Changes In Sexual Activity Research Articles

Hematospermia and Its Sexual Ramifications: A Systematic Review

ABSTRACT Introduction Hematospermia (HS) is the presence of blood in ejaculatory fluid. It is a rare, usually benign condition associated with various etiologies and treatments. Though a source of great anxiety for patients, no comprehensive review exists on the sexual ramifications of HS. Objective To determine HS effects on sexual wellbeing, with emphasis on original research. Methods A systematic review of HS was performed via PubMed (Figure 1). The following search terminology was used: “(hemospermia OR hematospermia) AND (sexual OR libido OR anxiety OR infertility OR cryopreservation OR erectile dysfunction).” Articles were assessed for sexual health-related implications, such as emotional disturbances, changes in sexual activity, hindered sexual response cycles, pain associated with intercourse, altered fertility, and sexual infections. Results Thirty-eight articles met our inclusion criteria while 111 were excluded. The effect of HS on sexual health proved multifaceted. Anxiety is known to compromise sexual health. Two articles reported that anxiety following transrectal ultrasound (TRUS)-guided prostate biopsy had a positive correlation with duration of HS. Additionally, in both studies, 50% of patients reported decreased sexual activity due to HS. A similar study showed that patients with substantial prostatic calculi had greater HS after biopsy as well as significantly increased anxiety compared to those with no prostatic calcifications. Patients with underlying comorbidities experienced sexual complications from HS. One study described a man who developed HS due to hypertensive emergency. In response to his HS, sexual partners ostracized him and family members believed he was divinely cursed. Another article described 3 patients with congenital bleeding disorders (e.g., hemophilia A, prothrombin deficiency, von Willebrand disease) who required episodes of sexual abstinence due to HS. HS was associated with blood during parts of the sexual response cycle. Two studies showed urethrorrhagia occurred after sexual excitation in those with HS and urethral hemangiomas. Likewise, four articles revealed HS and post-coital hematuria, sometimes with severe bleeding after ejaculation, in patients with urethral hemangiomas, previous coital trauma, or seminal vesicle cysts (SVC.) Of note, another study demonstrated patients with SVC experienced HS and post-ejaculatory pain. In certain populations, HS indicated increased risk of sexual pathologies. One study illustrated patients with HS and chronic prostatitis had 4-fold increased risk of erectile dysfunction (ED) compared to those without HS. Sixteen articles showed that HS was associated with infertility (IF) in various circumstances, including anatomic genitourinary pathologies (e.g., SVC, prostatic cysts, Mullerian duct cysts, ejaculatory duct stones, vas deferens injuries, varicoceles), herpes simplex virus (HSV) infection with low seminal volume, hydroxyurea treatment of essential thrombocythemia, leukospermia, Zinner syndrome, and isolated follicle-stimulating hormone deficiency. Furthermore, two studies revealed HS was related to temporarily altered semen quality after shockwave lithotripsy. In 7 articles, patients with HS had infections that could be sexually transmitted, including HSV, Chlamydia, enterococcus, Ureaplasma, Schistosoma, and Zika virus. Conclusions Sexual effects of HS included increased anxiety, exacerbated comorbidities, bleeding during sexual response cycle, ED, IF, and increased risk of sexual infections. Further research is needed to better understand causality in addition to associations of HS on sexual wellbeing. Disclosure No

Interruptions in Mental Health Care, Cannabis Use, Depression, and Anxiety during the COVID-19 Pandemic: Findings from a Cohort of HIV-Positive and HIV-Negative MSM in Los Angeles, California.

The objective was to examine the impact of the COVID-19 pandemic on mental health care, cannabis use, and behaviors that increase the risk of STIs among men living with or at high risk for HIV. Data were from mSTUDY — a cohort of men who have sex with men in Los Angeles, California. Participants who were 18 to 45 years and a half were HIV-positive. mSTUDY started in 2014, and at baseline and semiannual visits, information was collected on substance use, mental health, and sexual behaviors. We analyzed data from 737 study visits from March 2020 through August 2021. Compared to visits prior to the COVID-19 pandemic, there were significant increases in depressive symptomatology (CES-D ≥ 16) and anxiety (GAD-7 ≥ 10). These increases were highest immediately following the start of the pandemic and reverted to pre-pandemic levels within 17 months. Interruptions in mental health care were associated with higher substance use (especially cannabis) for managing anxiety/depression related to the pandemic (50% vs. 31%; p-value < .01). Cannabis use for managing pandemic-related anxiety/depression was higher among those reporting changes in sexual activity (53% vs. 36%; p-value = 0.01) and was independently associated with having more than one sex partner in the prior 2 weeks (adjusted OR = 1.5; 95% CI 1.0–2.4). Our findings indicate increases in substance use, in particular cannabis, linked directly to experiences resulting from the COVID-19 pandemic and the associated interruptions in mental health care. Strategies that deliver services without direct client contact are essential for populations at high risk for negative sexual and mental health outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-022-00607-9.

