Domains Of Sexual Function Research Articles

Predictors of duty sex frequency in women.

Duty Sex-the act of engaging in sex out of a sense of duty or obligation to a partner-is a commonly reported reason why women have sex, with studies indicating associations between Duty Sex and sexual dysfunction, as well as nonconsensual sexual experiences (NSEs). This study sought to examine the associations between Duty Sex frequency, sexual function, and NSEs using comprehensive, validated measures of sexual function and NSE histories in a large community sample of women. Six hundred and fifty-eight women with (n = 293) and without (n = 365) NSE histories completed measures of sexual function and sexual motivations. Women with NSE histories reported more sexual pain, lower sexual satisfaction, and more frequent Duty Sex. The relation between NSE history and Duty Sex remained after controlling for the variance in sexual function. The type of NSE behavior, but not the timing of the first NSE nor the perceived impact of the experience, predicted Duty Sex frequency. Clinicians should consider sexual motivations, particularly Duty Sex, when treating women with NSE histories or who experience sexual dysfunction. To our knowledge, this was the first study to examine how NSEs relate to all domains of sexual function and sexual motives, revealing a link between NSEs, sexual function, and Duty Sex. However, we were unable to account for what percentage of sexual encounters are considered Duty Sex. Therefore, our measurement of Duty Sex lacks specificity, which may explain the relatively low variance accounted for by the models in our analyses. There are consequences of NSEs, including difficulties with communicating sexual boundaries and impairment of sexual function, that may contribute to the increased likelihood of engaging in Duty Sex.

Examining the validity of an adaptive model of sustaining behaviors in long-distance relationships: Predicting intimacy and marital satisfaction

Long-distance romantic relationships present unique challenges, necessitating couples to employ adaptive strategies to maintain intimacy and marital satisfaction. This study aimed to examine the validity of an adaptive model of sustaining behaviors in long-distance relationships and its capacity to predict marital intimacy and satisfaction. The model included mindfulness, sexual function, religious, and online social support domains. Data were collected online from 366 couples (aged 18 to 57; Mean = 34.82, SD = 7.34; 79.8 % female) engaged in long-distance relationships. A confirmatory factor analysis confirmed the acceptable fit of the four-factor model which was also invariant across gender groups. The results indicated significant associations between sustaining behaviors and marital intimacy and satisfaction, with varying predictive power among specific components. Notably, relationship/sexual mindfulness and marital sanction/religious communication within the religion domain emerged as robust predictors. Conversely, religious practice showed a significant negative association. Additionally, the realization component of the sexual function domain significantly predicted both marital satisfaction and intimacy, while its partnership component significantly predicted only marital intimacy. None of the social support components significantly predicted marital intimacy or satisfaction. These findings are important as they highlight the nuanced interplay between sustaining behaviors and relational well-being in long-distance relationships, emphasizing the need for tailored interventions to enhance relationship quality in this context.

Female sexual function and distress and time-to-pregnancy in a prospective preconception cohort

