ArticleSexual medicine2026
Prolactin levels and female sexual distress: associations with sexual knowledge and behaviors.
Article in Sexual medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Introduction: Prolactin (PRL) abnormalities can negatively affect sexual function, yet their relationship with subjective female sexual distress remains insufficiently characterized. The primary aim of this study was to examine the association between serum PRL levels and female sexual distress. As a secondary exploratory aim, we assessed whether sexual knowledge and selected sexual health behaviors were independently associated with sexual distress. Methods: This cross-sectional study included 200 sexually active women aged ≥18 years attending a gynecology outpatient clinic. Participants completed the Female Sexual Distress Scale-Revised (FSDS-R) and a structured questionnaire evaluating sexual knowledge and sexual health behaviors, including Kegel exercise knowledge and practice. Morning fasting serum PRL levels were measured between 08:00 and 10:00. Participants were categorized as having normal serum PRL (≤25 ng/mL) or elevated serum PRL (>25 ng/mL). Secondary exploratory analyses stratified PRL into sample-based quartiles. Between-group comparisons and analysis of covariance models were used to examine associations with FSDS-R total scores. Results: Sixty-five participants (32.5%) had elevated PRL. Women with elevated PRL had higher FSDS-R total scores than those with normal PRL (26.1 ± 12.5 vs 22.2 ± 9.4; Discussion: Elevated PRL was independently associated with greater female sexual distress, and exploratory quartile analyses supported higher distress in the upper PRL quartile without evidence that the lowest PRL quartile was associated with worse distress. Higher sexual knowledge was independently associated with lower distress. These findings support a biopsychosocial framework in which hormonal and cognitive-educational factors contribute to women's subjective sexual well-being. Key limitations include the cross-sectional design, single PRL measurement, absence of routine macroprolactin screening, lack of menstrual-cycle-phase standardization, and use of an exploratory Sexual Knowledge Index.
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