Sexual Function and Depressive Symptoms in Young Women With Hypoprolactinemia

Robert Krysiak; Karolina Kowalcze; Bogusław Okopień

Disclosures

Clin Endocrinol. 2020;93(4):482-488. 

In This Article

Results

General Characteristics of the Study Groups

At the beginning of the study, there were no differences between the groups in age, body mass index, smoking, physical activity, education, occupational activity, a type of work, the number of sexual partners, the number and duration of marriages, the number of deliveries and miscarriages, stress exposure, as well as systolic and diastolic blood pressure (Table 1). Cabergoline doses at baseline and during the study did not differ statistically between groups A and B (1.24 [0.26] vs 1.12 [0.19] mg weekly and 0.95 [0.38] vs 1.12 [0.19] mg weekly, respectively).

Biochemical Variables

At the beginning of the study, serum prolactin and total testosterone levels, as well as values of the free androgen index, were lower in group A than in groups B and C. There were no differences between the treatment arms in baseline concentrations of gonadotropins, estradiol, DHEA-S and SHBG.

Cabergoline dose reduction increased prolactin, total testosterone and the free androgen index, as well as produced a neutral effect on serum levels of FSH, LH, estradiol, DHEA-S and SHBG. In the remaining treatment arms, there were no differences between baseline levels of the measured hormones and their levels in the last day of the study. At the end of the study, the study groups did not differ in circulating hormone levels (Table 2).

Assessment of Sexual Function

At the beginning of the study, sexual dysfunction was diagnosed more frequently in group A (27%) than in groups B (12%) and C (10%). The total FSFI score and domain scores for desire and arousal, but nor for lubrication, orgasm, sexual satisfaction and pain were lower in group A than in groups B and C. No differences in the total FSFI score and all domain scores were observed between groups B and C.

Cabergoline dose reduction increased the total FSFI score and domain scores for desire and arousal, as well as reduced the percentage of patients with sexual dysfunction. This strategy exerted a neutral effect on lubrication, orgasm, sexual satisfaction and pain. The total FSFI score, all domain scores and the percentage of patients with sexual dysfunction remained at the similar levels throughout the study in the remaining groups of patients. At the end of the study, all groups were comparable with respect to the total FSFI score, all domain scores and the percentage of patients with sexual dysfunction (Table 3).

Assessment of Depressive Symptoms

At entry, the overall BDI-II score, and a percentage of subjects with total and mild depressive symptoms were higher in group A than in groups B and C. There were no differences in the overall BDI-II score, and in the percentage of subjects with total, mild, moderate and severe depressive symptoms between groups B and C.

Cabergoline dose reduction decreased the overall BDI-II score, as well as the percentage of subjects with total and mild depressive symptoms. At the end of the study, the groups did not differ from one another in the overall BDI-II score, and the percentage of subjects with total, mild, moderate and severe depressive symptoms (Table 4).

Correlations

At baseline, the total FSFI score inversely correlated with the total BDI-II score and with the number of women with total and mild depressive symptoms (r values between −.26 [P < .05] and −.41 [P < .001]). The overall BDI-II score correlated with domain scores for sexual desire, arousal, lubrication, orgasm, sexual satisfaction and pain dyspareunia (r values between −.25 [P < .05] and −.44 [P < .001]). The total FSFI score and all domain scores correlated with serum testosterone levels (r values between .27 [P < .05] and .46 [P < .001]) and with the free androgen index (r values between .29 [P < .05] and .39 [P < .001]). There were also correlations between the overall BDI-II score and body mass index, physical inactivity, stress exposure, systolic blood pressure and diastole blood pressure (r values between .25 [P < .05] and .39 [P < .01]). In group A, the total FSFI score and all domain scores correlated also with serum prolactin levels (r values between −.30 [P < .05] and −.43 [P < .001]). Cabergoline dose reduction-induced changes in prolactin, total testosterone and the free androgen index correlated with the increase in the total FSFI score (r values between .31 [P < .05] and .42 [P < .001]) and in domain scores for desire (r values between .37 [P < .01] and .51 [P < .001]) and arousal (r values between .28 [P < .05] and .38 [P < .01]). Cabergoline dose reduction-induced changes in the overall BDI-II score correlated with the increase in the total FSFI score (r = .37, P < .01), and in domain scores for desire (r = .41, P < .001) and arousal (r = .27, P < .05). No other correlations were observed.

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