Sexual Desire Domain Research Articles

Effects of Abstinence from Opioid on Sexual Functioning in Men with Opioid Use Disorder: An Observational Study

Objective: Sexual dysfunction amongst persons with opioid use disorder (OUD) is quite prevalent. Research about the effects of abstinence from opioids on sexual functioning is scarce. The aim of this study is to assess the sexual functioning among men with OUD and examine the effects of abstinence from opioids on sexual functioning. Methods: An observational study was conducted at a tertiary-level multi-specialty public-funded hospital in northern India. A total of 50 men with OUD underwent a self-report–based assessment of sexual functioning using the International Index of Erectile Function (IIEF-15). Five sub-domains of IIEF-15 (i.e., erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) were assessed at baseline, two weeks and eight weeks of abstinence from opioids. Results: A total of 44 participants out of 50 reported significant dysfunction. Most of them reported dysfunction in the domains of overall satisfaction (88%, n = 44) and sexual desire (72%, n = 36). After eight weeks of abstinence from opioids, 10 participants out of 44 reported improvement on mean assessment scores. The improvement was noted as follows: erectile function (8%), orgasmic function (2%), sexual desire (8%), intercourse satisfaction (8%) and overall satisfaction (16%) as compared to baseline. There was significant improvement in the subdomain of sexual desire ( p value .05) over the course of eight weeks of abstinence compared to baseline. Conclusion: Abstinence from opioids leads to improvement in sexual functioning over a period of eight weeks of abstinence in men with OUD.

Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders

ObjectiveTo compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. Study designFrom January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26).We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. ResultsCervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively).Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%).Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). ConclusionsCervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.

Women and men with distressing low sexual desire exhibit sexually dimorphic brain processing

Distressing low sexual desire, termed Hypoactive Sexual Desire Disorder (HSDD), affects approximately 10% of women and 8% of men. In women, the ‘top-down’ theory of HSDD describes hyperactivity in higher-level cognitive brain regions, suppressing lower-level emotional/sexual brain areas. However, it is unknown how this neurofunctional disturbance compares to HSDD in men. To investigate this, we employed task-based functional MRI in 32 women and 32 men with HSDD to measure sexual-brain processing during sexual versus non-sexual videos, as well as psychometric questionnaires to assess sexual desire/arousal. We demonstrate that women had greater activation in higher-level and lower-level brain regions, compared to men. Indeed, women who had greater hypothalamic activation in response to sexual videos, reported higher psychometric scores in the evaluative (r = 0.55, P = 0.001), motivational (r = 0.56, P = 0.003), and physiological (r = 0.57, P = 0.0006) domains of sexual desire and arousal after watching the sexual videos in the scanner. By contrast, no similar correlations were observed in men. Taken together, this is the first direct comparison of the neural correlates of distressing low sexual desire between women and men. The data supports the ‘top-down’ theory of HSDD in women, whereas in men HSDD appears to be associated with different neurofunctional processes.

(126) Application of HIFEM Therapy Improves Orgasmic, Urinary and Erectile Function by Stimulation of Pelvic Floor Muscles

