Components Of Sexual Function Research Articles

Placebo-controlled effect of topical Qust (Costus) oil on postmenopausal women's sexual desire disorder: a double-blind, randomized clinical trial.

Decreased libido and anorgasmia are common problems for women after menopause that reduce the quality of life of couples. This study examined the effect of topical Qust oil on sexual desire disorder in postmenopausal women. In this double-blind, randomized, clinical trial, 110 postmenopausal women with decreased sexual desire visiting a Traditional Medicine Center and Hazrat Rasool Akram Hospital (affiliated to Iran University of Medical Sciences) were selected by convenience consecutive sampling and randomly assigned to experimental and control groups. The experimental group received qust oil, while the control group was given a placebo (liquid paraffin); they were instructed to massage the product topically on their pubic area and perineum daily. The sexual function of both groups was assessed and compared before the intervention and four weeks after the intervention using the Female Sexual Function Index. The mean and standard deviation of the improvement of sexual function post-intervention were 37.66±32.52% and 11.96±11.18% in the experimental and control groups, respectively (p<0.001). In terms of the improvement of components of sexual function, a significant difference was observed between the two groups in the sub-scales of sexual desire [57.05±42.99% vs. 21.25±27.85%, p<0.001], arousal, orgasm, and satisfaction (p<0.001 for all); however, no significant difference was observed in terms of lubrication (p=0.25) and pain during intercourse (p=0.776). In postmenopausal women with sexual dysfunction, massaging the pubic area and perineum with qust oil for at least four weeks significantly improves desire, arousal, orgasm, and sexual satisfaction.

Does Near Miss Compromise Sexual Function in Reproductive-Aged Women? A Comparative Cross-Sectional Study in Ahvaz, Iran

Background: Maternal near miss (MNM) is defined as any life-threatening event during pregnancy, delivery, or within six weeks after the termination of pregnancy. Objectives: This cross-sectional study aimed to assess sexual function in women with (n = 140) and without MNM (n = 246). Methods: Eligible participants were women with MNM and basic literacy who had given birth at least 8 - 12 weeks prior to the study. Participants were recruited from Imam Khomeini and Taleghani hospitals, while women without MNM were recruited from two public health centers in Ahvaz. Data collection commenced in December 2020 and concluded in March 2021. A demographic questionnaire and the Female Sexual Function Index were used to collect the data. Data were analyzed using independent t-tests, chi-square tests, and multiple linear regression. Results: The predominant mode of delivery among MNM women was cesarean section (70%, P &lt; 0.05). The most common causes of MNM were preeclampsia (41.43%) and placenta accreta (24.29%), followed by hypertension and diabetes (17.86%). Women without MNM reported significantly higher scores in sexual satisfaction (β = 0.355, 95% CI: 0.019, 0.690, P = 0.035), lubrication (β = 0.707, 95% CI: 0.435, 0.980, P &lt; 0.0001), sexual arousal (β = 0.394, 95% CI: 0.116, 0.522, P = 0.007), sexual desire (β = 0.319, 95% CI: 0.116, 0.522, p = 0.002), and total sexual function score (β = 1.768, 95% CI: 0.306, 3.230, P = 0.018). Women who had undergone cesarean section reported lower scores in sexual satisfaction (β = -0.646, 95% CI: -0.983, -0.309, P &lt; 0.0001), orgasm (β = -0.620, 95% CI: -0.965, -0.275, P &lt; 0.0001), sexual arousal (β = -0.473, 95% CI: 0.159, 0.439, P = 0.001), and total sexual function score (β = -3.181, 95% CI: -4.655, -1.707, P &lt; 0.0001). Older women scored significantly lower in all components of sexual function except for pain. Conclusions: The study results indicated that all components of sexual function, except pain, were lower in women with MNM. A significantly higher number of women who had undergone cesarean section experienced MNM and sexual dysfunction. Health policymakers should focus not only on the causes of MNM, particularly cesarean sections, but also on assessing the sexual function of women affected by MNM.

