Arousal Scores Research Articles

Distended Seminal Vesicles Are Involved in Specific Cerebral Sexual Arousal: A Pilot Study Using Functional Brain Imaging in Young Healthy Men

BackgroundWhether seminal vesicles play a role in sexual activity in men is unknown. No study so far has compared the neural processing of visual sexual stimuli in men depending on the filling state of the seminal vesicles. ObjectiveTo evaluate potential specific cortical activation by visual sexual stimuli with distended and empty seminal vesicles. Design, setting, and participantsA prospective case-control trial was conducted. Six male individuals underwent two visits on 2 consecutive days for hormone analyses; Derogatis Interview for Sexual Functioning (DISF) questionnaire; functional magnetic resonance imaging (fMRI) with passively viewing sexual, neutral, positive, and negative emotional pictures; and structural pelvic MRI. After the first visit, the participants had to empty seminal vesicles by masturbation. During fMRI, every participant viewed alternating blocks of sexual, neutral, positive, and negative emotional pictures. Outcome measurements and statistical analysisComparisons between days 1 and 2 were evaluated using paired t tests. Results and limitationsNo significant differences were observed regarding hormone analyses, DISF questionnaire score, and arousal scoring between days 1 and 2. Seminal vesicle volume was significantly lower on day 2 (p = 0.003). Significantly higher activation was observed in the right precentral gyrus, middle frontal gyrus, and right superior temporal sulcus when contrasted for sexual over neutral (p < 0.05). ConclusionsIn response to pictures with sexual emotional content, significantly higher activation was detected in brain areas involved in motor preparation (arousal) and coding of desirability of visual sexual stimuli in men with distended seminal vesicles than in the same men with emptied seminal vesicles. This suggests that the filling state of the seminal vesicles may influence sexual desire in men. Patient summaryWe compared brain activity of men with filled and emptied seminal vesicles by functional magnetic resonance imaging. We found that men with filled seminal vesicles had higher activation of brain areas involved in arousal and sexual desire.

Changing Positive Academic Emotions of Art Students Utilizing Computer Information Technology Based on the Perspective of Teaching.

This study is aimed at exploring the influencing factors on the altering academic mood of art students. With the assistance of computer information technology, the survey utilizing a questionnaire is conducted to explore the influence of different coping styles on the academic moods of art students when the influence of demographic variables is under consideration. It is concluded that the condition of being the only child of art students has a positive and high arousal emotional score of 80.93, which is significantly higher than that of not being an only-child art student of 78.61. Art students are more inclined to take a positive coping style. The scores of negative and high arousal academic emotions are found to be 79.3, 80, and 96.83, respectively, when the grade changes from 1 through 3. The general trend is that the scores of negative and high arousal academic emotions increase when grades go up. Art students experience more negative academic emotions than positive academic emotions when the general characteristics of art students' academic emotions are under consideration. Because females are more sensitive and delicate, they experience more negative academic emotions. Besides, while a positive coping style can positively predict art students' positive academic mood, a negative coping style can positively estimate the negative academic mood. It is concluded that the outcomes could provide a reference for the prediction of academic mood changes in art students.

