Vaginismus and Dyspareunia. A Case Report From Clinical Practice

Sexual dysfunction in women with epilepsy

Clinical Practice Guidelines for management of Sexual Disorders in Elderly.

Objective: To determine the perception of sexuality, sexual function disorders and the effects of quality of life of sexual problems in female patients with spinal cord injury (SCI) in a Turkish population. Material and Methods: This study group was between the ages of 18-58 years; female SCI patients, sexually active before the spinal cord injury, were included. The control group consisted of healthy women. Neurological levels T10 and above, T11-L2, conus, and cauda were classified in three sub-groups. SCI and healthy women were evaluated with the TAF Rehabilitation Center Sexual Rehabilitation Evaluation Form in Women with SCI, Female Sexual Function Index, and Satisfaction With Life Scale. Results: Fifty SCI and 50 healthy women were included into the study; 46 patients before the injury and 40 patients after the injury had sexual intercourse experience, respectively. The decrease in sexual arousal and sexual intercourse was statistically significant (p=0.000) in the after-injury group than before the injury. Sexual interest and importance given to sexuality were significantly lower before the injury than in the control group (p<0.05). After SCI, based on the need to share intimacy, sexual activity ratio was 84%. In patients with a sense of the genitals, level of arousal was greater than those without (p=0.002). Lack of orgasm and sexual desire after the injury was the major problem experienced in sexual intercourse and was significantly increased after the SCI (p<0.05). Conslusion: In this study, we found that female SCI patients have a significant deterioration in sexual function, and it also impairs quality of life.

Dyspareunia, defined as pain before, during or after intercourse, is a subset of female sexual dysfunction with overlapping gynecologic, urologic and psychosocial etiologies. This study aimed to evaluate the impact of menstrual pain and visceral hypersensitivity on sexual function and to identify risk factors for sexual pain in healthy reproductive-age females. In this prospective cohort study, we evaluated gynecologic and psychologic self-reported histories, validated sexual function questionnaires, and conducted a standardized gynecologic examination enhanced by quantitative sensory testing in reproductive-aged females with menstrual pain versus pain-free controls. Correlation analysis was conducted between the Female Sexual Function Index (FSFI) pain subdomain score and a priori hypothesized risk factors for dyspareunia: menstrual pain severity, experimentally provoked bladder sensitivity, anxiety, depression, pain catastrophizing, and vaginal pressure-pain sensitivity. The primary outcome was severity of sexual pain as measured by the FSFI, comparing participants with moderate-to-severe dysmenorrhea (n = 99), dysmenorrhea with bladder hypersensitivity (n = 49) identified on non-invasive oral water challenge, and pain-free controls (n = 37). In our young (median age 22 [IQR 19, 29]), nulliparous, predominantly heterosexual cohort (78.3%, 144/185), 64.3% (119/185) engaged in sexual intercourse within the four-week recall period. The median total FSFI score was 27.2 (22.0, 30.2). Across groups, only the dysmenorrhea with bladder hypersensitivity phenotype met the threshold for sexual dysfunction as measured by total FSFI score (24.6 [20.0, 28.1], p= 0.008). Dysfunction was driven by difficulties with lubrication and higher pain levels during and after intercourse. On physical examination, those with and without dyspareunia were largely indistinguishable, with little to no tenderness of the pelvic floor, bladder, uterus and uterosacral ligaments. Amongst the six hypothesized risk factors for sexual pain, only experimentally provoked bladder pain was significantly associated with the severity of dyspareunia (r = 0.41, corrected p< 0.001). Young, otherwise healthy individuals with dysmenorrhea and occult visceral hypersensitivity exhibit signs of sexual dysfunction and significantly higher rates of dyspareunia in the absence of reliable clinical examination findings. Strengths include the use of a nonclinical sample of almost exclusively nulliparous females with no co-morbid pelvic pain diagnoses and prospective diary confirmation of dysmenorrhea severity. The study is limited by the narrow heteronormative, cisnormative sexual experience of penile-vaginal intercourse captured by the FSFI. Sexual pain is more prevalent in those with dysmenorrhea with bladder hypersensitivity than isolated dysmenorrhea, suggesting visceral hypersensitivity may be a non-structural mechanistic driver for dyspareunia.

Dyspareunia and chronic pelvic pain in patients with interstitial cystitis/bladder pain syndrome

<h3>Summary</h3> <h3>Background</h3> As of March 2, 2020, SARS-CoV-2 has infected more than 80174 people and caused 2915 deaths in China. This virus rapidly spreads to 56 countries worldwide. Thus, in...

