Francesca Ferdeghini

Insight into Urogynecologic Features of Women with Interstitial Cystitis/Painful Bladder Syndrome

OBJECTIVE The prevalence of interstitial cystitis/painful bladder syndrome (IC/PBS) among gynecologic patients attending vulvar disease or pelvic pain clinics is higher than expected. The evaluation of gynecologic characteristics in patients with IC/PBS could be important to delineate a better therapeutic strategy. METHODS We compared clinical gynecologic characteristics including localized and generalized vulvodynia and sexual activity of 47 women with a definite diagnosis of IC/PBS versus 47 negative controls. RESULTS The prevalence of both generalized or localized vulvodynia was 85.1% (40 of 47) in the patients and 6.4% (3 of 47) in the control group (p<0.0001 by Fisher exact test). The mean visual analogue score on generalized or localized vulvodynia evaluated with the cotton swab test was 6.1+/-2.6 (SD) among women with IC/PBS and 0.6+/-1.7 in the control group (p<0.0001 with Mann-Whitney U test). Pain during intercourse was described as unbearable by 15 women with IC/PBS (31.9%) and 2 controls (4.3%; p=0.001 by Fisher exact test). Sexual function was significantly impaired in women with IC as measured by the median total score of the Female Sexual Function Index in comparison with controls (13.8 vs. 28.7; p<0.0001). CONCLUSIONS Patients with a definite diagnosis of IC/PBS appear to have a high risk of vulvodynia with the associated negative implications for sexual activity. The establishment of a multidisciplinary approach with the involvement of the gynecologist appears to be a logical requisite for a correct treatment strategy for these patients.

Serum allopregnanolone levels relate to FSFI score during the menstrual cycle.

The aim of this study was to measure serum allopregnanolone levels and other hormones in women who completed the Female Sexual Function Index (FSFI; Rosen et al., 2000) during the follicular or the luteal phase of the menstrual cycle. Twenty-nine women with a regular menstrual cycle completed the FSFI during days 5-7 and days 19-21 of their menstrual cycles. We collected a blood sample on the same days so that we could determine levels of allopregnanolone (AP), dehydroepiandrosterone (DHEA), free testosterone (FreeT), androstenedione (A), and estradiol (E2); we stored serum at -20 C until we assayed it. We performed statistical analyses by parametric and nonparametric comparisons and correlations, as appropriate. We found that the full FSFI score was 23 11.3 (mean SD; 31% under 95% confidence interval =18.7) in our study population. We also found a significant positive correlation between serum allopregnanolone levels and each FSFI domain, including full scale score (r = 0.47, p

Clitoral Artery Blood Flow in Healthy Young Women: Preliminary Report on Menstrual Cycle and Hormonal Contraception

The aim of the present study was to measure clitoral artery blood flow throughout the menstrual cycle and in oral contraceptive users. We recruited healthy young women ( n = 19, age range: 21-28 years; body-mass index: 18-23 kg/m 2 ) without sexual dysfunction (Female Sexual Functioning Index criteria; Rosen et al., 2000). Clitoral arterial peak systolic velocity (PSV) in at least two phases of the same ovulatory cycle or during the second week of the pill was measured by doppler ultrasonography. Clitoral arterial PSV measures (cm/s) were superimposable during the follicular and the luteal phase of the menstrual cycle (10.4 - 1.2 versus 10.2 - 1.6), whereas a slight but significant increase (12.2 - 1.2, f = 3.99; p < 0.04) was evident at the time of ovulation. In addition, PSV measures were significantly higher in women taking hormonal contraception compared to women studied throughout the menstrual cycle (14.2 - 2.7 versus 10.8 - 1.5; p < .001). Whether or not these preliminary data may be of any significance to female sexual arousal throughout the menstrual cycle remains to be established.