Female Sexual Function Index Domains Research Articles

A multicentre cross-sectional clinical study on female sexual dysfunction in postmenopausal Chinese women

ObjectiveThe aim of this study was to investigate the factors affecting the sex lives of postmenopausal Chinese women, especially the influence of body weight, climacteric symptoms and androgens. MethodsA total of 437 postmenopausal women were investigated in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University and two allied medical institutions from April 2020 to March 2021. Sociodemographic data were collected. Female sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI). The modified Kupperman index was used to assess climacteric symptoms. Methods based on liquid chromatography-tandem mass spectrometry were employed to measure the serum levels of total testosterone, bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone. Pearson's correlation coefficient and multiple linear regression analyses were performed to determine the correlation between characteristics and FSFI scores. ResultsThe multivariate linear regression analysis revealed that the modified Kupperman index score and the factor unsatisfactory marital relations had the strongest negative correlations with all FSFI domains (P < 0.05); secondary education level was negatively associated with desire, arousal and orgasm (P < 0.05). Total testosterone positively affected the score for pain (P < 0.05). There was no correlation between bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone and all FSFI domains (P > 0.05). ConclusionClimacteric symptoms and sociodemographic factors had a notable effect on sexual function. It is necessary to provide more attention to and intervention for their climacteric symptoms to improve the quality of life of postmenopausal women.

The effect of solifenacin treatment for urge urinary incontinence on sexual function in premenopausal and postmenopausal women: a prospective observational study

Purpose: The aim of this study is to determine whether solifenacin used for urge urinary incontinence improves sexual function and if so this improvement differs between premenopausal and postmenopausal women.&#x0D; Materials and Methods: 120 women, 48 premenopausal and 72 postmenopausal were enrolled in the study. They filled out the Female Sexual Function Index (FSFI) before, three months, and six months after the solifenacin 5mg daily treatment for urge urinary incontinence. The results were interpreted in two groups, premenopausal and postmenopausal. The FSFI scores for baseline and for post-treatment were compared for both groups and with each other.&#x0D; Results: All domains of FSFI except orgasm were improved with the use of Solifenacin. The mean FSFI scores following three months (n=110) and six months (n=65) of solifenacin treatment are significantly improved compared to the baseline in both premenopausal and postmenopausal patients. This improvement in FSFI scores does not significantly differ between premenopausal and postmenopausal groups.&#x0D; Conclusion: Solifenacin treatment for lower urinary tract symptoms has been shown to have a positive impact on the sexual functions of both premenopausal and postmenopausal women. Although treatment with solifenacin improved sexual dysfunction in women, this improvement did not vary between premenopausal and postmenopausal women.

Evaluation of Sexual Dysfunction in Brazilian Women with Infertility Undergoing Assisted Reproduction Treatment

Purpose: The increase in infertility around the world has a negative impact on sexual desire and function. The objective of this study was to evaluate the presence of sexual dysfunction in women diagnosed with infertility, comparing them with healthy controls. Methods: This is a cross-sectional study based on online questionnaire. Infertile women and healthy controls filled a questionnaire about epidemiological and assisted reproduction data. The infertile patients answered the Female Sexual Function Index (FSFI) and the Short-Form Health Survey (SF-12) questionnaires to assess sexual performance, physical, and mental health. The control group answered only to the FSFI. Results: The survey was completed by 357 subjects: 157 infertility patients and 200 matched controls. All medians of the FSFI domains of patients in the infertility group are lower (p=0.036) when compared to controls, especially the scores in the arousal and lubrication domains (p=0.003 and p&lt;0.0001, respectively). In this group, most are in good physical health and half are in good mental health. The depression rate was 12.7%. Patients who have depression have worse FSFI scores (p=0.009). Depression and sexual dysfunction were experienced by 27.4% (n=17) patients (p&lt;0.0001). Worse mental health was related to patients at higher risk for sexual dysfunction (p&lt;0.0001). Conclusion: In our sample of women undergoing infertility treatment, we found that the FSFI scores were significantly lower than in the control group, mainly in the arousal and lubrication domains. Additionally, it was found that the worse the mental health, the greater the possibility of sexual dysfunction in this group.

