Do serum homocysteine levels affect female sexual function in reproductive-age women: a cross-sectional study

The aim of this study was to investigate the association between serum homocysteine levels and female sexual function in reproductive-age women presenting with sexual dysfunction complaints and to evaluate relationships with vitamin B12 and folic acid levels.

This cross-sectional study included 114 sexually active women aged 18-45 years presenting with sexual dysfunction complaints. Female sexual function was assessed using the Female Sexual Function Index. Fasting serum homocysteine, vitamin B12, and folic acid levels were measured. Correlation analyses, group comparisons, and multivariable linear regression were performed. A priori sample size calculation indicated that at least 84 participants were required to detect a moderate correlation (ρ=0.30) with 80% power.

Female Sexual Function Index scores were available for 111 participants and homocysteine levels for 99 participants. The mean Female Sexual Function Index total score was 24.69±4.34, below the established cut-off for sexual dysfunction. Serum homocysteine levels were not associated with Female Sexual Function Index total or domain scores (ρ=-0.035, p=0.726). No significant differences were observed between homocysteine groups defined by ≤10 and >10 μmol/L or ≤15 and >15 μmol/L. Age showed a moderate negative correlation with the desire domain (ρ=-0.362, p<0.001). In multivariable regression, homocysteine, vitamin B12, and folic acid were not independent predictors of Female Sexual Function Index total score.

In this symptomatic population, homocysteine levels were not associated with female sexual function. These findings should be interpreted cautiously due to the lack of a control group. Further large-scale, population-based studies are needed.