Endocrine Abstracts

JOINT4016

Background: Sexual well-being is a complex process that involves both mental and physical aspects, influencing quality of life. Pituitary dysfunction is often associated with sexual dysfunction due to its critical role in regulating hormones involved in sexual health. In this patient group, sexual dysfunction may include impacts on sexual satisfaction, intimacy, function and fertility, significantly affecting quality of life. Despite its importance, there are limited systematic evaluations of sexual dysfunction across different subtypes of pituitary dysfunction. Therefore, this survey aimed to assess the prevalence and severity of sexual dysfunction in patients with pituitary disorders.

Methods: This cross-sectional, web-based, anonymous survey was designed by endocrinologists to evaluate sexual well-being, including aspects of sexual desire, behavior, and function, in adult patients with pituitary dysfunction. Participants were categorized into four groups: isolated anterior pituitary dysfunction (APD), isolated posterior pituitary dysfunction (arginine vasopressin deficiency, AVP-D), combined anterior and posterior pituitary dysfunction (Panhypopituitarism, PHP), and those with pituitary conditions without hormonal deficiency or excess (e.g., non-functioning pituitary adenomas). A Mean Global Index of Sexual Dysfunction (range: 0–3) was calculated using the Sexual Behavior Questionnaire. Sexual desire was assessed separately for dyadic (partnered) and solitary (individual) contexts using the Sexual Desire Inventory (SDI-2), with total scores ranging from 0 to 78, where higher scores reflect stronger desire. Total scores were compared between groups and adjusted for sex, age, and comorbidities.

Results: Between August and October 2024, 326 patients participated in the survey. The median age was 51 years [42–60], with 79% female participants, and the median duration of pituitary dysfunction was 8 years. Participants were categorized as follows: APD (44%), AVP-D (18%), PHP (26%), and non-hormonal pituitary disorders (12%). The most common etiologies were pituitary tumors or cysts (62%). 51% of patients were undergoing hormone replacement, while 28% had hormone excess. Sexual dysfunction and low sexual desire (median range: 20, [42–60]) were highly prevalent across all subgroups, with reference values of 38-42 in a healthy population. The highest severity was reported in patients with PHP. Sexual dysfunction was significantly correlated with sex, hormonal deficiencies, and comorbidities.

Conclusion: Sexual dysfunction is a prevalent and clinically significant issue in patients with pituitary dysfunction, affecting all subtypes. These findings highlight the importance for routine assessment and targeted treatment in this patient population. Further research is needed to better understand the underlying mechanisms and identify effective therapeutic approaches.