Agnieszka Drosdzol-Cop

Selected cytokines and glycodelin A levels in serum and peritoneal fluid in girls with endometriosis

Aim:  The aim of this study was to determine the role of serum and peritoneal interleukin (IL)‐6, tumor necrosis factor (TNF)‐α and glycodelin A levels as diagnostic markers of endometriosis in adolescent girls.

Changes in the Sexual Function During Pregnancy

INTRODUCTION The physiological changes during each trimester of pregnancy have a significant impact on womens sexual behavior. AIM The aim of the work was to assess changes in the sexual function during pregnancy. METHODS The prospective study encompassed 520 pregnant women aged between 18 and 45, of whom 168 were qualified for the final analysis. The research tool was a purpose-designed research questionnaire and the standardized Female Sexual Function Index. MAIN OUTCOME MEASURES To assess changes in the sexual function among pregnant women aged 18-45 in the three pregnancy trimesters. RESULTS All the studied parameters, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain, decreased significantly with the progression of pregnancy. Analyzing the frequency of sexual intercourse in the studied group before and during pregnancy, a statistically significant decrease (P<0.000001) was observed. Sexual desire changed statistically significantly (P=0.0004). The direction of change concerned decreased sexual desire in the three trimesters compared with the situation before pregnancy. Statistical significance was demonstrated for: decreased sexual desire (P=0.00007), partners reluctance (P=0.002), and pregnancy-related changes in appearance (P=0.03). CONCLUSIONS Sexual function was compromised and sexual activity decreased as the pregnancy progressed. Changes in the domains of arousal, lubrication, and orgasm were particularly notable in primaparae in the third trimester of pregnancy. Unsatisfying partner relationship was a significant factor affecting the quality of sexual life during pregnancy.

Sexual function and depressive symptoms in young women with thyroid autoimmunity and subclinical hypothyroidism

The results of few studies conducted to date suggest an increased prevalence of sexual dysfunction in patients with thyroid disorders.

The effect of three-month pre-season preparatory period and short-term exercise on plasma leptin, adiponectin, visfatin, and ghrelin levels in young female handball and basketball players

Objective: The aim of the study was to assess the effect of a 3-month pre-season preparatory period and short-term moderate aerobic exercise and intensive fitness and speed exercise on adipokine and ghrelin levels in young female handball and basketball players. Materials and methods: Fifty healthy young female professional basketball and handball players were enrolled into the study before the opening of the season (after a 2-month holiday with no training or dietary restrictions). Serum estradiol and plasma leptin, adiponectin, visfatin, and ghrelin levels were determined at the beginning and the end of a 3-month period of moderate aerobic training. Plasma adipokines and ghrelin levels were additionally assessed after 2 h of moderate aerobic exercise or after intensive fitness and speed exercise training. Results: Long-term moderate aerobic exercise was followed by a significant decrease in plasma ghrelin and leptin levels (921 ±300 vs 575±572 pg/ml. p<0.001 and 16.4±15.6 vs 11.8±16.3 ng/ml, p<0.01, respectively); plasma adiponectin and visfatin remained unchanged. No changes were observed in plasma ghrelin and leptin levels after short-term moderate aerobic exercise or after intensive fitness and speed exercise. Plasma visfatin concentration increased significantly after short-term moderate aerobic exercise (22.1 ±8.7 vs 27.6±9.0 ng/ml, p<0.001), whilst adiponectin increased after intensive fitness and speed exercise (16.7±7.8 vs 21.0±9.8 µg/ml, p<0.001). Conclusions: Regular moderate aerobic training in preparation for the match season is followed by a decline in circulating leptin and ghrelin levels even in athletes without body weight changes. Short-term intensive fitness and moderate aerobic exercise seem to modulate the production of different adipokines.

Sexual function and depressive symptoms in young women with elevated macroprolactin content: a pilot study

Elevated prolactin levels seem to be associated with impaired sexuality. The clinical significance of macroprolactinemia, associated with the predominance of high molecular mass circulating forms of prolactin, is still poorly understood. This study was aimed at investigating sexual function in young women with macroprolactinemia. The study enrolled 14 young women with macroprolactinemia, 14 with increased monomeric prolactin levels, as well as 14 age- and weight-matched healthy women. All patients completed a questionnaire evaluating female sexual function (Female Sexual Function Index—FSFI), as well as a questionnaire assessing the presence and severity of depressive symptoms (Beck Depression Inventory Second Edition—BDI-II). Apart from total prolactin levels and macroprolactin content, circulating levels of thyrotropin, total testosterone, and 17-β estradiol were also measured. Patients with elevated monomeric prolactin levels had a lower total FSFI score, as well as lower scores for all domains: sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and dyspareunia. These scores correlated with total and monomeric prolactin levels. In turn, women with macroprolactinemia were characterized by a lower score for sexual desire, and only this score correlated with total prolactin levels and macroprolactin content. The total score in the BDI-II questionnaire was higher in patients with hyper- and macroprolactinemia than in the control subjects. Contrary to multidimensional impairment of sexual function in women with elevated monomeric prolactin, macroprolactinemia only seems to disturb sexual desire.