0737 Factors Influencing Arousal Thresholds

Abstract Introduction Obstructive Sleep Apnoea (OSA) is the most common sleep-related breathing disorder with an estimated prevalence of approximately 15-30 percent in males and 10-15 percent in females. A low respiratory arousal threshold (ArTH) is one of several traits involved in OSA pathogenesis. This has been shown to be reliably predicted using an Arousal Score which is calculated using the patients overall Apnoea-Hypopnoea Index (AHI), nadir SpO2 and Hypopnoea:Apnoea ratio where a score of 2 or more predicts a low arousal threshold, and a score of 1 indicates a high arousal threshold. Our objective was to describe factors associated with high arousal thresholds in patients with OSA as determined by the Arousal Score in a metropolitan population. Methods 208 unselected, consecutive, adult, overnight polysomnography with prospectively calculated arousal scores were assessed from 2019 – 2020. Demographic and anthropometric data including Age, Sex, BMI, Epworth Sleepiness Score (ESS), AHI, SpO2 nadir, Hypopnoea:Apnoea ratio and arousal index was recorded. The arousal score was calculated by assigning one point for meeting each of the following requirements: AHI &amp;lt;30; SpO2 nadir &amp;gt; 82.8%; Hypopnoea:Apnoea ratio &amp;gt; 58.3, with a score &amp;lt;2 considered low. Spearmann correlation was performed to determine the factors associated with the Arousal Score. Results 208 patients were included in the study. 35.6% of patients had mild sleep apnoea, 23.1% moderate sleep apnoea, 22.6% severe sleep apnoea with 18.8% of patients with no sleep apnoea. Mean arousal score was 2.47 (Std Dev 0.839). Spearman correlation indicated that disease severity, BMI (rs -.374, p-value &amp;lt; 0.01) and STOP-BANG (r2 -0.419, p-value &amp;lt; 0.01) had a statistically significant relationship with Arousal Score. That is, a higher AHI, BMI and STOP-BANG was associated with a low arousal score. Moreover, Gender and Epworth Sleepiness Score exhibited an insignificant association with arousal score. We found increasing severity of disease was associated with lower arousal score and therefore a higher arousal threshold Conclusion Our study demonstrates that worsening sleep apnoea severity, higher BMI and higher STOP-BANG are associated with a lower arousal score and therefore higher arousal threshold. Gender and ESS do not appear to be significantly associated. Support (If Any)

Mood ratings and digital biomarkers from smartphone and wearable data differentiates and predicts depression status: A longitudinal data analysis

Depression is a prevalent mental disorder. Current clinical and self-reported assessment methods of depression are laborious and incur recall bias. Their sporadic nature often misses severity fluctuations. Previous research highlights the potential of in-situ quantification of human behaviour using mobile sensors to augment traditional methods of depression management. In this paper, we study whether self-reported mood scores and passive smartphone and wearable sensor data could be used to classify people as depressed or non-depressed. In a longitudinal study, our participants provided daily mood (valence and arousal) scores and collected data using their smartphones and Oura Rings. We computed daily aggregations of mood, sleep, physical activity, phone usage, and GPS mobility from raw data to study the differences between the depressed and non-depressed groups and created population-level Machine Learning classification models of depression. We found statistically significant differences in GPS mobility, phone usage, sleep, physical activity and mood between depressed and non-depressed groups. An XGBoost model with daily aggregations of mood and sensor data as predictors classified participants with an accuracy of 81.43% and an Area Under the Curve of 82.31%. A Support Vector Machine using only sensor-based predictors had an accuracy of 77.06% and an Area Under the Curve of 74.25%. Our results suggest that digital biomarkers are promising in differentiating people with and without depression symptoms. This study contributes to the body of evidence supporting the role of unobtrusive mobile sensor data in understanding depression and its potential to augment depression diagnosis and monitoring.

The development and validation of an electronic nicotine delivery system (ENDS) image cue stimulus set

RationaleResponsiveness to drug-related cues assesses drug reward in research studies. There are currently no validated visual image cues related to electronic nicotine delivery systems (ENDS), thus, this study aimed to develop and validate affective ENDS image cues. MethodsENDS users and non-vaping individuals in the United States and Canada were recruited via Amazon MTurk. A total of 120 ENDS-related images and 56 neutral images, matched for visual similarity, were assessed. These images were either selected from public databases or were photographed by study staff. Closely adhering to the International Affective Picture System procedure, each participant rated 66 images one-by-one on dimensions of valence, arousal, dominance, and desire-to-vape where higher scores indicated greater feelings of happiness, excitement, loss of control, and desire to vape. ResultsAfter excluding patterned responses, the data from 926 participants (610 ENDS users, and 316 non-vaping controls) were analyzed. When viewing ENDS-related images, desire-to-vape scores were correlated with valence (r = 0.55, p < 0.0005), arousal (r = 0.72, p < 0.0005), and dominance (r = 0.58, p < 0.0005) scores. Images that elicited greater desires to vape also elicited greater feelings of happiness and excitement, but less perceived control. Correlations between arousal and valence (r = 0.42, p < 0.0005) and dominance (r = 0.71, p < 0.0005) suggest that images that increased feelings of excitement also increased happiness and decreased perceived control. ConclusionsCorrelational findings of the affective ENDS-related images were similar to those of previous studies validating collections of tobacco and alcohol picture cues, supporting the future use of these stimuli in ENDS research.

