Changes In Sex Life Research Articles

Changes in sexual activity in young women during pregnancy

Objective: To conduct changes in sexual activity during pregnancy and its related factors in pregnant women. Methods: The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran. Participants were included in the study through convenient sampling. The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy. Results: 201 Pregnant women were included. The average age of pregnant women was (27.3±6.1) years and their average gestational age was (24.7±11.8) years. More than 62% of women had decreased sexual activity. There was a significant relationship between the amount of changes in sexual activity and delivery time (P=0.013), abortion history (P=0.001) and premature birth history (P=0.002). Most pregnant women believed that sex during pregnancy caused damage to the fetus (67.7%). A decrease in the intensity of sexual desire was reported in 63% of pregnant women. More than 60% of the subjects did not consult with doctors and midwives with regards to sexual issues (63.5%). The most common reason for not consulting was not feeling the need (32%). Most women experienced back pain during (42.8%) and after (39.8%) intercourse. Conclusions: Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples, which can affect the quality of relationships. The role of education is essential. Therefore, it is suggested that by including sexual counseling along with pregnancy care, wrong beliefs and information among women will be corrected.

‘I don't feel good about myself and sex’: sexual health experiences of women with gynaecological cancer in Ghana

Background/Aims Patients with gynaecological cancer undergoing treatment face numerous challenges, including issues surrounding sexual health. Sexual health is an important aspect of human life, and the negative impact of gynaecological cancer, its treatments and any side effects may cause physical, emotional and psychological distress. In sub-Saharan Africa, sexual health and childbirth form the core of marital relationships; changes in sexual response and function as a result of cancer can lead to dysfunctional relationships. This study explored the sexual health experiences of patients with gynaecological cancer at the Korle Bu Teaching Hospital in Ghana. Methods This study used an exploratory, descriptive, qualitative design. A total of 12 adults with gynaecological cancer (cervical, endometrial and ovarian) were purposively selected from the Korle Bu Teaching Hospital. Data were collected with a semi-structured interview guide through face-to-face or telephone interviews. Data were analysed using thematic analysis. Results Four themes emerged: changes to the sex organ, changes in sex life, anxiety about treatment outcome and coping strategies. The participants had generally had healthy sex lives before being diagnosed with cancer. Psychologically, participants experienced anxiety and lacked interest in sex. Physical effects included bleeding, changes to the female organ and pain. The participants self-stigmatised in the form of low self-esteem and separation. They coped through religious means, family support and health education. Conclusions There is a need for psychosocial interventions in the care of women with gynaecological cancers, including measures to support coping with the physical effects of the condition and its treatment. It is recommended that stakeholders in cancer care are made aware of, and make efforts to include in their care, spirituality, family support and health education.

Experience of Racial Discrimination was Associated with Psychological Distress and Worsening Sex Life Among Adult Americans During COVID-19

ABSTRACT The recent escalation of racism in the U.S. during the COVID-19 pandemic points to the importance of examining the association between experienced racism and sexual health. Based on data from a nationally representative survey conducted in the U.S. in October 2020 (n = 1,915), Chi-square tests and multivariable logistic regressions were estimated to examine the association between experience of racism and changes in sex life during the pandemic. We further performed a causal mediation analysis using the bootstrap technique to assess the mediating role of psychological distress in the observed association between the experience of racism and changes in sex life. Among the respondents, the proportions reporting better, worse, or no change in sex life were, respectively, 15%, 21%, and 64%. Experiencing racial discrimination during COVID-19 was significantly associated with worsening sex life (adjusted odd ratio [AOR] = 1.53; 95% confidence interval [CI] = 1.04, 2.25). Respondents with experienced racism were also more likely to report psychological distress (AOR = 1.68; 95% CI = 1.09, 2.59). About one-third (32.66%) of the observed association between experienced racism and worsening sex life was mediated through psychological distress. Addressing racism and its association with psychological distress has the potential to improve sexual health and reduce related racial and ethnic disparities.

Psychological, Socio-Demographic, and Logistical Factors Associated With Changes in Sex Life After Over a Year Into the COVID-19 Pandemic

This study examined changes in sex life about a year into the COVID-19 pandemic for both partnered and non-partnered individuals and identified the determinants of these changes. The results of an online survey (N = 675) reflect a significant decrease in the frequency of intimate and sexual behaviors and declines in sexual desire, quality, intimacy, diversity, and satisfaction. This study also showed that socio-demographic characteristics, psychological factors, and the logistical impacts of the pandemic explain trends in people’s sex lives during the pandemic. This study contributes to understanding the long(er)-term nature, scope, and determinants of changes in sex life during the pandemic.

