Differences In Sexual Function Research Articles

Pelvic floor muscle training vs radiofrequency for women with vaginal laxity: randomized clinical trial.

Vaginal laxity (VL) is a complaint of excessive vaginal looseness with a prevalence ranging from 24% to 38% across studies. The study sought to compare the effect of radiofrequency (RF) and pelvic floor muscle training (PFMT) on the treatment of women with VL. From February 2020 to December 2021, a prospective, parallel, noninferiority, randomized clinical trial was carried out in women ≥18years of age and complaining of VL in a tertiary hospital. Two groups (RF and PFMT) were evaluated at the beginning of the study and 30days and 6 months postintervention. A total of 42 participants per arm was sufficient to demonstrate a difference in sexual function on the Female Sexual Function Index at 90% power, 1-sided type 1 error of 0.025 with a noninferiority margin of 4 on the FSFI total score. Analysis was intention-to-treat and per-protocol based. The primary endpoint was the change of FSFI score after treatment, and the secondary outcomes were improvement in symptoms of VL and changes in questionnaire scores of sexual distress, vaginal symptoms, and urinary incontinence, in the quantification of pelvic organ prolapse, and pelvic floor muscle (PFM) contraction. Of 167 participants recruited, 87 were included (RF: n = 42; PFMT: n = 45). All questionnaires improved (P < .05) their total scores and subscales in both groups and during the follow-ups. After 30days of treatment, RF was noninferior to PFMT to improving FSFI total score (mean difference -0.08 [95% confidence interval, -2.58 to 2.42]) in the per-protocol analysis (mean difference -0.46 [95% confidence interval, -2.92 to 1.99]) and in the intention-to-treat analysis; however, this result was not maintained after 6 months of treatment. PFM contraction improved significantly in both groups (RF: P = .006, 30days; P = .049, 6 months; PFMT: P < .001, 30days and 6 months), with better results in the PFMT group. Sexual, vaginal, and urinary symptoms were improved after 30days and 6 months of treatment with RF and PFMT; however, better results were observed in the PFMT group after 6 months. The present randomized clinical trial used several validated questionnaires evaluating quality of life, sexual function and urinary symptoms, in addition to assessing PFM contraction and classifying the quantification of pelvic organ prolapse aiming at anatomical changes in two follow-up periods. The limitations were the lack of a sham-controlled group (third arm) and the difficulty of blinding researchers to assess treatments due to the COVID-19 pandemic. After 30days and 6 months of treatment, sexual, vaginal, and urinary symptoms improved with RF and PFMT; however, better results were observed in the PFMT group after 6 months. RF was noninferior to PFMT in improving FSFI total score after 30days; however, this result was not maintained after 6 months of treatment.

Sexual function, quality of life, anxiety, and depression in women of reproductive age using hormonal, nonhormonal, and no contraceptive methods.

Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial. In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods. This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale). This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P< .05), as well as higher anxiety and depression levels (P= .03, for both), increased pain (P= .01), and poorer overall health (P= .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P< .05). The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods. The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample. Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.

Comparative Investigation of Genital Self-image and Sexual Function in Women with and Without a History of Female Genital Cosmetic Procedures: A Cross-sectional Study.

Despite the increasing growth of female genital cosmetic procedures, the long-term effects of these procedures are not clearly understood. This study was conducted to compare the genital self-image and sexual function in women with and without female genital cosmetic procedures. This cross-sectional study was conducted on 315 participants (210 women without a history of genital cosmetic surgery and 105 women with it) in Alborz province, Iran, from early February 2023 to mid-May 2023. The sampling was done conveniently. Data collection instruments were Female Genital Self Image Scale and Female Sexual Function Index. Statistical analysis was done in SPSS 16 software using t-test, chi-square, and logistic regression, and P<0.05 was considered statistically significant. The use of laser to tighten the vagina with 77.77% and Perineoplasty with 29.2% were the main cosmetic procedures. The mean duration passed from the surgical procedures was 4.79±3.60 years, while it was 1.13±0.74 years for non-surgical procedures. Women with a history of genital procedures had a higher mean age (39.45±10.38, P=0.023). However, they were lower regarding the level of education (P<0.001), family income (P<0.001), and exercise (P<0.001). Also, they showed a higher number of pregnancies (P<0.001), deliveries (P<0.001), vaginal delivery (P<0.001), episiotomy (P<0.001), and neonates with a weight of ≥3.5 kg (P=0.002). In both groups, midwives and doctors were the most important sources of information about the appearance and function of reproductive system. However, the genital self-image and sexual function of the two groups did not differ significantly (P>0.05). No difference in sexual self-image and lack of difference in sexual function after cosmetic procedures show the need to pay attention to recommending and selecting these procedures. Public awareness about the diverse and natural forms of the female genitalia, education about the variety of the factors affecting sexual function, reduction of unnecessary interventions, increase in physiological births, retraining doctors and midwives, and multidimensional counseling can help to choose more appropriate candidates for cosmetic procedures.

