Nonalcoholic fatty liver disease (NAFLD) is a liver condition where fat builds up in the liver without the influence of alcohol, drugs, or other liver diseases. It ranges from mild to severe, potentially leading to liver cirrhosis or cancer. Major risk factors for NAFLD include obesity and type 2 diabetes, which also increase the chances of developing diabetes and metabolic syndrome. However, losing weight can improve the condition.

Female sexual dysfunction (FSD) involves difficulties with sexual desire, arousal, lubrication, orgasm, or pain during intercourse, negatively affecting a woman’s quality of life. Diagnosing FSD is complex and more difficult to diagnose than male sexual dysfunction, because many women may experience issues but remain sexually active.

While NAFLD impacts quality of life, it’s unclear if it directly contributes to sexual dysfunction. Therefore, a new study aimed to explore the relationship between NAFLD and sexual dysfunction in young Egyptian women using a specific sexual health questionnaire.

The study took place from January 2019 to November 2022 at the National Liver Institute Hospital, Menoufia University, with ethical approval. It involved premenopausal married women who were sexually active and could read Arabic. They were divided into two groups based on whether they had NAFLD or not. Women with NAFLD were assessed using ultrasound and liver function tests, while those without NAFLD were included as controls if they showed no signs of liver or systemic diseases.

Participants completed the Arabic Female Sexual Function Index (ArFSFI) questionnaire to evaluate their sexual function. The study aimed to compare sexual function scores between women with and without NAFLD. Data were analyzed using statistical methods to determine any significant differences in sexual health between the groups.

Over nearly four years, about 2,000 premenopausal married women visited the NAFLD screening clinic, and 1,175 agreed to participate in this study. Women from urban areas and those with higher education were more likely to join. Ultimately, 995 women met the criteria to be included in the study, of which, 487 had NAFLD and 508 did not. Women with NAFLD had higher waist circumference, BMI, blood sugar, cholesterol, and fatty liver index compared to controls.

According to the ArFSFI questionnaire, women with NAFLD scored significantly lower in arousal, lubrication, orgasm, satisfaction, and pain compared to controls, though there was no significant difference in sexual desire. Nearly all women with NAFLD (98.5%) had sexual dysfunction, compared to 82.1% of the controls. Most women with NAFLD had mild to moderate dysfunction, while controls mostly had minimal dysfunction.

While the overall prevalence of FSD was very high in both groups, the NAFLD patients had a notably higher rate of severe dysfunction. This may be due to NAFLD’s association with metabolic syndrome, which is linked to sexual dysfunction. These results suggest a need for more research on the relationship between NAFLD and sexual health, considering cultural and societal barriers.

References:

• Fouad, T. R., Mohamad, N. E., Elabd, M., Abd-Elwahab, R., Elsary, A. Y., Abd-Elghafar, T. S., Elshimi, E., & Attia, A. (2024). Nonalcoholic fatty liver disease and female sexual dysfunction in Egyptian premenopausal women: Is there a link between metabolic syndrome and sexual function? The Journal of Sexual Medicine, 21(9), 770–776. https://doi.org/10.1093/jsxmed/qdae080