Analysis of Emotional Suppression and Marital Distress in the First Five Years of Marriage

Emotional suppression is an emotion regulation strategy that is often used in Eastern or Asian cultures like in Indonesia. Emotional suppression can be related to various outcomes in marital relationships such as marital distress. This research explored the association between emotional suppression and marital distress in individuals during their first five years of marriage. 1770 married participants from various regions in Indonesia participated (mean marriage length = 23.49 months). The research variables were measured using the Emotional Regulation Questionnaire (ERQ) and the Revised Dyadic Adjustment Scale (RDAS). Emotional suppression and marital distress were found to be negatively correlated. Differences in the norms in various situations across the culture seemed to influence the result. Inferential statistics were calculated to determine whether there was a significant difference in individual marital distress levels based on gender, the number of children, residential status, and changes in sexual activity during the Covid-19 pandemic.&#x0D; Keywords: marital distress, emotional suppression, early marriage, Covid-19 pandemic

Sex in the Time of COVID-19: Patterns of Sexual Behavior Among LGBTQ+ Individuals in the U.S.

The SARS-CoV-2 virus, the pathogen which causes COVID-19, has left an indelible impact on the daily lives of individuals in the USA. This study sought to explore the sexual behaviors among people in the LGBTQ+ population at the onset of the pandemic. Behaviors were explored across sub-groups of the population. The study employed data from an internet survey about the impact of COVID-19 on LGBTQ+ identified individuals conducted between May and July 2020. The final sample was comprised of 1090 participants from across the USA. Overall, sexual activity and the number of sexual partners decreased after March 13, 2020 (as compared to before this date) across all sexual orientation groups; however, living situation and partnership status supported sexual activity. Gay and bisexual men living with a partner or a spouse (AOR = 2.20, p = .023) and those living with a non-romantic roommate or friend (AOR = 2.88, p = .004) reported more sexual activity. For both cisgender lesbian and bisexual women and transgender and non-binary individuals, those who were married or in a domestic partnership (AOR = 4.54, p < .001; AOR = 9.97, p < .001, respectively) and those in a committed relationship (AOR = 3.54, p = .001; AOR = 8.46, p < .001, respectively) reported more sexual activity. Additionally, cisgender lesbian and bisexual women living with their partner or spouse (AOR = 2.14, p = .044) reported more sexual activity. When examining the number of sexual partners, cisgender lesbian and bisexual women and transgender and non-binary individuals in a committed relationship (AOR = 0.31, p < 0.001; AOR = 0.26, p = .004, respectively) and those living with a partner or spouse (AOR = 0.30, p = .002; AOR = 0.25, p = .028, respectively) were less likely to report two or more sexual partners. Examining the changes in sexual activity and number of sexual partners helps us better identify the effects of COVID-19 on intimate relationships and sexual behaviors. Furthermore, this study may help develop clinical best practices to facilitate risk-reduction strategies for LGBTQ+ populations when engaging in sexual activity within a communicable disease framework. Current guidance on sexual activity within a pandemic has created a unique opportunity for sex-positive public health messaging that protects individual health while also offering a framework for conversations about risk mitigation that is applicable for both COVID-19 and STI/HIV prevention.

COVID-19 Related Experiences Among College Students With and Without Disabilities: Psychosocial Impacts, Supports, and Virtual Learning Environments.

