Abstract

Abstract Introduction Data on the role of prolactin (PRL) in the physiologic range in the female sexual response are scanty. Objective To investigate the association between PRL and sexual function as assessed by the Female Sexual Function Index (FSFI). We explored the presence of a cut-off level of PRL able to identify Hypoactive Sexual Desire Disorder (HSDD). Methods N=264 pre- and post-menopausal women consulting for FSD and sexually active were included in this observational, retrospective study. A clinical, biochemical and psychosexual evaluation was performed. Main Outcome measures: FSFI, Female Sexual Distress Scale-Revised, Middlesex Hospital Questionnaire and Sexual excitation/sexual inhibition scale (SIS/SES). HSDD was diagnosed through a clinical interview. Results In a multivariate model, PRL showed a significant, positive correlation with FSFI Desire (p=0.009) and Satisfaction (p=0.011). Women with PRL in the V quintile (14.58-24.59 μg/L) reported significantly higher FSFI Desire scores than those with PRL in the I quintile (5.12-6.53 μg/L). Women with HSDD presented a significantly lower PRL level than those without (p=0.032). A ROC curve analysis for PRL showed an accuracy of 0.610+-0.044 (p=0.014) in predicting HSDD. With a threshold of 9.83 μg/L, sensitivity and specificity for HSDD were 63% and 56%, respectively. Subjects with PRL =9.83 μg/L. The difference in SIS1 score was independent of cortisol. Conclusions Among FSD women with normo-PRL levels, those with the lowest levels demonstrated a poorer sexual desire than those with the highest levels. PRL <9.83 μg/L could predict HSDD and a lower sexual inhibitory trait. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: LV received scientific research grants, advisory board attendance and speaker honoraria from Therascience, Theramex, Bayer Schering Pharma, Intercept, Lipocine, Ibsa.

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