Effects of testosterone treatment on clitoral haemodynamics in women with sexual dysfunction

ABSTRACT Introduction Preclinical studies show that, in the clitoris, testosterone (T) is necessary to maintain a functional contractile and relaxant machinery, which represents the underlying mechanism of the peripheral arousal response. Although there is clinical evidence suggesting that T treatment significantly improves multiple domains of sexual functioning, the vascularization of clitoral tissue and its regulation by sex steroids are still under-investigated. Objective To explore the effects of 6-month systemic T administration on clitoral color Doppler ultrasound (CDU) parameters in women with female sexual dysfunction (FSD). Methods 81 women with FSD were retrospectively recruited. Data on CDU parameters at baseline and after 6 months with four different treatments were available and thus further longitudinally analyzed: local non-hormonal moisturizers (NH group), n=37; transdermal 2% T gel 300 mcg/day (T group), n=23; local estrogens (E group), n=12; combined therapy (T+E group), n=9. Patients underwent physical, laboratory, and genital CDU examinations at both visits and completed different validated questionnaires, including the Female Sexual Function Index (FSFI). Results At 6-month visit, T therapy significantly increased clitoral artery peak systolic velocity (PSV) when compared to both NH (p &amp;lt; 0.0001) and E (p &amp;lt; 0.0001) groups. A similar increase was found in the T + E group (p = 0.039 vs. E) (Fig.1). In addition, T treatment was associated with significantly higher FSFI desire, pain, arousal, lubrication, orgasm and total scores at 6-month visit vs. baseline. Similar findings were observed in the T + E group. No significant differences in the variations of total and high-density lipoprotein-cholesterol, triglycerides, fasting glycemia, insulin and glycated hemoglobin levels were found among the four groups. No adverse events were observed. Conclusions In women complaining for FSD, systemic T administration, either alone or combined with local estrogens, was associated with a positive effect on clitoral blood flow and a clinical improvement in sexual function, showing a good safety profile. Disclosure Work supported by industry: no.

Inactivation of Prefrontal Cortex Attenuates Behavioral Arousal Induced by Stimulation of Basal Forebrain During Sevoflurane Anesthesia.

BACKGROUND:Cholinergic stimulation of prefrontal cortex (PFC) can reverse anesthesia. Conversely, inactivation of PFC can delay emergence from anesthesia. PFC receives cholinergic projections from basal forebrain, which contains wake-promoting neurons. However, the role of basal forebrain cholinergic neurons in arousal from the anesthetized state requires refinement, and it is currently unknown whether the arousal-promoting effect of basal forebrain is mediated through PFC. To address these gaps in knowledge, we implemented a novel approach to the use of chemogenetic stimulation and tested the role of basal forebrain cholinergic neurons in behavioral arousal during sevoflurane anesthesia. Next, we investigated the effect of tetrodotoxin-mediated inactivation of PFC on behavioral arousal produced by electrical stimulation of basal forebrain during sevoflurane anesthesia.METHODS:Adult male and female transgenic rats (Long-Evans-Tg [ChAT-Cre]5.1 Deis; n = 22) were surgically prepared for expression of excitatory hM3D(Gq) receptors or mCherry in basal forebrain cholinergic neurons, and activation of these neurons by local delivery of compound 21, an agonist for hM3D(Gq) receptors. The transgenic rats were fitted with microdialysis probes for agonist delivery into basal forebrain and simultaneous prefrontal acetylcholine measurement. Adult male and female Sprague Dawley rats were surgically prepared for bilateral electrical stimulation of basal forebrain and tetrodotoxin infusion (156 μM and 500 nL) into PFC (n = 9) or bilateral electrical stimulation of piriform cortex (n = 9) as an anatomical control. All rats were implanted with electrodes to monitor the electroencephalogram. Heart and respiration rates were monitored using noninvasive sensors. A 6-point scale was used to score behavioral arousal (0 = no arousal and 5 = return of righting reflex).RESULTS:Compound 21 delivery into basal forebrain of rats with hM3D(Gq) receptors during sevoflurane anesthesia produced increases in arousal score (P < .001; confidence interval [CI], 1.80–4.35), heart rate (P < .001; CI, 36.19–85.32), respiration rate (P < .001; CI, 22.81–58.78), theta/delta ratio (P = .008; CI, 0.028–0.16), and prefrontal acetylcholine (P < .001; CI, 1.73–7.46). Electrical stimulation of basal forebrain also produced increases in arousal score (P < .001; CI, 1.85–4.08), heart rate (P = .018; CI, 9.38–98.04), respiration rate (P < .001; CI, 24.15–53.82), and theta/delta ratio (P = .020; CI, 0.019–0.22), which were attenuated by tetrodotoxin-mediated inactivation of PFC.CONCLUSIONS:This study validates the role of basal forebrain cholinergic neurons in behavioral arousal and demonstrates that the arousal-promoting effects of basal forebrain are mediated in part through PFC.

