The effect of inflammation on sexual desire and sexual function in pre- and post-menopausal women is moderated by sexual violence history.

Introduction At least 10% of women in the United States are affected by problems with sexual desire which can impact sexual satisfaction, relationship satisfaction and overall quality of life. Postmenopausal women are disproportionally at risk. The mechanisms and causes are still not well understood, contributing to a lack of treatment options. Inflammation might be an important component that has so far been overlooked. Given prior research showing links between elevated inflammation and reduced sensitivity to reward, a link between heightened inflammation and decreased sexual desire seems likely. A lack of anti-inflammatory effects of estrogen in postmenopausal women might exacerbate the effects. Objective The aim of this study was to explore the connection of inflammation and sexual desire, global function and self-reported sexual arousal in healthy pre- and postmenopausal women. Methods 48 premenopausal (M = 25.9, SD =9) and 7 postmenopausal participants completed in-person procedures while 55 postmenopausal participants completed remote procedures (M = 55.2, SD = 8) due to the COVID-19 restrictions. Participants were prescreened online and gave informed consent. All participants provided a sample of whole blood via dried blood spot, from which we derived a marker of inflammation, C-reactive protein (CRP). Self-reported subjective sexual arousal and emotional states were measured before and after exposure to an erotic film. Sexual function, desire and self-reported mental health symptoms were measured using validated questionnaires and a structured clinical interview. Data was transformed prior to data analysis and analyzed using general linear models. Results Postmenopausal women reported a significant lower global sexual function, measured by the Female Sexual Function Index (FSFI) (t (54.18) = - 2.64, p = 0.01) and lower desire, arousal and lubrication subscale scores. No significant group differences were observed in the Sexual Desire Inventory (SDI) or mental health outcomes. Premenopausal women had a significantly lower CRP than postmenopausal women (t (73.13) = −7.32, p < 0.001); however, CRP did not predict sexual function as measured by the FSFI. When controlling for BMI, diabetes, sexual trauma history, psychiatric disorders, and frequency of partnered sexual activity, CRP significantly predicted sexual desire as measured by the SDI (β = -19.57, SE = 8.28, t = -2.36, p = 0.037). There was no statistically significant relationship to self-reported subjective arousal. Menopausal status did not significantly moderate any of the main effects. Conclusions We did not find strong evidence for a link between baseline CRP and sexual desire, global sexual function or self-reported subjective arousal in pre- and postmenopausal women. However, there was some evidence that CRP may be a significant predictor of some elements of sexual desire when considering known predictors of inflammatory parameters such as metabolic conditions, sexual trauma history and partnered sex frequency. Possibly, CRP is not sensitive to subtle effects; future research may benefit from examining markers of inflammation that may be more sensitive to subjective sexual response, such as inflammatory cytokines. Disclosure No.

Arriving at the diagnosis of female sexual dysfunction

Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study

Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples

Clinical Practice Guidelines for management of Sexual Disorders in Elderly.

Group mindfulness-based therapy significantly improves sexual desire in women

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Sexual dysfunction in women with cancer

Although studies suggest that alcohol increases women's sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women's sexual desire. The majority of research examining alcohol's effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women's sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol's influence on women's sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal.

To describe the current state of research on interactions between inflammation and female sexual function. Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of inflammation on sexual function, arising from different evolutionary selection pressures on regulation of reproduction. A variety of inflammation-related conditions are associated with risk of female sexual dysfunction, including cardiovascular disease, metabolic syndrome, and chronic pain. Clinical implications include the need for routine assessment for sexual dysfunction in patients with inflammation-related conditions, the potential for anti-inflammatory diets to improve sexual desire and arousal function, and consideration of chronic inflammation as moderator of sexual effects of hormonal treatments. Although the evidence points to a role for inflammation in the development and maintenance of female sexual dysfunction, the precise nature of these associations remains unclear.

