Female Sexual Dysfunction and Hormonal Status in Spinal Cord Injured (sci) Patients Running Title: Female Sexual Dysfunction and Hormonal

Objective: To investigate a possible correlation between sexual hormonal status and presence of female sexual dysfunctions (FSD) through the Female Sexual Function Index (FSFI) in females with spinal cord injuries (SCI). Methods: We selected 39 SCI fertile-aged women. At visit 1 we assessed the 5 presence of FSD using the FSFI and all individuals were submitted to a haematic hormonal evaluation on the 3 day of their menstrual cycle. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH); cortisol, dehydroepiandrosterone sulphate (DHEA-S), androstenedione, 17[alpha]-hydroxyprogesterone; total and 10 free testosterone, 17 beta estradiol, inhibin and Sex Hormone Binding Globulin (SHBG), and thyroid hormones (fT3 and fT4) were checked. On the 20 21 day following their menstrual cycle we evaluated the progesterone. In patients with amenorrhea we tested all the hormones using one random blood test. After a 3month period the same investigations were repeated. 15 Results: 23 out of 39 patients (58.9%) continued to manifest at least one sexual dysfunction. These patients reached a median score of 19.52. All but 6 patients (15.3%) consistently showed hormonal values within the normal range. Of the 6 patients with abnormal hormonal alterations 5 showed at least one sexual dysfunction: 2 20 females had low levels of total testosterone, 1 low level of free testosterone, 1 suffered from hypothyroidism, 1 presented low levels of cortisol, and 1 showed hypoprogesterone. Conclusions: We did not observe a significant correlation between abnormal hormonal status and presence of a specific sexual dysfunction through the FSFI. 25