Maseroli Dr. Elisa, Cipriani Dr. Sarah, Vignozzi Prof. Linda, Ravelli Dr. Serena

(181) APPLICATION OF A VERY LOW CALORIES KETOGENIC DIET (VLCKD) PROTOCOL IN WOMEN'S ENDOCRINOLOGY: PSYCHOSEXUAL CORRELATES OF WEIGHT LOSS

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives To evaluate the psychosexual correlates of obesity and the Metabolic Syndrome (MetS) in a large sample of women consulting for sexual symptoms; to investigate the change in measures of arousal after weight loss obtained with Very Low Calories Ketogenic Diet (VLCKD). Methods In a retrospective study, n=322 women consulting for sexual symptoms were enrolled. The patients underwent a clinical, laboratory, sexual and psychometric examination and were studied by color-Doppler ultrasound with measurement of the Pulsatility Index (PI) of the clitoral artery. Twelve patients underwent a lifestyle intervention based on a VLCKD protocol and compared with patients treated with different strategies for sexual symptoms, in a 1: 1 case-control study. Results Clitoral PI was significantly higher in obese women (p = 0.018) and in those diagnosed with MetS (p=0.043). A statistically significant inverse correlation emerged between WC ≥ 88 cm and FSFI Arousal score (R=-0.126, p=0.028). In patients undergoing a lifetsyle intervention (n = 12), after a mean follow-up of 20±2 weeks, BMI showed a reduction of 6.7±2.8 kg/m2 (p <0.001). At follow-up, the total FSFI and FSDS-R scores significantly improved (17.0±13.6 vs. 11.2±7.9, p=0.016, and 7.4±8.3 vs. 13.3±10.6, p=0.039, respectively). A significant increase was observed in FSFI Arousal (p=0.035), whereas clitoral PI displayed a non-significant reduction (p = 0.218). At multivariate analysis, the change in Total FSFI was correlated with the improvement in Body Image (BUT-B PSDI score: β=0.744, p=0.031; Eating Disorder Evaluation “Shape” domain: β=0.523, p=0.043), after adjusting for confounders. Finally, in the case-control study (subjects matched for age, BMI and menopausal state), the improvement in FSFI total score was more relevant in cases than in controls (p = 0.046). Conclusions Our data suggest that weight loss obtained by VLCKD is associated with an improvement in sexual function, and in particular in Arousal, which could be mediated by improved body image. Conflicts of Interest LV received scientific research grants, advisory board attendance and speaker honoraria from Therascience, Theramex, Bayer Schering Pharma, Intercept, Lipocine, Ibsa. EM and SC have nothing to declare.

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