BackgroundFertility success among mixed-sex couples often depends on frequency and timing of sexual intercourse, yet little research has evaluated the association between preconception sexual function and time-to-pregnancy (TTP). Objective(s): To evaluate the effects of female sexual dysfunction, distress related to sexual functioning, and painful intercourse on TTP. Study DesignWe followed 2,500 participants from Pregnancy Study Online (PRESTO), a prospective cohort study of self-identified females attempting pregnancy without the use of fertility treatments. Participants enrolled between 2021 and 2024. Thirty days after enrollment, participants completed a supplemental questionnaire that contained questions about sexual health, including a modified version of the 6-item Female Sexual Function Index (score range 2-30, score ≤19 defined as sexual dysfunction) and the Female Sexual Distress Scale (score range 0-48, score ≥20 defined as clinically-relevant distress), which assess experiences in the previous 4 weeks. Participants completed the supplemental questionnaire no later than 6 months after initiating conception attempts. We estimated TTP based on self-reported pregnancy status on follow-up questionnaires completed every 8 weeks for up to 12 months. We used proportional probabilities regression to calculate fecundability ratios (FRs) and 95% confidence intervals (CIs) relating exposure measures with TTP, adjusting for a range of pre-specified confounders. As an exploratory analysis, we evaluated individual domains of sexual function (i.e., interest, arousal, orgasm, lubrication, and satisfaction) in relation to TTP. ResultsThe study population was primarily non-Hispanic White, high income, with college or graduate education. Exposure prevalence was 20.1% for female sexual dysfunction, 8.8% for distress, and 29.6% for any pain with intercourse. We observed no association between FSD and TTP (adjusted FR 1.00, 95% CI 0.890, 1.13) when FSD was defined using a clinically-validated cut point, but observed that those in the first, second, and third quartile of scores had delayed conception compared to those in the fourth (highest function) (adjusted FRs 0.90, 95% CI 0.76, 1.06; 0.88, 95% CI 0.75, 1.04; and 0.90, 95% CI 0.77, 1.04, respectively). We found 18% reduced fecundability among those with sexual distress as defined by a clinically-validated cut point compared to those without (adjusted FR 0.82, 95% CI 0.69, 0.98). Participants reporting painful intercourse most or all the time had a longer TTP than those reporting no pain (adjusted FR 0.81, 95% CI 0.62, 1.06). In exploratory analyses, lower function in orgasm and lubrication domains, but not interest, desire, and arousal, were associated with longer TTP. Conclusion(s)Preconception sexual dysfunction, specifically distress and frequent painful intercourse, was associated with delayed conception. Preconception clinical assessment of sexual function, including discussion of individual domains of sexual function, may elucidate important modifiable issues.

From diagnosis to survivorship addressing the sexuality of women during cancer.

For women diagnosed with cancer, side effects affecting their sexuality are extremely common and can be distressing and life-changing; however, most women are left in the dark without any guidance from their oncology teams regarding possible side effects and treatment options. American Society of Clinical Oncology clinical guidelines provide guidance on the recommended assessments related to the domains of sexual function and their respective interventions. Despite the existence of these guidelines, the reality is that only a few women with cancer are asked about sexual concerns that result from cancer treatments. Common barriers to sexuality discussion reported by oncology providers include a lack of qualification and knowledge, not having a place to refer patients, and not knowing how to start the conversation. Social media remains a widely untapped resource regarding sexuality and cancer interventions, as people are increasingly turning to social media for health information and advice. This may be especially relevant for sexuality, as oncologists may not feel comfortable or well-trained to discuss the topic, and patients may be reluctant to bring up sexual concerns during their visits. Social media can play a critical role in studying sexual health and in sexuality interventions, particularly in adolescent and young adult patients with cancer. Here, we discuss the lack of inclusion regarding sexuality in oncology, the rates of sexual dysfunction in patients with cancer, treatment options for common sexual concerns, how to utilize the reach of various social media channels, and provide patient and provider resources.

Adulthood cosmetic and sexual outcomes of the patients who underwent hypospadias repair in childhood.

This study aimed to assess the cosmetic and sexual outcomes of childhood hypospadias repair after puberty. Among 672 patients who underwent hypospadias repair between 2001 and 2017, 243 sexually active patients were included in the study. At their last visit, cosmetic and sexual evaluation were done through the Penile Perception Score, the Hypospadias Objective Scoring Evaluation, IIEF, MSHQ-EjD. The levels of erectile dysfunction(ED) severity were determined according to erectile function domain of IIEF. The median follow-up after the last surgery was 16 [IQR (13-18)] years, and median patient age at the time of study was 19.67 [IQR(18-22)] years. Patients were divided into two subgroups as follows: Group I; Repairs using grafts (n = 120, 49.4%) and Group II; Graft-free repairs (n = 123, 50.6%). The rate of dissatisfaction with penile appearance was higher in Group I (16.7% vs. 4.9%, p = 0.003). Mild ED was more frequent in Group I (14.2% vs. 3.3%, p = 0.007); while none of the patients had either moderate or severe ED. Other domains of sexual function were observed to be similar in both groups. The need for unwanted interventions due to complications, and surgeries requiring grafts were found to be risk factors for ED development and dissatisfaction with penile appearance in adulthood. Those who underwent graft-free hypospadias repair experience better cosmetic and sexual outcomes when compared to grafted repairs, yet, satisfactory results were achieved in almost 90% of the grafted repairs.