Postmenopausal sexual function and steroid hormone levels: a hospital-based cross-sectional study

Objective Steroid hormone levels, particularly androgens, play an important role in sexual function in premenopausal women, but this relationship is not so well determined after menopause. This study aimed to assess the association between steroid hormone levels and sexual function in postmenopausal women. Methods A total of 84 postmenopausal women with intact ovaries, who had never used systemic hormone therapy, were enrolled in a cross-sectional study. Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire and serum levels of steroid hormones were quantified by gas chromatography and tandem mass spectrometry. Associations between estradiol, testosterone, dehydroepiandrosterone, androstenedione and FSFI domain scores were evaluated. Results After adjustment for confounding variables, the analysis revealed a statistically significant association between androstenedione and overall sexual function (β = 1.23, 95% confidence interval [CI] [0.37; 1.98], p = 0.010), arousal (β = 0.19, 95% CI [0.02; 0.37], p = 0.034), orgasm (β = 0.33, 95% CI [0.15; 0.45], p = 0.001) and satisfaction (β = 0.25, 95% CI [0.11; 0.36], p = 0.001). No associations were found between the other hormones and FSFI domains. Conclusion The main finding of this study is the association of androstenedione with sexual function in postmenopausal women, not verified for other steroid hormones. Further studies are necessary to determine the importance of androstenedione for postmenopausal sexual function.

Sexual dysfunction in women with interstitial cystitis/bladder pain syndrome: Do onabotulinum toxin-A injections improve sexual function?

Interstitial cystitis/bladder pain syndrome (IC/BPS) has a negative impact on female sexual function. We aimed to evaluate the effect of intravesical botulinum toxin-A (BTX-A) injection on the improvement of sexual dysfunction and urinary symptoms using the multi-domain female sexual function Index (FSFI), interstitial cystitis symptom index (ICSI), and interstitial cystitis problem index (ICPI). The data of the 23 patients (study group) who received intravesical BTX-A with the diagnosis of IC/BPS were reviewed. Twenty-three age-matched healthy, sexually active women were determined as the control group. Patients received 100 U BTX-A submucosally injections, including the trigone. One hundred units of BTX-A were diluted to 20 cc0.9% saline, and 1 cc was then applied submucosally on 20 different points of the bladder wall (5 U/1 mL per site). The study group was asked to fill out FSFI, ICSI,andICPI, as well as the visual analog scale (VAS) and bladder diary before and 3 months after the treatment. Patients in the control group completed the same questionnaires once. The pre- and post-treatment questionnaire scores were compared in the study group. The study group's data were also compared to the control group. Compared to the pretreatment period, the study group showed statistically significant improvement in the total FSFI score and each domain of the FSFI after BTX-A injection. The mean total FSFI score and three domains of FSFI (desire, lubrication, pain) reached to the score of the control group following BTX-A injection. Statistically significant improvements were also shown in scores of ICSI, ICPI, and VAS. (p < 0.05). IC/BPS is associated with a very high incidence of sexual dysfunction. Intravesical BTX-A injection may provide significant improvement in sexual dysfunction in women with IC/BPS.

Nursing counseling utilizing BETTER model on sexuality, marital satisfaction and quality of life among cervical cancer women

Background The most common sexual dysfunction problem for women with cervical cancer is decreased sexual desire. Aim The aim of the present study was to evaluate the effect of nursing counseling guided by BETTER model on sexuality, marital satisfaction, and quality of life among cervical cancer women. Design A quasi-experimental design was used. Patients and methods A purposive sample of 44 women with cervical cancer who attended the oncology outpatient clinic at Zagazig University Hospital and Elmabera Hospital in the Sharkia Governorate was recruited. Tools A structured interviewing questionnaire, Female Sexual Function Index (FSFI), and a short version of the Quality of Life Enjoyment and Satisfaction Questionnaire were used to gather data. Results The mean score of all female sexual function index domains was improved significantly (P&lt;0.001) after intervention as compared with before intervention. Moreover, following applying nursing counseling guided by the BETTER model compared with before intervention, there was a highly significant improvement (P=0.0001) in the quality of life enjoyment and satisfaction among study participants. Following the adoption of the nursing instructions, there was a positive association between the overall Female Sexual Function Index score and quality of life. Conclusion The quality of life and sexual function of women with cervical cancer have improved. Recommendation Implement a BETTER sexual counseling model to handle sexual dysfunction in oncology units. The availability of facilities and decision-making aids for individuals in need, as well as the promotion of women counseling activities about cervical cancer and sexuality, are all necessary.