Abstract Introduction The weak pelvic floor in men contributes to various urological disorders. Treatment can be accomplished by strengthening the pelvic floor muscles (PFM) through pelvic floor muscle training. Nevertheless, such development of PFM is time-consuming and heavily dependent on the subject's ability to perform selective muscle contractions. An advantageous approach is the targeted stimulation of PFM which can be accomplished via electromagnetic stimulation. Particularly, the pelvic floor muscles can be non-invasively and selectively stimulated via the HIFEM field. This results in the natural development and rehabilitation of PFM, which, among other functions, plays a vital role in facilitating orgasmic, urinary and erectile function. Objective The aim of this study is to assess the safety and efficacy of the HIFEM pelvic procedure for the treatment of erectile dysfunction. Methods In this study, 28 males with a median age of 56 (30-72 years) were enrolled. The treatment was composed of ten weekly 28-minute sessions. Outcome measurements were collected via questionnaires and ultrasound imaging prior to and after the last treatment. To assess changes in erectile and sexual function, and prostate-related symptoms, the International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) were used. Transverse B-Mode ultrasound video scans were recorded along the long axis of the penile shaft from the tip to the base with the penis in a flaccid state. A linear transducer was used, the depth was set at 2 cm, and the frame rate was approximately 30 frames per second. Separate video recordings of the left and right cavernosum were taken. The ultrasound scans were processed by the Morphometrix cloud-based algorithm. Adverse events were monitored during the study. Results All evaluation methods proved the efficiency of treatment on a statistically significant level. A significant improvement was detected in the majority (4 of 5) of the domains of IIEF, with the overall score improvement from a baseline value of 45.14±2.42 to 48.75±2.86 (+3.61 points). The most exceptional improvement was found in Sexual desire (+18.78%; p=1.06x10-3), Erectile dysfunction (+13.03%; p=5.7x10-4), and Orgasmic function (+10.69%; p=7.04x10-5) domains. The mean difference in the total score of the IPSS questionnaire reached -3.04 points (p=5.1x10-6), exceeding the corresponding minimal clinical difference (MIC=3 points). Overall, subjects, on average, shifted from moderately symptomatic (9.57±1.37 points) to mildly symptomatic (6.54±0.91 points). An increase in vascularity of both cavernosal was measured within 57% of patients who underwent ultrasound examination; specifically, a significant improvement was recorded in tissue segment count (TSC; +104%; p=1.17x10-4) and density (TSD; +81% p=2.20x10-3), pointing to better blood flow and delivery in examined tissues. No adverse event was observed. Conclusions The therapy administering HIFEM technology of the pelvic floor for selective PFM stimulation demonstrated significant improvement of erectile and orgasmic function and urinary symptoms. The questionnaire results corresponded with ultrasound measurements using a novel algorithm, identifying positive changes in the penile vascular system. Overall, the treatment may be considered a safe and a possible first-line solution for male patients suffering from dysfunctions linked to weakened pelvic floor muscles. Further investigation is needed. Disclosure Yes, this is sponsored by industry/sponsor: BTL. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: AFFIRM Science.

A comparison of the effects of oral dydrogesterone and levonorgestrel-releasing intrauterine device on quality of life and sexual function in patients with abnormal uterine bleeding.

The purpose of this study is to compare the effects of cyclic oral dydrogesterone treatment and levonorgestrel-releasing intrauterine device (LNG_IUD) on quality of life (QoL) and sexual function in patients diagnosed with abnormal uterine bleeding (AUB). The study was conducted at the University of Health Sciences Turkey Health Istanbul Kanuni Sultan Süleyman Training and Research Hospital, on 171 sexually active patients, aged 18-45, who were under a minimum of 6months of treatment for AUB. 85 patients were treated with oral cyclic dydrogesterone, and 86 patients received LNG-IUD. Following a minimum of 6 months of treatment, these patients were recruited to the study and were asked to complete a 36-Item Short Form Survey (SF-36) and the Female Sexual Function Index (FSFI). When the FSFI scores of the patients were compared, it was observed that the total FSFI score was significantly higher in the cyclic dydrogesterone group (p < 0.05). Likewise, it was observed that sexual desire, arousal, and lubrication domains were significantly higher in the cyclic dydrogesterone group (p < 0.05). No significant differences were found between the treatment groups in 7 out of the 8 dimensions of SF-36. The energy/vitality dimension was found to be significantly higher in the cyclic dydrogesterone group. Total FSFI score, as well as sexual desire, arousal, and lubrication scores, were significantly higher in the cyclic dydrogesterone group compared to the LNG-IUD group indicating that cyclic dydrogesterone has a more positive impact on sexual function when compared to LNG-IUD.

Does Significant Weight Loss After Bariatric Surgery Affect Sexual Function and Urinary Symptoms? An Iranian Study.