Factors associated with people’s satisfaction with their sex life: a survey conducted in Kinshasa (Democratic Republic of Congo) during the COVID-19 pandemic

Background: COVID-19’s restrictive measures have significantly affected our health, work and social relationships. As yet, less attention has been given to the changes in sex life. Aim: This study investigates people’s satisfaction with sex life in Kinshasa in the Democratic Republic of Congo (DRC). Methods: A cross-sectional survey of the general population (18 years and over) was conducted, from 1st to 18th July 2020, in 17 municipalities in Kinshasa and several measures were used: Quality of life MANSA, EQ-5D-3L, UCLA Loneliness; PHQ-9; GAD-7. Prior to conducting data analysis, diagnostic tests for our data were performed to assess distribution, variance and multicollinearity. Descriptive statistics, bivariate correlation and multiple regression analysis were used. Results: Sex life satisfaction increases from young adults aged 18- 35 to those aged 36-55 and then there is a decrease from ages 56-69. After controlling for socio-demographic factors, sex life satisfaction was positively associated with the number and quality of people’s friendships (B=0.30, p=0.01) and people’s relationships with their families (B=0.32, p=0.03). People who feel lonely have lower sex life satisfaction (B=-0.15, p=0.01). Conclusion: People’s quality of their friendships and family relationships are important for their sexual well-being. Healthcare providers and policymakers should consider people’s quality of friendships and family relationships when planning to improve the sexual well-being of people in DRC.

Texting Lost-to-follow-up PrEP Patients from a San Francisco Sexual Health Clinic

It is critical to understand what happens when PrEP patients are lost-to-follow-up (LTFU) and, where appropriate, attempt to re-engage them in care with the goal of preventing future human immunodeficiency virus (HIV) acquisition. We evaluated the benefits and limitations of using text-based outreach to re-engage with LTFU PrEP patients and offer re-initiation of PrEP care. Using text-messaging, we surveyed San Francisco City Clinic patients who started PrEP from January 2015 to October 2019 and were LTFU by October 1, 2020. Our goals were to better understand (1) whether our patients remained on PrEP through another provider or source, (2) why patients choose to discontinue PrEP, and (3) whether text-based outreach could successfully re-engage such patients in care. Multiple-choice survey questions were analyzed quantitatively to determine the proportion of respondents selecting each option; free-text responses were analyzed qualitatively using an inductive approach to identify any additional recurring themes. Of 846 eligible survey recipients, 130 responded (overall response rate 15.4%). Forty-two respondents (32.3%) were still on PrEP through another provider while 88 (67.7%) were not. Common reasons for stopping PrEP included: COVID-19–related changes in sex life (32.3% of responses), concerns regarding side effects (17.7%), and the need to take a daily pill (8.3%). Free text responses revealed additional concerns regarding risk compensation. While 32 participants agreed to be contacted by City clinic staff for PrEP counseling, only 6 were reached by phone and none of the six subsequently restarted PrEP. We learned that text messaging is a possible approach to survey certain PrEP program participants to determine who is truly LTFU and off PrEP, and to better understand reasons for PrEP discontinuation. While such information could prove valuable as programs seek to address barriers to PrEP retention, efforts to improve acceptability and increase response rates would be necessary. We were less successful in re-engaging LTFU patients in PrEP care, suggesting that text-messaging may not be the optimal strategy for this purpose.

Initial Impacts of COVID-19 on Sex Life and Relationship Quality in Steady Relationships in Britain: Findings from a Large, Quasi-representative Survey (Natsal-COVID)

ABSTRACT Intimate relationships are ubiquitous and exert a strong influence on health. Widespread disruption to them may impact wellbeing at a population level. We investigated the extent to which the first COVID-19 lockdown (March 2020) affected steady relationships in Britain. In total, 6,654 participants aged 18–59 years completed a web-panel survey (July–August 2020). Quasi-representativeness was achieved via quota sampling and weighting. We explored changes in sex life and relationship quality among participants in steady relationships (n = 4,271) by age, gender, and cohabitation status, and examined factors associated with deterioration to a lower-quality relationship. A total of 64.2% of participants were in a steady relationship (of whom 88.9% were cohabiting). A total of 22.1% perceived no change in their sex-life quality, and 59.5% no change in their relationship quality. Among those perceiving change, sex-life quality was more commonly reported to decrease and relationship quality to improve. There was significant variation by age; less often by gender or cohabitation. Overall, 10.6% reported sexual difficulties that started/worsened during lockdown. In total, 6.9% reported deterioration to a ”lower quality” relationship, more commonly those: aged 18–24 and aged 35–44; not living with partner (women only); and reporting depression/anxiety and decrease in sex-life quality. In conclusion, intimate relationship quality is yet another way in which COVID-19 has led to divergence in experience.