Micro-Focused Ultrasound Therapy in Patients with Urogenital Atrophy and Vaginal Laxity

Vaginal laxity (VL) and genitourinary syndromes of menopause (GSM) create physical, psychological, and functional problem for women and their partners. We aimed to evaluate the efficacy and safety of micro-focused ultrasound (MFU) therapy performed twice in the vaginal canal in a patients with VL and GSM. A total of 20 women with GSM and VL were treated with MFU Ultravera by Hironic. The treatment course consisted of two vaginal applications of MFU at an interval of 6 weeks. The clinical effects of the protocol were evaluated using the Vaginal Laxity Questionnaire (VLQ), the Vaginal Health Index (VHI), and the Female Sexual Function Index (FSFI). The overall values of the vaginal laxity evaluation for the total subject population showed a statistically significant improvement between the baseline and the findings at 3 and 6 months after treatment. The effect of therapy was consistent across all domains of FSFI. It peaked at the 6 week follow-up visit (from 26.5 to 32) and plateaued at 12 weeks and 6 months. There was a significant VHI improvement over time, with the greatest and most significant change between the study entry and 21 days after treatment; the VHI score leveled off up to 3 months after the procedures. MFU therapy, performed twice in the vaginal canal, showed promising efficacy and safety profiles, meriting further investigation.

Probiotic effects on sexual function in women with polycystic ovary syndrome: a double blinded randomized controlled trial

BackgroundConsidering the presence of sexual dysfunction in patients with polycystic ovary syndrome, our aim was to provide scientific evidence studying effect of oral probiotic on sexual function in patients with PCOS treated with letrozole in an Iranian population.MethodsThis study was a double blind randomized clinical trial. Eligible women were allocated to Lactofem plus letrozole (n = 20) or letrozole (n = 20). Folic acid was prescribed to all participants in two groups during the study. In group A, Lactofem capsule was administered daily for the first month. In the second month, letrozole (2.5 mg daily from the third day of the menstrual cycle for 5 days) plus Lactofem capsule same as previous month were prescribed. In group B, letrozole administered 2.5 days from the third day of the menstrual cycle for 5 days in the second month. All questionnaires were completed by patients after the intervention (two months after the start of treatment). The Female Sexual Function Index (FSFI) and Body Image Concern Inventory (BICI) were used to assess sexual function and body satisfaction, respectively.ResultsThere is statistically significant increase in chemical pregnancy rate (10% vs. 0%; p = 0.05) and clinical pregnancy (10% vs. 0%; p = 0.05) in Probiotic plus letrozole group compared to letrozole group after intervention. Based on our results, there was a statistically significant difference in each domain and sum score of sexual function of before and after the intervention between group (P < 0.05). Our findings have been shown, after eight weeks, the probiotic plus letrozole group had a significant improvement in the FSFI domains and sum score compared to letrozole alone group. Moreover, there are a significant improvement in mean (IQR) of body image score in probiotic group [30 (4.99) vs. 40 (4.36); P < 0.01].ConclusionThe results of the current study suggests that eight weeks of administration of probiotic may improve chemical and clinical pregnancy rate, sexual function and body satisfaction in women with PCOS.

Female sexual function after repair of uterovaginal prolapse.

