Female sexual dysfunction and hormonal status in spinal cord injured (SCI) patients

Abstract

To investigate a possible correlation between sexual hormonal status and the presence of female sexual dysfunction (FSD) using the Female Sexual Function Index (FSFI) in females with spinal cord injuries (SCI), we selected 39 SCI fertile-aged women. At visit 1, we assessed the presence of FSD using the FSFI, and all individuals were submitted to a blood hormone evaluation on the third day of their menstrual cycle. The levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid-stimulating hormone (TSH), cortisol, dehydroepiandrosterone sulphate (DHEA-S), androstenedione, 17[alpha]-hydroxyprogesterone; total and free testosterone, 17beta-estradiol, inhibin, sex hormone-binding globulin (SHBG), and thyroid hormones (fT3 and fT4) were checked. Progesterone was measured on the 20th to 21st day after the menstrual cycle. In patients with amenorrhea, we tested all the hormones using 1 random blood test. After a 3-month period, the tests were repeated. Overall, 23/39 (58.9%) patients continued to manifest at least one sexual dysfunction. These patients reached a median score of 19.52. All but 6 patients (15.3%) consistently showed hormonal values within the normal range. Of the 6 patients with abnormal hormonal alterations, 5 showed at least one sexual dysfunction, 2 had low levels of total testosterone, 1 had a low level of free testosterone, 1 suffered from hypothyroidism, 1 presented with low levels of cortisol, and 1 showed hypoprogesterone. There was no significant correlation between abnormal hormonal status and the presence of a specific sexual dysfunction, as assessed with the FSFI.