Androgen status and female sexual dysfunction in healthy pre-menopausal women
A Nyunt1, G Stephen1, A Fielding1, M Wheeler2, J Gibbin1, L Durgan1 & DE Price1
Androgen deficiency may contribute to sexual dysfunction in hypoadrenalism but its role in normal female physiology is uncertain. The aim of this study was to determine the role of androgens in the aetiology of sexual dysfunction in healthy women. Twenty-nine premenopausal women with loss of libido (subjects) and 13 healthy females (controls) were studied. They were aged 18 to 45 years and in a stable heterosexual relationship. Venous blood was taken at 9 am in the follicular phase for oestradiol, total testosterone (TT), DHT, DHEAS and SHBG levels. Subjects were interviewed by a psychosexual counsellor. Sexual drive was assessed by the modified Wilson's sexual fantasy questionnaire and sexual satisfaction by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The TT and DHT levels (mean (SD)) were respectively 1.19 (0.6) mmol/L & 0.86 (0.3) nmol/L in subjects and 0.97 (0.5) mmol/L & 0.77 (0.2) nmol/L in controls. The SHBG and DHEAS were respectively 65 (42) mmol/L & 3.7 (1.6) umol/L in subjects and 65 (29) mmol/L & 3.7 (2.6) in controls. The scores of Wilson and GRISS were respectively 21 & 5 in subjects and 35 & 2 in controls. Subjects were more likely than controls to have low income (48% vs 7%, p<0.02), suffer with depression (55% vs 7%, p<0.01) and minor illnesses (57% vs 15%, p<0.02) and report sexual problems in their partners (24% vs 0%, p=0.053).
In conclusion, loss of libido in otherwise healthy women may be related to relationship problems, psychosocial factors, depression and sexual dysfunction in the partner but does not appear to be related to androgen status.