Initial Impacts of COVID-19 on Sex Life and Relationship Quality in Steady Relationships in Britain: Findings From a Large, Quasi-Representative Survey (Natsal-COVID)

Background: Intimate relationships are ubiquitous and exert strong influence on health. Widespread disruption to them may impact wellbeing at a population level. We investigated the extent to which the first COVID-19 lockdown (March 2020) affected steady relationships in Britain. Methods: 6,654 participants aged 18-59 years completed a web-panel survey between 29/7-10/8/2020. Quasi-representativeness was achieved via quota sampling and weighting. We explored changes in sex life (5 dimensions) and relationship quality (6 dimensions) among participants in steady relationships (n=4,271) by age, gender, and cohabitation status, and examined factors associated with deterioration to a lower quality relationship. Results: 64.2% of participants were in a steady relationship, mostly cohabiting (88.8%). 22.1% perceived no change in their sex-life quality, and 59.5% no change in their relationship quality. Among those perceiving change, sex-life quality was more commonly reported to decrease and relationship quality to improve. There was significant variation by age, but less often by gender or cohabitation. Overall, 10.6% reported sexual difficulties that started or worsened during lockdown. 6.9% reported deterioration to a ‘lower quality’ relationship, more commonly those: aged 18-24 (women only OR 2.38;1·39-4·08) and aged 35-44 (women OR1.63;1.03-2.56, men OR 2.31;1.45-3.66) compared with those aged 45-59; not living with partner (women only aOR 2.01;1.28-3.16); and reporting depression/anxiety (e.g., depression (women aOR 2.56;1.79-3.64, men aOR 3.06;2.02–4.63). Interpretation: Intimate relationship quality is yet another way in which COVID-19 has led to divergence in experience, with age a key determinant of impact. Funding Information: Natsal (Wellcome Trust/ESRC/NIHR), MRC/CSO, UCL COVID-19 Rapid Response Fund. Declaration of Interests: The authors have no interests to declare. Ethics Approval Statement: Ethical approval was obtained from the University of Glasgow MVLS College (20019174) and LSHTM research ethics committees (22565).

Changes in Sex Life among People in Taiwan during the COVID-19 Pandemic: The Roles of Risk Perception, General Anxiety, and Demographic Characteristics.

This study used data collected from an online survey study on coronavirus disease 2019 (COVID-19) in Taiwan to examine changes in sex life during the pandemic and the factors affecting such changes. In total, 1954 respondents were recruited from a Facebook advertisement. The survey inquired changes in sex life during the pandemic, including satisfaction with the individual’s sex life, frequency of sexual activity, frequency of sex-seeking activity, and frequency of using protection for sex. The associations of change in sex life with risk perception of COVID-19, general anxiety, gender, age, and sexual orientation were also examined. For each aspect of their sex life, 1.4%–13.5% of respondents reported a decrease in frequency or satisfaction, and 1.6%–2.9% reported an increase in frequency or satisfaction. Risk perception of COVID-19 was significantly and negatively associated with frequencies of sexual and sex-seeking activities. Higher general anxiety was significantly and negatively associated with satisfaction of sex life and frequencies of sexual and sex-seeking activities. Sexual minority respondents were more likely to report decreased satisfaction with sex life and frequencies of sexual activity and sex-seeking activities during COVID-19. Health care providers should consider these factors when developing strategies for sexual wellness amid respiratory infection epidemics.

Sexual health in young women with metastatic breast cancer: The state of the science.