Sexual dysfunction in bipolar depression: Gender differences.

To find sexual dysfunction in acute-phase bipolar depression patients and subsequently characterize the gender-wise differences in sexual functioning. A cross-sectional, descriptive, observational, purposeful, and hospital-based study was done with 45 patients (age range: 18-59 years) with moderate to severe acute phase bipolar depression (HAM-D scores >18). The domain-wise (Pleasure, Desire/Frequency Desire/Interest, Arousal/Excitement, and Orgasm/Completion) sexual functioning was assessed by the Change in Sexual Functioning Questionnaire (CSFQ-14) (≤41 for females, ≤47 for males as a cut-off for dysfunction). This study is registered in the CTRI (Clinical Trials Registry India, Number: CTRI-2021-07-035182). The prevalence of sexual dysfunction was 91% of bipolar disorder patients with more male participants (53.3%) compared to females (46.7%). The mean HAM-D score for the study sample was 27.93 ± 8.035. The female gender had more dysfunctional scores in desire/frequency (t = 2.229, P = 0.031), desire/interest (t = 2.448, P = 0.019), orgasm/completion (t = 2.974, P = 0.005), and overall total CSFQ (t = 2.946, P = 0.005). The odds of sexual dysfunction were significant given a one-unit increase in suicidal ideation in the index episode (adjusted OR = 1.222, 95% CI: 1.004-1.488, P = .049). Acute-phase bipolar patients have very high sexual dysfunction rates. Females have both global and specific sexual response cycle deficits in comparison to acute phase bipolar depressed males. Future trials shall amuse neurobiology grounded, more individualistic sexual rehabilitation-based interventional paradigms, and longitudinal research models in acute phase bipolar depression.

Improving sexual dysfunction through guided imagery music (GIM): A clinical trial study.

Women with perfect health are strong foundations of a healthy and prosperous family life and suppressing the natural needs of women will have adverse effects on the intimacy and vitality of family members, especially in the field of sexual function. This study aimed to determine the effect of GIM on the level of sexual function in women with sexual dysfunction. In this cluster randomized trial, which was conducted from 2018 to 2019 in the randomly selected comprehensive health centers of Isfahan, Iran, 72 women of reproductive age (two groups of 36 people) with sexual dysfunction were selected by convenience sampling method, and then, music-guided imagination was performed on the intervention group. No special intervention was performed in the control group. Data collection tools were demographic characteristics questionnaire and a standard questionnaire of the female sexual function index. There was no statistically significant difference in sexual function and demographic characteristics before the intervention between the two groups (P = 0/301). The results demonstrated that the overall score of sexual function in the intervention subjects was better than the control group (P = 0/003). Improvement of sexual function dimensions (desire, arousal, orgasm) was also significant in the intervention group compared to the control group (P < 0.05). GIM can be effective in improving women's sexual function. Providing this technique as a low-cost and affordable method is recommended to health experts in private and government clinics. This method can improve the mental health of the family and society.

