Sexual function in women with Cushing’s Syndrome: A controlled study

Abstract

Objective: The aim of this study is to determine the severity of female sexual dysfunction (FSD), quality of life, and depression status in female patients with Cushing's syndrome (CS). Material and methods:This study included 29 sexually active women with CS and 30 healthy age and body mass index matched women. The Female Sexual Function Index (FSFI) questionnaire, Beck Depression Inventory (BDI) and Short Form Health Survey (SF-36) were filled by each participant. Plasma levels of FSH, LH, PRL, cortisol, DHEA-S, 17-hydroxyprogesterone, androstenedione, free testosterone, total testosterone and estradiol were measured.Results: Female sexual dysfunction was present in 88.9% of the women with CS and 24.1% of the control group. The CS group showed a lower total FSFI score [16.6 (IQR: 5-23)] compared to the healthy women [26.8 (IQR: 25.5-30.4) (p<0.001)]. The FSFI scores in the arousal, lubrication, orgasm, pain and satisfaction domains were all lower in the women with CS (p<0.001). Both summary scores of the SF-36 were reduced in women with Cushing's syndrome compared to the control group (p=0.001). The BDI scores of patients were significantly higher than those of the control subjects (p=0.007). In patients with CS, levels of LH, estradiol, and DHEA-S04 were significantly lower while cortisol (p<0.05), and 17 hydroxyprogestrone levels were higher than control subjects (p<0.05). Conclusion:This study showed that majority of the women with CS had FSD. This may be related to the inhibitory effect of cortisol on sex hormones.

Quality of Life in Patients With Cushing's Disease

“…More specifically, lower scores for arousal, lubrication, orgasm, satisfaction and higher levels and frequency of pain during intercourse were found, while no differences were found for sexual desire. FSFI scores were positively correlated with LH levels (which were lower in the patient sample compared with controls) (44).…”

“…SF-36 results are low in physical and mental summary scores compared to healthy controls matched for age and sex (35,44). When compared to other untreated pituitary tumors (which not have been treated) CD were the patients with most impairment in all SF-36 measures (43).…”

“…When using specific diagnostic criteria, major depressive disorder has been reported in 50-80% of the active patients according to different studies, with higher presence in the older studies (10). Furthermore, the level of depression correlates with QoL scores measured with SF-36 in female patients with CS, who are clearly worse than controls (44).…”

Investigation of common risk factors between polycystic ovary syndrome and Alzheimer's disease

“…An increase in LH increases androstenedione's production is converted to testosterone by 17β reductase in thecal cells and released into the blood (91). Androstenedione can also be converted to estradiol by the FSH-dependent aromatase enzyme in ovarian granulosa cells (92).…”

MANAGEMENT OF ENDOCRINE DISEASE: Female sexual dysfunction for the endocrinologist

“…Excessive circulating levels of glucocorticoids result in Cushing's syndrome (CS) (57). Only a single study analyzed the presence of SD in the case of CS (58). This is a case control study that showed that women with CS had lower FSFI scores with respect to healthy controls, 24 (88%) out of 29 CS women had a SD.…”