223 Background: The incidence of metastatic breast cancer (MBC) in women under 40 is increasing. Sexual health is a key element of quality of life (QOL) and is impacted by MBC. While those searching the Internet receive primarily anecdotal information, the state of the science around MBC and sexual health for young women appears to be limited. Methods: Four databases were searched for English language articles: PubMed, PsycINFO, Embase, and Sociological Abstracts.Search topics included sexual health, sexual activity, intimacy, gender identity, sexual orientation, body image, and/or intimate partner relationships among young women with MBC. Results: 598 studies were reviewed; 9 met selection criteria. Four studies were included on body image and sexual activity: 2 reported a correlation between young age and poor body image; in a third, no relationship was found for women 30-49; in the fourth, among patients with metastatic or localized disease, women < 45 placed greater importance on body image or changes in sex life than women > 65. Three studies examined sexual health and treatment: a review of hormonal therapies in young patients recommended that sexual side effects be considered; a qualitative study reported on the impact of mastectomy on feelings of femininity and body image; an observational study of patients with locally recurrent or MBC found younger age was associated with greater vaginal dryness and decreased sexual interest/activity. One qualitative study did not find patterns of difference in sexual health needs related to age-patients of all ages and relationship status desired more information. In a study of QOL and MBC, younger age was associated with less sex life satisfaction. Subjects across all studies were primarily white, and sexual activity studied was primarily heterosexual, vaginal sex. Conclusions: The scientific literature on sexual health among young women with MBC is exceedingly limited. Studies that do examine sexual health often exclude those with MBC, do not examine the impact of age, and are focused on heterosexual, white women. Understanding the impact of MBC on young women’s sexual health can inform future care practices for this growing population.

Beyond viral suppression: the quality of life of people living with HIV in Sweden

ABSTRACTSweden has one of the best HIV treatment outcomes in the world and an estimated 95% of all diagnosed people living with HIV are virally suppressed, but the quality of life (QoL) is understudied. The aim of this study was to examine the associations between variables within sociodemographic, behavioural, clinical, psychological, sexual life, social support and personal resource component and the QoL of people living with HIV in Sweden. Data were derived from a cross-sectional, nation-wide survey completed by 15% (n = 1096) of all people living with HIV and collected at 15 infectious disease clinics and 2 needle exchange sites during 2014. Ordinal univariate and multivariate logistic regression analyses were used to examine associations between potential contributors and QoL. Respondents reported high QoL: 63% rated their QoL 7 or higher on a scale ranging from 0 to 10. QoL was independent of gender, age, mode of HIV transmission and country of origin. Lower QoL was associated with recent homelessness, hazardous alcohol consumption, comorbidities, treatment side-effects, HIV-related physical symptoms, hopelessness, negative self-image, sexual dissatisfaction, and negative changes in sex life after HIV. The QoL of people living with HIV in Sweden was high overall, but still significantly influenced by HIV.

Social construction of the experience of living with chronic kidney disease.

ABSTRACTObjective:To understand the experience of people living with Chronic Kidney Disease who have been transplanted, from the meanings constructed based on the experienced phenomenon. Method:Hermeneutic-phenomenological study based on the five lifeworld existentials, according to Van Manen’s theoretical framework. Eleven transplanted patients participated in the study and data collection was carried out through semi-structured interviews, after approval of the study by the Ethics Committee of the University of Antioquia. Results:The theme of Living with Chronic Kidney Disease emerged, and the subthemes were grouped as lifeworld existentials of Temporality: something unexpected, being present and not seeing it, being young and sick. Relationality: support, feeling stuck and Terminal Chronic Renal Failure. Spatiality: changes in life, sadness and depression. Corporeality: body deterioration and changes in sex life. Materiality: effects on the economic status. Conclusions:The care provided to people must be oriented in order to recognize their individualities, understanding what the illness means for the individual and his family, how they live with it and what the changes are, leading them to modify their lives and start a long process, such as living with a chronic disease.

Sexual (Dis)satisfaction and Its Contributors Among People Living with HIV Infection in Sweden

Earlier research reports lower sexual satisfaction among people living with HIV (PLHIV) compared to HIV-negative persons. A number of psychosocial factors directly associated with sexual dissatisfaction have been identified. Little is known about sexual satisfaction and their contributors among PLHIV in Sweden. The aim of this study was to examine direct and indirect effects of variables within sociodemographic, clinical HIV-related, psychological, and sexual domains on sexual (dis)satisfaction among PLHIV in Sweden. Data for this study were derived from a nationally representative, anonymous survey among PLHIV conducted in 2014 (n = 1096). Statistical analysis included four steps: descriptive analyses, identification of variables associated with sexual (dis)satisfaction, identification of variables associated with those contributors of sexual (dis)satisfaction, and a path model integrating all these analyses. A total of 49% of participants reported being sexually dissatisfied, and no significant differences were observed when non-heterosexual men, heterosexual men, and women were compared. Among women, a negative change in sex life after HIV diagnosis and distress with orgasmic difficulties was directly associated with sexual dissatisfaction. For men, hopelessness, high HIV stigma, sexual inactivity in the last 6 months, and a negative change in sex life after HIV diagnosis were directly associated with sexual dissatisfaction. Path analyses showed in both men and women significant indirect associations between not being involved in an intimate relationship, lower self-reported CD4 cell counts, and perceiving obligation to disclose HIV status to sexual partners as a barrier to look for a long-term partner and sexual dissatisfaction. Our results show that despite good treatment outcomes, the HIV diagnosis has a negative bearing on sexual satisfaction. The need for gender-tailored interventions and clinical implications of these findings are discussed.

