Female sexual dysfunction is a largely uninvestigated, yet significant, public health problem, with 43% of women complaining of at least one sexual problem (1). Despite the high prevalence, which appears to surpass that of male sexual dysfunction, only recently has there been some focus on the sexual problems of women. We assessed the prevalence of sexual dysfunction in premenopausal women with the metabolic syndrome as compared with the general female population.
Premenopausal women (n = 100) were enrolled if they had three or more of the criteria to meet the diagnosis of the metabolic syndrome, as recommended by the Adult Treatment Panel (2). One hundred women, matched for age, body weight, and premenopausal state, served as the control group. Sexual function was assessed by completing the Female Sexual Function Index (FSFI), which is a validated 19-item self-report measure of six separate domains of female sexual function (3). Four domains are related to the four major categories of sexual dysfunction: desire, arousal, orgasmic, and sexual pain disorder. The fifth domain assesses the quality of vaginal lubrication, and the sixth domain is related to global sexual and relationship satisfaction. Each domain is scored on a scale of 0 or 1 to 6, with higher scores indicating better function. The full FSFI scale score, which could be 36 at the highest, is obtained by adding the six domain scores.
Women with the metabolic syndrome were matched with women of the control group for age (40.2 ± 4.3 vs. 39.1 ± 3.9 years), BMI (27.8 ± 2.9 vs. 26.9 ± 2.8 kg/m2), and premenopausal state. Compared with the control group, women with the metabolic syndrome had a reduced mean full FSFI score (23.9 ± 5.4 vs. 29.9 ± 4.8, P < 0.001). We considered the functional results to be good when the FSFI score was ≥30, intermediate between 23 and 29, and poor when <23. The percentages of women falling within these three categories of FSFI score were 77, 21, and 2%, respectively, for control women and 55, 36, and 9%, respectively, for women with the metabolic syndrome (P < 0.01).
In our study, we have shown that women with the metabolic syndrome have an increased prevalence of sexual dysfunctions as compared with matched control women. The complexity of the female sexual response and the limited experimental models available have severely hampered progress in this field. Future research in this area will reveal the clinical significance and possible implications of our findings.
