Female sexual dysfunction as a multidisciplinary problem of reproductive health disorders in women of reproductive age. Review

The article examines the impact of female sexual dysfunction on women’s reproductive health. The effects of comorbid pathology on the peculiarities of the steroid homeostasis of a woman’s body was analyzed. Information on the prevalence of female sexual dysfunction is still limited in the international published literature. However, the prevalence of sexual dysfunction in women is estimated to be 43—90%. Previously published studies have shown that hormonal imbalances caused by endocrinopathy, polycystic ovary syndrome, obesity, metabolic disorders, diabetes, and some hormonal contraceptive methods are also associated with sexual dysfunction in women. In particular, the role of thyroid autoimmune diseases in the manifestation of clinical manifestations of female sexual dysfunction (FSD) in fertile women is shown. The role of hyperhomocysteinemia and vitamin D deficiency was considered among the possible triggers contributing to a decrease in androgen levels in women. In this case, the pathogenetic basis is considered to be the activation of oxidant stress, endothelial dysfunction and a decrease in the bioavailability of nitric oxide. At the same time, the authors noted the negative impact of the specified processes on follicular growth and the formation of a pro‑inflammatory intrafollicular background with subsequent formation of ovarian endometriosis and blocking of the aromatase enzyme of granulosa tissue. Violation of the conditions for the correct growth of the follicle leads to a violation of menstrual function and infertility in women with endometriosis and FSD. The psychological consequences of endometriosis and female sexual dysfunction, such as depression, anxiety, powerlessness, feelings of guilt, deterioration of interpersonal relationships, contribute to an increase in the divorce rate among young couples. Thus, considering the peculiarities of the formation of female sexual dysfunction in women of reproductive age, and its polymorbid background, the algorithms of examination and treatment should be personalized, and a multidisciplinary team of doctors should be involved in overcoming the problem.