P-597 Sexual function in women with Polycystic Ovary Syndrome: an updated systematic review and meta-analysis

Abstract Study question To present a comprehensive review of the evidence on sexual function in women with polycystic ovary syndrome (PCOS) compared to women without PCOS. Summary answer Women with PCOS report lower sexual function and sexual satisfaction compared to women without PCOS. What is known already Research focusing on the psychosocial aspects of PCOS or sexual function is fairly recent and data are limited. Data are often contradicting with studies reporting no differences in sexual function in women with PCOS and studies reporting more sexual problems in women with PCOS. A meta-analysis from our group in 2018 reported lower sexual function and lower sexual satisfaction in women with PCOS compared to women without PCOS. Study design, size, duration A systematic review and meta-analysis of the published literature was conducted. Participants/materials, setting, methods Eight databases were searched from inception to August 24th 2022. Two authors independently screened articles based on pre-defined inclusion (e.g. adequate PCOS diagnosis) and exclusion criteria (e.g. hyperandrogenism caused by other diseases),assessed their quality and graded the certainty of the evidence. Review Manager was used to perform all analyses. Main results and the role of chance Twenty-seven articles were included, of which 23 used questionnaires and four used visual analogue scales (VAS). Pooling FSFI scores showed worse sexual function across most domains in women with PCOS, including arousal (weighted mean difference [WMD]== -0.37, P= 0.002), lubrication (WMD= -0.53, P &amp;lt;0.001), and orgasm (WMD= -0.32, P &amp;lt;0.001). Total sexual function (WMD= -2.47, P &amp;lt;0.001) and sexual satisfaction (WMD= -0.42, P &amp;lt;0.001) were also significantly lower. Selection on fertility status did not change the direction of results. VAS results were not pooled in meta-analysis due to using the same control group across the included studies. However, effects within individual VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness and lower sexual satisfaction in women with PCOS compared with controls, with no differences in the perceived importance of a satisfying sex life. Certainty of evidence was graded low for all included studies. Conclusion: Women with PCOS place similar importance on sexual satisfaction as women without PCOS, yet have lower sexual function and sexual satisfaction. Distress was not assessed. Sexual function assessment, and, psychosexual counseling should be considered as part of standard care in women with PCOS. Limitations, reasons for caution Sexual distress was not assessed. Hence, prevalence of sexual dysfunction which requires both lower sexual function and sexual distress, remains unkown. Certainty of evidence was graded low for all included studies. Wider implications of the findings Sexual function assessment, and, psychosexual counseling should be considered as part of standard care in women with PCOS. Findings from this review have directly informed the international PCOS guideline on sexual function assessment and management. Trial registration number NA

Sexual Function and Depressive Symptoms in Young Women with Euthyroid Hashimoto's Thyroiditis Receiving Vitamin D, Selenomethionine and Myo-Inositol: A Pilot Study.

Thyroid autoimmunity is associated with an increased risk of sexual dysfunction. The aim of this study was to compare sexual functioning and depressive symptoms in women with Hashimoto's thyroiditis receiving different treatments. The study included euthyroid women with autoimmune thyroiditis, untreated or receiving vitamin D, selenomethionine, or myo-inositol. Apart from measuring antibody titers and hormone levels, all participants completed questionnaires evaluating female sexual function (FSFI) and depressive symptoms (BDI-II). In untreated women, the overall FSFI scores and domain scores for desire, arousal, lubrication, and sexual satisfaction were lower than in women receiving vitamin D, selenomethionine, and myo-inositol. In the vitamin D-treated women, the total FSFI scores and scores for desire and arousal were higher than in women receiving the remaining micronutrients. The BDI-II score was lowest in the vitamin D-treated women and highest in the untreated patients with thyroiditis. Vitamin D-treated women were also characterized by lower antibody titers and higher testosterone levels than the women receiving the remaining micronutrients. There were no differences in sexual functioning and depressive symptoms between the selenomethionine- and myo-inositol-treated women. The study results suggest that although all antibody-lowering treatments are associated with better sexual functioning and well-being in young women with euthyroid autoimmune thyroiditis, the greatest benefits are observed in patients receiving vitamin D.

Neoclitoral location may affect sexual function in transgender women: a preliminary pelvic MRI study.

