Cardiometabolic Factors Have “milder” Effects on Women’s Sex Health Compared to Men

An estimated 40% to 50% of women have at least one symptom of female sexual dysfunction (FSD), researchers say. Cardiometabolic factors may be associated with FSD, they added, but the association between cardiovascular risk factors and sexual health “appears milder” for women than for men.

Their study, published recently in Sexual Medicine Reviews, is the first of a two-part paper focusing on the association for women.

The reviewers commented on the following factors:

Diabetes. Diabetes and its relation to FSD has been widely studied, with 48 papers evaluated for this review. In general, it appears that more diabetic women report at least one sexual dysfunction than the general population. Studies suggest that desire, arousal, and lubrication are the domains most affected by diabetes. However, the authors noted that “a cause-effect relation between [diabetes and FSD] cannot be assumed.”
Dyslipidemia. Research suggests that FSD is common in women with dyslipidemia.
Hypertension. Evidence on any association between hypertension and FSD is limited and more research is necessary.
Obesity. Study results have been mixed.
Metabolic syndrome. FSD in women with metabolic syndrome varies depending on menopausal status. FSD affects an estimated 19% to 37% of premenopausal women and 38% to 55% of postmenopausal women, the authors wrote. In addition, the number of symptoms seems to affect the severity of FSD. Still, the authors called the findings “controversial,” as other studies did not show a “tight link” between the two conditions.
Polycystic ovary syndrome (PCOS). The literature on PCOS and FSD was described as “relatively limited” with “inconsistent results.” The authors noted that several components of PCOS (such as depression, menstrual disorders, and insulin resistance) could affect a woman’s sexual function.

The authors also considered the mechanisms driving the link among cardiovascular risk factors, vascular function in the genitals, and FSD. For example, they noted that blood flow to the genitals contributes to clitoral engorgement and vaginal lubrication. Healthy neural, endocrine, and vascular systems are essential for arousal. Endothelial problems, which may be caused by obesity, insulin resistance, hypertension, and dyslipidemia, could reduce the amount of blood reaching the genitals. Drops in estrogen at menopause may also interfere with pelvic blood flow.

The authors pointed out that risk for cardiovascular symptoms (such as diabetes, obesity, and hypertension) increases as people age. Changes in relationships, loss of partners, and other psychosocial aspects of aging may also affect function.

In their conclusion, the authors noted that the association between cardiometabolic risk factors and sexual health appears to be “milder” for women than it is in men. The second part of their review focuses on this difference and offers suggestions for future research.

Resources

Sexual Medicine Reviews

Maseroli, Elisa, MD, et al.
“Cardiometabolic Risk and Female Sexuality—Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes”
(Full-text article in press. Published online: May 2, 2018)
https://www.smr.jsexmed.org/article/S2050-0521(18)30045-3/fulltext

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