Onset of Flibanserin Treatment Effect in Postmenopausal Women Assessed by Subdomain Scores of the Female Sexual Function Index (FSFI)

ABSTRACT Introduction Flibanserin, a treatment for acquired, generalized hypoactive sexual desire disorder (HSDD), is approved in the US for use in certain premenopausal women and in Canada for use in both premenopausal and naturally postmenopausal women ≤60 years of age. Improvement in symptoms following initiation of flibanserin may take several weeks to emerge and it is important to set realistic expectations of treatment onset. Objective The primary objective of this analysis was to evaluate the onset of flibanserin's treatment effect in naturally postmenopausal women with HSDD across the 6 subdomains of the FSFI. Methods A post-hoc analysis was conducted using FSFI data from a randomized, controlled, double-blind trial of flibanserin in naturally postmenopausal women with HSDD that included 895 postmenopausal women (flibanserin, n=432; placebo, n=463) who had at least one on-treatment efficacy assessment. The FSFI is a validated, 19-item self-report questionnaire comprising 6 subdomains of sexual functioning: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each subdomain has a maximum score of 6 and higher scores indicate better sexual functioning. For each subdomain, change from baseline at each assessment visit (4, 8, 16, and 24 weeks) was calculated as the least squares mean difference. Comparisons between flibanserin and placebo groups were performed using analysis of covariance. Results Postmenopausal patients treated with flibanserin had significantly greater sexual desire and arousal scores than those treated with placebo at Week 4 and at every assessment timepoint thereafter (see figure). By Week 8, patients in the flibanserin group had significantly higher scores for all FSFI subdomains compared to the placebo group. This treatment effect was maintained at Week 24 for all subdomains except for pain. Conclusions Results from this post-hoc analysis indicates that postmenopausal women treated with flibanserin experienced improved sexual function compared to those treated with placebo with regard to sexual desire, arousal, lubrication, orgasm and satisfaction. This improvement was maintained over the entire course of treatment. These findings are consistent with those from a previous FSFI post-hoc analysis of clinical trial data from premenopausal women and suggest that flibanserin treatment of postmenopausal women was associated with improvement of multiple aspects of sexual function in addition to sexual desire. Disclosure Yes, this is sponsored by industry/sponsor: Sprout Pharmaceuticals, Inc. Clarification Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Inc.

Female sexual dysfunction in newly diagnosed egyptian patients with neuromyelitis optica spectrum disorder

BackgroundFew research works have explored female sexual dysfunction (FSD) in patients with Neuromyelitis optica spectrum disorder (NMOSD) which remains an ignored disease symptom. This work aimed to describe the frequency, patterns, and predictors of FSD in a sample of newly diagnosed AQP4-ab seropositive NMOSD patients.MethodsThis case-control study was conducted on 28 seropositive NMOSD patients and 31 age matched healthy controls. All included patients were asked to privately fill and hand back the following questionnaires: female sexual function index questionnaire (FSFI), Beck depression inventory II (BDI) and fatigue severity scale (FSS). Also, Modified Modified Ashworth scale (MMAS) and Expanded disability status scale (EDSS) were applied to all included patients.ResultsNMOSD patients had significantly lower total FSFI scores and significantly higher BDI and FSS scores than controls (P < 0.001). FSS scores were negatively correlated with total scores of FSFI as well as desire, lubrication, orgasm, and satisfaction scores. BDI scores was negatively correlated with desire and orgasm scores. The uncorrected visual FS score was negatively correlated with lower total scores of FSFI as well as arousal, orgasm, and satisfaction scores. The pain score was negatively correlated with the scores of the MMAS. The only predictors of FSFI total score were fatigue and visual disability. Visual disability was also a predictor of dysfunction in arousal and satisfaction domains, whereas spasticity in the lower limbs predicted sexual related pain.ConclusionsSexual dysfunction in patients with NMOSD is strongly related to fatigue, depression, visual disability, and lower limbs spasticity.

