Background: Perimenopause is associated with increased risk of depression, vasomotor symptoms, and sexual dysfunction.
Aims: To explore the effect of sex hormones on the functional connectivity (FC) of different brain regions related to sexual function in perimenopausal women.
Methods: 32 premenopausal women (mean age, 47.75 ± 1.55 years) and 25 perimenopausal women (mean age, 51.60 ± 1.63 years) underwent sex hormone level measurements and resting-state fMRI.
Main outcome measures: Serum levels of sex hormones, including prolactin (PRL), follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), free testosterone (free-T), and progesterone (P), were measured. 10 brain regions related to sexual function were selected according to a meta-analysis, and FCs of the selected regions of interest were calculated as Pearson's correlation coefficient.
Results: Compared with premenopausal women, perimenopausal women showed increased FC between the right area 13 (A13_r) and the right medial superior frontal gyrus (mSFG), between the left dorsal granular insula (dIg_L) and the right superior frontal gyrus (SFG) (Gaussian random field-corrected at the voxel level, P < .001, and cluster level, P < .025). Furthermore, the PRL level was negatively correlated with the FC of A13_R with the right mSFG and the FC of dIg_L with the right SFG.
Clinical translation: These findings may be applicable to assessing brain dysfunction with FC changes in women approaching menopause.
Strengths & limitations: This study is the first to evaluate a direct relationship between sex hormone levels and brain FC changes in women approaching menopause. Sexual function was not assessed, which may weaken the conclusions related to sexual function.
Conclusions: The results show that women approaching menopause suffered from aberrant intrinsic FC in regions related to sexual function, and reveal a direct relationship between serum sex hormone levels and FC changes related to sexual function. Lu W, Guo W, Cui D, et al. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019;16:711-720.
Keywords: Functional Connectivity; Menopause Transition; Perimenopause; Premenopause; Sex Hormones; Sexual Function; fMRI.
Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.