Sexual function, health functionality, and quality of life in females with pulmonary arterial hypertension: a cross-sectional study.

Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life. The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH. A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey. Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant. A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life. The data reinforce the need for rehabilitation programs and social support for this population. This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse. We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life.

Female sexual dysfunction and distress in premenopausal women with migraine followed in a tertiary headache center: A pilot study

BackgroundFemale sexual dysfunction (FSD) is an underdiagnosed and undertreated problem. Few studies have addressed sexual distress in migraine. We aimed to perform a pilot study to determine if there is an association between migraine and sexual dysfunction/distress in premenopausal women and to identify their respective risk factors. MethodsRetrospective, cross-sectional pilot study, including 71 premenopausal female patients with migraine, from the headache outpatient clinic of a tertiary hospital, and 34 age-matched-controls. Female Sexual Function Index-6 (FSFI-6), Female Sexual Distress Scale-Revised (FSDS-R), Migraine Disability Assessment (MIDAS) Scale, Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and Sleep Health Scale (RU-SATED) were applied. ResultsOf the 71 patients [40.0 (IQR = 11.00) years], only 12.7 % (n = 9) were not under migraine prophylactic treatment, and most (n = 33, 62.3 %) reported severe disability (MIDAS-IV). FSD and sexual distress were present in 50.7 % (36) patients with migraine [vs 20.6 % (7) controls]. Migraine patients showed lower FSFI-6 scores [19.0 (9.0) vs 24.0 (6.0), p = 0.005], with significantly lower levels of desire (p = 0.011), lubrication (p = 0.002), and satisfaction (p = 0.013), higher sexual distress [11.2 (25.6) vs 3.2 (9.6), p = 0.001], anxiety (p < 0.001), and depression (p < 0.001) levels, and lower sleep health scores (p = 0.005). Old age of onset, being under preventive medication, anxiety/depression, and dysfunctional sleep, were significantly associated with sexual distress. Certain domains of sexual function were associated with sociodemographic and migraine characteristics, anxiety, depression, and sleep health. ConclusionsThis pilot study highlights the possible association between migraine and elevated sexual dysfunction/distress levels among premenopausal women. It underscores the importance of sexual health assessments in these individuals, particularly those with higher levels of anxiety, depression, or poor sleep quality. It is important to exercise caution when interpreting results, as they may not be applicable to a wider context. This research paves the way for a larger study that will include a broader population of women from the community and encompass patients followed in different levels of health care.

Female Sexual Function following Pelvic Organ Prolapse Reconstruction: A Case Serial Study

Background: Pelvic organ prolapse (POP) may reduce women's quality of life and is one of the most important aspects in the occurrence of sexual dysfunction. Objective: This study aimed to assess sexual function in POP women with pelvic floor dysfunction pre and post-surgery. Methods: This study was a prospective cohort study. Using the total sampling technique at Arifin Achmad Hospital, Indonesia, the study recruited women who underwent POP surgery with active sexual function from July 2020 to December 2021. The pelvic floor disorder was evaluated through Pelvic Floor Distress Inventory (PFDI) questionnaires validated in the Indonesian language, pre, and post-surgery. The assessment of sexual function was carried out using the Indonesian linguistic validation of the Female Sexual Function Index (FSFI) questionnaires before and after surgery. Results: There was a decrease in the average value of pelvic floor disorder scores before and six months after surgery (P&lt; 0.05). However, the sexual function increased with a cut-off score of FSFI &gt; 20.25 at 3 and 6 months post-surgery, respectively as much as 61.1% (11/18 subjects) and 72.2% (13/18 subjects), compared to the pre-surgery sexual function scores by 7.8% (5/18 subjects). Out of the 6 domains of sexual function, an increase was found in the sexual arousal domain (P&lt;0.05). Conclusion: There is a decrease in pelvic floor disorder and an increase in sexual function, particularly an increment in sexual arousal at six months post-surgery.

Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women

BackgroundPsychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them. MethodsIn a cross–sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress. ResultsAcross the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms. DiscussionOverall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems.

The association between female sexual function and metabolic features of the polycystic ovary syndrome in Turkish women of reproductive age

Objective To investigate the association between female sexual function and metabolic features among women with polycystic ovary syndrome (PCOS) during reproductive age. Method This was a cross-sectional study in which 288 women with PCOS and 180 women without PCOS between the ages of 20 and 40 years were evaluated. All women had serum total testosterone, androstenedione, DHEA-S, fasting glucose, total cholesterol, HDL-C, LDL-C, and triglyceride levels analyzed. The McCoy Female Sexual Questionnaire (MFSQ) was applied to all studied women. Exploratory factor analysis and reliability analysis were done after data collection. The factor loadings of MFSQ domains were compared between women with PCOS and controls. Results Average factor loadings of the MFSQ sexuality domain and MFSQ sexual partner domain were significantly lower in the PCOS group when compared to controls. There was no correlation between the two sexual function domains of the MFSQ and the PCOS features either in the PCOS group or the controls. Conclusion PCOS is a heterogeneous disease with different metabolic components, such as insulin resistance, obesity, and hyperandrogenism. Although sexual function among women with PCOS was lower than controls, no differences were found in metabolic features of the PCOS and non-PCOS groups with relation to sexual function determined by the MFSQ.

Polycystic ovarian syndrome elevates the distress of sexual pain in Iranian women with infertility

BackgroundSexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility.MethodsThe Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS).ResultsThere were negative correlations between sexual function domains and sexual distress (P < .001) in the total sample. Moderation analysis revealed that higher levels of impaired desire, arousal, and pain elevated sexual distress in the PCOS group. After adjusting for depression and anxiety, only the association between sexual pain and sexual distress was moderated by PCOS condition (P = .008).ConclusionsThe findings suggest that impaired sexual function is associated with increased levels of sexual distress in infertile female patients. Importantly, comorbid PCOS renders patients susceptible to sexual distress where sexual pain is increased. Further research may shed light on the physiological, psychological, and relational aspects of sexual pain and associated distress in infertile female patients with comorbid PCOS.

Factors associated with self-rated health in people with late-stage parkinson’s and cognitive impairment

PurposeTo investigate the contributors to self-rated health in people with late-stage Parkinson’s disease (PD) and cognitive impairment.MethodsA secondary analysis of baseline data from the international Care of Late-Stage Parkinsonism (CLaSP) cohort study was conducted. Participants with PD and either dementia or mild cognitive impairment or MMSE < 24/30 in the absence of major depression were included if they had completed the EQ-5D-3L assessment (n = 277). Factors associated with self-rated health (EQ-5D-3L Index and Visual Analogue Scale) were investigated through multivariable linear regression.ResultsMore severe PD (motor and non-motor) was associated with worse self-rated health. The EQ-5D-3L dimensions of Mobility, Self-Care and Usual Activities were almost universally affected; the latter two particularly severely. Being unable to perform usual activities or having moderate to extreme anxiety or depression were significantly associated with EQ-5D-3L Visual Analogue Scale, suggesting these are particularly valued. Worse motor impairment and function and the non-motor symptom domains of mood, perception, sexual function, and miscellaneous (e.g., pain) were associated with worse self-rated health, whereas greater burden of gastrointestinal symptoms was associated with better self-rated health in multivariate analysis. Better self-rated health was associated with recent PD nurse consultation, and higher doses of dopaminergic medication.ConclusionImprovement of activities of daily living, mood and anxiety should be prioritised in clinical practice, with consideration of perception and sexual function in this population. Recent nurse consultations and higher antiparkinsonian doses are associated with better self-rated health, suggesting there is no room for a therapeutic nihilism in this population of people within a complex phase of PD.