Classification of Contrasting Discrete Emotional States Indicated by EEG Based Graph Theoretical Network Measures.

The present study shows new findings that reveal the high association between emotional arousal and neuro-functional brain connectivity measures. For this purpose, contrasting discrete emotional states (happiness vs sadness, amusement vs disgust, calmness vs excitement, calmness vs anger, fear vs anger) are classified by using Support Vector Machines (SVMs) driven by Graph Theoretical segregation (clustering coefficients, transitivity, modularity) and integration (global efficiency, local efficiency) measures of the brain network. Emotional EEG data mediated by short duration video film clips is downloaded from publicly available database called DREAMER. Pearson Correlation (PC) and Spearman Correlation have been examined to estimate statistical dependencies between relatively shorter (6sec) and longer (12sec) non-overlapped EEG segments across the cortex. Then the corresponding brain connectivity encoded as a graph is transformed into binary numbers with respect to two different thresholds (60%max and mean). Statistical differences between contrasting emotions are obtained by using both one-way Anova tests and step-wise logistic regression modelling in accordance with variables (dependency estimation, segment length, threshold, network measure). Combined integration measures provided the highest classification accuracies (CAs) (75.00%80.65%) when PC is applied to longer segments in accordance with particular threshold as the mean. The segregation measures also provided useful CAs (74.13%80.00%), while the combination of both measures did not. The results reveal that discrete emotional states are characterized by balanced network measures even if both segregation and integration measures vary depending on arousal scores of audio-visual stimuli due to neurotransmitter release during video watching.

Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles

Preliminary evidence indicates that acute and chronic psychological stress affect sexual arousal and satisfaction. African American women, in particular, are vulnerable to the impacts of gender- and race-related stress, given their socially constructed identities as African Americans and as women. We examined associations between minority stress and sexual function using data from 248 African American women. Surveys were conducted with 248 African American women in South LA with male partners at risk for acquiring HIV. We analyzed self-reports on (i) stress indicators: chronic burden, perceived racism/sexism, and histories of trauma/sexual abuse; (ii) Female Sexual Function Index domains: desire, arousal, and satisfaction; and (iii) potential moderators: social support and spirituality. We used multiple regression, adjusting for potential confounding factors, to examine the relationships between stress indictors, potential moderators, and sexual function domains. The outcomes were the female sexual function index domains of desire, arousal, and satisfaction. This largely low-income sample experienced significant chronic and acute stressors, was highly spiritual and reported strong social support. Moderate-high chronic burden and increasing sexism scores were independently associated with decreased arousal (B=-0.38, 95%CI=-0.75, -0.02) and satisfaction (B=-0.03, 95%CI=-0.06, 0.00) scores, respectively. Providers may want to explore chronic burden in patients who complain about low sexual arousal. Additionally, to develop effective HIV- and other STI-related interventions that impact behaviors that can confer sexual risk, prevention strategies are needed that either reduce contextual stressors or mitigate their impact. Strengths of this research are that it focuses on sexual function among previously under-studied, low-income African American women and that it takes into account the unique set of stressors faced by these women. A limitation is that the sample size may have been too small to capture the effects of potential moderators. Low-income African American women accumulate life stressors that may harm sexual function. Schrode K, Poareo E, Li M, et al. Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles. J Sex Med 2022;19:603-612.