Sacral Neuromodulation in Male Sexual Dysfunction – A Systematic Review

Introduction: Contemporary patient care requires full consideration of sexual health as well. Sexual dysfunction has a high prevalence and significantly affects quality of life. The cost to the health care system is estimated to be high but has not yet been calculated with certainty. Therapy considers sexual appetence, sexual arousal, orgasmic experience in both genders, lubrication in women and erection in men. Sacral nerve stimulation (SNS) has been used primarily for neurogenic bladder dysfunction, idiopathic pelvic pain, nonobstructive urinary retention, and fecal incontinence. Effects have also been observed on various components of sexual function. Sexual function as a primary outcome parameter of SNS has not been studied to date. Methods: For a systematic literature search, the Healthcare Databases Advanced Search (HDAS) platform was used, employing the Medline, EMBASE, and CINHAL search engines, and considering only publications from international peer-reviewed journals. Results: We identified 16 studies with inclusion of a total of 662 women and 40 men in which potential effects of SNS on sexual function were noted when used in other indications. For the female sex, there was evidence for significant improvements in sexual function. The very weak data situation for the male sex so far only allows to assume similar effects. In any case, it remains unclear whether these effects are primary or secondary to SNS. Discussion: SNS affects urinary bladder emptying, urinary bladder continence, pelvic pain, and fecal continence and defecation. The direct anatomical and physiological relationship between these organ systems and sexual function raises the question of whether there is a primary effect of SNS on sexual function. High-quality studies with sexual function as the primary endpoint should verify this.

Relationship of insomnia to sexual function and sexual satisfaction: Findings from the sleep and sex survey II

ObjectiveResearch suggests that healthy sleep is a key component of sexual function. When evaluating sexual function, however, poor sleep is often overlooked as a contributing factor. This cross-sectional survey expands prior work by exploring relationships among insomnia severity, sexual satisfaction, and sexual function with an updated battery of measures for the Sleep and Sex Survey. MethodThe sample (N = 1266) consisted of 618 men, 648 women recruited via Prolific, an online survey platform. The Sleep and Sex Survey II included measures addressing insomnia, fear of sleep, nightmares, sexual function, sexual satisfaction, sexual activity, depression, anxiety, posttraumatic stress, and alcohol use. ResultsRecent sexual activity was correlated with better sleep, lower anxiety, and lower scores on a posttraumatic stress disorder screener. Insomnia severity was negatively correlated with sexual satisfaction (r = 0.22, p < .001) and the presence of insomnia was associated with higher rates of sexual dysfunction in women (53.8% vs. 31.8%; p < .001) and men (22.7% vs. 12.5%; p = .036). In regression analyses, after accounting for depression and anxiety, insomnia had a statistically significant association with sexual function for women (β = 0.12; p < .01) but not men (β = 0.11; p = .60). ConclusionFindings support a relationship of insomnia to sexual function and satisfaction with some gender differences. Future work may be enhanced by assessing these relationships in a gender diverse population including objective sleep measures and addressing contributing mechanisms. Clinically, findings support the assessment of sleep when evaluating patients for sexual dysfunction.

PS05 A qualitative assessment of the impact of hidradenitis suppurativa on sexual function

