Purpose

Spinal cord injury (SCI) affects sexual health of both male and female, but little attention has been given to sexuality of SCI women. Similar to penile erection, vaginal lubrication represents a neurovascular event and then both denervation and vascular damage might contribute to its impairment. Nevertheless, the relative weight of lesion location/degree and vascular risk factors in determining hypolubrication in women with SCI has not yet been investigated. The aim of this study was to recognize among putative determinants of poor sexual arousal in women with SCI, neurogenic and vascular/metabolic independent predictors of vaginal hypolubrication.

Methods

Twenty-eight consecutive female patients admitted to a rehabilitation program because of chronic SCI (≥ 1 year) underwent clinical and biochemical evaluations, including assessment of vaginal lubrication by the Female Sexual Function Index (FSFI). As, in people with SCI, waist circumference overestimates visceral fat mass due to abdominal muscle paralysis, metabolic syndrome (MetS) was defined according to specific criteria proposed for SCI population: BMI ≥ 22 kg/m² and two or more of the following: triglycerides ≥ 150 mg/dL (or actual treatment), HDL < 50 mg/dL, hypertension (or actual treatment), fasting glucose ≥ 100 mg/dL or diabetes mellitus type 2.

Results

A FSFI lubrication sub-score < 3.6, suggestive for impaired vaginal lubrication, was exhibited by 53.7% of the study population. When compared to the group with normal lubrication, a significantly higher proportion of these women had paraplegia (93.3% vs 38.5%, p = 0.003) and met the SCI-specific criteria for MetS (73.4% vs 7.6%, p = 0.0006), whereas, no significant differences were found between the two groups in the proportion of women exhibiting the single components of MetS. At the multiple logistic regression analysis, only the presence of MetS exhibited a significant independent association with impaired vaginal lubrication (OR = 3.1, 95% CI 1.2, 5.8, p = 0.01).

Conclusions

In women with SCI, a clustering of modifiable vascular/metabolic risk factors, constituting the MetS, could contribute to sexual dysfunctions by affecting the vaginal lubrication, independently of the level of the spinal cord lesion.

中文翻译：

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代谢综合征是慢性脊髓损伤妇女阴道润滑受损的关键决定因素。

目的

脊髓损伤（SCI）会影响男性和女性的性健康，但是对SCI妇女的性行为却鲜有关注。类似于阴茎勃起，阴道润滑代表神经血管事件，然后神经支配和血管损伤都可能导致其受损。然而，尚无关于确定SCI妇女润滑不足的病变部位/程度和血管危险因素的相对权重。这项研究的目的是要认识到SCI妇女性唤起不良的决定因素，阴道润滑不足的神经源性和血管/代谢性独立预测因子。

方法

由于慢性脊髓损伤（≥1年）而被纳入康复计划的28位连续女性患者接受了临床和生化评估，包括通过女性性功能指数（FSFI）评估阴道润滑。因为在SCI患者中，腰围高估了由于腹肌麻痹引起的内脏脂肪量，因此根据针对SCI人群提出的特定标准定义了代谢综合征（MetS）：BMI≥22 kg / m ²以及以下两项或多项：甘油三酸酯≥150 mg / dL（或实际治疗），HDL <50 mg / dL，高血压（或实际治疗），空腹血糖≥100 mg / dL或2型糖尿病。

结果

FSFI润滑评分低于3.6，表明阴道润滑受损，占研究人群的53.7％。与正常润滑的女性相比，截瘫的女性比例显着更高（93.3％vs 38.5％，p  = 0.003），并且符合针对MetS的SCI特定标准（73.4％vs 7.6％，p  = 0.0006），然而，在显示MetS单一成分的女性比例上，两组之间没有显着差异。在多元logistic回归分析中，仅MetS的存在与阴道润滑受损表现出显着的独立关联（OR = 3.1，95％CI 1.2，5.8，p  = 0.01）。

结论

在患有SCI的女性中，构成MetS的一系列可调节的血管/代谢危险因素可能通过影响阴道润滑而导致性功能障碍，而与脊髓病变程度无关。