Comparison of sexual function between women with iatrogenic and natural menopause

IntroductionMenopause refers to the permanent cessation of menstruation resulting from the loss of ovarian activity. Studies have shown that menopause has an impact on the life quality of women as well as their sexual function. In this study, we sought to characterise the differences in the sexual function of women with iatrogenic menopause and those with natural menopause. MethodsData were collected from 300 women in this study. The Symptom Check List and the Female Sexual Function Index were the main data collection instruments. Forty-eight patients with a Symptom Check List score ≥0.5 were not included in the study. Therefore, we enrolled a cohort of 252 menopausal women at a tertiary care setting in Turkey. The independent sample t-test, one-way analysis of variance, Pearson correlation and logistic regression analysis were used in this study and p value of <0.05 was considered statistically significant. ResultsIn our study, menopause women were divided into two equal groups based on the type of menopause (natural vs. iatrogenic). The iatrogenic group was further divided into 3 sub-groups; drug-induced 30 (12%), radiotherapy-induced 18 (7%) and surgical 78 (31%). No significant difference in sexual function between groups were observed with respect to mean scores for desire, arousal, lubrication, orgasm, satisfaction, pain and sexual function (p>0.05). ConclusionsOur results suggest that sexuality-specific problems during menopause are multifactorial and not solely attributable to biological or psychological factors. Our findings call for comprehensive interventions to address the psychological and biological effects of menopause in order to improve the life quality of women.

Evaluation of Bedside Tests of Attention and Arousal Assessing Delirium in Parkinson's Disease, Dementia, and Older Adults.

Delirium is a serious acute neuropsychiatric condition associated with altered attention and arousal. To evaluate simple bedside tests for attention and arousal to detect delirium in those with and without Parkinson's disease (PD) and dementia. Participants from two prospective delirium studies were pooled comprising 30 with PD without cognitive impairment, 24 with Lewy body cognitive impairment (PD dementia or dementia with Lewy bodies), 16 with another dementia and 179 PD and dementia-free older adults. Participants completed standardised delirium assessments including tests of attention: digit span, Memorial Delirium Assessment Scale (MDAS) attention and months of the year backwards; and arousal: Glasgow Coma Scale (GSC), Observational Scale of Level of Arousal (OSLA), Modified Richmond Agitation Scale and MDAS consciousness. Delirium was diagnosed using the DSM-5 criteria. On their first admission, 21.7%participants had prevalent delirium. Arousal measures accurately detected delirium in all participants (p < 0.01 for all), but only selected attention measures detected delirium in PD and dementia. In PD and dementia-free older adults, impaired digit span and OSLA were the optimal tests to detect delirium (area under the curve [AUC] = 0.838, p < 0.001) while in PD and dementia the optimal tests were MDAS attention and GCS (AUC=0.90 and 0.84, respectively, p < 0.001 for both). Simple bedside tests of attention and arousal at a single visit could accurately detect delirium in PD, dementia and PD and dementia-free older adults; however, the optimal tests differed between groups. Combined attention and arousal scores increased accuracy, which could have clinical utility to aid the identification of delirium neurodegenerative disorders.

Female sexual dysfunctions: an overview on the available therapeutic interventions.

There are different types of female sexual dysfunctions (FSDs), and FSD in general has a high prevalence worldwide. Studies of FSD should consider it as a multifactorial disorder that has biological, psychological, environmental, and relational aspects. In this review we discuss the available therapeutic interventions for FSD. For the current narrative review the PubMed database was searched to identify all publications up to 30 March 2021 that were systematic reviews and meta-analyses which examined therapeutic interventions for FSDs based on the diagnostic classifications of ICD-10 and ICD-11. Thirty systematic reviews and meta-analyses were included in this review. Hormone therapy (HT) and testosterone are effective to improve sexual desire in menopausal women. In these women HT and ospemiphene may improve pain during intercourse. Flibanserin may improve sexual desire and may reduce desire-related distress in premenopausal women. Bremelanotide is effective to improve desire, arousal, and orgasm scores. Evidence are still limited on the efficacy of psychoactive drugs, phosphodiesterase type 5 (PDE5), oxytocin, herbal drugs, and tibolone to treat FSDs. Psychological interventions such as cognitive-behavior therapy, mindfulness training, sensate focus, bibliotherapy are effective for the management of several different FSDs. The management of FSDs may require multidisciplinary and interdisciplinary approaches. Pharmacological and nonpharmacological interventions appears to have potential as a treatment for FSDs, but there are currently no gold standards regarding recommended treatment modalities, and the duration, frequency, and intensity of therapy sessions.