Abstract Hidradenitis suppurativa (HS) is associated with significant physical and psychosocial morbidity. There are limited data in the literature on the impact of the condition on patients’ psychological, physical and emotional sexual functioning and wellbeing. A patient survey was collaboratively designed by dermatologists and a clinical psychologist to assess sexual function in HS. This was adapted from existing published scales assessing components of sexual functioning, as there is no validated tool for use in HS. Nineteen patients (10 men and nine women) with HS were surveyed. They had a mean age of 41 years and a mean Hurley stage of 2.2. Twenty-six per cent (n = 5) were current smokers. The mean body mass index of participants was 28 kg m−2. Seventy-nine per cent (n = 15) were in a current sexual relationship. Seventy-four per cent (n = 14) felt that HS affected their sexual relationships negatively and 50% (n = 8/16) documented that HS had prevented them starting a new sexual relationship. Eighty-four per cent (n = 16) reported that their HS caused them to avoid sexual intimacy. Sixty-three per cent (n = 12) suffered a degree of dyspareunia and 63% (n = 12) described that odour from HS lesions impacted negatively on sexual activity. Confidence with regard to emotional closeness with partners during sex was variable, with 31% (n = 5) reporting low confidence; 58% (n = 11) had low confidence when engaging in sexual activity. Fifty per cent (n = 9/18) felt sad when considering the impact of HS on their sexual life and 88% (n = 14/16) felt ashamed and stressed when considering being naked or intimate. Ninety-four per cent (n = 17/18) felt a degree of sexual unattractiveness due to HS, with 44% (n = 8/18) rating it as ‘extremely’ or ‘very much’. Eighty-nine per cent (n = 16/18) reported that HS had negatively impacted on the sexual quality of their lives, with 33% (n = 6) rating it as ‘extremely’ or ‘very much’. Sexual function in HS is an important, often overlooked component of quality of life. Sexual dysfunction is of particular concern in HS due to the location and nature of lesions, which are often close to or affect erogenous zones (Varney P, Guo W, Brown M et al. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol 2022; 85:AB23). This study demonstrates that HS has a significant impact on patients’ psychosexual, physical and emotional sexual functioning and wellbeing. The Permission, Limited Information, Specific Suggestions, Intensive Therapy model is a useful, structured framework for clinicians to incorporate the discussion and management of sexual dysfunction into consultations, and clinicians should work with local psychological, sexual and biomedical services to address any identified morbidity.

The effectiveness of treatment based on acceptance and commitment on sexual performance and emotional safety in men with cardiovascular disease

Aim: The aim of the research was to determine the effectiveness of the treatment based on acceptance and commitment on sexual performance and emotional safety in people with cardiovascular disease. Method: The research method was quasi-experimental with a pre-test-post-test design with a control group and a two-month follow-up phase. The statistical population of the study was cardiovascular patients in Isfahan city in 2022, and 34 patients were selected using the purposive sampling method and randomly assigned to one experimental group and one control group (17 people in each group). The research tools were Rosen's Male Sexual Performance Questionnaire (2004) and Emotional Safety Questionnaire. Treatment based on acceptance and commitment was implemented in 9 sessions of 90 minutes once a week and the control group was waiting for treatment. The data were analyzed using the statistical method of mixed analysis of variance and Bonferroni post hoc test. Results: The results showed that the effectiveness of treatment based on acceptance and commitment and transdiagnostic treatment was on the components of sexual function and emotional safety in cardiovascular patients (P&lt;0.001). Also, the results showed that these effects had maintained their stability in the follow-up phase (P&lt;0.001). Conclusions: Therefore, both interventions can be used to improve the components of sexual function and emotional safety of cardiovascular patients and improve their quality of life.

The effectiveness of group problem-solving therapy on women's sexual function and satisfaction after mastectomy surgery