Assigned female at birth with anorgasmia possess a smaller clitoral glans and clitoral components farther from the vagina lumen than women with normal orgasmic function. There are no studies evaluating this correlation in operated transgender women. We evaluated whether differences in MRI measurements of neoclitoris volume and distance between the neoclitoris and the neovagina were correlated with differences in sexual function. We recruited for a prospective survey study 40 operated male to female patients (oMtF) who had undergone genital gender affirming surgery and postoperative pelvic MRI. Individual pelvic MRIs were reviewed by two blinded investigators, the three axes of the neoclitoris were measured and the volume was calculated using the ellipsoid formula. The distance between the neoclitoris and the neovagina was also measured. Sexual functioning was assessed using the Female Sexual Function Index (FSFI) and the operated Male to Female Sexual Function Index (oMtFSFI). Mean scores differences in FSFI, oMtFSFI were examined; associations with clitoral size, location, sexual functioning and demographical variables were investigated as well. The response rate was 55%, 11 MtFs operated with pubic neoclitoris technique (PNT) and 11 with neo-urethroclitoroplasty according to Petrović (NCP). The NCP group presented a neoclitoris mean volume of 1.04 (SD 0.39) cc vs 1.31 (SD 0.78) cc of the other group (p = 0.55). The mean distance between neoclitoris and neovagina was 4.20 (SD 0.57) cm in the PNT group and 2.55 (SD 0.45) in the NCP group (p < 0.001). Patients who had undergone NCP achieved a higher FSFI and oMtFSFI mean Total Score than those operated with the previous technique (FSFI 25.81 SD 3.02 vs 18.62 SD 9.92 p = 0.08; oMtFSFI 37.63 SD 8.28 vs 43.36 SD 13.02 p = 0.23). According to pelvic MRI measurements, this study suggests a correlation between neoclitoral location and oMtF sexual satisfaction.

Impact on sexual functioning: total versus subtotal hysterectomy

Objective To evaluate and compare postoperative sexual functioning following total (TH) versus subtotal hysterectomy (STH). Design A longitudinal, prospective and comparative study in women undergoing hysterectomy for benign diseases in Ibn El Jazzar Hospital, Kairouan in Tunisia. Sample Sixty women undergoing hysterectomy for benign disease. Main outcome measures Sexual functioning evaluation using the Arizona Sexual Experiences Scale (ASEX) and Female Sexual Function Index (FSFI) before the operation and after 6 months. Results Following surgery, significant improvement in sexual functioning according to both scales. In fact, the mean total score of the ASEX scale went from 25.14 to 21.15 and from 11,99 to 19,31 for the FSFI. The average time to resume sexuality postoperatively was 50 days. No significant difference was found in these results between total and subtotal hysterectomy. Conclusion Hysterectomy, whether total or subtotal, has a positive impact on the overall sexual satisfaction of the patients especially in those with an impaired sexuality before surgery. There were no statistically significant differences in sexual function between the two groups TH versus STH. Therefore, cervix preservation for the purpose of improving overall sexual satisfaction cannot be recommended. Keywords Hysterectomy . Sexual dysfunction . Supracervical hysterectomy . Cervix