Decreased sexual functioning is prevalent among female survivors of sexual violence yet psychological factors that contribute to sexual impairments in this population are understudied. To extend research in this area, the current study examined two psychological factors as they relate to sexual functioning concerns among 148 female survivors of sexual violence: severity of posttraumatic stress symptoms (PTSSs) and sexual self-schemas. Four domains of sexual functioning were examined: sexual desire, sexual arousal, sexual satisfaction, and orgasm functioning. It was predicted that PTSSs would be associated with a more negative sexual schema, which in turn, would be associated with decreased sexual functioning across the four domains. Using path analysis, PTSSs were found to be indirectly associated with decreased sexual satisfaction (b = -.08, SEb = .04, p = .035), sexual arousal (b = -.01, SEb = .001, p = .02), and reduced orgasm functioning (b = -.01, SEb = .001, p = .002). Results also supported significant direct paths from PTSS to all sexual functioning variables. These results support that negative sexual self-schemas may be relevant to the co-association of PTSSs and reductions in sexual functioning and satisfaction.

Problems related to low sexual desire in women are common clinical complaints, and the aetiology is poorly understood. We investigated predictors of change in levels of sexual desire using a novel network approach, which assumes that mental disorders arise from direct interactions between symptoms. Using population-based data from 1,449 Finnish women, we compared between-subject networks of women whose sexual desire decreased, increased, or remained stable over time. Networks were estimated and analyzed at T1 (2006) and replicated at T2 (2013) using R. Domains included were, among others, sexual functions, sexual distress, anxiety, depression, body dissatisfaction, and relationship status. Overall, networks were fairly similar across groups. Sexual arousal, satisfaction, and relationship status were the most central variables, implying that they might play prominent roles in female sexual function; sexual distress mediated between general distress and sexual function; and sexual desire and arousal showed different patterns of relationships, suggesting that they represent unique sexual function aspects. Potential group-differences suggested that sex-related pain and body dissatisfaction might play roles in precipitating decreases of sexual desire. The general network structure and similarities between groups replicated well; however, the potential group-differences did not replicate. Our study sets the stage for future clinical and longitudinal network modelling of female sexual function.

Previous research suggested that disgust may interfere with healthy sexual functioning by demonstrating that women with sexual pain disorders are characterized by heightened disgust propensity, relatively strong (physiological and subjective) disgust responses when exposed to sexual stimuli, and relatively strong automatic sex-disgust memory associations. To broaden the understanding of the relationship between sex and disgust, Study 1 tested the relationship between trait disgust and sexual functioning in both men (N = 109) and women (N = 187), and showed that specifically for women both relatively high disgust propensity and high sensitivity were related to lower sexual functioning. Study 2 focused on healthy young adults (N = 19 men and N = 24 women), and tested the relationship between trait disgust and automatic sex-disgust associations as well as the predictive value of trait disgust propensity for participants' level of sexual arousal while watching an erotic video. Participants completed a single-target Implicit Association Task and self-report measures of trait disgust propensity, disgust sensitivity, and sexual functioning. Furthermore, genital and subjective sexual arousal was measured, while participants were watching neutral and erotic video clips. Women showed stronger sex-disgust associations and reported higher disgust propensity than men. Overall, indices of trait disgust and sex-disgust associations were not strongly associated with sexual functioning or sexual arousability. Unexpectedly, specifically in men, high levels of trait disgust sensitivity predicted higher levels of genital and subjective sexual arousal. Overall, no strong evidence was found to support the view that, among young adults without sexual difficulties, high trait disgust or relatively strong automatic sex-disgust associations are associated with low sexual functioning and low sexual arousal.

