THE ROLE OF DEHYDROEPIANDROSTERONE IN THE FORMATION OF FUNCTIONAL HYPOANDROGENISM, ENDOMETRIOSIS AND WOMEN’S SEXUAL HEALTH DISORDERS
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Abstract
The study aims to evaluate the role of the DHEA-S (dehydroepiandrosterone) as an indicator of female sexual dysfunction (FSD), in hypoandrogenism and endometriosis in women of reproductive age. Materials and methods. Totally, 215 women of reproductive age were included in the study and were divided into 3 groups: Group A (n=114) – women with early pregnancy loss in the anamnesis with/without FSD; Group B (n=77) – women with FSD and hypoandrogenism with/without endometriosis; Group C (n=24, control) – healthy women. DHEA-S, free testosterone (fT), and estradiol levels were evaluated. The steroid hormones blood tests were conducted on the 5th to 7th day of the physiological or induced menstrual cycle. Results. DHEA-S levels in group A women with FSD, corresponded to its deficit and were statistically significantly lower than those without FSD (p <0.001). In women with FSD, estradiol levels were statistically significantly lower (deficiency) vs. without FSD (normal ranges), p<0.001. The median levels of fT in group A without FSD were at optimal ranges, while with FSD, they were at deficiency ranges, p<0.001. Levels of fT statistically significantly correlated with DHEA-S (r=0.32; p=0.004), which was also confirmed by linear regression (adjR2 = 0.087; p=0.005). In Group B women with FSD +/- endometriosis, a significant difference in estradiol, fT, and DHEA-S values was not found: p=0.24, p=0.05, and p=0.05 respectively. In both subgroups, the average hormone values corresponded to: estradiol, fT – deficiency; DHEA-S – deficit. Conclusions. The presence of FSD in isolated and combined forms with endometriosis is accompanied by a deficiency of estradiol, free testosterone and a deficiency of DHEA-S, which is clinically accompanied by a change in the structure of the mucous membranes, hypolubrication and dyspareunia. The diagnosis of androgen deficiency in women is of clinical importance, since the restoration of the physiological level of androgens is important for the prevention and treatment of miscarriage and disorders of a woman’s sexual health.
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РОЛЬ ДЕГІДРОЕПІАНДРОСТЕРОНУ У ФОРМУВАННІ ФУНКЦІОНАЛЬНОЇ ГІПОАНДРОГЕНІЇ, ЕНДОМЕТРІОЗУ ТА ПОРУШЕННЯ СЕКСУАЛЬНОГО ЗДОРОВ’Я ЖІНОК
DOI:
https://doi.org/10.32782/2226-2008-2024-4-9Ключові слова:
дегідроепіандростерон, тестостерон, жіноча сексуальна дисфункція, ендометріоз.Анотація
Мета дослідження – оцінити роль дегідроепіандростерона (ДГЕА-С) як індикатора жіночої сексуальної дисфункції (ЖСД), при гіпоандрогенії, ендометриозі у жінок репродуктивного віку. Усього в дослідження було включено 215 жінок репродуктивного віку, які були розподілені на 3 групи: група А (n=114) – жінки з ранньою втратою вагітності в анамнезі з/без ЖСД; група B (n=77) – жінки з ЖСД гіпоандрогенією з/без ендометріозом; група C (n=24, контроль) – здорові жінки. Результати. Рівень ДГЕА-С у жінок групи А з ЖСД відповідав його дефіциту та був нижчим порівняно з жінками без ЖСД (p<0,001). У жінок із ЖСД рівні естрадіолу були значуще нижчими (дефіцит) порівняно з жінками без ЖСД (нормальні діапазони), p<0,001. Середні рівні вільного тестостерону (вТ) у групі A без ЖСД були в оптимальних діапазонах, тоді як з ЖСД вони були в межах дефіциту, p<0,001. Висновки. Діагностика андрогенної недостатності у жінок має клінічне значення, оскільки відновлення фізіологічного рівня андрогенів важливе для профілактики та лікування невиношування вагітності та розладів сексуального здоров’я жінки.
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