To evaluate the impact of repair of uterovaginal prolapse using sacrospinous hysteropexy on female sexual function. A cross-sectional study was conducted at the Urogynecology Clinic of the Suez Canal University Hospital from May 2014 to April 2019. Twenty-seven women with a diagnosis of uterovaginal prolapse and wishing to preserve their uteri were recruited. Sacrospinous ligament fixation was done. Sexual symptoms were assessed using the female sexual function index (FSFI) questionnaire just before and 6months after the operation. The mean age of the participants was 36.5 ± 4 years. Sacrospinous hysteropexy only was performed for three women. Additional procedures included anterior colporrhaphy (12), posterior colporrhaphy (9), and perineorrhaphy (15). There was a significant improvement in pre- and postoperative patients' orgasm (3.1 ± [0.8] vs. 3.7 ± [1.1]; p value=0.03) and satisfaction (3.4 ± [0.6] vs. 4.2 ± [0.8]; p value < 0.001) while there was worsening of pain (4.3 ± [1.5] vs. 3.2 ± [1.6]; p value=0.017). There was insignificant improvement in the other three domains as well as total score of FSFI, with all patients having sexual dysfunction. Sacrospinous hysteropexy was associated with significant improvement orgasm and satisfaction domains of FSFI and significant worsening of pain.

Effects of intrauterine devices on female sexual function: a cross-sectional study

Objectives: To examine the differences in sexual functions between women using copper intrauterine device (Cu-IUD) and levonorgestrel intrauterine system (LND-IUS). Methods: A total of 125 women between the ages of 20 and 40 were included in the study. The demographic data of all participants were recorded. Female Sexual Function Index (FSFI) was performed to all participants. Study participants were divided into 3 groups; 42 Cu-IUD users, 42 LND-IUS users, and 41 control (not use contraceptive) group, then compared. Women with a total score lower than ≤ 26.5 were considered as having sexual dysfunction. Results: The prevalence of female sexual dysfunction (FSD) was 56.8% among the participants. The total FSFI scores of Cu-IUD and LNG-IUS groups were similar. Moreover, the FSFI score of both IUD users was lower than the control group, and the difference was statistically significant (p &amp;lt; 0.001). The presence of Cu-IUD affected arousal more than pain, satisfaction, lubrication and orgasm scores (p = 0.016). Pain score was similar among IUD groups and significantly lower than controls (p &amp;lt; 0.001). Moreover, orgasm and satisfaction scores were found to be significantly higher in the control group than in the both IUD groups (p &amp;lt; 0.001). All of three groups were also similar about desire and lubrication domains of FSFI. Conclusions: In conclusion, this study found that Cu-IUD and LNG-IUS users did not differ in terms of sexual function according to scores calculated by FSFI.

Effect of date palm pollen supplementation on female sexual function in non-menopausal women: A double blind randomized clinical trial

ObjectiveDespite numerous experimental studies in the literature, there are few clinical trials regarding the effect of date palm pollen (DPP) supplementation on sexual function improvement. In the present study, we sought to evaluate the impact of DPP on female sexual function in Iranian non-menopausal women. MethodsBetween October 2019 and December 2019, health centers in the city of Khalkhal, volunteers meeting the inclusion criteria were recruited in randomized clinical trials. Sixty-eight women were randomly stratified and assigned to one of the two study groups: placebo group (n = 35) and palm pollen group (n = 35), and received a starch or palm pollen capsule (300 mg per day), respectively, for 35 d. The Female Sexual Function Index (FSFI) instrument was used to assess female sexual function. ResultsAfter DPP supplementation, the increase in desire, lubrication, and the overall score, was statistically significant compared to the placebo group (P = 0.002, P = 0.000, and P = 0.042; respectively); Whilst there was no significant differences in the remaining domains (arousal: P = 0.763; orgasm: P = 0.370; satisfaction: P = 0.474; pain: P = 0.259). There was a statistically significant positive correlation between the coitus and preintervention levels of desire (r = 0.298, P = 0.038), arousal (r = 0.328, P = 0.021), lubrication (r = 0.361, P = 0.011), orgasm (r = 0.320, P = 0.025), satisfaction (r = 0.327, P = 0.022), and overall scores (r = 0.338, P = 0.018). ConclusionThis study suggests that DPP (300 mg supplementation for 35 d), given to non-menopausal women, could improve the lubrication and desire domains of FSFI.