BackgroundBreast cancer is the second cause of death and the most common cancer in women worldwide, threatening different aspects of individual and mental health, quality of life, sexual function, and sexual satisfaction. This study aimed to determine the effectiveness of group counseling based on a problem-solving solution on women's sexual function and satisfaction after mastectomy surgery.MethodsThe present research was an open pilot study, with a pretest, a post-test, and a follow-up period. Of women referred to the Tehran Breast Cancer Institute, 32 were selected using convenience sampling. The group received eight 90-min sessions of problem-solving solution counseling. This approach is based on cognitive-behavioral therapy and can improve an individual's ability to cope with stressful life experiences. The data collection tool was FSFI and sexual satisfaction questionnaires, which were filled before the intervention (baseline), immediately after the intervention, and one month later (follow up). Data analysis was performed using SPSS 21 statistical software application at the certainty level of 95% (P < 0.05).ResultsThe mean FSFI score increased from 18.37 ± 8.35 before the intervention to 20.88 ± 7.67 immediately after the intervention and 22.95 ± 5.79 one month later (P < 0.0001). Also, the mean sexual satisfaction score was 65.27 ± 5.98, 68.08 ± 5.61, and 70.46 ± 5.35 before the intervention, immediately after the intervention, and one month later, respectively (P < 0.05). The results also showed that although the two components of sexual function and satisfaction were statistically significant after sexual counseling, this improvement was not clinically progressive. The mean sexual function and satisfaction score was still low after sexual counseling.ConclusionsIt was observed that sexual function and satisfaction were improving among the patients after the intervention. Thus, sexual health counseling sessions are recommended for breast cancer patients.

The relationship between sexual function and irrational beliefs and self-concept in married women in Tehran

Aim: The aim of this study was to investigate the relationship between sexual function and irrational beliefs and self-concept in women. Method: The present study is a correlational descriptive method. The statistical population of this study includes married women aged 20-40 years living in Tehran (regions 1 and 3) who were studied in the spring of 1400. In this study, the sample size was estimated by Tabachink and Fidel formulas of 116 people, which was reduced to about 140 people, and in order to be optimized for generalization to the community, we were able to use 216 people who were selected by sampling method and selected voluntarily. The Rosen et al.'s (2000) Women's Sexual Performance Questionnaire, Jones (1969) Irrational Beliefs Questionnaire, and Beck and Steer (1978) Self-Esteem Questionnaire were used to collect data. The present study was analyzed using regression test. SPSS software version 25 was also used for data analysis. Results: The results showed that among the components of sexual function, psychological stimulation, humidity and satisfaction in a negative way and sexual pain in a positive and significant way predicts irrational beliefs in women (P&lt;0.01). The results also showed that among the components of sexual function, sexual desire (p&lt;0.05, β= 0.191) and satisfaction (p&lt;0.05, β= 0.117) were positive and sexual pain (p&lt;0.05, β= 0.404) negatively and significantly predicts self-concept in women. Conclusion: Based on the findings of the present study, psychological stimulation predicts negative moisture and satisfaction and sexual pain positively and significantly predicts irrational beliefs in women. It also predicts sexual desire and satisfaction in a positive way and sexual pain in a negative and meaningful way in women.

Vulvovaginal atrophy of menopause and its impact on sexual function in an Italian clinical cohort of post-menopausal women

The aim of current study was to estimate the impact of vulvovaginal atrophy (VVA) on sexual function in a clinical population of Italian postmenopausal women. Women aged 45–75 years with at least one VVA symptom completed three questionnaires: Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI) and Female Sexual Distress Scale revised (FSDS-R). A gynaecological examination was performed for VVA confirmation. Among the 1,066 evaluable patients, VVA was confirmed in around 90% of the sample. Sexual function impairment was significantly higher in patients with confirmed VVA as observed by significant differences in the sexual function component of the DIVA questionnaire (p = .014), the FSDS-R (p < .0005), and the FSFI (p < .0005), as well as for all the FSFI subdomains: desire (p < .0005), arousal (p < .0005), lubrication (p < .0005), orgasm (p < .0005), satisfaction (p < .0005) and pain (p < .0005). Significant impairment of sexual function was demonstrated in Italian postmenopausal women who were clinically confirmed with signs of VVA through gynaecological examination. IMPACT STATEMENT What is already known on this subject: At least half of postmenopausal women report VVA associated symptoms with significant impact on sexual function and ultimately on sexual activity. What the results of this study add: As compared with patients without confirmed VVA, the negative impact on sexual function was significantly higher in patients with confirmed VVA. This difference was observed for the sexual function component (DIVA-C) of the DIVA questionnaire, for the overall FSDS-R result, and for the overall FSFI score, as well as for all the FSFI subdomains (desire, arousal, lubrication, orgasm, satisfaction and pain). What the implications are of these findings for clinical practice and/or further research: An impairment of sexual function is significantly associated with VVA diagnosis in Italian post-menopausal women, especially when diagnosis was objectively confirmed by clinical signs of VVA visible in the gynaecological examination. In addition, this study demonstrates that inquiring about VVA using a structured questionnaire may increase the diagnosis of VVA related changes in sexual function.