This cross-sectional analysis estimated differences, based on disability status, in college students' (n = 777) experiences during the COVID-19 pandemic. Data were modeled using t-tests and logistic regression. Most participants were white (86.2%), and women (66.4%). The mode age was 23. A third (35.6%) had at least one disability. Students reported high rates of psychosocial distress, like fear of contracting (59.7%) and spreading (74.3%) COVID-19, worry about friends and family (83.7%), and increased anxiety (72.5%), depression (59.9%), and substance use (24.7%). Forty-two percent (42.2%) were scared they would miss out on their education through virtual classes. About a third feared forgetting assignments (34.1%) and making mistakes (33.9%). Fewer students expressed apprehension about (27.9%) and intimidation by (26.3%) virtual learning. Only 17.2% would continue taking virtual classes after the pandemic. Students with disabilities (M = 12.4, SD = 4.1) experienced more psychosocial stressors compared to students without disabilities (M = 9.9, SD = 4.2), [t(775) = 7.86, p < 0.001]. In adjusted models, disabled students were more than twice as likely to experience worry about medical bills (OR = 2.29), loneliness (OR = 2.09), and increased anxiety (OR = 2.31). They were also more than three times as likely to report increased depression (OR = 3.51) and changes in sexual activity (OR = 3.12). However, students with disabilities (M = 1.5, SD = 1.1) also reported receiving more support compared to their non-disabled classmates (M = 1.1, SD = 1.1), [t(775) = 6.06, p < 0.001]. Disabled students were more likely to feel a sense of contributing to society by following precautions (OR = 1.80) and receive support from family and others (emotional support: OR = 2.01, financial support: OR = 2.04). Interestingly, no significant differences were found in students' feelings associated with online or virtual learning [t(526.08) = 0.42, p = 0.68]. Students with disabilities, though, trended toward reporting negative experiences with virtual learning. In conclusion, students with disabilities were disproportionately affected by COVID-19 stressors, but also expressed more support and a sense of contributing to the common good.

Sexuality in Kidney Transplant Recipients: A Qualitative Study.

End-stage kidney disease has a negative impact on patients’ quality of life. People who receive a kidney transplant experience an improvement in many areas of their daily life. Sexuality is a general component of health, which can be affected by end-stage kidney disease and kidney transplant. The aim of this study was to explore and understand the experiences and perspectives of kidney transplant recipients regarding their sexuality. A qualitative study based on Gadamer’s hermeneutic philosophy was carried out. Two focus groups and nine interviews were conducted with 18 kidney transplant recipients. Data were audio-recorded, transcribed, and analyzed with the help of qualitative analysis software. Two main themes emerged from the data: (1) “The impact of a kidney transplant on sexuality”, with the subthemes “sexuality is relegated to the background”, “physical decline acts as a sexual inhibitor”, and “changes in sexual activity following a kidney transplant”; (2) “Sexual education in kidney transplant recipients” with the subthemes “sexuality: a hidden concern amongst kidney transplant recipients” and “talking about sexuality with healthcare professionals”. Sexuality is a frequent concern among kidney transplant recipients. The physiological and emotional changes experienced after kidney transplant exert a great influence on their sexuality. Healthcare professionals rarely discuss sexuality concerns with kidney transplant recipients. Professional sexual education and assistance are necessary to improve sexual health satisfaction of kidney transplant recipients.

Sexual dysfunction in married female patients on antidepressants: A Cross Sectional Observational study from Patna medical college and hospital

Background: Clinicians and patients now have a broad variety of antidepressants to choose from, due to an ever-growing pharmacopoeia. However, one of the most significant considerations preventing antidepressant use is their side effects, one of which is sexual dysfunction. This issue has a negative impact on the patient’s quality of life which can contribute to clinical non-adherence in long-term therapies. Aims and Objectives: The objective of this research was to look into the characteristics of sexual dysfunction in married female antidepressant patients and patterns of sexual dysfunctions in female patients receiving antidepressants. Materials and Methods: It was Cross-sectional observational study. The study was conducted in the department of Psychiatry, Patna Medical College and Hospital at Patna.The Departmental Research Committee accepted the report, and 50 patients were enrolled after receiving written informed consent. Purposive sampling was used to pick the sample for the analysis, which had a cross-sectional study. The women contacted were in the outpatient psychiatric care of the department of Psychiatry and had been diagnosed with depressive disorder during the study period June 2018 to February 2019. Results: Seventy percent of patients were taking selective serotonin reuptake inhibitors (SSRIs), 20 % were taking tricyclic antidepressants (TCAs), and 10 % were taking other medications such as mirtazapine or desvenlafexine. Within six months, 44 % of patients were on therapy, and 22.0 % had been on treatment for more than two years. Patients taking Escitalopram (80 %) have less sexual activity than those taking Sertraline (66.7 %) or Fluoxetine (77.8 %), Patients observed a change in sexual activity in 58 percent of cases, a decrease in sexual desire in 70 % of cases (p=0.0009*), a slight decrease in 14 percent of cases, and a slight decrease in only 8 % of cases (p=0.0009). 18 % of patients reported a delay in orgasm, with 66 percent reporting a major delay, 8 % reporting a moderate delay, and 8 % reporting a slight delay (p=0.0001). Conclusion: Our findings indicate that sexual dysfunction is common in married female patients taking antidepressants, and that antidepressants affect both aspects of sexual functioning.

