Profiles of testosterone and pre-androgens and sexual function in premenopausal women

Abstract

Background: There is inconsistent evidence as to the role of testosterone and pre-androgens in premenopausal female sexual function and reported associations between blood concentrations of these hormones and female sexual function vary in strength. Aim: To examine the patterns of testosterone and pre-androgen concentrations and variations in sexual function in premenopausal eumenorrheic women. Methods: This was a secondary analysis of a sample of 588 premenopausal eumenorrheic women from the Grollo-Ruzzene Foundation Young Women’s Health Study. Socio-demographics, health information, and questionnaire data was collected using online surveys. Eligible women were invited to provide a blood sample. We ran latent profile (LPA) and subsequent analyses in R using RStudio. Outcomes: Indicator variables in the LPA included sexual arousal and desire domains of the Profile of Female Sexual Function and testosterone, dehydroepiandrosterone (DHEA) and androstenedione, measured by liquid chromatography-tandem mass spectrometry. Results: Analyses resulted in a pattern of three latent classes. Classes reporting relatively lower and higher sexual arousal (LPA-derived Means and 95% CIs: -0.79 [-1.24; -0.34] and 0.62 [0.51; 0.72]) did not differ significantly in sex steroid concentrations (testosterone: -0.21 [-0.38; -0.03] and -0.33 [-0.47; -0.20]; DHEA: -0.47 [-0.57; -0.37] and -0.26 [-0.39; -0.13]; androstenedione: -0.36 [-0.50; -0.22] and -0.39 [-0.49; -0.29]), while the class reporting relatively medium arousal (-0.11 [-0.31; 0.08]) showed the highest testosterone, DHEA and androstenedione concentrations (testosterone: 0.8 [0.60; 1.01]; DHEA: 0.99 [0.76; 1.23]; androstenedione: 1.08 [0.88; 1.29]). There were no significant differences in sexual desire between classes (-0.08 [-0.23; 0.06]; 0.00 [-0.13; 0.14]; 0.10 [-0.09; 0.30]) differing significantly in sex steroid concentrations (-0.69 [-0.80; -0.58], -0.04 [-0.15; 0.07], 0.94 [0.71; 1.16] for testosterone) nor associations between the sex steroid concentrations and degrees of sexual desire. Clinical Implications: These findings cast further doubt on the utility of measuring sex steroids for diagnosing female sexual dysfunction in premenopausal eumenorrheic women, even when considered in combination. Strengths & Limitations: We analyzed a large community sample and controlled for potentially biasing factors. We analyzed sex steroid concentrations determined with gold standard methodology. Excluding women with early menopause and menstrual dysfunction might have resulted in finding three, rather than more, latent classes. Conclusion: Testosterone and pre-androgen profiles do not clearly identify premenopausal eumenorrheic women with low sexual arousal and desire