Evaluation of sexual function and its related factors in women with breast cancer undergoing chemotherapy referred to Iran-Mehr Medical Center in Birjand, 2018

Background and Aim: The Breast cancer is very common. These patients develop sexual dysfunction following chemotherapy. The aim of this study was to evaluate the effect of chemotherapy in breast cancer patients on their sexual function. Materials and Methods: This descriptive-analytical cross-sectional study was performed on patients with breast cancer referred to Iran-Mehr Medical Center in winter 2018 undergoing chemotherapy. 119 patients were enrolled in the study under census. The Rosen’s Sexual Function Questionnaire was used to collect data. Data were analyzed by using SPSS (Version 16) and Smirnov-Kolmogorov, Kruskal-Wallis and Mann-Whitney tests at the significant level of (P&lt;0.05). Results: In terms of sexual function, the lowest score was 2.40 and the highest score was 14.90. In the study of sexual function components, patients were in the worst condition in terms of pain, 0.84±0.75 and humidity 0.85±0.73. The mean scores of other components included orgasm 1.13±0.64, irritability 1.05±0.84, satisfaction 1.23±0.30 and sexual desire 1.66±0.66, respectively. The only factor affecting sexual function Location, age of marriage and age of patients. Conclusion: The score of sexual function was less than the minimum; the most disorders were recorded for the components of pain and humidity. Factors affecting sexual function were included: location, years of menopause, type of treatment, age of patients and years of marriage. It is recommended that the sexual status of breast cancer patients be evaluated before and during treatment and that the necessary training be provided to inform patients about this disorder and the necessary treatments to improve sexual function.

Changes in the motivational component of sexual function in the offspring of rats after prenatal exposure to cholinotropic drugs

Prenatal exposure to N-cholinoblocker gangleron and in lesser degree to M-cholinoblocker metamisil leads to significant violations of the motivational component of sexual function in sexually mature offspring of males, expressed in low values of primary sexual activity, and increased latency of the approach and sexual dysfunction after the acquisition of sexual experience. Among the causes of sexual dysfunction in the offspring, it can be noted a change in the hormonal background in male rats, in the form of a significant decrease in the level of the main androgen testosterone, as well as damage in the dopaminergic systems of the brain, manifested by a decrease in dopamine levels.

The European Vulvovaginal Epidemiological Survey (EVES): impact on sexual function of vulvovaginal atrophy of menopause.

To estimate the impact of vulvovaginal atrophy (VVA) on sexual function in a clinical population of postmenopausal women. Women 45 to 75 years old and more than 12 months after the last menstruation, who attended menopausal/gynecological centers in Italy and Spain, were included. Women with at least one VVA symptom completed the following questionnaires: Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale revised (FSDS-R). A physical gynecological examination was performed to confirm the VVA diagnosis. Data were analyzed by chi-square and Student's t tests. In all, 2,160 evaluable women were included in the study. VVA was confirmed in 90% of the included participants. The negative impact on sexual function was significantly higher in women with than in women without confirmed VVA, as evaluated with the sexual function component (DIVA-C) of the DIVA questionnaire (P = 0.013). Statistically significant differences (P < 0.0005) were also detected in the scores of overall FSDS-R, the overall FSFI, and of all the FSFI subdomains (desire, arousal, lubrication, orgasm, satisfaction, and pain). For postmenopausal women with at least one VVA symptom, the presence of physician-confirmed VVA is associated with significant impaired sexual function, as shown by unadjusted analyses. Given the impact on quality of life and the prevalence of VVA, further research to improve and reduce VVA is warranted.