Clitoral reconstructive surgery after female genital mutilation: A systematic review

ObjectiveTo summarize available evidence on clitoral reconstruction after Female genital mutilations/cut (FGM/C). Study designSystematic review of the literature to identify studies on clitoral reconstruction after previous FGM/C with at least 6 months of follow-up. The literature search was performed in the following databases: PubMed, EMBASE, Web of Science, and the Cochrane Library. The period considered was from the database inception to June 30th, 2020. Main outcome measuresPost-operative vulvar pain or dyspareunia, changes in sexual activity or orgasm, and the impact on self-image. ResultsWe identified 8 studies; four used the same “Foldès technique”, and four adopted similar techniques based on the downward mobilization of the clitoral stump, with different reconstructions of glans and prepuce. The postoperative complication rate was reported at 5.3%. Sexual function is the only outcome investigated by all studies, which consistently suggest that clitoral reconstruction appear effective to improve clitoral pleasure/orgasm. Almost all studies assessed self-image, which appears improved. Only 2 studies provided data about pain and/or dyspareunia, which were improved by clitoral reconstruction. However, the risk of bias is high. Most patients were lost at follow-up, and validated instruments to assess outcomes were used only in a minority of studies. ConclusionsAlthough clitoral reconstructive surgery for FGM/C appears safe and effective, caution is required to interpret available evidence due to significant limitations. Further studies are required to compare the proposed techniques and to confirm the effectiveness in terms of vulvar pain and/or dyspareunia, sexual activity and/or orgasm, and self-image improvement.

Sexual behavior after childbirth

ObjectiveTo study the prevalence of female sexual dysfunction after childbirth.BackgroundWomen's sexual activity changes at various stages of life and is affected by numerous factors; one of them includes childbirth and maternity. After childbirth, numerous physical, psychological, and sociocultural factors may affect the sexual activity of women and the quality of their lives.Patients and methodsThis cross-sectional study included 200 Egyptian postpartum women in the period from August 2018 till April 2019. The study was performed on postpartum women who attended the gynecology clinic, Shebin El Kom Teaching Hospital.ResultsThe finding of the study indicated that all domains of Female Sexual Function Index (FSFI) were affected after labor, and the most affected was the sexual desire. The mean score before labor was 4.94 ± 0.84 and after labor was 3.40 ± 1.30, and the least prevalent was the dyspareunia; the mean score before labor was 4.16 ± 0.97 and after labor it was 4.89 ± 1.54.ConclusionPhysical and emotional health problems are common after childbirth. In this article, we found that there were significantly lowered mean score values of all domains of FSFI, except pain (increased) and overall scale score decreased after labor. Decreased sexual desire is the most prevalent disorder of the sexual relationship in postpartum and the least prevalent was the dyspareunia.

Sexual educational needs of Jordanian women after giving birth.

Pregnancy and birth entail many bodily changes, including changes in sexual activity. The postpartum period is a time of considerable recovery and adaptation for women, yet women do not always receive adequate information, especially in countries where such topics may be considered taboo. The purpose of this project was to explore the sexual educational needs of Jordanian women after giving birth. A qualitative, phenomenological approach was used. A purposive sample of 25 women were recruited from two health care centers. Semi-structured, in-depth interviews were conducted in person in Arabic between August and November 2015. Transcripts were independently analyzed and coded by each researcher. Two major themes with six subthemes emerged. Theme 1, sexual education, included discussions about the women's needs for scientific information and the husband's involvement, and their psychological needs. Theme 2, professional approaches, involved discussions about the most appropriate person to deliver education, preferred place and time for education, and effective educational approaches to be used. Congruent with previous studies, findings indicated that issues related to sexuality are often ignored in this population. Jordanian women have many unmet educational needs with respect to sexuality after giving birth. More efforts are needed from health care professionals and other stakeholders to help improve Jordanian women's sexual health education after giving birth. These should include greater access to classes, websites with scientific information, and informational handouts that target husbands, and postpartum women themselves.