Women and ESRD: Modalities, Survival, Unique Considerations

191 Comparing Provider-Led Sexual Health Counseling of Male and Female Radical Cystectomy Patients

Sexual dysfunction in women with cancer

Comparing Provider-Led Sexual Health Counseling of Male and Female Patients Undergoing Radical Cystectomy

The global and regional burden of sexual behaviors and food insecurity and their combined association on the magnitude of suicidal behaviors among 121,248 adolescent girls: An international observational study in 67 low- and middle-income and high-income countries

Sexual Dysfunction and Abnormal Androgen Level after Hematopoietic Stem Cell Transplantation

Objective To understand the characteristics of sexual partners and the influence of having multiple sexual partners on substance use among young male students man who have sex with men (MSM) in China, and to provide scientific basis for the prevention and control of HIV/AIDS among young MSM students. Methods A mixed recruitment method of snowball sampling and respondent driven sampling was used to recruit young MSM students in Beijing and Tianjin, and a questionnaire survey was conducted among 220 participants from November to December 2019. Chi-square test and generalized linear model multi-factor Logistic regression were used to analyze the influencing factors of substance use before sexual behavior. Results The average age of them was (22.39±2.57) years old, 84.5% of them were students, the average age of first sexual behavior was (18.83±2.45) years old, 44.1% of them had two or more sexual partners (including fixed sexual partners, temporary sexual partners and commercial sexual partners), 22.7% had more than one male fixed partner. After adjusting for age and education, having multiple sexual partners was risk factor for drinking alcohol before sex ( aOR = 2.97) or substance abuse ( aOR = 2.39). Having male temporary sexual partner was an risk factor in substance use before sexual behavior ( OR = 4.10). Conclusion The characteristics of sexual partners among young MSM students are complex, and the proportion of multiple sexual partners is high. Having fixed single sexual partner can reduce the risk of substance use before sexual behavior. AIDS prevention education for young MSM students should be further strengthened. 【摘要】 目的 了解中国青年学生男男性行为人群 (men who have sex with men, MSM)性伴特征和多性伴现象对性行为 前使用物质行为的影响, 为制定青年学生 MSM 艾滋病防控干预提供科学依据。 方法 2019 年 11一12 月通过受试者推荐 和滚雪球 2 种抽样方法进行抽样, 以北京和天津为中心对 220 名青年 MSM 进行问卷调查, 采用； χ 2 检验和广义线性模型多 因素 Logistic 回归分析性行为前物质使用的影响因素。 结果 研究对象平均年龄 (22.39±2.57) 岁, 84.5% 为在读学生, 首次 性行为年龄为 (18.83±2.45)岁, 44.1%有2 个及以上性伴 (包括固定性伴、临时性伴和商业性伴), 22.7%有多个男性固定性 伴。调整年龄和受教育水平的影响后, 多性伴与性行为前饮酒 (a OR = 2.97)或滥用药物 (a OR = 2.39)呈正相关;有男性临时 性伴与性行为前使用物质呈正相关 ( OR = 4.10)。 结论 青年MSM的性伴特征复杂, 多性伴比例较高, 单一固定性伴可降 低性行为前使用物质行为的风险, 应进一步加强青年学生MSM的预防艾滋病教育。

Sexual dysfunction is commonly observed in individuals with Major Depressive Disorder (MDD), along with various psychological symptoms such as anxiety, somatic complaints, interpersonal sensitivity, and obsessive-compulsive tendencies. However, there is a research gap in understanding the impact of these psychological symptoms on sexual functioning in MDD. Furthermore, there is limited data on the incidence of sexual dysfunction among drug-naive MDD patients in West China. This study aims to determine the prevalence of sexual dysfunction in this patient population and explore its association with other psychological indicators. We conducted a retrospective analysis of patient data from October 2020 to September 2022 using propensity score matching. A focused group of 165 males and 490 females was selected from a total of 1941 MDD patients. This allowed for a comparative analysis of demographic data, as well as scores from the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Symptom Checklist-90 (SCL-90), the Arizona Sexual Experience Scale (ASEX). Our findings reveal that 46.2% of drug-naive MDD patients experienced sexual dysfunction. Notably, there was a higher prevalence of sexual dysfunction among female patients (50.3%) compared to males (37.5%). MDD patients without sexual dysfunction consistently exhibited higher SDS scores than those with sexual dysfunction (p < 0.01), There were no statistically significant differences between male and female MDD patients with or without concomitant sexual dysfunction in terms of Somatic complaints, Obsessive-compulsive, Interpersonal sensitivity, Anxiety, Phobic anxiety, Paranoid ideation, Psychoticism and Diet/sleep difficulties (p > 0.05). In addition, male MDD patients with sexual dysfunction showed a emerging trend towards elevated Hostility scores on the SCL-90 (p = 0.058), male MDD patients with sexual dysfunction showed an increasing trend in hostility scores on the SCL-90, whereas female MDD patients with sexual dysfunction did not show such a trend. The study highlights a significant gender difference in the prevalence of sexual dysfunction among MDD patients, with females being more susceptible than males. There is a positive correlation between the severity of depression and sexual dysfunction in both genders. Interestingly, male MDD patients demonstrated a potential protective effect of hostility against sexual dysfunction, which was not observed in female patients.

Aim: The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage. Patients and methods: Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yılmaz Education and Research Hospital, were enrolled. Age- and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed. Findings: Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p = 0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p = 0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p > 0.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p = 0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p = 0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p = 0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p = 0.0001). Conclusion: We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.