The Effect of Renal Transplantation on Female Sexual Function: An Age-Matched Pair Analysis

To evaluate female sexual function (FSF) after renal transplantation (RT) and compare it to an age-matched normal females (control). The study included 100 sexually active RT females in child-bearing period. Sexual function was evaluated with Female Sexual Function Index (FSFI). We compared the mean scores of all domains of FSFI to an age-matched sexually active normal females. Also, we compared the current FSFI to the pre-transplant status in 54 married females before RT. Factors affecting the FSF after RT were assessed. In comparison to control group, RT group had statistically significant lower sexual desire (P <.001) with no significant differences as regard arousal, lubrication, orgasm, satisfaction, pain, and total FSFI score (P >.05). Among RT-females, 83% had normal sexual function, and 83.7% of the control had normal sexual function (P=.8). After RT, the FSFI score increased significantly from 20.7 ± 5.4 to 27.8 ± 3.1 (P <.001), and 85.2% had normal sexual function compared to 22.2% before RT (P <.001) with statistically significant improvement in all domains (P <.001) except for pain score (P=.8). Female circumcision was the only identified factor associated with FSD (P=.02). Successful RT significantly improves female sexual function of ESRD patients. The sexual function after RT is comparable to healthy control except for lower sexual desire.

Bremelanotide for Treatment of Female Hypoactive Sexual Desire.

Hypoactive sexual desire disorder (HSDD) is a persistent deficiency or absence of sexual fantasies and desire resulting in significant distress or interpersonal difficulty. Women with this disorder may display a lack of motivation for sexual activity, reduced responsiveness to erotic cues, a loss of interest during sexual activity, and avoidance of situations that could lead to sexual activity. The pathophysiology of HSDD is thought to be centered around inhibitory and excitatory hormones, neurotransmitters, and specific brain anatomy. Due to the multifactorial nature of HSDD, treatment can be complex and must attempt to target the biological and psychosocial aspects of the disorder. Bremelanotide is a melanocortin receptor agonist and has been recently approved by the FDA to treat HSDD. Bremelanotide is administered intranasally or as a subcutaneous injection. The recommended dosage of bremelanotide is 1.75 mg injected subcutaneously in the abdomen or thigh at least 45 min before sexual activity. Studies showed improvements in desire, arousal, and orgasm scores when 1.75 mg of bremelanotide was administered before sexual activity compared to a placebo. Bremelanotide is a promising way to treat HSDD.

The Effective Factors on The Sexual Function of Polycystic Ovary Syndrome Women: A Cross-Sectional Study.

Background:One of the most common endocrine disorders in women during reproductive age is polycystic ovary syndrome (PCOS). This study aimed to evaluate sexual functioning among women with PCOS in a sample of a region’s population in the west of Iran.Materials and Methods:This study was a cross-sectional study that was conducted on 130 women with PCOS who referred to three clinics of gynecology, infertility, and dermatology affiliated with Hamadan University of Medical Sciences, Iran, from September to November 2020. The measurement tools included demographic characteristics, hirsutism score, and sexual function was assessed using the female sexual function index (FSFI) questionnaire.Results:In total, 60% of patients had reported sexual dysfunction related to lubrication, satisfaction, and pain as domains of sexual dysfunction. The number 109 (83.85%) of them had hirsutism and these patients had a lower score for lubrication (3.7 ± 1.47 vs. 4.47 ± 1.71, P=0.03), orgasm (3.2 ± 1.34 vs. 3.95 ± 1.37, P=0.02), satisfaction (3.4 ± 1.29 vs. 3.71 ± 1.33, P=0.03), and FSFI score (22.56 ± 5.78 vs. 25.42 ± 5.51, P=0.04). Women with higher education had reported higher scores of FSFI and its domains. Rural participants had a higher arousal score (3.93 ± 1.4 vs. 3.37 ± 1.28, P=0.04). Moreover, housekeeper women had higher scores regarding desire, pain, and total FSFI score.Conclusion:Our results showed that there was a significant association between hirsutism and FSFI scores, different domains, including lubrication, orgasm, and satisfaction.