Reproductive Cycle and Fecundity Tristramella simonies (Gunther, 1864) (Teleostei: Cichlidae) in the Northern Great River (Lattakia, Syria)

This research was conducted to study the reproductive cycle and fecundity of the fish Tristramella simonis in the Northern Great River (Nahr Alkabeer Alshmali) north of Lattakia city. 263 individuals were collected from the northern great river, during the period between July 2017 and June 2018. Samples were collected every 15 days using gill nets, which its pores diameter ranged from 16 to 20 mm and using cages (1 × 1 × 1 m). The total length of the collected fish ranged from 9.5 to 16.5 cm, and their weights ranged from 19.5 to 112.27 g. Samples contained (128 females) and (88 males) and (47) undetected. Results of Gonado Somatic Index (GSI) showed that the reproduction period was between April and August with three obvious peaks of maturity. Where the highest value of GSI was (10.06±8.46) % for females and (0.13 ± 0.05) % for males. Results of Hepato Somatic Index (HSI) was concurrence highly with the ecological and physiological changes, which result from changes in sexual activity during the reproductive cycle. Where the highest value of HSI attained 3.79 ± 1.86 % for females and attained 3.95 ± 1.38 % for males. In the first sexual maturity, the length attained 13.31 cm for females and (14.87 cm) for males. The sexual rate was (1: 0.7), which means 40.7 % males and 59.3 % females in the population. The absolute fecundity ranged from 940 to 1229 egg. While the relative fecundity ranged between 158- 215 egg/ g of ovary weight. Egg diameter during reproduction season ranged between 2.4- 4 mm, with several sizes, which mean a relatively long reproduction term.

Short-Term Changes in Behaviors Resulting from COVID-19-Related Social Isolation and Their Influences on Mental Health in Ghana.

This study assessed the behavioral outcomes of Coronavirus 2019 (COVID-19) social distancing protocols and their influences on mental health. An online survey hosted by Survey Monkey was utilized to collect data from residents of three Ghanaian cities of Accra, Kumasi and Tamale. A total of 621 surveys were analyzed, with a sensitivity analysis utilized to select covariates for the regression model. The average age of participants was about 36 years. Findings indicate that reduced physical activity time and a change in sexual activity and smoking frequency are some short-term changes in behavior resulting from social isolation during the lockdown. An increase in sedentary behavior had a negative influence on mental health. For the most part, changes in behaviors in the short-term were associated with lower mental health scores. The study implied that COVID-19 social distancing measures should be implemented alongside public education for discouraging unhealthy changes in behaviors.

Changes in Sexual Activity and Function After Pelvic Organ Prolapse Surgery: A Systematic Review.

We aimed to systematically review the literature to describe sexual activity and function before and after prolapse surgery. We searched MEDLINE, EMBASE, and ClinicalTrials.gov databases from inception to April 2018. Prospective, comparative studies of reconstructive pelvic organ prolapse (POP) surgeries that reported sexual function outcomes were included. Studies were extracted for population characteristics, sexual function outcomes, and methodologic quality. Data collected included baseline and postoperative sexual activity, dyspareunia, and validated sexual function questionnaire scores. Change in validated scores were used to categorize overall sexual function as improved, unchanged, or worsened after surgery. The search revealed 3,124 abstracts and identified 74 articles representing 67 original studies. The overall quality of evidence was moderate to high. Studies reporting postoperative results found higher rates of sexual activity than studies reporting preoperative sexual activity in all POP surgeries except sacrospinous suspension, transvaginal mesh, and sacrocolpopexy. The prevalence of dyspareunia decreased after all prolapse surgery types. The risk of de novo dyspareunia ranged from 0% to 9% for all POP surgeries except posterior repair, which lacked sufficient data. Overall sexual function based on PISQ-12 (Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12) scores improved for mixed native tissue repairs, anterior repairs, uterosacral suspensions, sacrospinous suspensions, and sacrocolpopexy; scores were similar for posterior repairs, transvaginal mesh, and biologic grafts. Sexual function did not worsen after any POP surgeries. Sexual function improves or remains unchanged after all types of reconstructive POP surgeries and does not worsen for any surgery type. Prevalence of total dyspareunia was lower after all POP surgery types, and de novo dyspareunia was low ranging 0-9%. This information can help surgeons counsel patients preoperatively. PROSPERO, CRD42019124308.

Perbedaan Kualitas Seksual pada Wanita Akseptor KB Hormonal dengan KB Non-Hormonal

Background: Sexual intercourse in the family is the peak of harmony, therefore both parties must be able to enjoy it together. Sex dissatisfaction can lead to differences of opinion, disputes and ultimately divorce. Hormonal contraception has side effects, one of which is an imbalance of the hormones estrogen and progesterone which can cause changes in sexual activity. Each type of family planning has its own side effects, but in most cases a decrease in sexual desire is a side effect that can be found in every use of the type of family planning. The purpose of this study was to determine differences in sexual quality in female hormonal and non-hormonal family planning acceptors.Methods: Descriptive analytic type of research with a comparative design using the Case Control approach, a sample of 68 Wus which is a hormonal and non-hormonal family planning acceptor. Simple Random Sampling sampling technique and observation sheet instrument and SQOL-F questionnaire. This research uses Chi Square data analysis.Results: Chi Square Continuity Corrections test results showed significant results P = 0.000 (P &lt;0.1), meaning that P value 0.000 is smaller than 0.1 there are differences in sexual quality in female hormonal and non-hormonal KB acceptors.Conclusion: Most non-hormonal family planning acceptors have good sexual qualities while hormonal birth control acceptors mostly have moderate sexual quality.