(071) IMPROVING TRAINEE COMFORT IN ASSESSMENT AND MANAGEMENT OF FEMALE SEXUAL HEALTH AND MENOPAUSE THROUGH AN INTERACTIVE WORKSHOP

Abstract Introduction Concerns related to female sexual health and menopause are common in clinical practice, but these topics are often inadequately covered during training. Many medical schools and residency programs lack a formal curriculum, and trainees in internal medicine, family medicine, and obstetrics and gynecology often graduate feeling uncertain in their management of these conditions. Objective Improve resident comfort with assessment and management of female sexual health and menopause through an interactive workshop. Methods We created a 90-minute, interactive workshop focused on female sexual health and menopause. Residents in internal medicine at a large academic medical center were invited to participate. A multidisciplinary group including physicians, advanced practice providers, registered nurses and a certified sex therapist were recruited to lead the workshop. Results Participants rotate through three 30-minute sessions targeted to learning objectives. One session focuses on conducting a symptom-based pelvic exam. A 3-dimensional model is used to review the anatomy of the female pelvic floor and demonstrate physical exam techniques to evaluate vaginal and vulvar symptoms, pelvic pain, and dyspareunia. Diagnostic skills include vulvar inspection to assess for skin and mucosal changes, cotton swab test of the vestibule, and assessment of pelvic floor musculature. A second session focuses on the genitourinary syndrome of menopause (GSM). The pathophysiology, presentation and treatment of GSM is introduced. Next, registered nurses with expertise in female sexual health and menopause lead an interactive demonstration of vaginal moisturizers and lubricants. Advice for counseling patients on the proper use and application of vaginal estrogens is also reviewed. The final session focuses on sexual health counseling, including sexual history-taking skills. Participants are taught about the domains of sexual function, female sexual response cycle, types of desire, patient resources, and sexual aids. Feedback following the initial iteration of this workshop was very positive. All participants felt that the experience was an effective use of time, would recommend it to others, and were confident in their ability to apply skills to their clinical practice. Conclusions This interactive workshop led by a multidisciplinary group of providers aims to improve trainee comfort in evaluation and management of female sexual health and menopause. Given the commonplace nature of these topics in primary care and paucity of existing curricula, consideration could be given to the inclusion of a similar educational experience into internal medicine, family medicine and/or obstetrics and gynecology residency programs. Disclosure No.

Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial.

Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177.

Sexual Dysfunction with Risperidone in Male and Female Patients of Schizophrenia

Background: Sexual side-effects due to use of Antipsychotic drugs have become one of the most important determinants of treatment compliance. Studies regarding sexual side-effects associated with antipsychotics comprise only a handful in the Indian population, especially so in this north-eastern part of the country. Aims and Objectives 1. To assess the sexual dysfunction associated with Risperidone in male and female patients of Schizophrenia. 2. To compare the sexual dysfunction associated with Risperidone between male and female patients of Schizophrenia. Materials and Methods: This was a hospital based comparative study conducted on 50 clinically stable male and female patients of Schizophrenia on Risperidone only. A Sexual Functioning Questionnaire (SFQ) was administered after assessing the clinical stabilities with the Brief Psychiatric Rating Scale (BPRS). Sexual dysfunction was assessed by calculating the mean scores on all the domains of sexual functioning in SFQ which were then compared across the study groups using the Chi square test . The results were analysed using SPSS Version 16.0 setting the significance threshold at p &lt;0.05. Results: From this study, we inferred that with Risperidone, impairment is seen in desire disorders (12%), arousal disorders (14%), orgasmic difficulties (26%) and overall sexual dysfunction (20%) although not statistically significant. It was also found that in females, Risperidone caused more desire disorders, more arousal disorders and a more overall sexual dysfunction; whereas in case of males, Risperidone caused more arousal disorders, more orgasmic difficulties, more sex related pain problems and a more overall sexual dysfunction; Conclusion: Sexual dysfunction is an important side-effect of Antipsychotic drugs. So clinicians should try to address these side-effects to help patients’ attain a better compliance.

