CHARACTERISTICS OF CHANGES IN THE HORMONAL PROFILE OF FEMALE SEXUAL DYSFUNCTION AND GENITAL ENDOMETRIOSIS IN THE TREATMENT PROCESS

O. I. Kryzhanovska, D. O. Hovsieiev
In: The Odesa Medical Journal · 2024 · pp. 40–44 · doi:10.32782/2226-2008-2024-2-7 · W4401381875
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Treatment for external genital endometriosis and female sexual dysfunction significantly increased vitamin D, steroid hormones, and gonadotropins while decreasing thyroid markers and homocysteine over nine months.

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This study evaluated hormonal profile changes in 70 women of reproductive age diagnosed with both female sexual dysfunction and external genital endometriosis during pharmacological treatment. Researchers measured levels of peptide and steroid hormones, vitamin D, and homocysteine at baseline and at three, six, and nine months post-treatment, comparing results against a control group of healthy women. The findings indicated that significant normalization of vitamin D levels occurred by the sixth and ninth months, while optimal optimization of sexual function and reduction in sexual dysfunction indices were achieved by the ninth month of therapy. This paper is centrally about endometriosis — specifically examining the hormonal and functional outcomes associated with external genital endometriosis in the context of comorbid sexual dysfunction.

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Abstract

Vitamin D deficiency and hormonal disbalance could be involved in the development of endometriosis and female sexual dysfunction (FSD). The purpose of the study – to determine the characteristics of changes in the hormonal profile of women with FSD and external genital endometriosis. The evaluation of peptide, steroid hormones, vitamin D, and homocysteine level was conducted on the 5–7th days of the menstrual cycle at the beginning of the study and 3, 6, 9 months after the treatment. A value of p < 0.0085 was considered significant difference between the intervention group (n=70) and control group (healthy women, n=30) under comparison. Results. Statistical analysis (Friedman’s test) of the dynamics of laboratory indicators during the control periods in group I showed a significant gradual increase in the levels of dehydroepiandrosterone sulfate (DHEA-S), free testosterone, estradiol, progesterone, FSH, LH, and Vitamin D (p<0.001) and decrease – 17-ОНР, Prolactin, thyroid-stimulating hormone (TSH), antibodies to thyroperoxidase (Anti-TPO) and homocysteine (p<0.001) against the background of the treatment. Normalization of the level of vitamin D was observed starting at the 6th and 9th months of observation in 32.9% (n=23) and 80.0% (n=56) and was significantly higher compared to the 6th month – χ2 = 29.75, p<0.001. Reference values of the homocysteine level in the 1st group were also achieved starting from the 6th month, but the share of such women was only 20.0% (n=14). In the 9th month of treatment, the proportion of patients with normhomocysteinemia increased significantly to 38.6% (n=27), χ2 = 4.97, p=0.026. Dynamics of changes in the hormonal profile of the thyroid gland after 3 months was characterized by a significant decrease in the initial levels of TSH level (on the 3rd, 6th, 9th months, p<0.001). The optimization of female sexual function occurs in the 9th month of therapy and is accompanied by a reliable normalization of the index of sexual dysfunction. In this term, the indicator of the sexual dysfunction index approaches the norm (26.55), which is classified as a sign of the absence of female sexual dysfunction.