Effect of Guided psychosexual Instructions on Sexual Activity among Hypoactive Women’s Sexual Dysfunctions

Female sexual dysfunction (FSD) is a serious health problem because of its high prevalence and deleterious effects on women's quality of life. Practitioners of women's health must care able to detect FSD in its early stage so that timely treatment could be offered. Also, the clinicians have lack understanding about the approach for identification and evaluation of the sexual problem. The study aimed to investigate the effect of guided psychosexual health instructions on changes in sexual activity among women with reduced sexual dysfunctions (hypoactive). Methods: A quasi- experimental design was used (pre and posttest one group) Setting: The study was conducted at Kebly and Bahary Maternal& Child Health Care Centers at Shibin Elkom Sample 100 participants of women were selected according to their responses in two-scale of sexual dysfunctions and elicited as hypoactive sexual dysfunctions from MCH Tools of the study: 1- Structured interview questionnaire classified into two parts, the first part deal with a biosocial data as age, level of education, and the employment status as well as complaining from physical or gynecological problems hindering them for conducting healthy marital relationship with their partner. The second part was: The Female Sexual Function Index (FSFI), A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function in a 19-item questionnaire, It was developed by Rosen, et al. (2010) as a brief instrument for assessing the key dimensions of sexual function in women. 2-Sexual Dysfunction Questionnaire It was developed by Infrasca et, al (2011) to assess women's readiness and preparation for sexual functions disorders Introduced as a brief self-report inventory. Results showed that there was a highly statistically significant difference P well as vaginal lubrication, orgasm, and degree of satisfaction during sexual activity. It was concluded that the use of guided psychosexual intervention was effective in managing sexual dysfunctions problems and enhancing satisfaction to reach orgasm. Recommendations. All health care providers should include screening questions regarding sexual well-being as a standard of practice. Treating medical, psychosexual, relationship problems, and addressing sociocultural issues, which can be effective in helping women and their partners dealing with hypoactive sexual desire disorder. Health care providers should involve the woman’s partner in the assessment and treatment of sexual health concerns when it is appropriate and safe to do so. Also, health guidelines protocol of care for (SD) should be providers to involve the woman’s partner in addressing sexual issues,

Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women

BackgroundThe beginning of 2020 was characterized by the COVID-19 pandemic. The world governments have adopted restrictive measures to reduce the spread of infection. These measures could affect the sexual function and quality of life of women living with their partner. AimThe aim is to assess the impact of the social distancing measures caused by the COVID-19 pandemic on sexual function and quality of life of noninfected reproductive-age women, living with their sexual partner. MethodsObservational analysis on sexually active women, living with their partner, and without COVID-19 infection was performed. The population previously answered FSFI, FSDS, and SF-36 questionnaires. 4 weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for an evaluation during the COVID-19 outbreak. Main Outcome MeasuresThe primary endpoint was the assessment of the women's sex function change during the social restriction period, by analyzing the FSFI and FSDS questionnaires. The secondary endpoint was the evaluation of the impact on the quality of life calculated by the SF-36 questionnaire. Results89 patients were considered. The median age was 39 (28–50) years. Mean sexual intercourses/month decreased from 6.3 ± 1.9 to 2.3 ± 1.8, mean difference: −3.9 ± 1.2. FSFI decreased significantly (29.2 ± 4.2 vs 19.2 ± 3.3, mean difference: −9.7 ± 2.6) and FSDS increased significantly (9.3 ± 5.5 vs 20.1 ± 5.2, mean difference: 10.8 ± 3.4). The SF-36 showed a significant change from 82.2 ± 10.2 to 64.2 ± 11.8 4 weeks after the introduction of the restrictive measures; mean difference: −17.8 ± 6.7. The univariable analysis identified working outside the home, university educational level, and parity ≥1 as predictive factors of lower FSFI. In multivariable analysis, working outside the home and combination of working outside the home + university educational level + parity ≥1 were the independent factors of a lower FSFI. Clinical ImplicationThe negative impact of the COVID-19 epidemic period on sexual function and quality of life in women shows how acute stress might affect the psychological state. Thus, psychological or sexual support could be useful. Strengths and LimitationsTo our knowledge, this study is the first that analyzes the change in sexual activity in women during the COVID-19 outbreak period. The limitations were the low number of the analyzed participants, psychological tests were not included, and no data were collected on masturbation, self-heroism, solitary, and nonpenetrative sex. ConclusionThe COVID-19 epidemic and the restrictive social distancing measures have negatively influenced the sexual function and quality of life in not-infected reproductive-age women who live with their sexual partners.Schiavi MC, Spina V, Zullo MA, et al. Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women. J Sex Med 2020;17:1407–1413.