Impact of biofeedback therapy for pelvic floor-related constipation to improve sexual function.

The purpose of this study was to investigate the effect of biofeedback therapy on constipation to improve sexual function among the female population with pelvic floor hypertonicity. It appears that pelvic floor disorder could lead to sexual complaints. Unfortunately, there are few data on the correlation between pelvic floor-related constipation and sexual disorders. The biofeedback role as a conservative method in improving the health status in these patients is conflicting. Forty-two eligible women were included in the study. The exclusion criteria were not being sexually active, not having functional constipation according to Rome IV criteria, and having other psychiatric issues, according to DSM4TR criteria. All participants were treated using biofeedback in eight sessions, during two months. Before and after the treatment, they were analyzed by pelvic floor impact questionnaire, pelvic floor Distress Inventory, and Short Scale Personal Experiences Questionnaire (SPE Q). Biofeedback significantly improved orgasm, arousal, and dyspareunia (respectively P = 0.001, P = 0.001, P = 0.001). However, there was no significant improvement in libido and partner satisfaction domains (respectively P = 0.132, P = 0.341). Significant negative correlations were detected between the age and sexual function. On the other hand, there was no negative relationship between vaginal delivery as well as cesarean delivery and different components of sexual function. It seems the improvement in pelvic floor muscle hypertonicity leads to sexual satisfaction. Nevertheless, more data are required to prove this correlation.

The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women.

Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide, and an important health problem especially in women of reproductive age. This study aimed to determine the relationship between IDA and sexual satisfaction and function among reproductive-aged Iranian women. In this study, 129 women (52 with IDA and 77 non-IDA) with age 18–45 in Mahshahr, Iran were recruited. Data was gathered by a demographic questionnaire, Female Sexual Function Index (FSFI) and Larson Sexual Satisfaction Questionnaire. Data were analyzed using an independent t-test, Mann-Whitney test, Chi-square, and correlation coefficient test. The results of this study showed that the means of hemoglobin (Hb), hematocrit (HCT), serum iron and ferritin were significantly lower in the IDA group than those in the non-IDA group (p<0.01). All dimensions of sexual function and satisfaction were significantly lower in women with IDA compared to the healthy women (p<0.001). Also, all blood indices for IDA had a significant relationship with all sexual function components and sexual satisfaction (p = 0.01) except for pain with Hb and ferritin. Health care providers should provide screening, education, and counseling about anemia and sexual function in reproductive age women.

Is the age at menopause a cause of sexual dysfunction? A Brazilian population-based study.

The aim of the study was to evaluate the association between age at menopause and sexual dysfunction and the components of sexual function in postmenopausal women. In this cross-sectional population-based study, data of 540 women aged 45 to 60 years regarding the age they were when they achieved menopause and its association with sexual dysfunction (evaluated using the Short Personal Experiences Questionnaire) were obtained through interviews. We assessed the data for associations between age at menopause and sexual dysfunction and demographic, behavioral, and clinical characteristics. Age at menopause was not associated with sexual dysfunction. Arousal (dysfunction) was the only component of sexual function that was associated with premature ovarian insufficiency (POI) and early menopause (P = 0.01). It was reported by 64.2% of women with POI (women <40 y), compared with sexual dysfunction rates of 50% and 45.6% of women aged 40 to 45 and >45 years, respectively (P = 0.04). In women with POI or early menopause, Poisson regression analysis showed that having a partner with sexual problems (prevalence ratio [PR] = 6.6; 95% CI: 3.3-13,2; P < 0.001) and dyspareunia (PR = 3.9; 95% CI: 1.8-8.2; P = 0.0005) were factors associated with arousal dysfunction. Satisfaction with the partner as a lover (PR = 0.4; 95% CI: 0.2-0.7; P = 0.002) was protective against arousal dysfunction. Arousal dysfunction was associated with early ovarian failure and POI. The major factors affecting this association were having a partner with sexual problems, dyspareunia, and no satisfaction with the partner as a lover. These findings highlight the importance of evaluating partner problems and improving lubrication in these groups of women.