Experiences and psychological distress of spouses of prostate cancer patients at time of diagnosis and primary treatment.

We studied experiences and psychological distress of partners of prostate cancer patients at the time of diagnosis and primary treatment and investigated associates of their psychological wellbeing and the emotional social support they give to and receive from the patient. Using a quantitative questionnaire we studied the spouses' experiences (psychological response and sources of information and emotional support at diagnosis; impacts of prostate cancer on partnership and sex life; impact of side effects of treatment) and the emotional support given and received, and measured their psychological symptom distress. Many spouses reported distressing experiences and all psychological symptoms. Two thirds perceived no impact of the cancer on the partnership while 29% no change in sex life. Distress was associated with a shock, fear of the man's death and impact of side effects, whereas emotional support from a doctor predicted less distress. More support given to the patient was associated with information and emotional support received from a doctor and the patient's sexual dysfunction and pain, and less with experiences of depression, no impact on the partnership and the patient's irritableness. The spouses' distress was relieved by emotional support from a doctor, which along with received information also enhanced their capability to support the patient.

Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction.

Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee2. Systematic review of the literature with a focus on publications since 2010. Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

Impacto da incontinência urinária na vida de esposas de homens com incontinência: revisão integrativa

A incontinência urinária masculina tem sido relacionada a vários fatores, destacando-se a hiperplasia prostática benigna e o tratamento de câncer de próstata. A incontinência urinária gera implicações negativas tanto para o indivíduo incontinente, como para seus familiares e cuidadores. No presente estudo foi realizada uma revisão integrativa a fim de identificar o impacto na vida das parceiras de homens incontinentes. A busca dos artigos foi realizada nas bases de dados CINAHL, EMBASE, SCOPUS, MEDLINE e PubMed. Foram incluídos artigos na língua portuguesa, inglesa e espanhola, e excluídos os que não citavam esposas. A amostra final foi composta por 15 artigos, de sete países. Os artigos foram distribuídos nas categorias: Sofrimento Psíquico, Fadiga, Mudança na Vida Sexual, e Limitação da Vida Social. A categoria Sofrimento Psíquico esteve presente em todos os artigos e foi avaliada como a mais prejudicial na vida dessas mulheres.

What I wish I’d known before surgery: BRCA carriers’ perspectives after bilateral salipingo-oophorectomy

We retrospectively studied BRCA carriers with a history of prophylactic bilateral salingo-oophorectomy (PBSO) regarding: (1) their post-operative symptoms, (2) their recollection of pre-operative conversations with their health care providers regarding possible surgical side-effects and (3) what information they would have found helpful to have before surgery. Female BRCA carriers seen through the Yale Cancer Genetic Counseling Program who had PBSO were invited to participate in a questionnaire that assessed their recall of information they received pre-operatively compared with their post-operative knowledge and symptoms related to menopause, cognitive changes, loss of fertility, cancer risks, osteoporosis, heart disease, vasomotor symptoms, urogenital symptoms, sexuality and body image. The questionnaire also elicited written feedback from participants regarding their decision to have PBSO, what they wished they had known before surgery, advice for other BRCA carriers considering this surgery and advice for health care providers who counsel women about PBSO. Two hundred and ninety female BRCA carriers were invited to participate and 113 (39.0%) indicated they were interested. Of those, 99 (87.6%) returned their questionnaire and 98 (86.7%) responses were included in the analysis. The mean age at PBSO was 45.5 years (range: 32-63 years). The five most common "frequent" or "very frequent" post-surgical symptoms were: vaginal dryness (52.1%), changes in interest in sex (50.0%), sleep disturbances (46.7%), changes in sex life (43.9) and hot flashes (42.9%). The majority of women would have found it helpful to have more information regarding the impact of this surgery on their sex life (59.2%), the availability of sex counseling (57.1%) and the risk of coronary heart disease (57.1%). This study illustrates that while health care providers are discussing selected side effects of PBSO, women undergoing this surgery have other concerns that should be addressed. This information provides insights into the informational needs of BRCA carriers considering PBSO.