Clinical outcomes and adherence to topical corticosteroid therapy in women with vulvar lichen sclerosus: A retrospective cohort study

Vulvarlichen sclerosus is a progressive dermatitis with significant itching, pain, and sexual dysfunction. To investigate topical steroid use and clinical improvement across multiple specialties. Retrospective cohort study at dermatology, gynecology, and vulvovaginal specialty clinics from 2012 to 2017. Descriptive statistics and panel logistic regression were performed. A total of 333 women attended 1525 visits (median 6/patient; range, 1-24 visits). Patients used steroids exactly as prescribed at 66% of visits, less than prescribed at 26%, and not at all at 8%. Versus no use, exact use improved symptoms (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.2-9.6) and physical examination findings (OR, 6.9; 95% CI, 2.7-17.6) more than infrequent steroid use (symptoms: OR, 2.5; 95% CI, 1.2-5.4; physical examination findings: OR, 4.2; 95% CI, 1.6-11.0). Sexual activity status was noted in 93% of vulvovaginal, 29% of gynecology, and 0% of dermatology visits. At intake, 42% of women were sexually inactive because of pain; of these, 37% became sexually active after steroid treatment. Steroid adherence was not associated with change in sexual activity. Women with vulvar lichen sclerosus improve more when topical steroids are used exactly as prescribed, although some improvement occurs with imperfect use. Sexual activity documentation is inconsistent, limiting quality of life follow-up.

Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial

BackgroundSexual concerns and changes in sexual activity are common among patients and their intimate partners after an implantable cardioverter defibrillator (ICD). AimsOur aims were to (i) describe patient and partner sexual activity and related concerns from the time of an initial ICD implant through 12-month follow-up and (ii) identify factors predictive of return to sexual activity and fears associated with sexual activity. MethodsThis secondary descriptive analysis was conducted with data from a randomized controlled trial (2009–2015) designed to compare 2 interventions for patients (Patient-Only) and for patients and their partners (Patient+Partner) after implant of an initial ICD. The sample included 105 patients and their intimate partners who reported sexual activity during the 24 months before ICD implant. OutcomesThe Sexual Concerns Inventory was used to assess sexual activity and related concerns. ResultsStudy participants comprised 72% male and were of mean age 65.6 ± 10.6 years; partners comprised 64% female and were of mean age 63 ± 11.6 years. Sexual activity increased after ICD: 73% of patients reported no sexual intercourse during 2 months before study enrollment, whereas only 46% reported no sexual intercourse during the 2 months before 12-month follow-up. Reductions in sexual concerns were evident 1 month after implant, with continued reductions through 12 months (patient 6.48 ± 4.03 to 5.22 ± 3.38, P = .004; partner 6.93 ± 4.01 to 5.2 ± 3.56, P < .001). Patient physical health predicted sexual activity 3 months after implant placement (P = .04); general ICD concerns (P < .001) predicted patient ICD-related sexual fears at 3 months. At 12 months, baseline general ICD concerns (P < .02) predicted sexual fears. Clinical ImplicationsICD patients and partners report low levels of sexual activity at the time of initial ICD implant, with reported increases in sexual activity over the 12-month recovery period: Sexual concerns were highest immediately after ICD implant. Strengths & LimitationsNotably, the major strengths of this study were the repeated measures and longitudinal study design; the main limitation of the study was the lack of a “usual care” control group. ConclusionSexual activity at the time of an initial ICD implant is low, and sexual concerns are most prominent for both patients and partners immediately after implant placement. Baseline physical health predicts subsequent sexual activity at 3 months, while general ICD-related worry predicts sexual fears at 3 and 12 months.Streur MM, Rosman LA, Sears SF, et al. Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial. J Sex Med 2020;17:892–902.