CHOICE OF MESH IMPLANTS FOR LICHTENSTEIN PLASTIC OF MALE IN REPRODUCTIVE AGE

The article deals with the impact of polypropylene and polyester mesh implants on the sexual function of men of reproductive age after the plastic surgery of the inguinal canal in the Lichtenstein technique. For an adequate comparison of groups of patients with established polypropylene and polyester implants, an algorithm for their examination was developed. For a comprehensive assessment of sexual function in the study, it is divided into two components. Fertility of 155 patients was assessed through the analysis of spermiological studies performed in young patients with inguinal hernia. The possible reason of the immunological form of sterility, against the background of established reticular endoprostheses, a spermiological study in each patient was supplemented with a Mar-test in order to search for antisperm antibodies. To assess the copulative component of sexual function, patients of both groups were questioned according to the questionnaire “International Index of Erectile Function, Version 5” (ICEF 5). After statistical processing of the data based on the developed algorithm, no statistically significant differences between the groups of patients with established polypropylene and polyester implants were revealed. However, in one patient in the group where polypropylene mesh endoprostheses were used, changes in the spermiological analysis taken after the operative allowance, which can speak of a sharp decrease in the quality of the ejaculate, up to the development of sterility, are revealed. Also, this patient recorded a decrease below the ICEF 5. The results of the study, conclusions were drawn and recommendations were given to practicing surgeons about the possibility of using polypropylene and polyester reticular endoprostheses in plastics of the posterior wall of the inguinal canal in men of reproductive age.

Sexual dysfunction is associated with suicidal ideation in female service members and veterans

BackgroundSuicide is a leading cause of premature death among military service members/veterans (SM/Vs). The Interpersonal Theory of Suicide (Joiner, 2007) proposes that higher thwarted belonging, perceived burdensomeness, and acquired capability confer increased risk for suicide. However, no studies have examined the association of sexual dysfunction, a possible component of thwarted belonging and perceived burdensomeness, with suicidal ideation. The present study explored whether sexual dysfunction was associated with suicidal ideation when accounting for mental health, demographic, and military characteristics among female SM/Vs. MethodFemale SM/Vs (n = 710) completed an anonymous online survey assessing demographics, mental health, military characteristics, sexual dysfunction, and suicidal ideation. ResultsOne hundred fifty-nine participants (22.39%) reported suicidal ideation during the preceding two weeks. A multivariable ordinal regression adjusted for age, marital status, probable posttraumatic stress disorder (PTSD), probable depression, race/ethnicity, Army service, and deployment history. Lower sexual functioning (adjusted odds ratio [AOR] = 0.98, 95% confidence interval[CI] = 0.95–0.99), probable PTSD (AOR = 2.54, 95% CI = 1.61–4.01), and probable depression (AOR = 5.28, 95% CI = 3.34–8.34) were associated with suicidal ideation. Post-hoc analyses examined the association of suicidal ideation with specific components of sexual functioning: difficulties with sexual arousal (AOR = 0.87, 95% CI = 0.79–0.97) and sexual satisfaction (AOR = 0.85, 95% CI = 0.75–0.96) were associated with suicidal ideation. LimitationsData were cross-sectional and limited to self-report. DiscussionSexual dysfunction is associated with suicidal ideation, accounting for established mental health, military, and demographic characteristics among female SM/Vs. Efforts to prevent suicidal ideation in female SM/Vs may be enhanced by screening for and treating sexual dysfunction, particularly sexual arousal and satisfaction.