Clinical Presentation of Clitorodynia associated with Clitoral Adhesions and Keratin Pearls

ABSTRACT Introduction Clitoral adhesions occur when the clitoral prepuce adheres to the glans clitoris. This can lead to accumulation of desquamated epithelial cells under the prepuce, resulting in the formation of smegmatic pseudocysts and keratin pearls. A keratin pearl is a focus of central keratinization within concentric layers of squamous cells. Presence of these firm, millimeter-sized masses can lead to clitoral pain (similar to a grain of sand in the eye). Although keratin pearls have been described in the literature, there is little known about their clinical presentation or association with female sexual dysfunction (FSD). Objective Explore the clinical presentation of clitoral pain associated with clitoral adhesions and keratin pearls related to concomitant genitopelvic pain conditions and sexual dysfunction. Methods A retrospective chart review was conducted in two metropolitan gynecology clinics specializing in vulvar pain between January 2018 and September 2021. Patients presenting with clitoral pain (clitorodynia) were identified in the electronic medical record through a search of physician-entered diagnoses and confirmed by review of the clinical notes. Adult patients with documented clitoral pain as well as clitoral adhesions (clitoral phimosis) and keratin pearls noted on exam were included in the study. FSD was measured with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Data was presented in means and percentages. Results Forty-one patients met inclusion criteria. Average age at presentation was 35 years (range 19-73 years). Self-reported ethnicity of the study population was 73% White, 5% Hispanic, 5% Asian, 2% Black, with no response from 15% of participants. Vulvar lichen sclerosus was noted in 17% (7/41) of patients, with an average age of 46 years (range 24-73 years). Seventy-six percent (31/41) of patients also had the diagnosis of overactive (hypertonic) pelvic floor muscle dysfunction (PFD), 25% (8/31) had pudendal neuralgia and 10% (3/31) had interstitial cystitis/painful bladder syndrome. Forty-six percent (19/41) of patients had provoked vestibulodynia (PVD) associated with a hormonal factor (hormonal contraceptive use, postpartum/breastfeeding, perimenopause, or menopause). Recurrent vulvar candidiasis or tinea cruris was noted in 5% of patients. Four patients (10%) presented with clitoral pain alone and were not found to have other identified genitopelvic pain conditions. Baseline FSFI and FSDS-R data were available in 35 patients. Mean FSFI score was 13.25, with 91% of patients meeting criteria for FSD (total FSFI score &amp;lt; 26.55). Mean scores for FSFI domains were: desire (2.4), arousal (2.1), lubrication (2.5), orgasm (2.0), satisfaction (2.5), and pain (1.6). Mean FSDS-R score was 29.42, with 89% of patients meeting criteria for FSD (FSDS-R score ³11). Conclusions Clitoral pain associated with clitoral adhesions and keratin pearls occurs in women of all ages. Clitoral adhesions are not confined to patients with vulvar lichen sclerosus. A vast majority of patients with clitoral adhesions and keratin pearls have additional chronic vulvar pain conditions, most commonly overactive PFD, pudendal neuralgia, or hormonally-associated PVD. Clitoral pain with clitoral adhesions and keratin pearls is associated with FSD and sexual distress. Clitorodynia and clitoral phimosis should be identified in the clinical evaluation of genitopelvic pain. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Consultant for Good Clean Love and Mahana Therapeutics; part-time employee of Dare Bioscience. Received research funding from Dare Science, SST, Endoceutics, The Cellular Medicine Association, and Ipsen for other projects. He is a consultant for Ipsen, SST, and AMAG

Women's sexual function before and during COVID-19 pandemic: A systematic review and meta-analysis.