Introduction. Sexual arousal is a multifaceted process that involves both mental and physical components. No instrument has been developed and validated to assess subjective aspects of male sexual arousal. Aim. To develop and psychometrically validate a self-administered scale for assessing subjective male sexual arousal. Methods. Using recommendations of the Food and Drug Administration (FDA) guidance on patient-reported outcome instruments, important aspects of male sexual arousal were identified via qualitative research (focus groups and interviews) of U.S. men with erectile dysfunction (ED) and healthy controls. After a preliminary questionnaire was developed by a panel of experts, a quantitative study of men with ED and controls was conducted to psycho- metrically validate the Subjective Sexual Arousal Scale for Men (SSASM). Main Outcome Measures. To develop a male sexual arousal scale and determine its factor structure, reliability, and construct validity. Results. Five aspects of male sexual arousal were identified from the qualitative focus groups and cognitive inter- views. Men's preferred language for describing sexual arousal and preferred response formats were incorporated into the questions. Factor analysis of data from the quantitative study of 304 men aged 21 to 70 years identified five domains with eigenvalues >1: sexual performance (six items), mental satisfaction (five items), sexual assertiveness (three items), partner communication (three items), and partner relationship (three items). The five domains had a high degree of internal consistency (Cronbach's alpha values 0.88-0.94). Test-retest reliability over a 2- to 4-week period was high-moderately high (r values 0.75-0.88) for the five domain scores. Correlations between SSASM domain scores and standardized scale scores for social desirability, general health, life satisfaction, and sexual function demonstrated the construct validity of the scale. Conclusions. Preliminary validation data suggest that the 20-item SSASM scale may be useful as a multidimensional, reliable, self-administered instrument for assessing subjective sexual arousal in men of different ages. Althof SE, Perelman MA, and Rosen RC. The Subjective Sexual Arousal Scale for Men (SSASM): Preliminary devel- opment and psychometric validation of a multidimensional measure of subjective male sexual arousal. J Sex Med 2011;8:2255-2268.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of fertile age. It is associated with somatic and psychological comorbidities and lower sexual function. To study which psychosocial factors predict sexual dysfunction, and dyadic and solitary sexual desire in women with PCOS. This is an observational case control study amongst healthy heterosexual women with (n= 68) and without PCOS (n= 67), aged 18-40years, in a steady relationship. All participants filled out questionnaires on sexuality (sexual function, sexual distress, sexual desire), psychosocial factors (general self-esteem, relationship satisfaction, body image, body self-consciousness, sexual esteem, sexual abuse), and mental health (anxiety and depression). Standard multiple regression analyses were performed to assess which factors predict sexual dysfunction and dyadic and solitary sexual desire. sexual dysfunction, dyadic sexual desire, solitary sexual desire. Women with PCOS reported significantly more often sexual dysfunction (41.2% vs. 11.9%, P< .001, φ: 0.331) and lower dyadic sexual desire (P: .005, η: 0.057), but no difference in solitary sexual desire (P: .160, η: 0.015) compared to women without PCOS. Also, women with PCOS reported significantly less positive body image (P: .012, η: 0.047), higher body self-consciousness (P: .011, η: 0.048), higher anxiety (P: .002, η: 0.072), higher depression scores (P: .006, η: 0.055), more sexual abuse experiences (P: .009, φ: 0.225), and less relationship satisfaction (P: .017, η: 0.042). No differences in general self-esteem (P: .169, η: 0.014) were found in contrast to sexual esteem (P: .021, η: 0.039). Body self-consciousness (P: .05, r= 0.242), depression (P: <.001, r= .357), relationship satisfaction (P: .05, r= -0.286), and sexual esteem (P: <.001, r= 0.644) showed significant correlations with sexual dysfunction; and sexual esteem (P: <.001, r= -0.475) and use of the combined oral contraceptive pill (P: .05, r= -0.270) with dyadic sexual desire. Regression showed the strongest associations (all P: <.001) between sexual esteem and sexual dysfunction and dyadic sexual desire, and between depression and sexual dysfunction with moderate explained variance. Sexual function should be discussed with women with PCOS and psycho-education on the association with sexual esteem and depression given. Other common psychosocial comorbidities in PCOS should be screened. Refer for psychotherapy or a tailormade psychosexual treatment including interventions targeted on sexual esteem and depression. Strengths are the broad assessment of psychosocial factors and sexual distress. A weakness is the relatively healthy population possibly underestimating the effect of psychosocial factors. Sexual dysfunction and dyadic sexual desire in women with PCOS are predicted by depression and sexual esteem suggesting psychosexual counseling might be helpful.