MP21-16 PROVIDING CULTURALLY SENSITIVE SEXUAL MEDICINE FOR PERSONS WITH DISABILITIES

You have accessJournal of UrologyCME1 Apr 2023MP21-16 PROVIDING CULTURALLY SENSITIVE SEXUAL MEDICINE FOR PERSONS WITH DISABILITIES Rebecca Howland, Benjamin Tooke, Courtney Streur, and Daniela Wittmann Rebecca HowlandRebecca Howland More articles by this author , Benjamin TookeBenjamin Tooke More articles by this author , Courtney StreurCourtney Streur More articles by this author , and Daniela WittmannDaniela Wittmann More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003246.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Persons with Disabilities (PWD) are viewed by society and health care providers as asexual. Providers often do not address sexual health with PWD. This has contributed to misconceptions among PWD leading to poor sexual confidence, unintended pregnancies, increased risk of sexually transmitted illnesses and sexual exploitation. While PWD may experience differences in sexual function, they can have satisfying sex lives. It is crucial that health care providers offer sexual health education and care that considers the neurobiopsychosocial context of PWD. To inform provider knowledge and culturally sensitive sexual health care delivery, we reviewed existing literature on these topics. METHODS: A scoping literature review of articles published between 1/1/2005 and 1/1/2022 was conducted using PubMed with search terms: Spina Bifida, Multiple Sclerosis, Spinal Cord Injury, Cerebral Palsy, Parkinson’s, Disabilities, and sexual, sexual function, quality of life, perceptions, attitudes, physician, physician attitudes, physician perceptions, or cultural. Authors independently reviewed these for inclusion or exclusion criteria, with discrepancies resolved by team discussion. Of the 959 relevant articles, 63 met all inclusion criteria. RESULTS: PWD experience common neurologic-related sexual concerns including erectile and ejaculatory dysfunction, vaginal dryness, and diminished orgasms, while some experience orgasms originating in different areas of the body. Functional concerns include bowel and bladder incontinence during sex, positioning to prevent pain, fatigue, and medication side-effects. Psychological concerns include low confidence and difficulties with partner communication. Emerging sexual orientation research suggests a trend toward a higher proportion of PWD identifying as bisexual than the general population. Providers report addressing sexual health as within their scope of practice but feel uncomfortable doing so. CONCLUSIONS: It is both critical and feasible for providers to deliver culturally sensitive sexual health care for PWD. Providers should learn to discuss sexual function and challenges with their PWD patients, recognize their neurobiopsychosocial reality, encourage body mapping of new erogenous body areas, discuss positioning options and assistive devices, and encourage partner communication. Further research is needed to further define preferences for culturally sensitive sexual health care relevant to each disability type and to create resources for sexual health support. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e292 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rebecca Howland More articles by this author Benjamin Tooke More articles by this author Courtney Streur More articles by this author Daniela Wittmann More articles by this author Expand All Advertisement PDF downloadLoading ...

Impact of an HPV diagnosis on the psychosexual sphere

We aimed to evaluate the psychosexual impact of being diagnosed with human papillomavirus (HPV). A cross-sectional study was conducted to assess the anxiety and depression levels and sexual functions in women with and without HPV between March and May 2021. Beck anxiety inventory (BAI), the Beck depression inventory (BDI), and the Libido scoring system scales (LSSS) were used as scales. A total of 575 respondents were included; 292 (50.2%) HPV-negative, and 283 (49.8%) HPV-positive, of whom 170 (60,1%) had high risk HPV genotypes 16/18 and 113 (39,9%) had non-16/18 high risk HPV-positive patients. There was no significant association between HPV-negative and HPV-positive patients in terms of sociodemographic characteristics. While 21.6% of the HPV-positive group experienced masturbation, it was 15.1% in the HPV-negative group (p=0.044). While severe depression was 4.9% in HPV-positive women, this rate was 1.4% in HPV-negative women (p=0.002). The present study showed that being diagnosed with HPV made a significant difference in sexual function, except for sexual interest, but increased anxiety and depression scores. Sexual dysfunction following an HPV diagnosis cannot be explained solely by depression and anxiety.

Operative Hysteroscopy Versus Levonorgestrel-Releasing Intrauterine System (LNG-IUS) Insertion: A Prospective Observational Study on the Effect of Surgical and Medical Treatments on Sexual Functions in Women With Abnormal Uterine Bleeding.

Background This study aims to evaluate the effect of operative hysteroscopy and levonorgestrel-releasing intrauterine system (LNG-IUS) insertion for abnormal uterine bleeding on sexual function and, if it improves sexual function, to examine differences in sexual function between women undergoing hysteroscopy and women using LNG-IUS. Methods Ninety women aged between 25 and 52 enrolled in the study. Participants were divided into two groups, including 45 operative hysteroscopy patients and 45 LNG-IUS patients. All patients completed the Female Sexual Function Index (FSFI) questionnaire pre-treatment and after three months post-treatment. Pre- and post-treatment FSFI scores were compared both within and between groups. Results The mean FSFI scores at three months following both treatments were significantly higher than baseline in both groups (p<0.05). When the two groups were compared, no significant difference was observed between baseline and three-month post-treatment differences in FSFI scores except for the pain domain. In the pain domain of the FSFI questionnaire, a more significant improvement was found in the LNG - IUS inserted group compared to the operative hysteroscopy group. Conclusion Patients had improvement in sexual functions after both operative hysteroscopy and LNG - IUS insertion treatment. No significant difference was observed in hysteroscopy and LNG-IUS patients after both treatments in terms of sexual function according to scores calculated by FSFI, except for the pain domain. Significant improvement was observed in the pain domain of the FSFI for the LNG - IUS inserted group compared to the operative hysteroscopy group, thus demonstrating a significant effect and improvement for dyspareunia and chronic pelvic pain complaint in the LNG-IUS inserted group.