Sexual functioning throughout menopause

Previous studies on menopausal transition and sexual functioning have mixed findings. Most are cross-sectional, exclude hormone therapy users and hysterectomized women, and are unable to separate the effects of age from menopause or account for psychosocial, vasomotor, and somatic factors. We examine relationships between women's reports of a change in sex life and difficulties with intercourse and their experience of menopausal transition, use of hormone therapy, and hysterectomy. A British cohort study with 1,525 women were followed since their birth in 1946 and annually from age 47 to 54 years. The outcome measures were self-reported change in sex life and difficulties with sexual intercourse over 8 consecutive years. Compared with women who remained premenopausal, peri- and postmenopausal women reported a decline in sex life (mean difference [95% CI]: perimenopausal, -0.1 [-0.2 to -0.03]; became postmenopausal, -0.1 [-0.2 to -0.1]) and were more likely to report difficulties with intercourse (perimenopausal, 0.6 [0.1 to 1.1]; postmenopausal, 1.0 [0.5 to 1.5]) beyond the effects of aging and other psychosomatic factors. Women reported difficulties with intercourse more often if they had been on hormone therapy for more than a year (0.5 [0.03 to 1.0]) or if they had undergone a hysterectomy (0.6 [0.1 to 1.1]); no differences were found for change in sex life. For both outcomes, vaginal dryness was the major risk factor. Married women were also more likely to report adverse outcomes. Somatic symptoms and hot flushes/cold sweats were associated with difficulties with intercourse, whereas psychological symptoms, stressful lives, increasing age, and smoking were associated with a decline in sex life. Menopausal transition status had an independent effect on the reported change in sex life and difficulties with intercourse. The results support health professionals in their development of management strategies that (a) consider treatments directly for vaginal dryness, (b) identify somatic symptoms for difficulties with intercourse, (c) investigate psychological factors for a reported decline in sex life, and (d) for both outcomes, consider the potential role of intimate partners.

Lifestyle changes and beliefs regarding disease severity in patients with chronic hepatitis C

The aim of this prospective study was to investigate beliefs regarding disease severity and lifestyle changes following hepatitis C diagnosis in patients with chronic hepatitis C (CHC). One hundred and eighty-five consecutive CHC patients were interviewed by means of self-questionnaires exploring several aspects of their disease. Most patients (93%) identified cirrhosis and liver cancer as the two main complications of CHC. More than half of patients (59%) thought that CHC was always associated with a fatal outcome whereas 3% thought that they would stay healthy. HCV viral load was the most commonly reported factor associated with disease severity. Sex life changes were reported by 107 patients (58%) whereas dietary intake changes were reported by 88 patients (48%). In multivariate analysis, changes in sex life were associated with male gender [odds ratio (OR): 2.57, 95% CI: 1.30-5.08, P < 0.007], perceived disease severity (OR: 1.02, 95% CI: 1.00-1.03, P < 0.03) and anxiety (OR: 1.05, 95% CI: 1.01-1.08, P < 0.003), whereas changes in dietary intake were associated with age (OR: 1.04, 95% CI: 1.02-1.08, P < 0.003) and anxiety (OR: 1.04, 95% CI: 1.01-1.08, P < 0.006). Our results show the considerable impact of CHC diagnosis on patients' lifestyle. They emphasize the need for improving CHC patient counselling in order to avoid unnecessary sex life and dietary intake changes.

Sex, Menopause, and Culture

Past research finds that after menopause some women experience negative changes such as vaginal dryness, decreased libido, and decreased orgasm quality; very little research inquires about positive changes. In contrast, this study shifts the research focus from whether women experience menopausal changes to how women view any changes in sex life. Based on 30 in-depth interviews with heterosexual and lesbian women, the author finds that most women emphasize cultural and social issues, such as relationship status and quality, health, and sexual history, rather than menopausal changes when they describe sex after menopause. However, she finds a difference by sexual orientation in how women handle problems in sex. The author concludes by discussing the implication of this research for future menopause and sex research; most important, she emphasizes studying sex in the context of women's lives rather than as a result of the biological changes of menopause.