Personality and sexuality in older adults

Objective: This study explored cross-time associations between personality and multiple components of sexual functioning and behaviour in a large cohort of older adults (n = 5745).Design: Participants (Mage = 65.57 ± 8.28 years) completed questionnaires in 2010 and 2012.Main outcome measures: Outcomes explored included sexual attitudes, sexual activity, sexual satisfaction, lifetime sexual partners, sexual orientation and sexual dysfunction.Results: We found that higher levels of openness and lower levels of agreeableness were related to more liberal attitudes toward sex, a greater number of sexual partners, a higher sex drive, more frequent sexual activity, lower levels of sexual dysfunction and (for women) a greater tendency towards homosexuality. Higher levels of conscientiousness were also related to more conservative attitudes towards sex, lower levels of sexual dysfunction and a greater tendency towards heterosexuality. For sexually active older adults, higher levels of extraversion and lower levels of neuroticism were related to greater sexual satisfaction. Higher levels of extraversion and lower levels of conscientiousness were also related to a greater number of sexual partners in men but not women.Conclusion: These findings provide evidence that personality is an important correlate of sexual functioning and behaviour in older adults.

Comparison of citalopram and fluoxetine sexual side-effects in male patients referred to psychiatric clinic

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are among the selected medication to treat depression, panic disorder and many other psychiatric disorders. The most common undesirable effects of SSRIs are sexual dysfunctions that may lead to discontinuation of treatment in some patients. This study was conducted to compare sexual side-effects of two common drugs, citalopram and fluoxetine in male patients. Methods: This cross-sectional study was carried out on 60 male patients referred to the psychiatric clinics of Tabriz University of Medical Sciences, Iran, in 2013. They were candidates for SSRIs treatment and the clinic physicians prescribed citalopram or fluoxetine for them. The patients were examined in two groups after taking written informed consent and initial completion of the International Index of Erectile Function (IIEF) questionnaire and no history of sexual dysfunction, considering the inclusion and exclusion criteria. Both citalopram and fluoxetine groups completed IIEF questionnaire again at the end of the first and second months after treatment and statistical analysis was done using SPSS. Results: Sexual dysfunction was observed in both groups in the all sexual function indices and its components. Although there was no significant difference in terms of sexual function components between the two groups, general sexual dysfunction was significantly higher in the fluoxetine group. In both groups, age was inversely related to the general sexual function index. Conclusion: Unlike many other studies suggesting no difference on SSRI sexual side-effects, the present study showed a reduction in sexual function of men taking citalopram and fluoxetine and the reduction was more prominent with fluoxetine.

Urogenital function in robotic vs laparoscopic rectal cancer surgery: a comparative study

PurposeUrological and sexual dysfunction are recognised risks of rectal cancer surgery; however, there is limited evidence regarding urogenital function comparing robotic to laparoscopic techniques. The aim of this study was to assess the urogenital functional outcomes of patients undergoing laparoscopic and robotic rectal cancer surgery.MethodsUrological and sexual functions were assessed using gender-specific validated standardised questionnaires. Questionnaires were sent a minimum of 6 months after surgery, and patients were asked to report their urogenital function pre- and post-operatively, allowing changes in urogenital function to be identified. Questionnaires were sent to 158 patients (89 laparoscopy, 69 robotic) of whom 126 (80 %) responded. Seventy-eight (49 male, 29 female) of the responders underwent laparoscopic and 48 (35 male, 13 female) robotic surgery.ResultsMale patients in the robotic group deteriorated less across all components of sexual function and in five components of urological function. Composite male urological and sexual function score changes from baseline were better in the robotic cohort (p < 0.001). In females, there was no difference between the two groups in any of the components of urological or sexual function. However, composite female urological function score change from baseline was better in the robotic group (p = 0.003).ConclusionRobotic rectal cancer surgery might offer better post-operative urological and sexual outcomes compared to laparoscopic surgery in male patients and better urological outcomes in females. Larger scale, prospective randomised control studies including urodynamic assessment of urogenital function are required to validate these results.