Pelvic floor disorders and impact on sexual function: a cross-sectional study among non-sexually active and sexually active women.

Pelvic floor disorders are common and associated with impaired sexual function in women. To assess women with pelvic floor disorders and describe factors associated with not being sexually active and those associated with sexual function in sexually active women. A cross-sectional study was conducted that included nonpregnant women with symptoms of pelvic floor disorders who were referred to the urogynecologic and surgical outpatient clinic at 2 Norwegian university hospitals: St Olavs Hospital, Trondheim University Hospital, and the University Hospital of Northern Norway, Tromsø. Women answered a questionnaire anonymously. Pelvic Organ Prolapse Incontinence Sexual Questionnaire-IUGA Revised. Of 157 respondents, 111 (71%) reported being sexually active (with or without a partner), and 46 (29%) reported not being sexually active. As compared with sexually active women, not sexually active women were older (mean ± SD, 60.2 ± 13.3 vs 51 ± 12.1 years; P < .001), more were menopausal (78% vs 47%, P = .001), and more had symptom debut <1year (31% vs 9%, P < .001). They reported more distress related to pelvic floor disorders, especially pelvic organ prolapse. In a multivariate logistic regression analysis, menopausal women and women with symptom debut <1year were 4 times more likely to be not sexually active than premenopausal women (odds ratio, 4.0; 95% CI, 1.7-9.2) and women with symptom debut ≥1year (odds ratio, 4.0; 95% CI, 1.5-10.7). In sexually active women, colorectal-anal distress was negatively associated with 5 of 6 domains of sexual function: arousal/orgasm (ß = -0.36; 95% CI, -0.02 to -0.005), partner related (ß = -0.28; 95% CI, -0.01 to -0.002), condition specific (ß = -0.39; 95% CI, -0.002 to -0.009), global quality (ß = -0.23; 95% CI, -0.02 to -0.002), and condition impact (ß = -0.34; 95% CI, -0.02 to -0.006). Health care professionals should discuss sexual function in patients with pelvic floor disorders, especially menopausal women and women with colorectal-anal symptoms. The study used condition-specific measures and recruited women from 2 university hospitals with wide range of age. Limitations include the small sample size and wide confidence intervals. The number of women who considered themselves not sexually active was low, and item nonresponse levels among these women where somewhat high. Of 625 eligible women, 200 (32%) answered the questionnaire. Sexual health and sexual function are still surrounded with taboo, and some women were probably not comfortable answering the questions. Menopausal women and women with recent onset of symptoms of pelvic floor disorders are more likely to be sexually inactive, and colorectal-anal symptoms have the most negative impact on sexual function in sexually active women.

A study of sexual dysfunction in females having major depressive disorder

Introduction: Major depressive disorder has the highest lifetime prevalence of any psychiatric disorder and negatively impacts sexual functioning in many patients. Females hesitate to discuss sexual problems due to cultural barriers. So sexual dysfunctions are under-reported and under-studied. Method: This is a cross-sectional study to evaluate the pattern of sexual dysfunction in 18 to 40-year-old married females having major depressive disorder attending psychiatry OPD in a tertiary care hospital in Delhi, India. The severity of depression was assessed by the Hamilton Depression Rating Scale (HAM-D), and sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX) and Female Sexual Function Index (FSFI) scales. Data was analysed using SPSS. Mean and standard deviation (±SD) were used to describe quantitative data meeting normal distribution. As appropriate, the chi-square or Fisher’s exact test was used to compare categorical data amongst independent groups. Results: 64% and 56% of participants in drug naïve and on-treatment groups respectively had sexual dysfunction as per ASEX scale as compared to 10% of controls. As per the FSFI scale, 84% and 76% of participants of drug naïve and on-treatment groups had sexual dysfunction compared to 20% of the control group. Of all domains of sexual functioning, domains of desire, arousal, and orgasm were most commonly affected. Conclusion: This study showed a high prevalence of sexual dysfunction in depressed females emphasizing the need for direct inquiry about sexual problems by the treatment provider and appropriate management for the benefit of patients.