Sexual function improves as depressive symptoms decrease during treatment with escitalopram: results of a naturalistic study of patients with major depressive disorder

Major depressive disorder (MDD) is closely associated with sexual dysfunction, which may worsen during treatment with selective serotonin reuptake inhibitors (SSRIs) due to the side effects of pharmacologic treatment. To examine the association between sexual function and severity of MDD in drug-naïve patients as compared with healthy controls and how treatment with SSRIs affects sexual function over time in individuals with MDD. Interaction with gender and treatment response was examined. In 92 patients with MDD, we measured MDD severity with 6- and 17-item versions of the Hamilton Depression Rating Scale (HDRS6 and HDRS17) and the level of sexual function with the Changes in Sexual Functioning Questionnaire at baseline and 4, 8, and 12weeks after initiating treatment with escitalopram. Baseline sexual function was compared with the sexual function of 73 healthy controls. Linear regression models were used to assess differences in sexual function between healthy controls and patients and change in sexual function from baseline to week 12. Linear mixed models were used to assess differences in change in sexual function between treatment response groups. Outcomes included total scores on the HDRS6, HDRS17, and Changes in Sexual Functioning Questionnaire and changes in total scores from baseline to week 12. Unmedicated patients with MDD reported impaired sexual function as compared with healthy controls. Level of sexual function was not associated with severity of MDD at baseline. Patients' sexual function improved significantly during treatment, which was coupled with amelioration of depressive symptoms. Treatment response groups (remitters, intermediate responders, nonresponders) did not predict change in sexual function. Gender had no effect on sexual dysfunction symptoms during treatment. Major depression is a risk factor for sexual problems, and improvement in sexual function was coupled with amelioration of depressive symptoms. Among its strengths, this was a naturalistic study reflecting real-world settings in clinical practice. It additionally included a baseline measurement of sexual function and MDD severity on drug-naïve patients prior to the initiation of treatment. Finally, the follow-up of 12weeks extends beyond the acute phase of treatment in which previous research has observed a peak in sexual side effects. In terms of limitations, there was no placebo arm; thus, the study cannot attribute the effects on sexual function to treatment with antidepressants per se. Also, the patients were young, which may have served as a protective factor against sexual side effects. Sexual dysfunction was strongly associated with MDD and improved in parallel with overall symptoms of depression across a standard 12-week treatment with SSRI antidepressants. NCT02869035 (https://clinicaltrials.gov/ct2/show/NCT02869035).

Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study

&lt;abstract&gt; &lt;p&gt;Patients with Chronic Kidney Disease (CKD) report sexual dysfunction to a large extent. The objective of this study was to investigate if CKD-stage and mode of treatment correlate to self-reported experience in sexual function before and after onset of symptomatic CKD in patients without active treatment, after transplantation or on dialysis. Participants (N = 234) answered a questionnaire on frequency of sexual desire, initiative, intercourse, erection (men) /vaginal lubrication (women), and orgasm, currently and compared with before onset of symptomatic CKD. Clinical data were taken from medical charts. Within-group differences in sexual function were compared for patients without active treatment (PreT), patients with a renal transplant (Tx) and patients on dialysis treatment (D). In a subgroup analysis, five patient groups were created based on mode of treatment and CKD stage. Between-group differences in sexual function were analyzed as differences in mean composite scores and 95% CI and were estimated using ordinary least square regression with robust standard errors. In the first analysis of the study, all CKD patients reported a decrease in the frequency of sexual desire, initiative, intercourse, erection (men)/vaginal lubrication (women), and orgasm (Bonferroni p &amp;lt; 0.001) compared to before disease onset, irrespective of treatment mode. In the subgroup analysis, when adjusting for sex and age, dialysis patients reported a statistically significant decrease in their average score of sexual function (−2.65; 95% CI: −4.19 to −1.11; p = 0.001) compared to patients without active treatment CKD 2–3 (the reference group). The self-reported experience of CKD-patients of a deteriorating sexual function over time correlates to treatment modality and CKD stage. It is important for health-care personnel to be aware of the patients' experience of a deterioration in sexual function over time regardless of treatment modalities.&lt;/p&gt; &lt;/abstract&gt;

The Effect of Testosterone Replacement on Sexual Function in the Elderly: A Systematic Review and Meta-Analysis.