For sexual dysfunction and lower urinary tract symptoms (LUTS), obesity is identified as an independent risk factor. The current study aimed to evaluate the effect of significant rapid weight loss by bariatric surgery on LUTS and sexual function among men and women with class III obesity. A group of patients who were planned to undergo bariatric surgery was enrolled in the study. Male patients were given the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS) questionnaires. In the female group, they filled in the female sexual function index (FSFI) and the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) questionnaires. Patients were followed up 1year after their bariatric surgery. All questionnaires were completed by eighty-one patients. (mean age ± SD: 39.4 ± 9.2years; mean body mass index (BMI) ± SD: 47.15 ± 5.4kg/m2). The total score of the IPSS questionnaire decreased from 5.83 ± 3.01 preoperatively to 2.37 ± 1.66 postoperatively. The weight loss caused significant improvement in the storage phase of LUTS domains, but there were no considerable changes in the voiding phase. In the IIEF questionnaire, domains of sexual desire, overall satisfaction, and orgasmic function improved significantly. There was not a significant change in any FSFI domains after bariatric surgery. Mean ICIQ-SF decreased, but it was not substantial. Bariatric surgery can significantly improve the storage phase in men, but not the voiding phase. Sexual desire, orgasmic function, and overall satisfaction were significantly improved in men. No significant improvement in sexual function and UI in women was observed.

Global olfactory function correlates with global sexual functioning in men and women.

Olfaction is intimately involved in reproductive behaviors. However, there is limited evidence about the relationship between olfactory and sexual functioning, and whether this relationship is modulated by gender. This study aimed to investigate the correlates between olfactory and sexual functioning in a cohort of young healthy individuals; secondary outcomes were the possible correlates between disgust and perceived vulnerability to illness, with particular relation to sexual attitudes. Between January 2019 and December 2022, we enrolled 125 participants (51 males and 74 females) without known sexual disorders. The mean age was 28.47±8.6, and the mean Body Mass Index (BMI) was 23.86±3.3 without major disease or concomitant drug assumption, except for nutraceutical use. Olfactory sensitivity was tested with the Sniffin' Sticks Test (SST). Body Odor Disgust Scale (BODS) and Perceived Vulnerability to Disease (PVD) questionnaires were administered for the evaluation of perceived susceptibility to illness along with the Sexual Attitude Scale (SAS) for the evaluation of sexual attitudes. Sexual function was evaluated by the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) questionnaires, respectively. Overall, a close relationship between sexual function and olfaction in both sexes (P<0.05) was found. In the male sample, better olfactive scores were positively correlated to all IIEF sub-domains but negatively with BMI and age, respectively (P<0.05). Moreover, olfaction was negatively correlated with a restrictive attitude towards sexuality (SAS) (P<0.05). The latter was also positively correlated with PVD (P<0.01). In the female sample, all FSFI subscales but sexual desire was positively correlated with olfaction (P<0.05). We herein confirm that olfactory capacities positively correlate with sexual behavior in both sexes. In males, these findings were mostly dependent upon increasing age and BMI. In females all domains of sexual function but sexual desire correlated with olfactory capacity, thus suggesting independent neural pathway activation for sexual desire. Finally, better olfactory capacities seem to determine sexual attitudes and disease avoidance behaviors irrespective of gender.

(292) Impact of Urinary Incontinence on Sexual Function in Patients Presenting for Lower Urinary Tract Symptoms

