Hyperglycemia in postmenopausal women screened for the metabolic syndrome is associated to increased sexual complaints

Sexual function scores are associated with arterial stiffness in postmenopausal women

BACKGROUND

Female sexual dysfunction (FSD) has been suggested to be correlated with the burden of cardiovascular risk factors.

AIM

We aimed to evaluate the possible association between functional indices of vascular function and FSD scores in apparently healthy postmenopausal women.

METHODS

This cross-sectional study included 116 postmenopausal women who underwent assessment of endothelial function with measurement of flow-mediated dilation (FMD) of the branchial artery and arterial stiffness estimation with measurement of the carotid-femoral pulse wave velocity (PWV). We used the Greene Climacteric Scale to evaluate vasomotor symptomatology, the Female Sexual Function Index (FSFI) to evaluate FSD and the Beck Depression Inventory to evaluate mood disorder. Low sexual function was defined as an FSFI score <26.55.

OUTCOMES

These included FSFI and low sexual function scores as well as measures of PWV and FMD.

RESULTS

Sexual function scores were associated with measures of blood pressure (normal vs low sexual function; systolic blood pressure: 120.2 ± 15.0 mm Hg vs 113.4 ± 14.6 mm Hg; analysis of covariance P = .026; diastolic blood pressure: 75.9 ± 10.5 mm Hg vs 70.3 ± 9.9 mm Hg; analysis of covariance P = .012; both adjusted for age, body mass index, current smoking, and PWV). Systolic blood pressure, but not diastolic blood pressure, was associated with FSFI (B = 0.249, P = .041) and PWV (B = 0.392, P < .001). PWV measures were associated with FSFI (B = -0.291, P = .047) and pulse pressure (B = 0.355, P = .017). FMD measures were also associated with FSFI (B = 0.427, P = .033). All models were adjusted for age, body mass index, current smoking, insulin resistance, vasomotor symptomatology, and Beck Depression Inventory.

CLINICAL IMPLICATIONS

Our findings demonstrate that lower scores of sexual function are associated with deteriorated vascular function mainly manifested as arterial stiffening, further contributing to systolic blood pressure changes.

STRENGTHS AND LIMITATIONS

The strength of this study is the carefully selected healthy sample of postmenopausal women, with simultaneous assessment of climacteric symptomatology and mood disorders. The limitations include the small sample size, the cross-sectional design, and the recruitment of consecutive outpatients of a university menopause clinic.

CONCLUSION

Longitudinal studies and interventions to improve FSD should further assess the clinical relevance of these findings.

Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes

INTRODUCTION

Erectile dysfunction is recognized as an opportunity for preventing cardiovascular (CV) events, and assessing the impairment of penile vascular flow by Doppler ultrasound is an important tool to ascertain CV risk. Conversely, the role of genital vascular impairment in the pathophysiology of female sexual dysfunction (FSD) remains contentious.

AIM

To focus on the current scientific support for an association between CV risk factors and female sexual health in the 1st part of a 2-part review.

METHODS

A thorough literature search of peer-reviewed publications on the associations between CV risk factors and FSD and their underlying mechanisms was performed using the PubMed database.

MAIN OUTCOME MEASURES

We present a summary of the evidence from clinical studies and discuss the possible mechanisms providing the pathophysiologic bases of vasculogenic FSD syndromes.

RESULTS

The peripheral sexual response in women is a vascular-dependent event, and evidence suggests that cardiometabolic-related perturbations in endothelial function can determine vascular insufficiency in female genital tissues. Although epidemiologic and observational studies demonstrate that the prevalence of FSD is higher in women with diabetes mellitus, a cause-effect relation between these clinical conditions cannot be assumed. Evidence on the effect of obesity, metabolic syndrome, and polycystic ovary syndrome on sexual function in women is controversial. Data on the associations of dyslipidemia and hypertension with FSD are limited.

CONCLUSION

Common cardiometabolic alterations could affect vascular function in the female genital tract. Based on limited data, there is an association between CV risk factors and female sexual health in women; however, this association appears milder than in men. Maseroli E, Scavello I, Vignozzi L. Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev 2018;6:508-524.

Use of the Menopause-Specific Quality of Life (MENQOL) questionnaire in research and clinical practice: a comprehensive scoping review

OBJECTIVE

The Menopause-Specific Quality of Life (MENQOL) questionnaire was developed as a validated research tool to measure condition-specific QOL in early postmenopausal women. We conducted a comprehensive scoping review to explore the extent of MENQOL's use in research and clinical practice to assess its value in providing effective, adequate, and comparable participant assessment information.

METHODS

Thirteen biomedical and clinical databases were systematically searched with "menqol" as a search term to find articles using MENQOL or its validated derivative MENQOL-Intervention as investigative or clinical tools from 1996 to November 2014 inclusive. Review articles, conference abstracts, proceedings, dissertations, and incomplete trials were excluded. Additional articles were collected from references within key articles. Three independent reviewers extracted data reflecting study design, intervention, sample characteristics, MENQOL questionnaire version, modifications and language, recall period, and analysis detail. Data analyses included categorization and descriptive statistics.

RESULTS

The review included 220 eligible papers of various study designs, covering 39 countries worldwide and using MENQOL translated into more than 25 languages. A variety of modifications to the original questionnaire were identified, including omission or addition of items and alterations to the validated methodological analysis. No papers were found that described MENQOL's use in clinical practice.

CONCLUSIONS

Our study found an extensive and steadily increasing use of MENQOL in clinical and epidemiological research over 18 years postpublication. Our results stress the importance of proper reporting and validation of translations and variations to ensure outcome comparison and transparency of MENQOL's use. The value of MENQOL in clinical practice remains unknown.