Healthy aging is an important concern in an aging society. Although the causal relationship between hypogonadism and erectile dysfunction in elderly men remains unclear, many physicians have achieved positive results after implementing exogenous testosterone supplementation therapy in patients with normal or slightly low blood testosterone. The purpose of this study was to conduct a systematic review and meta-analysis on whether testosterone replacement therapy (TRT) could improve sexual function in the elderly, as reported recently. As a comprehensive literature search was performed to find articles published in PubMed, Embase, and Cochrane databases by January 2022. The search used keywords of 'aged', 'male', 'sexual behavior', and 'testosterone'. Randomized controlled trials (RCTs) were finally selected. As the main effect variable, results of a questionnaire on sexual function were analyzed and the effects of TRT were compared to those of placebo control. Five RCT studies were included in this meta-analysis. The overall improvement by mean difference of sexual function for testosterone supplementation was 0.082 (95% CI: -0.049 to 0.213). In subgroup analysis, only intramuscular injection of 1,000 mg testosterone significantly improved sexual function of the elderly (0.229, 95% CI: 0.112 to 0.347). There was no significant difference in sexual function according to testosterone dose in meta-ANOVA (p=0.957). The difference was not statistically significant either in the meta-regression test (p=0.310). Egger's regression coefficient test did not indicate a publication bias (p=0.132). Although our overall effect size (that is, sexual function effect of TRT) did not show a significant improvement, the direction of improvement in erection and motivation was clearly shown. The injection formulation resulted in a significant sexual function improvement. Since only a few RCTs were included in the analysis, more well-designed prospective studies are needed to have a definite conclusion.

Effect of Mindfulness Based Sexual Relationship Therapy on Orgasm Quality and Sexual Function in Women With Orgasmic Disorder: A Clinical Trial

Objectives The quality of sexual function, especially orgasm, is one of the most important issues related to sexual health and fertility. The present study aims to investigate the effect of mindfulness-based sex therapy on orgasm quality and sexual function of women with orgasm disorder. Methods This is a clinical trial. Participants were 25 Iranian married women referred to clinics of family therapy, sex therapy, and psychiatry in Tehran, Iran who were selected by a convenience sampling method. After obtaining informed consent, they completed the sexual function questionnaire and a researcher-made questionnaire on orgasm quality. Then, education in about the structure and performance of sexual system and sexual response processes were given to them and received the mindfulness-based sex therapy at 8 sessions before, immediately after, and three months after the intervention. The data were compared using multivariate analysis of covariance (MANOVA). Results The interventions improved orgasm quality and sexual function, and the interaction effect of treatment and time was significant. Results of MANOVA showed a significant difference in sexual function (F(2,22)=195.95, P&lt;0.0001), orgasm quality (F(2,22)=330.97, P&lt;0.0001), number of orgasms per month (F(2,22)=352.28, P&lt;0.0001) and number of sexual intercourses per month (F(2,22)=183.15, P&lt;0.0001) over time. Conclusion It seems that mindfulness-based sex therapy is effective in improving sexual function and treating orgasmic disorders in women.

THE DIFFERENCES IN SEXUAL FUNCTION BETWEEN WOMEN AFTER CESAREAN SECTION WITH INDICATION OF SECOND STAGE DISTOCIA AND ELECTIVE INDICATION

This research want to know the difference between a woman's sexual function after childbirth with Caesarean section on indications second stage dystocia and elective.This study is observational analytic with cross sectional design using comparative in M. Djamil General Hospital and Networking Hospital. Obtained samples are 26 women after childbirth cesarean section for second stage dystocia and 26 women after elective Caesarean section were spawned from term pregnancies that meet the inclusion and exclusion criteria. Data analysis was performed using univariate and bivariate using independent T test. The average female sexual function after cesarean section indication of second stage dystocia is 27,70 ± 8,53 and female sexual function after elective Caesarean section indications are 33,55 ± 3,18. Statistical test results are known there is a difference in sexual function between women after Caesarean section indication of second stage dystocia and elective p = 0,003 (p ≤ 0,05). There is a difference between a woman's sexual function after childbirth Caesarean section on indications second stage dystocia and elective.