Adolescent Sexual Activity, Contraceptive Use, and Pregnancy in Britain and the U.S.: A Multidecade Comparison

PurposePregnancy rates among adolescents have declined in the U.S. and Britain but remain high compared with other high-income countries. This comparison describes trends in pregnancy rates, recent sexual activity, and contraceptive use among women aged 16–19 years in the U.S. and Britain to consider the contribution of these two behavioral factors to the decline in pregnancy rates in the two countries and the differences between them. MethodsWe use data from two rounds of the U.S. National Survey of Family Growth, conducted 2002–2003 and 2011–2015, and the British National Survey of Sexual Attitudes and Lifestyles, conducted 2000–2001 and 2010–2012, to describe population-level differences between countries and over time in sexual activity and contraceptive use. We calculate pregnancy rates using national births and abortions data. ResultsPregnancy rates declined in both countries; this began earlier in the U.S. and was steeper. There was no change in sexual activity in Britain, but in the U.S., the proportion reporting recent sex declined. In both countries, there was a shift toward more effective contraception. A higher proportion in Britain than the U.S. reported ever having had sex (65% vs. 49%) and sex in the last year (64% vs. 45%), 6 months (59% vs. 39%), and 4 weeks (48% vs. 29%). A higher proportion in Britain reported using more effective contraception (68% vs. 52%). ConclusionsIn both countries, improvements in contraceptive use have contributed substantially to declines in pregnancy rates; however, the steeper decline in the U.S. likely also reflects declines in recent sex occurring only in that country.

SUN-LB042 The Novel Androgen 11β-Methyl-19-Nortestosterone Dodecylcarbonate (11β-MNTDC) Effectively Suppresses Gonadotropins and Testosterone in Healthy Men: A Potential Oral Male Hormonal Contraceptive

Background: 11β-MNTDC is an orally bioavailable prodrug of 11β-methyl-19-nortestosterone (11β-MNT). It is a modified testosterone (T) with androgenic and progestational activity being developed as a male contraceptive. 11β-MNTDC suppressed serum T and gonadotropin production while maintaining androgenic functions in preclinical studies. Single oral doses of 11β-MNTDC (up to 800 mg) were well-tolerated in healthy men and reversibly suppressed serum T. Methods: We conducted a placebo-controlled, double-blind study at two academic medical centers. 40 healthy men (18-50 years) were randomized to receive either oral placebo (P, n=10) or 11β-MNTDC 200 (n=14) or 400 (n=16) mg dosed daily for 28 consecutive days and completed the study. Participants presented twice weekly for assessment of the primary outcome measures, namely safety parameters (vital signs, hematocrit, liver function tests, lipids, EKG, QTc interval, adverse events). Subjects also underwent serial blood sampling over 24h on Day 1 and 28 to assess the pharmacokinetic and pharmacodynamic effects of oral 11β-MNTDC, including 24h serum drug concentrations, T, LH and FSH suppression (secondary outcomes). Potential effects on mood (PHQ-9) and sexual function (PDQ) were evaluated at baseline, day 28, and end of study via standardized questionnaires. Results: 11β-MNTDC was well tolerated. There were no serious adverse events or significant clinical concerns. None of the participants discontinued due to an adverse event. Administration of 11β-MNTDC resulted in a dose-proportional increase in serum 11β-MNTDC and 11β-MNT concentrations over 24h. This was accompanied by a dose-related profound suppression of serum Cavg24h T (median P 461.1 vs 200mg 22.3, 400mg 7.6 ng/dL), LH (median P 6.0 vs 200mg 1.9, 400mg 0.3 IU/L) and FSH (median P 3.1 vs 200mg 1.2, 400mg 0.2 IU/L) on day 28. Treatment related adverse events occurred in 3 participants in the placebo compared to 22 participants administered 11β-MNTDC including 4 with fatigue, 6 with headache, 5 with acne, 5 with decreased libido and 2 with mild erectile dysfunction. There were no significant changes in blood pressure, liver enzymes, EKG, and QTc. Depression (PHQ-9) scores did not change. On a scale of 0-7, sexual desire score was reduced (median -0.80) without changes in sexual activity in the 400 mg group. As anticipated, there were significant dose-related increases in weight (median change P 0.6 vs 200mg 1.3 and 400mg 1.9 kg), hematocrit (median change P 0 vs 200mg 1.2, 400mg 1.0%), LDL-C (median change P 3 vs 200mg 10, 400mg 18 mg/dL), and decrease in HDL-C (median change P 3 vs 200mg 9, 400mg 11.5 mg/dL). Conclusion: Daily oral administration of 11β-MNTDC for 28 days in healthy men is well tolerated and resulted in marked suppression of endogenous testosterone and gonadotropin production. These results warrant further evaluation of 11β-MNTDC as a potential oral male contraceptive. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.