Abstract
BACKGROUND: Inflammation may contribute to lower desire and arousal functioning in women; however, little research has examined effects across the reproductive lifespan. AIM: To examine associations between inflammation and sexual functioning in pre- and post-menopausal women. METHODS: 103 healthy, sexually active cisgender women (48 pre-menopausal; 55 post-menopausal) completed a standardized sexual arousal induction paradigm. C-reactive protein (CRP), a marker of inflammation, was assessed from blood samples. Participants also completed validated clinical surveys and diagnostic interviews of sexual desire, arousal, and overall sexual functioning. OUTCOMES: Self-reported sexual arousal to a sexual film; survey indices of sexual desire and sexual functioning; and female sexual dysfunction diagnosis. RESULTS: While there was lower sexual functioning and higher CRP in the post-menopausal group, there was no significant association nor interaction between CRP and menopausal status in predicting sexual function, self-reported arousal, nor diagnosis. Exploratory analyses revealed a significant negative association between CRP and sexual desire among women with higher lifetime exposure to sexual violence, but positive association at lower levels of lifetime sexual violence exposure. CLINICAL IMPLICATIONS: Caution is warranted for interpreting CRP as a clinical marker of sexual dysfunction in either pre- or post-menopausal women. STRENGTHS AND LIMITATIONS: Strengths include well-validated clinical assessments of sexual function, direct measures of inflammation, and inclusion of women across the lifespan. Limitations include a cross-sectional design, limited racial/ethnic diversity, and reliance on one inflammation biomarker. CONCLUSION: CRP was not associated with subjective sexual arousal or sexual functioning in a sample of healthy women; further work may identify if more sensitive inflammation biomarkers are needed, or if inflammation has greater effects on sexual function in specific conditions such metabolic syndrome. Of note, CRP did predict lower sexual desire in women with sexual violence histories, suggesting that survivors of sexual violence may be particularly sensitive to inflammation-mediation suppression of sexual motivation and/or reward.