Abstract Introduction Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI). Objective We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-referral centre. Methods In this cross-sectional study, data were retrospectively retrieved from 938 consecutive patients aged &amp;gt;18 years seeking first medical help for self-reported LUTS (i.e., all patients had IPSS≥1). All patients had a complete clinical assessment and completed the IPSS, the ICIQ-UI-SF, the OAB-q and the IIEF questionnaires. Patients were stratified into “no UI” (ICIQ-UI-SF=0), “mild UI” (ICIQ-UI-SF=1-7), “moderate UI” (ICIQ-UI-SF=8-13) or “severe UI” (ICIQ-UI-SF=14-21). ANOVA test assessed differences in baseline characteristics among these groups. Spearman correlation test was applied to evaluate the correlation between ICIQ-UI-SF and IIEF domain scores. A linear regression analyses tested putative risk factors associated with increased ICIQ-UI-SF scores. Results Of 938, 589 (63%) patients had no UI, 237 (25%) had mild UI, 76 (8%) moderate UI and 36 (4%) severe UI. There were no substantial differences in total PSA levels and uroflowmetry parameters among UI groups, whereas prostate volume, IPSS and OAB-q scores were higher as UI symptoms increased (all p≤ 0.03). A negative correlation was found between IIEF-total, IIEF-Erectile Function, IIEF-Intercourse Satisfaction and IIEF-Overall Satisfaction scores and ICIQ-UI-SF scores (i.e., the worse UI symptoms, the worse the overall sexual function (rho= -0.12; p&amp;lt;0.001), IIEF-EF (rho= -0.15; p&amp;lt;0.001), IIEF-IS (rho = -0.1; p=0.004) and IIEF-OS (rho = -0.12; p&amp;lt;0.001). Sexual desire and orgasmic function domains were not correlated with ICIQ-UI-SF. Finally, higher BMI (Coeff 0.12; 95% CI 0.03-0.32; p=0.011), diabetes (Coeff 1.76; 0.35-3.18; p=0.015) and presence of comorbidities (Coeff: 0.9; 0.06-0.1.74; p=0.035) were associated with higher ICIQ-UI-SF scores. Main limitations of the study were that ICIQ-UI-SF does not discriminate between urge or stress UI. Conclusions In patients presenting with LUTS, the presence of urinary incontinence was associated with worsening of overall sexual function (i.e., erectile function, intercourse satisfaction and overall satisfaction). Disclosure No

Effect of Group Counseling on Sexual Knowledge, Attitude, and Function of Young Women with Sexual Dysfunction: A Randomized Controlled Clinical Trial

Background and Objective: Inadequate information and false sexual beliefs are common psychological factors in sexual disorders. This study aimed to determine the effect of counseling on the sexual knowledge, attitude, and performance of women with sexual dysfunction. Materials and Methods: This randomized controlled clinical trial was conducted on 80 women aged 18 to 30 years with sexual dysfunction. Samples were randomly assigned to two test and control groups. The required data were collected using a demographic form, the Sex Knowledge and Attitude Test, and Female Sexual Function Index. The intervention was performed in 4 counseling sessions of 45-90 minutes weekly based on the rapport building, exploring, decision making, and implementing the decision (REDI) model. Data were gathered before and 4 weeks after the intervention and analyzed using Stata-13 software. The significance level was considered less than 5%. Results: After the intervention, the mean scores of sexual knowledge, sexual attitude, and sexual knowledge and attitude, as well as the total score of sexual function in the test group were obtained at 47.13±1.74, 51.16±2.34, 98.30± 3.73, and 26.29±2.46, respectively. These resultsshowed a statistically significant increase compared to before the intervention and also compared to the control group (P&lt;0.001). After the intervention, the mean scores of sexual desire, orgasm, and pain domains showed a significant difference between the two test and control groups (P&lt;0.05). Conclusion: It was found that REDI model-based counseling was effective in improving the sexual knowledge, attitude, and function of young women with sexual dysfunction. Considering the simplicity and effectiveness of this method, it is recommended to use it in sexual counseling.

Comparative Study of Extrapyramidal Side Effects, Sexual Dysfunctions and Hyperprolactinaemia Using Typical and Atypical Antipsychotic Medications Among Patients with Schizophrenia in Maiduguri.

Extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia are major side effects with the use of antipsychotic medications that impede treatment adherence leading to relapse, increased cost of care and rehospitalization among patients with schizophrenia on antipsychotic medications. The study aims to compare the prevalence of extra-pyramidal side effects (EPSE), sexual dysfunctions (SD) and hyperprolactinaemia (HPRL) among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine if any associations exist between extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia. A cross-sectional hospital-based survey involving 209 patients with schizophrenia were interviewed with structured instruments for the assessment of sexual dysfunction, EPSE and the estimation of serum prolactin was done using Enzyme-linked Immunosorbent Assay. Frequencies and Chi-square analysis were used to compare differences in EPSE, SD & HPRL. The study revealed non-statistically significant differences as a group between typical and atypical antipsychotic medication in terms of extra-pyramidal side effects, sexual dysfunction and hyperprolactinaemia. However, a significant association was observed when individual drugs were compared with haloperidol causing the highest frequency of hyperprolactinaemia (χ 2 = 14.9, P = 0.011). A significant relationship between sexual dysfunction and hyperprolactinaemia, sexual dysfunction and extra-pyramidal side effects as well as extra-pyramidal and hyperprolactinaemia was found when individual items for sexual functionin were used. The significant relationships between sexual dysfunction only in the domains of sexual desire and arousal with hyperprolactinaemia and extrapyramidal side effects as well as hyperprolactinaemia with extrapyramidal side effects point to a common anti-dopaminergic activity of antipsychotics via different pathways. Prospective studies among a larger sample of patients with schizophrenia are needed to unfold these relationships.

DİABETES MELLİTUSLU KADINLARDA CİNSEL FONKSİYONLARIN BELİRLENMESİ

Background: Diabetes mellitus is a chronic disease that causes sexual dysfunction. &#x0D; Aim: The aim of this descriptive study is to determine the frequency and factors affecting of sexual function in women with diabetes. &#x0D; Method: The study sample was comprised of 255 women between the ages of 18 to 55. The participants were not climacteric, were sexually active and had not had a surgery involving the reproductive system. The data were collected using a data collection form and the Female Sexual Function Index. &#x0D; Results: The frequency of sexual dysfunction was 69.0% in women. It was determined that having other health problems (95% CI=1.087–5.609, p=0.031) increased 2.47 times the risk of sexual dysfunction in women with diabetes. When the duration of diabetes increased, the arousal dysfunction risk of women also increased 1.19 times (95% CI=1.073–1.339, p=0.001). In addition, when duration of marriage increased, orgasmic dysfunction risk also increased 0.95 times (95% CI=0.909–0.993, p=0.024). However, there was no relation between age, duration of marriage, duration of diabetes, and HbA1c values of women and sexual desire, lubrication, satisfaction and pain domains (p&gt;0.05).&#x0D; Conclusion: The most of the women have sexual dysfunction. When the domains of Female Sexual Function Index are examined, most of the women experience sexual dysfunction in the desire, arousal and pain domains. In addition, with increased duration of diabetes mellitus, arousal dysfunction risk increases, as does orgasm dysfunction risk with increased marriage duration. Having a health problem other than diabetes mellitus increase sexual dysfunction risk.

Impact of urinary incontinence on sexual function in patients presenting for lower urinary tract symptoms