Impact of sexual function domains on sexual satisfaction and quality of life: Importance across the age spectrum.

Sexual satisfaction is an important component of global quality life for many adult men. Substantial gaps exist in our appreciation of how age mediates sexual satisfaction in the context of functional sexual measures. We sought to evaluate modifiable factors associated with overall sexual satisfaction and health-related quality of life (HRQoL) in a large, age-stratified community-based sample of adult men. A sample of adult males registered with the online research service ResearchMatch completed a 75-item online questionnaire in this cross-sectional study. Queries included demographics, general health data, and validated sexual health measures including International Index of Erectile Function-5 (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT). Multivariable regression was performed to assess associations with self-reported sexual satisfaction (defined by "moderately satisfied" or "very satisfied" on the 5-level Likert scale) and overall HRQoL (as measured by the EQ-5D-visual analog scale (VAS) stratified by age. One thousand thirty-three men completed the survey and were stratified by age cohorts. IIEF-5 and PEDT scores were higher in younger cohorts. On multivariable regression analysis, higher IIEF-5, lower PEDT, better overall health-related quality of life, and the presence of a sexual partner within the last month were associated with an increased likelihood of overall sexual satisfaction. When stratified by age cohort, higher IIEF-5 scores were consistently positively associated with sexual satisfaction (Odds Ratio (OR) 1.18, 95% CI 1.15-1.22, P < 0.001), as well as independently associated with improved overall HRQoL by EQ-5D-VAS (β = 0.71, Standard Error (SE) = 0.08, P < 0.001). The erectile function was independently associated with sexual satisfaction and quality of life across all age strata and predictive of both sexual satisfaction and global HRQoL. Low overall rates of sexual satisfaction across cohorts highlight the critical importance of evaluation and treatment of sexual health, regardless of age.

Atypical Antipsychotics and Sexual Functions in Schizophrenia: A Cross-sectional Study

Abstract Background: Antipsychotics are associated with sexual dysfunction. However, studies selectively exploring the sexual impact of atypical antipsychotics in a standardized male population are limited, and further more in the Indian context. Thus, a need was felt to understand, explore and assess the impact of atypical antipsychotics on sexual wellness in a standardized male population suffering from Schizophrenia. Objective: To study the effect of Atypical Antipsychotics on Sexual functions in sexually active male patients of Schizophrenia treated with Atypical Antipsychotics. Materials and Methods: 150 sexually active freshly diagnosed treatment naïve males with Schizophrenia were administered atypical antipsychotics. Their sexual functions were assessed after 1 month using Arizona Sexual Experience Questionnaire (ASEX). Results: Olanzapine, risperidone, and clozapine had maximum incidence of sexual dysfunction (SD) while quetiapine and aripiprazole were having the least. 54% had one or more SD, prominent ones being low sexual desire (54%), dissatisfaction with their sexual drive (41.3%), dissatisfaction with orgasm (39.3%) and inability to reach orgasm (32%). Conclusion: SD rates are higher among patients of Schizophrenia treated with Atypical Antipsychotics. All the domains of sexual functioning are affected. Clinicians should routinely assess the sexual functioning in patients on treatment with antipsychotics and should incorporate sexual health as a dimension in their treatment plan.

Repercussions of perineal repair using surgical glue or suture thread on postpartum outcomes: A controlled randomized clinical trial in São Paulo, Brazil.

The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth. A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out. A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH2O and 27.4 cmH2O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance. Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.