BackgroundTo systematically review and summarize the available literature regarding the women's sexual function during COVID‐19 pandemic and compare it to pre‐pandemic period.MethodsWe searched PubMed and Embase from the inception of the databases until 15th April 2021. Data regarding the sexual function, measured by female sexual function index (FSFI), of adult sexually active women were extracted from the eligible studies and compared between the before and during the COVID‐19 pandemic. The secondary outcome was the frequency of intercourse during pandemic time. The random‐effect model was used to pool the mean differences and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the I 2 value.ResultsOur search resulted in a sample of six eligible studies, which involved 1114 female participants. The total FSFI score among study participants during pandemic was 22.93 (95% CI: 19.26–26.59), which indicated a significant decrease in sexual function of women during pandemic as compared to pre‐pandemic time (mean difference = −3.80, 95% CI: −6.48 to −1.12, p = 0.005, I 2 = 96%). We also conducted a meta‐analysis of individual FSFI domains. During pandemic, women had problems with arousal (p < 0.0001), orgasm (p = 0.0008), satisfaction (p = 0.0009), and pain (p = 0.009). No significant difference in frequency of intercourse was observed between pre‐ and during pandemic (p = 0.80). Furthermore, no significant publication bias was present among included studies.ConclusionOverall, there was a significant decrease in sexual function of sexually active adult women during COVID‐19 pandemic. The most affected areas of sexual function were arousal, orgasm, pain, and satisfaction. Physicians must be aware of COVID‐19 impact on sexual life of women and provide proper counseling.

Can running influence women's sexual function?

Studies have shown that athletes have three times increased risk of urinary incontinence compared to non-athletes, in addition to anal incontinence and sexual dysfunction (SD). This study aimed to assess the sexual and pelvic floor muscle (PFM) functions and to compare these variables among female athlete runners with and without SD and to identify predictive factors that may be associated with sexual function among the athletes. Cross-sectional study including 90 female runners, who ran ≥ 20 km/week for at least 6 months, had had sexual intercourse in the last 4 weeks and were > 18 years old. PFM function was assessed by vaginal palpation and manometry. Women also answered the International Consultation on Incontinence Questionnaire-Short Form to investigate presence of urinary incontinence. Sexual function was assessed by Female Sexual Function Index (FSFI); total scores ≤ 26.5 were considered to indicate SD. The scores of each FSFI domain and the total score were compared individually between each predictor using simple linear regression. In addition, multiple linear regression analysis was performed. Athletes with SD presented lower PFM strength. The results of the multiple linear regression analysis among all the predictor variables, FSFI domains and total score show that the Modified Oxford Scale is a predictor for the desire, excitation, lubrication, orgasm, pain and total score domains. Female runners with lower PFM strength presented worse sexual function regardless of age, parity, BMI and running practice time.

Platelet-rich plasma: An effective modality to improve sexuality in FGM/C

Now, accepted treatments for Female Sexual Dysfunction (FSD) are limited to surgical, psychological, behavioral, hormonal and psychopharmacologic interventions. Because of the complex and multifactorial nature of FSD, current therapeutic options may leave a subset of women suffering with sexual dysfunction without clinical improvement and may be with side effects of the procedures. This is a study to evaluate the effect of platelet rich plasma (PRP) in treating FSD FGM/C. PRP was administered to the anterior vaginal wall (1 session), clitoris of 45 females with FGM/C and non-FGM/C with sexual dysfunction and orgasmic disorder [Female Sexual Function Index (FSFI) total score ≤ 26 orgasmic subdomain score ≤ 3.75]. The correlation between PRP sessions and FSFI domain scores was done with Pearson's correlation and linear regression analysis. Following the application of the PRP, the total FSFI score was converted significantly in both FGM/C and non-FGM/C ( P < 0.05). A significant change was observed in all sub-domains of FSFI score after PRP ( P < 0.05). The total FSFI score increased in all 45 females [16 non-FGM/C and 29 FGM/C] ( P < 0.05). That correlations between all sub-domains of FSFI score before and after PRP injection were significantly positive ( P < 0.05). Also, there were statistically significant positive correlations between total FSFI scores before and after PRP injection, and sociodemographic and obstetric characteristics of the study population in both FGM/C and non-FGM/C. As a minimally invasive method, PRP administration to the distal anterior vaginal wall may improve female sexuality with high satisfaction in FGM/C.