Sexual Functioning in Female Patients Undergoing Surgical Treatment for Colorectal Cancer-A Single-Center, Prospective Triple Timepoint Yearly Follow-Up.

The study was aimed at assessing the quality of sexual functioning in female patients having undergone surgical treatment for cancer depending on the type of surgery. The prospective cohort consisted of 48 female patients (23 patients with stoma [A2] and 25 patients with maintained continuity of the GI tract [A1]). Study methods included a diagnostic survey and the analysis of medical records of patients. Research tools consisted of a standardized FSFI questionnaire and a proprietary form for evaluation of sociodemographic data. Measurements were performed at threetimepoints: On the day before the surgery (Measurement I) as well as six and 12 months after the surgery (Measurements II and III, respectively). Statistically significant differences in results were observed in Measurements II and III in the subscales of arousal (II:p = 0.0068, III:p = 0.0018), lubrication (II:p = 0.0221, III:p = 0.0134), orgasm (II:p = 0.0044, III:p = 0.0021), satisfaction (II:p = 0.0021, III:p = 0.0433), and pain/discomfort (II:p = 0.0343, III:p = 0.0473). In all cases, lower scores corresponding to lower quality of sexual functioning were observed in patients in whom stoma had been performed. Statistically significant differences in sexual functioning were observed at Measurements II and III in each group, with the results being significantly (p > 0.05) worse in patients having undergone Hartmann’s procedure or abdominoperineal resection). Variables significantly affecting self-assessed sexual satisfaction included marital status, age, and modality of neoadjuvant treatment. Restoration of the continuity of the gastrointestinal tract is a chance for better self-assessment of the patient’s quality of life as regards sexual functioning.

Breast cancer and sexual dysfunction: Does surgery matter?

ABSTRACT Introduction It is well known that breast cancer and its associated treatments have negative effects on women's physical, emotional, and overall sexual health. Studies have shown that the incidence of sexual dysfunction is significantly higher after the diagnosis and associated treatments of breast cancer. For surgical procedures, there is evidence of an increase in sexual problems 6 months after surgery. . Objective The aim of this review is to examine the available research on the impact of breast cancer surgery on women's sexuality. Methods A comprehensive search of Medline, Scopus, and Web of Science databases was conducted to find Englishlanguage articles published since January 2000. We used a list of keywords combining "breast cancer" AND "surgery" AND "sexual function" AND "sexual dysfunction". Results We found 1947 results, and after selecting quantitative and original articles on the effects of breast cancer surgery on female sexuality, there were 14 eligible articles. Three articles from other sources were included. Studies comparing the sexuality of the general population with that of women who had undergone breast cancer surgery found a higher risk of sexual dysfunction in these women. When comparing different types of surgery, namely mastectomy with or without reconstruction and breast-conserving surgery, different results were obtained. Four studies found no differences in sexual function between the different types of surgery. Mastectomy without reconstruction was associated with a negative impact on sexual function in four other studies, with all sexual domains affected in some of these studies. In contrast, two studies found lower scores in women who had undergone breast-conserving surgery. Axillary lymph node removal has also been associated with genital arousal disorder. Two studies found no association between sexuality and breast cancer surgery. Conclusions Breast cancer and related treatments, including surgery, have a negative impact on women's sexuality. Different types of surgery appear to have different effects, with mastectomy without reconstruction associated with worse outcomes, while breast-conserving surgery was associated with lower sexual function scores in only two studies. All of these studies relied on different methods and populations with different expectations, which may explain some of the disparity in outcomes. By pointing out the surgical consequences of mastectomy preoperatively, surgeons can make patients' expectations of esthetic and functional outcomes after breast cancer surgery more realistic and help patients make better treatment decisions. Disclosure Work supported by industry: no.

Comparison of sexual function between women with iatrogenic and natural menopause

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