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ОСОБЛИВОСТІ ЗМІН ГОРМОНАЛЬНОГО ПРОФІЛЮ ЖІНОК ІЗ ЖІНОЧОЮ СЕКСУАЛЬНОЮ ДИСФУНКЦІЄЮ ТА ГЕНІТАЛЬНИМ ЕНДОМЕТРІОЗОМ У ПРОЦЕСІ ЛІКУВАННЯ DOI: https://doi.org/10.32782/2226-2008-2024-2-7Ключові слова: жіноча сексуальна дисфункція, ендометріоз, гомоцистеїн, вітамін Д.Анотація Метою дослідження було визначення особливостей змін гормонального профілю жінок із жіночою сексуальною дисфункцією (ЖСД) та зовнішнім генітальним ендометріозом (ЗГЕ) у процесі лікування. Було проведено аналіз рівня пептидних, стероїдних гормонів, вітаміну Д, гомоцистеїну на 5–7 дні менструального циклу, а також через 3, 6, 9 місяців після фармакологічної корекції у 70 жінок активного репродуктивного віку із ЖСД та ЗГЕ (І група) і 30 здорових жінок (ІІ група). У результаті проведеного лікування нормалізація рівня вітаміну Д відзначалась через 6 і 9 місяців спостереження у 32,9% і 80,0% (р<0,001) жінок; на 9-му місяці нормогомоцистеїнемія спостерігалась у 38,6% жінок (р=0,026 стосовно контролю). Оптимізація сексуальної функції жінок відбувається на 9-му місяці терапії і супроводжується достовірною нормалізацією індексу сексуальної дисфункції (ІСД). У цей термін показник ІСД наближається до показника норми (26,55), що класифікується як ознака відсутності ЖСД. Посилання Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020; 382(13): 1244–1256. doi: 10.1056/NEJMra1810764. Semeniuk LM, Demyanenko LV, Chernukha LS, Kryzhanovska OI. Sexual dysfunctions an early marker of endometriosis. Clinical endocrinology and endocrine surgery. 2020; 2(70): 86–92. (in Ukrainian). doi: 10.30978/cees-2020-2-86. Oppo A, Franceschi E, Atzeni F, Taberlet A, Mariotti S. Effects of hyperthyroidism, hypothyroidism, and thyroid autoimmunity on female sexual function. J Endocrinol Invest. 2011; 34(6): 449–53. doi: 10.1007/BF03346712. Babić Leko M, Jureško I, Rozić I, Pleić N, Gunjača I, Zemunik T. Vitamin D and the Thyroid: A Critical Review of the Current Evidence. Int J Mol Sci. 2023; 24(4): 3586. doi: 10.3390/ijms24043586. Taheriniya S, Arab A, Hadi A, Fadel A, Askari G. Vitamin D and thyroid disorders: a systematic review and Meta-analysis of observational studies. BMC Endocr Disord. 2021; 21(1): 171. doi: 10.1186/s12902-021-00831-5. Miyashita M, Koga K, Izumi G, Sue F, Makabe T, Taguchi A, Nagai M, Urata Y, Takamura M, Harada M, Hirata T, Hirota Y, Wada-Hiraike O, Fujii T, Osuga Y. Effects of 1.25-Dihydroxy Vitamin D3 on Endometriosis. J Clin Endocrinol Metab. ; 101(6): 2371–9. doi: 10.1210/jc.2016-1515. Zhang X, Chen Y, Ye H, Luo Z, Li J, Chen Z, Zhang E, Li W. Correlation between thyroid function, sensitivity to thyroid hormones and metabolic dysfunction-associated fatty liver disease in euthyroid subjects with newly diagnosed type 2 diabetes. Endocrine. 2023; 80(2): 366–379. doi: 10.1007/s12020-022-03279-2. Chedraui P, Pérez-López FR, Mezones-Holguin E, San Miguel G, Avila C. Collaborative Group for Research of the Climacteric in Latin America (REDLINC). Assessing predictors of sexual function in mid-aged sexually active women. Maturitas. 2011; 68(4): 387–90. doi: 10.1016/j.maturitas.2010.12.004. Romashchenko OV, Yashchenko LB, Melnykov SM. Otsinka zhinochykh seksualnykh dysfunktsii u systemi planuvannia simi. Medical aspects of women’s health. 2012; 8(61): 59–61 (in Ukrainian). Semenyuk LM, Yuzvenko TY, Kozachuk YS, Chernukha LS. Pre-pregnancy preparation of women with hypoandrogenism and female sexual dysfunction. Clinical endocrinology and endocrine surgery. 2024; 1: 18–27 (in Ukrainian). doi:

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