Female sexual function before and during the severe acute respiratory syndrome coronavirus-2 pandemic: a systematic review and Meta-analysis of longitudinal studies

Purpose To compare the female sexual function before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Female Sexual Function Index (FSFI). Methods Relevant studies were retrieved by online databases and manual searching reporting FSFI scores before and during the SARS-CoV-2 pandemic. The methodological quality of reviewed articles was evaluated using the Newcastle-Ottawa Scale, and heterogeneity with the I 2 statistic. The standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were calculated by random-effect meta-analyses. Results Four studies met the inclusion criteria reporting 1002 sexually active non-pregnant women comparing results of the 19-item FSFI. The meta-analysis of the overall FSFI score showed an SMD (95% CI) of −1.16 (−1.97 to −0.35), comparing the pandemic with the pre-pandemic scores. In addition, SMD scores for the FSFI domains were also significantly lower during the pandemic for arousal −0.80 (−1.13 to −0.48), orgasm −0.66 (−1.07 to −0.25), satisfaction −0.59 (−0.97 to −0.22), and pain −0.35 (−0.54 to −0.16), whereas there were not significant differences for desire and lubrication domains. There was a low risk of bias and the sensitivity analysis suggests that results are robust. Conclusion The available studies showed a lower overall FSFI score during the pandemic, suggesting an increased risk of female sexual dysfunction compared to prepandemic results. Also, there were increased risks of sexual arousal, orgasm, satisfaction, and pain disorders. However, there were no alterations in the desire and the lubrication domains. Limitations are related to the heterogeneity populations, and pandemic confounding and aggravating factors.

A cross sectional study on female sexual function following pelvic radiotherapy.

e24051 Background: Pelvic radiotherapy (PRT) is an integral part of treatment in many pelvic cancers. PRT is associated with multiple organic changes in the genital area that have the potential to negatively impact female sexuality and quality of life. Fear of cancer transmission and stigma associated can result in lack of sexual activity and many women get abandoned by their partners. Often this topic is neglected and limited studies are available assessing female sexual function (FSF) especially from Indian subcontinent. This study was an attempt to assess the FSF in patients who had received PRT as part of their curative treatment for pelvic malignancy. Methods: This was an observational cross-sectional study conducted in January 2022. Study included female patients who received RT for pelvic malignancy. Patients with a minimum of 6 months follow up after RT with clinical complete response, sexually active before start of treatment &amp; living with their partners at time of study were included. Demographic profile was collected from treatment records. Socioeconomic status calculated using updated B J Prasad’s scale. Female Sexual Function Index (FSFI) questionnaire was used with score ≤ 26 indicating female sexual dysfunction (FSD). Questionnaire was filled by patients under supervision of a trained staff. 6 domains of sexual function i.e. desire, arousal, lubrication, orgasm satisfaction &amp; pain were studied. Patients reporting zero score in any of the domain indicating no sexual activity in the last 4 weeks were also included. Results: 38 eligible patients with age range from 34-69 years, mean age 51 years, 37% patients were &gt; 60 years. All were house wives, 40% illiterate, 50% high school &amp; below, 10% were above high school. 70% were from rural area. 13% belonged to upper class, 35% upper middle &amp; middle class, 52% to lower middle and lower class. Commonest diagnosis was carcinoma cervix (86%) followed by endometrium (10%) &amp; anorectum (4%). All patients with carcinoma cervix received radical chemoRT. Patients with Ca Endometrium were postoperative. 92% of all patients received pelvic EBRT &amp; 3% only vault brachytherapy. The mean duration from completion of RT was 17 months (range 6 – 41 months). FSD was found in 89%. Age wise mean scores in six domains of FSFI &amp; overall score is illustrated in the table. 0 score in at least one of the domain was reported by 65% patients. Conclusions: Study showed a very high incidence of FSD among pelvic cancer survivors after RT. Since there are limited data in this domain from Indian patients, this can become baseline data for further studies. Our data is limited by lack of comparison of FSD from age adjusted healthy females of this region.[Table: see text]