Assessing sexual problems in women at midlife using the short version of the female sexual function index

Assessment of sexual function is a complex process, especially in women, which requires in any individual case: time, appropriate training and experience. The prevalence of female sexual dysfunction is quite variable depending on the studied population, assessment methods, comorbid conditions and treatments, and age. A large number of screening methods have been developed over the last decades which range from tedious, exhaustive and boring tools to very simple standardized questionnaires. The 19-item female sexual function index (FSFI-19) is among the most used and useful- instrument designed to assess female sexual function in all types of circumstances, sexual orientation and perform the comparison of transcultural factors. A short 6-item- version of the FSFI-19 has been developed to provide a quick general approach to the six original domains (one item per domain). Nevertheless, further studies are needed to demonstrate its validity in different clinical situations as it has been extensively demonstrated with the original tool.

Overweight, obesity and female sexuality in perimenopause: a preliminary report

INTRODUCTION

The research was conducted among patients of the Department of Perinatology and Gynaecology of the Poznań University of Medical Sciences. Its aim was to investigate the influence of overweight and obesity on female sexuality during the perimenopausal period. Preliminary results of the research are presented in the thesis, which was as a matter of fact intended as a preliminary report. The examination of sexual functions of the patients was performed with the use of the Female Sexual Function Index (FSFI) form.

MATERIAL AND METHODS

Sixty-one women during the perimenopausal period filled out the survey, with the average age of these women being 51 years. Forty-two of the examined women had an appropriate body mass index (BMI), i.e. between 18.5 and 25, while for 19 of the women, the BMI was above normal. For statistical analysis and in order to assess the differences between the two above-mentioned groups of patients, the nonparametric Mann-Whitney test was applied. A statistically significant value was assumed at p < 0.05. The results of the conducted research indicated no such difference between the women with differing BMI for the specific domains of the FSFI test.

RESULTS

The results obtained show that research in the area needs to be continued.

CONCLUSIONS

All the hitherto existing scientific studies also seem to indicate that the influence of overweight and obesity on female sexuality during the perimenopause has not yet been unambiguously proven. Beyond any doubt, however, sexual disorders appear in women at this time of life and the factors which determine them can vary greatly. Given the character of the situation, women ought to be supported both by a team of specialists representing different branches of medicine as well as by their relatives. The whole situation also calls for more research of the important subject matter.

Pilot study on the effects of a 2-week hiking vacation at moderate versus low altitude on plasma parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome

Background

Hypoxic and hypobaric conditions may augment the beneficial influence of training on cardiovascular risk factors. This pilot study aimed to explore for effects of a two-week hiking vacation at moderate versus low altitude on adipokines and parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome.

Methods

Fourteen subjects (mean age: 55.8 years, range: 39 – 69) with metabolic syndrome participated in a 2-week structured training program (3 hours of guided daily hiking 4 times a week, training intensity at 55-65% of individual maximal heart rate; total training time, 24 hours). Participants were divided for residence and training into two groups, one at moderate altitude (1,900 m; n = 8), and the other at low altitude (300 m; n = 6). Anthropometric, cardiovascular and metabolic parameters were measured before and after the training period.

Results

In study participants, training overall reduced circulating levels of total cholesterol (p = 0.024), low-density lipoprotein cholesterol (p = 0.025) and adiponectin (p < 0.001). In the group training at moderate altitude (n = 8), lowering effects on circulating levels were significant not only for total cholesterol, low-density-lipoprotein cholesterol and adiponectin (all, p < 0.05) but also for triglycerides (p = 0.025) and leptin (p = 0.015), whereas in the low altitude group (n = 6), none of the lipid parameters was significantly changed (each p > 0.05). Hiking-induced relative changes of triglyceride levels were positively associated with reductions in leptin levels (p = 0.006). As compared to 300 m altitude, training at 1,900 m showed borderline significant differences in the pre-post mean reduction rates of triglyceride (p = 0.050) and leptin levels (p = 0.093).

Conclusions

Preliminary data on patients with metabolic syndrome suggest that a 2-week hiking vacation at moderate altitude may be more beneficial for adipokines and parameters of lipid metabolism than training at low altitude. In order to draw firm conclusions regarding better corrections of dyslipidemia and metabolic syndrome by physical exercise under mild hypobaric and hypoxic conditions, a sufficiently powered randomized clinical trial appears warranted.

Trial registration

ClinicalTrials.gov ID NCT02013947 (first received November 6, 2013).

Effect of metabolic syndrome on sexual function in pre- and postmenopausal women

Female sexual dysfunction is a prevalent and multidimensional disorder related to many biological, psychological, and social determinants. The authors assessed the effect of one of the many factors affect sexual function-metabolic syndrome-on female sexual function. They equally divided 400 women participants among 4 groups: (a) premenopausal with metabolic syndrome, (b) premenopausal without metabolic syndrome, (c) postmenopausal with metabolic syndrome, and (d) postmenopausal without metabolic syndrome. The authors used the Female Sexual Function Index to assess women's sexual function. Female sexual dysfunction was found more often in both pre- and postmenopausal women with metabolic syndrome (p =.001). Overall Female Sexual Function Index score and satisfaction, pain, and desire domain scores independently of the menopause status showed statistically significant differences across women with metabolic syndrome in comparison with participants with no metabolic syndrome (p <.05). The authors also evaluated the associations among 5 components of metabolic syndrome and Female Sexual Function Index scores. Higher fasting glucose levels were significantly associated with the Female Sexual Function Index score (p <.05). This study shows that sexual dysfunction is more prevalent in pre- and postmenopausal women with the metabolic syndrome.