ABSTRACT Introduction Patients with low urinary tract symptoms (LUTS) frequently complain some sexual dysfunction and sometimes even episodes of bothersome urinary incontinence (UI). Objective We aimed to assess the relationship between UI (as measured with the ICIQ-UI-SF), and sexual disfunction (as measured with the IIEF), in men presenting with LUTS at a tertiary-referral centre. Methods In this cross-sectional study, data were retrospectively retrieved from 938 consecutive patients aged &amp;gt;18 years seeking first medical help for self-reported LUTS (i.e., all patients had IPSS≥1). All patients had a complete clinical assessment and completed the IPSS, the ICIQ-UI-SF, the OAB-q and the IIEF questionnaires. Patients were stratified into “no UI” (ICIQ-UI-SF=0), “mild UI” (ICIQ-UI-SF=1-7), “moderate UI” (ICIQ-UI-SF=8-13) or “severe UI” (ICIQ-UI-SF=14-21). ANOVA test assessed differences in baseline characteristics among these groups. Spearman correlation test was applied to evaluate the correlation between ICIQ-UI-SF and IIEF domain scores. A linear regression analyses tested putative risk factors associated with increased ICIQ-UI-SF scores. Result Of 938, 589 (63%) patients had no UI, 237 (25%) had mild UI, 76 (8%) moderate UI and 36 (4%) severe UI. There were no substantial differences in total PSA levels and uroflowmetry parameters among UI groups, whereas prostate volume, IPSS and OAB-q scores were higher as UI symptoms increased (all p≤ 0.03). A negative correlation was found between IIEF-total, IIEF-Erectile Function, IIEF-Intercourse Satisfaction and IIEF-Overall Satisfaction scores and ICIQ-UI-SF scores (i.e., the worse UI symptoms, the worse the overall sexual function (rho= -0.12; p&amp;lt;0.001), IIEF-EF (rho= -0.15; p&amp;lt;0.001), IIEF-IS (rho = -0.1; p=0.004) and IIEF-OS (rho = -0.12; p&amp;lt;0.001). Sexual desire and orgasmic function domains were not correlated with ICIQ-UI-SF. Finally, higher BMI (Coeff 0.12; 95% CI 0.03-0.32; p=0.011), diabetes (Coeff 1.76; 0.35-3.18; p=0.015) and presence of comorbidities (Coeff: 0.9; 0.06-0.1.74; p=0.035) were associated with higher ICIQ-UI-SF scores. Main limitations of the study were that ICIQ-UI-SF does not discriminate between urge or stress UI. Conclusion In patients presenting with LUTS, the presence of urinary incontinence was associated with worsening of overall sexual function (i.e., erectile function, intercourse satisfaction and overall satisfaction). Disclosure Work supported by industry: no.

Beneficial effects of natural products on female sexual dysfunction: A systematic review and meta-analysis

BackgroundFemale sexual dysfunction (FSD) includes female orgasmic disorder, female sexual interest or arousal disorder, and genito-pelvic pain or penetration disorder. FSD affects 40% of women worldwide, but it is understudied and likely undertreated. Natural products are frequently used by women to treat FSD, but scientific evidence of their efficacy is lacking. ObjectiveThis systematic review and meta-analysis focused on the study of the efficacy of natural products on FSD. Study designSystematic review and meta-analysis of existing studies on natural products in the treatment of FSD. MethodsThe literature search included MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trial databases for studies published from January 2000 to February 2020. The quality and the level of evidence of the studies were assessed. The association between natural products and FSD was summarized using standardized mean differences (SMD) with a 95% confidence interval (CI). ResultsA total of 536 studies were identified, with 20 of them meeting the criteria. According to this meta-analysis, Tribulus terrestris showed a significant positive effect in improving overall female sexual function (SMD = 1.12, 95% CI = 0.46 - 1.79, p = 0.001) and individual sexual arousal (SMD = 1.03, 95% CI = 0.22 - 1.84, p = 0.013), sexual desire (SMD = 1.08, 95% CI = 0.52 - 1.63, p ≤ 0.001) and sexual orgasm (SMD = 0.51, 95% CI = 0.02 - 1.00, p = 0.040) domains compared to placebo. Panax ginseng was found to be effective in treating sexual arousal (SMD = 0.54, 95% CI = 0.11 - 0.97, p = 0.014) and sexual desire (SMD = 0.59, 95% CI = 0.27 - 0.90, p < 0.001) compared to placebo. Meanwhile, other natural products reviewed in this study, such as Trifolium pretense, did not differ significantly from placebo in terms of improving FSD. ConclusionPreliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.

Sexual Function and Associated Factors in Postmenopausal Women.

To assess the sexual function and associated factors in postmenopausal women. This a descriptive, cross-sectional study with 380 women aged 40 to 65 years, users of public health services in 2019. Questionnaires were applied on demographic characteristics, on climacteric symptoms (menopause rating scale) and on sexual function (sexual quotient, female version). Bivariate and multiple analyses by logistic regression were performed, with adjusted odds ratios (ORad) and 95% confidence intervals (95%CIs). More than half (243/64%) of the participating women were at risk of sexual dysfunction, with lower scores in the domains of sexual desire and interest, comfort, orgasm, and satisfaction. Women with a partner (ORad 2.07; 95%CI 1.03-4.17) and those who reported sleep problems (ORad 2.72; 95%CI 1.77-4.19), depressed mood (ORad 2.03; 95%CI 1.32-3.10), sexual complaints (ORad 8.16; 95%CI 5.06-13.15), and vaginal dryness (ORad 3.44; 95%CI 2.22-5.32) showed greater chance of sexual dysfunction. There was a high prevalence of sexual dysfunction, with the influence of conjugality and climacteric symptoms on sexual function.

