs in different phases of the menses in young women with type 1 diabetes. The relationship between EPCs levels and sexual function will be also investigated.

Matherials and methods: Sexually active women, aged 18-30 years, with type 1 diabetes (T1D) and age-matched healthy controls with a stable couple relationship and no oral contraceptive use were included in the study. Blood samples were drawn in the follicular, ovulatory and luteal phases of the same menses to assess sexual hormones levels, including FSH, LH, progesterone and estradiol. EPCs were quantified by flow cytometry. Sexual function was investigated using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) during the three phases of menstrual cycle; FSD was diagnosed by a FSFI score < 26.55 and a FSDS score >15. Women with hypogonadism, polycystic ovarian syndrome or irregular menses were excluded.

Results: A total of 18 women with T1D and 8 healthy controls were enrolled. Mean age was 25 years and mean BMI was 23.4 Kg/m2. In the overall population FSD prevalence was 7%. There were no differences in sexual hormone levels during the different phases of menses in the 2 groups. The FSFI total score as well as the scores related to desire, arousal, lubrication and pain were lower in diabetic women as compared with those of control subjects. Moreover, circulating levels of CD34+ and CD34+KDR+ cells EPCs were significantly lower in the ovulatory phase (P=0.03) and ovulatory/luteal phases (P=0.04;P=0.02) respectively in women with diabetes as compared healthy controls. No significant difference was observed in the other EPCs phenotypes.

Conclsion: Young fertile diabetic women showed a worse sexual function and lower levels of EPCs as compared with healthy age-matched women during the different phases of menstrual cycle.