Sexual Functioning and Depressive Symptoms in Women with Diabetes and Prediabetes Receiving Metformin Therapy: A Pilot Study

Aim:Metformin is a drug of choice for the management of type 2 diabetes mellitus. Very little is known about its effect on human sexual function. Methods: The study included 3 age- and weight-matched groups of premenopausal women: individuals with type 2 diabetes, women with prediabetes and healthy controls. All women with diabetes and 50% of those with prediabetes were then treated with metformin and complied with lifestyle modification. The remaining individuals, not receiving pharmacotherapy, only complied with dietary recommendations. Apart from measuring plasma glucose and assessing insulin sensitivity, all enrolled women completed questionnaires evaluating sexual function (Female Sexual Function Index - FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II) initially and after 6 months. Results: Women with diabetes had a lower total FSFI score, as well as lower scores for all domains: sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction and dyspareunia, and these scores correlated with a degree of insulin resistance. Women with prediabetes had lower scores for sexual desire and sexual satisfaction. Moreover, women with diabetes and prediabetes were characterized by a higher total BDI-II score. Metformin treatment not only normalized sexual desire and sexual satisfaction in both studied groups, but also normalized or improved the remaining domains of FSFI in patients with diabetes, and these effects correlated with an improvement in insulin resistance. Conclusions: Metformin treatment provides a beneficial effect on female sexual function and the strength of this effect depends on the degree of insulin resistance.

Long-term impact of surgical repair for stress urinary incontinence on female sexual functions, distress and behaviours

AIMS AND OBJECTIVES To evaluate sexual functions, distress and behaviours in women who underwent surgical repair of stress urinary incontinence (SUI) in long-term follow-up. BACKGROUND Contemporary management of SUI includes conservative therapy and surgical repair - the choice of treatment modality depends on the severity of symptoms. If conservative treatment fails, surgical correction is necessary. The outcomes of the surgery for SUI and their influence on sexual functions are satisfactory in short-term follow-up. DESIGN A total of 50 women diagnosed with SUI according to International Continence Society standards were included in the study. The patients were qualified for surgical procedures such as: transobturator suburethral tape (TOT) (n = 35), Perigee (n = 6) or MiniArc (n = 9). METHODS Sexual functions and behaviours were evaluated prior to the operation and 1-3 years postoperatively in all patient using Female Sexual Function Index (FSFI) and non-validated questions. RESULTS The mean time after the operation was 1·96 ± 0·83 years. Postoperatively, all women reported significant reduction of urinary incontinence symptoms. According to DSM-IV criteria, female sexual dysfunctions were diagnosed in 12% of females after the urogenital operation. However, sexual complaints (FSFI scores equal or <26·55 points) without distress were reported by 62% of the patients. The comparison of sexual complaints declared prior to and after the operation showed significant differences in the prevalence of decreased desire, decreased arousal and decreased orgasm frequency. In addition, we documented significant improvement of sexual attractiveness and sexual life evaluation after the SUI operation. CONCLUSIONS Surgical repair for SUI improves female sexual functions and reduces sexual distress, as observed in a long-term follow-up. RELEVANCE TO CLINICAL PRACTICE Sexual functions, distress and behaviours in women who underwent surgical repair of SUI; the impact of SUI female quality of life as well as on sexual functions.

Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes.

Sexual Function and Depressive Symptoms in Young Women With Nonclassic Congenital Adrenal Hyperplasia

INTRODUCTION Women with classic forms of congenital adrenal hyperplasia (CAH) or polycystic ovary syndrome have been found to have impaired sexual function. AIM This study investigated sexual activity in young women with nonclassic CAH (NC-CAH). METHODS The study included 24 untreated women with NC-CAH and 24 age-matched healthy women. Plasma levels of free and total testosterone, androstenedione, and dehydroepiandrosterone sulfate were measured. Hirsutism was evaluated according to the modified Ferriman-Gallwey score. Questionnaires assessing female sexual function (Female Sexual Function Index) and the presence and severity of depressive symptoms (Beck Depression Inventory, Second Edition) were completed by each participant. MAIN OUTCOME MEASURES Sexual function and depressive symptoms in young women with NC-CAH. RESULTS Women with NC-CAH presented increased plasma levels of 17-hydroxyprogesterone, total and free testosterone, androstenedione, and dehydroepiandrosterone sulfate and higher hirsutism scores compared with healthy women. The study group also showed a lower total Female Sexual Function Index score and lower scores in four domains (sexual arousal, lubrication, sexual satisfaction, and dyspareunia). Scores for sexual desire and orgasm correlated with total hirsutism score and testosterone levels. The Beck Depression Inventory questionnaire showed that the total score was higher in women with NC-CAH than in healthy women, correlating with the hirsutism score and testosterone levels. CONCLUSION The presence of NC-CAH in young women is associated with impaired sexual function and mild depressive symptoms.

Hypogonadism and Sex Steroid Replacement Therapy in Girls with Turner Syndrome

Turner syndrome is the most common example of hypergonadotropic hypogonadism resulting from gonadal dysgenesis. Most patients present delayed, or even absent, puberty. Premature ovarian failure can be expected even if spontaneous menarche occurs. Laboratory markers of gonadal dysgenesis are well known. The choice of optimal hormone replacement therapy in children and adolescents remains controversial, particularly regarding the age at which therapy should be initiated, and the dose and route of estrogen administration. On the basis of a review of the literature, we present the most acceptable schedule of sex steroid replacement therapy in younger patients with Turner syndrome.