The Influence of Cannabis and Alcohol Use on Sexuality: An Observational Study in Young People (18–30 Years)

The consumption of cannabis and alcohol results in a variety of effects on the psychic functions of young users. Notwithstanding their widespread and prevalent use, the impact of these drugs on sexual health remains unknown. Thus, the aim of this study is to analyse the influence of alcohol and cannabis consumption on sexual function in young people. An observational study was conducted in 274 participants aged 18–30 years. The following selection tools were used: Alcohol Use Disorders Identification Test, Cannabis Abuse Screening Test (CAST), and Changes in Sexual Functioning Questionnaire Short-Form. Participants who were at high risk of having cannabis-related problems performed better on the CAST concerning sexual function, arousal, and orgasm. Participants at high risk had higher arousal and orgasm scores than those who were not at risk for cannabis problems. Improvements in sexual function were found between people who were at high risk of having alcohol problems and those who were not at risk. Sexual function in young people who use cannabis and alcohol more frequently was shown to be better than in those who do not use either, highlighting the need for more information aimed at the young population.

Sexual Function of Women With Deep Endometriosis Before and After Surgery: A Prospective Study

Deep endometriosis (DE) may significantly affect women's quality of life. Limited data exists on the effect of surgery on the several domains of sexual function. To prospectively compare various domains of sexual function before and after laparoscopic surgery for DE. A prospective observational cohort study in a tertiary university-affiliated referral center. Patients with suspected DE who were planned to undergo laparoscopic surgery completed the Female Sexual Function Index questionnaire before surgery. The same questionnaire was completed by the participants 6 weeks, 6 months, and 12 months after surgery. Rate of sexual dysfunction over time was compared using multilevel logistic regression. Summary scores were then compared at each time point to the corresponding score before surgery using multilevel linear regression. Multivariable analysis was performed of potential confounders. Change in desire, arousal, orgasm, lubrication, satisfaction and pain summary scores as well as in the full-scale score between before and after surgery. We followed 149 patients with surgically confirmed DE. Sexual dysfunction rate as per the full-scale score was 75.5% before surgery and remained over 60% to 12 months after. The full-scale sexual function score improved at 6 (change in score = 2.8 ± 9.5, P = .004) and 12 months (change in score = 2.1 ± 9.9, P = .03). None of the summary scores improved at 6 weeks. Desire score (P < .001), arousal score (P = .02), and pain score (P = .01) improved at 6 months. Desire score (P = .03) and pain score (P = .01) also improved at 12 months, as compared to before surgery. On multivariable multilevel analysis, scores before surgery significantly contributed to the scores after surgery (P < .001). While sexual function improved after surgery, dysfunction rate remained substantial. Proper preoperative counseling should address sexual function measures and clinical and research attention should be given to seek ways to further reduce sexual dysfunction. The main strengths of our study are the prospective design, the relatively long follow-up and the use of a detailed validated questionnaire allowing assessment of a large variety of clinically relevant sexual function domains and scores as well as a full-scale score. Among our limitations are the lower response rate at 12 months and the limited generalizability as this is a single center study. Sexual function is a major and often under reported domain of quality of life. Further research is needed to identify the specific populations who may improve, not change or experience deterioration in their sexual functioning after surgery.

Effect of drug naïve versus escitalopram on sexual function of depressed females: A cross-sectional comparative study

We aimed in the current cross-sectional study to evaluate rates and patterns of SD among drug naïve women with mild to moderate depression against those receiving escitalopram. Group (A) included 120 females diagnosed with mild to moderate depression. Group (B) served as controls included 60 age-matched volunteers. Female participants were evaluated by the validated Arabic female sexual function index (ArFSFI), perceived stress situation scale (PSS), patient health questionnaire-9 scale (PHQ-9) and center for epidemiological studies-depression scale (CES-D). The study demonstrated that females with mild to moderate depression treated with escitalopram had better sexual function than those who were drug naïve. Additionally, treated females got better scores of PSS, CES-D and PHQ-9 compared to those who were drug naïve. The PSS and the CES-D and the PHQ-9 scales negatively correlated with the domains of desire, pain, arousal, lubrication, orgasm, satisfaction and total score of FSFI. Finally, a linear regression analysis after adjustment of FSFI as a dependent variable had revealed that the PSS scale, the PHQ-9 scale and the international index of erectile function-5 were significant independent predictors of the affected females’ sexual function. Escitalopram is associated with lesser risk of SD in females with mild to moderate depression.