Physical activity and female sexual dysfunction: A lot helps, but not too much

ABSTRACT Introduction Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Objective To investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (&amp;lt;1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, &amp;gt;6 hours/week: extremely active) were investigated with a specific question. FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Uneasiness Test (BUT), and Middlesex Hospital Questionnaire (MHQ). Results Mean age was 45.1±12.9, mean body mass index was 25.24±6.34 kg/m2 and 46.3% (n=149) of women were post-menopausal. At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several FSFI domains - including desire, arousal and lubrication (see Table 1) - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed (see Table 1). In the same adjusted model, the association between PA and the vascular resistance of clitoral arteries, expressed by clitoral PI, retained statistical significance. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (BUT Global severity index), psychopathological symptoms (MHQ total score) and sexual distress (FSDS-R score). These latter two factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction – see Figure 1) and histrionic/hysterical symptoms), even compared to a sedentary lifestyle. Conclusions In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Women consulting for FSD may gain benefits from regular PA; however, physicians should remain alert to the downsides of excessive exercise. Disclosure Work supported by industry: no.

The burden of female sexual dysfunction in Basrah-Iraq: The first preliminary report

ABSTRACT Introduction Help-seeking behavior in women with female sexual dysfunction (FSD) from conservative communities is affected by cultural and religious factors. Objective To evaluate psychosexual, social, physical, and biochemical factors which impact FSD in premenopausal women from Basrah. Methods This was a cross-sectional observational study in a tertiary endocrine center on 673 reproductive-aged premenopausal women with sexually-related complaints for more than 6 months during (Sep 2018-Jan 2021). Relevant history and examination were done in the initial visit using non-judgmental patient-centered integrative approach, with ubiquity statement followed by a closed-ended question, and then an open-ended follow-up. FSD diagnosis was done (n=219). A couple-interview session was scheduled, involved intimacy assessment through series of questions, then we used Female Sexual Function Index (FSFI) and Decreased Sexual Desire Screener (DSDS), to diagnose generalized and secondary acquired hypoactive sexual desire disorder (HSDD), and related sexual disorder. The gonadotropins, androgens, thyroid, adrenal, ovarian, and pituitary function, along with insulin resistance, glycemic and lipid level were assessed. The final number of the women in the study was 166 women. We used Pearson's correlational analysis to confirm the significance correlations between FSD and different parameters. We used Mann-Whitney U test in subgroup analysis HSDD subtypes. Results FSD prevalence was 24.67% with mean duration (8±2 months). Intercourse frequency prior to complaint onset (3±1 times weekly), compared to (2±1 times monthly) in the latest month before consultation. All FSFI domains scores were reduced. DSDS diagnosed generalized and secondary acquired-HSDD in 31 and 57 women, respectively. Hormonal investigation did not aid FSD diagnosis. Pearson's correlational analysis did not show any significant correlation between the test variables and FSD. Conclusions No significant correlation between FSD and any psychosexual, physical, and biochemical parameter could be seen. Longitudinal multicenter larger scale studies are needed. Disclosure Work supported by industry: no.

Efficacy of intradermal hyaluronic acid plus polynucleotides in vulvovaginal atrophy: a pilot study

Objective This study aimed to evaluate the safety and efficacy of vulvovaginal intradermal injections of polynucleotides (PN) combined with hyaluronic acid (HA) in postmenopausal women affected by vulvovaginal atrophy (VVA). Materials and methods Postmenopausal women affected by VVA were treated with vulvar and vaginal intradermal injections of one prefilled syringe of 2 ml PN/HA every 2 weeks for four sessions. Patients were evaluated at T0 (baseline), T1 (after session 4) and T2 (1 month after session 4). Evaluation of the treatment was assessed by three international validated questionnaires: Vaginal Health Index (VHI), Vulvar Health Index (VuHI) and Female Sexual Function Index (FSFI). The Wilcoxon matched-paired signed-rank test was used to compare the differences in VHI, VuHI, FSFI and FSFI domains within the groups. Statistical significance was set at p < 0.05. Results Fifty patients were included in the study (mean age 59.9 ± 7.6 years). Overall, the VHI, VuHI and FSFI reported statistically significant differences between baseline and T1 (p < 0.001) and between baseline and T2 (p < 0.001). All FSFI domains registered a statistically significant increase between baseline and T2 (p < 0.001). No complications or side effects were observed. Conclusions Vulvovaginal intradermal injection of PN/HA is a safe, effective treatment, is not expensive and is a reproducible procedure in postmenopausal women with VVA.