“Mesh free” autologous transobturator mid urethral sling placement for predominant stress urinary incontinence: A pilot study

To assess the efficacy and safety of autologous mid-urethral sling (MUS) in women with predominant stress urinary incontinence (SUI). This prospective cohort study included adult women with predominant SUI seen in our urology clinic between January 2018 and March 2019. Patients with: negative cough stress test, history of prior incontinence surgery, urogenital malignancy, pelvic radiation, neurological disease, body mass index more than 40 kg/m2 , the presence of more than Stage I pelvic organ prolapse, active urinary tract infection, maximum flow rate less than 15 ml/sec, postvoid residual urine more than 100 ml, abdominal leak point pressure less than 60 cm of H2 O, and pregnant women were excluded. Eligible patients underwent a transobturator MUS procedure using rectus fascia as a sling. Before the procedure, patients filled the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS) and the Female Sexual Function Index (FSFI) questionnaire. Urinary outcomes were assessed at 3- and 12-months while sexual outcomes were assessed at 12-months. Thirty patients with median age of 44.5 years were included. All patients had a negative cough stress test during follow up. A significant improvement was noted in the ICIQ-FLUTS scale, bother scale, filling and incontinence subscales at 3 and 12 month follow-up. A significant improvement was also noted in the FSFI full scale score and FSFI domains of mean sexual desire, arousal and lubrication at 12 months follow-up. Two patients developed voiding dysfunction requiring urethral dilatation. Autologous transobturator MUS surgery appears to be safe and efficacious in the short term. More research is needed to clarify its role in the surgical management of SUI in women.

Prevalence of sexual dysfunction in women resident of a capital city in the brazilian western Amazon

Objective: To determine the prevalence of sexual dysfunction in non-pregnant, pregnant, and postpartum women, and its association with potential risk factors. Methods: Cross-sectional study composed of 419 women, who attend public health units, from April to August 2019, in Rio Branco, Acre. The volunteers were subjected to a self-report questionnaire previously validated at national level: The Sexual Quotient-Female version. Results: Based on the total number of responses, 35.6% of the participants had sexual dysfunction. Of those, almost half of the volunteers (42%) were unemployed (p = 0.003). In the sexual desire and orgasm domains, the average score was higher among women during pregnancy (2.8203) (3,4844) than in the puerperal women (2.3454) (2,0912), respectively (p&lt;0,05). Regarding pain, 30.1% answered "always" for its incidence during sexual intercourse. Age alone does not influence the sexual function of the participants, (r &lt;1 and p&gt; 0.05). Conclusion: The present study unveiled an important percentage of sexual dysfunction, predominantly in the pain subdomain. In addition, a significant difference was found in the sexual desire and orgasm domains, with higher scores found in pregnant women compared to puerperal women. Another fact was the higher percentage of sexual dysfunction in unemployed women.

Treatment of women's sexual dysfunction using Apium graveolens L. Fruit (celery seed): A double-blind, randomized, placebo-controlled clinical trial

