Endocrine Abstracts

Rationale: The gluco-metabolic changes during pregnancy significantly impact women’s sexual behavior. This study aimed to define the relationship between metabolic health and sexual function, along with human circadian rhythms and sleep quality during pregnancy.

Methods: This study included 57 pregnant women (14 evaluated at first trimester, G1; 18 at second trimester, G2, and 25 at third trimester, G3). Among groups, no difference between age, gestational hypertension, number of pregnancies obtained by ART, glucocorticoid treatment and BMI before pregnancy (pre-BMI) was detected. In G2 former smokers (P<0.001) and physically active women (P<0.001) were lower than G1 and G3. All women exhibited vitamin D insufficiency. The entire cohort completed the following questionnaires: 1) FSFI and FSD, to assess female sexuality; 2) PREDIMED, to test adherence to the Mediterranean diet; 3) Pittsburgh Sleep Quality index (PSQI), to assess quality of sleep; 4) Morningness-eveningness (ME), to determine chronotype.

Results: In G1, HbA1c directly correlated with age (P=0.019;r=-0.98) and inversely with desire score (P=0.038;r=-0.96). In G2, 4/18 (22%) were diagnosed with gestational diabetes (GDM). Pre-BMI correlated with higher blood glucose (GL) 60 minutes after the OGTT (P=0.002; r=0.9), while the lubrication score inversely correlated with fasting GL (P=0.039; r=-0.6), insulin (P=0.041; r=-0.59), and HOMA-index (P=0.037; r=-0.60). HOMA index emerged as the best predictor of lubrication score (τ=-2.4; P=0.037). In G3, 11/25 (44%) had well-controlled GDM, and the entire group showed lower GL (P=0.04) but higher insulin (P=0.009) and HOMA-Index (P=0.03) than G2. Prolactin levels were significantly higher than G1 (P=0.02) and correlated with insulin levels of third trimester (P=0.002;r=0.9). Vitamin D significantly correlated with sexual satisfaction score (P=0.007;r=0.81), also confirmed in pregnancy complicated by GDM (P=0.02; r=0.93). Low adherence to Mediterranean diet (G1, 21.4%; G2, 16.7%, G3, 30.7%) was more prevalent in G3 than other groups (P=0.03). In the entire cohort, PSQI indicated sleep disturbances in 91.2% and the ME questionnaire revealed only intermediate and moderate morning chronotype, the latter being more represented in G3 (P=0.0013). FSFI score confirmed sexual dysfunction in 57.1% of patients in G1, in 72.2% of G2, and in 64% of G3, with no difference based on chronotype, or between healthy and diabetic women.

Conclusions: Metabolic parameters negatively influence sexual function during pregnancy. Gluco-insulinemic metabolism predicted a worse lubrication score during the second trimester while the lower Vitamin D levels were, the lower satisfaction score was at third trimester. Chronotype did not interfere with sexual function or with metabolic parameters in pregnancy, suggesting that sexual health during pregnancy is independent of circadian rhythms.