Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt.
Dermatology and Venereology Department, Faculty of Medicine, Fayoum University, Al Faiyum, Faiyum, 2933110, Egypt.
J Sex Med. 2024 Sep 3;21(9):770-776. doi: 10.1093/jsxmed/qdae080.
Nonalcoholic fatty liver disease (NAFLD) is a major health problem with a paucity of available information about its impact on female sexual dysfunction (FSD).
We aimed to study the association between NAFLD and FSD in Egyptian premenopausal women.
Sexually active married premenopausal women who visited our NAFLD outpatient screening clinic (2019 to 2022) were divided into NAFLD and non-NAFLD (control) groups based on liver ultrasound and fatty liver index data. All participants completed the Arabic Female Sexual Function Index (ArFSFI) questionnaire. The resulting data were used to calculate the domains and total scores. FSD is then graded as follows: no FSD (≥28.2), minimal (21.7-28.1), mild (14.5-21.6), moderate (7.3-14.4), and severe (≤7.2).
We determined the proportions of patients and controls for whom ArFSFI scores indicated dissatisfaction with their sexual lives.
Of 995 women participants whose FSFI scores were available, NAFLD was detected in 487 (48.9%) and absent in 508 (51.1%). The two groups were comparable in age, socioeconomic level, residence, and history of female genital cutting. The NAFLD patients had significantly much lower mean scores for the sexual arousal, lubrication, orgasm, satisfaction, and pain domains of the FSFI (P < .001 for all), while no statistical difference was noticed in the desire domain for NAFLD patients compared with the controls. NAFLD women had significantly lower mean total FSFI scores than the controls (mean [SD] 16.7 [6.8] vs 21.7 [5.1], respectively; P < .001) with higher rates of FSD (98.5% vs 82.1%; P < .001, respectively). Most NAFLD women had higher FSD grades than controls (%): no FSD (1.5, 17.9), minimal (20.6, 51.8), mild (42.5, 38.8), moderate (26.2, 9.4), and severe (10.7, none), respectively.
Given the high prevalence of FSD in patients with NAFLD, greater attention to FSF could improve the quality of life in patients with NAFLD.
This study was limited by the lack of testing of sex hormones and some other important factors that were not tested (eg, age, socioeconomic level, residence, and female genital cutting), as these characteristics were previously matched. Strengths of the study include the large study size, to our knowledge the largest to date to investigate the possible link between FSD and NAFLD in premenopausal women, together with the inclusion of the detailed version of the validated ArFSFI.
In Egyptian premenopausal women, NAFLD could harm their sexual function.
非酒精性脂肪性肝病（NAFLD）是一个主要的健康问题，关于其对女性性功能障碍（FSD）的影响，相关信息十分匮乏。
我们旨在研究埃及绝经前女性中非酒精性脂肪性肝病与女性性功能障碍之间的关系。
2019 年至 2022 年，我们对就诊于非酒精性脂肪性肝病门诊筛查诊所的有性生活的已婚绝经前女性进行了研究，根据肝脏超声和脂肪肝指数数据将其分为非酒精性脂肪性肝病组和非非酒精性脂肪性肝病（对照组）。所有参与者均完成了阿拉伯女性性功能指数（ArFSFI）问卷。根据所得数据计算各领域和总分。性功能障碍随后分为以下几个等级：无性功能障碍（≥28.2）、轻度（21.7-28.1）、中度（14.5-21.6）、重度（7.3-14.4）和极重度（≤7.2）。
我们确定了 ArFSFI 评分表明对性生活不满意的患者和对照组的比例。
在埃及绝经前女性中，NAFLD 可能会损害其性功能。