Ethnopharmacological relevanceTraditional manuscripts refer to plants such as Apium graveolens L. Fruit (celery seed), which could be used to improve sexual function among women. Since that time, local herbal shops in Iran continue to provide this herb as a natural aphrodisiac product. Aim of the studyThis study aimed to evaluate the efficacy and safety of celery seed for the treatment of female sexual dysfunction. Methods and materialsIn this parallel, randomized, double-blinded clinical trial, 80 women were assigned to receive either 500 mg of celery seed or placebo 3 times a day for a period of 6 weeks (n = 40 per group). The female sexual function index (FSFI) questionnaire was used to evaluate women's sexual function before and after treatment. ResultsAt the end of the sixth week, an improvement in the total FSFI score was significantly greater in celery seed-treated women than those receiving the placebo (P < 0.001). Increased total FSFI score is mainly contributed by improvement in the sexual desire (p < 0.001), arousal (p < 0.001), lubrication (p < 0.001), and pain (p = 0.033) domains at the endpoint of study. No serious side effects were noticed in both groups during the study period. ConclusionIt seems that celery seed improved sexual function in women and could be used as a safe, well-tolerated, and effective herbal medicine in women with sexual dysfunction.

The effect of tension-free vaginal tape on coital incontinence concomitant with stress urinary incontinence.

The aim of this study was to evaluate the impact of tension-free vaginal tape (TVT) on coital incontinence concomitant with stress urinary incontinence. TVT was performed on sexually active women diagnosed with urodynamic stress incontinence (USI) who also experienced coital incontinence with penetration and/or orgasm. The patient-reported success rate was assessed by the Patient's Global Impression of Improvement (PGI-I) scale. The sexual function of the women was evaluated by the fulfilled Female Sexual Function Index (FSFI) before and after the operations. Eighty-two women underwent the TVT procedure with epidural anesthesia and 80 of them (97%) answered pre-operative and post-operative FSFI questionnaires. In the pre-operative clinical assessment, 48 women (58%) stated they experienced urinary incontinence during penetration, 13 (15%) during orgasm, and 21 (25%) identified it for both. The patient-reported success rate was 86% (71 of 82 patients) according to the PGI-I results: 44 of 48 women (91%) during penetration, nine of 13 (69%) during orgasm, and 18 of 21 (85%) for both. The FSFI scores for sexual desire, lubrication, and sexual arousal domains increased in 57 (71%), 49 (61%), and 44 (55%) patients, respectively, whereas they remained unchanged in 23 (28%), 31 (38%), and 36 (45%) patients. For the orgasm, satisfaction, and pain domains, the results were similar. The mean total FSFI score before the operations was 23.63 ± 6.84 and it significantly increased after surgery to 29.47 ± 4.28 (P < .05). The TVT procedure may offer treatment for coital incontinence accompanying USI. It also provides significant improvement in the sexual lives of women.

The correlation between sexual dysfunction and intimate partner violence in young women during pregnancy

BackgroundSexual function is one of the main aspects of life. Pregnancy affects sexual function. The aim of this study was to determine the sexual dysfunction in young pregnant women and its correlation with intimate partner violence (IPV).MethodsThis cross-sectional study was conducted using two-stage cluster sampling method. The data were collected using a socio-demographic questionnaire, Female Sexual Function Index (FSFI), and Conflict Tactics Scale (CTS2). Multivariate logistic regression was used to determine the relationships between sexual dysfunction with IPV and socio-demographic factors.ResultsThe results of this study on 346 pregnant women aged 18–29 years showed that mean (SD = standard deviation) of the total sexual function score was 25.4 (5.9), within a possible score range of 2 to 36. About 66% of the young pregnant women had a sexual dysfunction. The lowest and the highest prevalence of sexual dysfunction were in sub domains of sexual satisfaction and sexual desire, respectively. The prevalence of overall IPV against young women was 63%. The most common type of IPV experienced by women was psychological aggression (56.6%). There were statistically significant relationships between sexual dysfunction and IPV (OR (Odds Ratio) = 0.4, 95% Confidence Interval = 0.2 to 0.6, p < 0.001), sufficiency of income for expenses (0.2, 0.1 to 0.6, p = 0.005), husband educational level (0.5, 0.3 to 0.9, p = 0.028) and marriage duration (1.9, 1.0 to 3.7, p = 0.044).ConclusionsSexual dysfunction has a high prevalence in young pregnant women and IPV had correlation with sexual dysfunction. The routine screening for sexual dysfunction and IPV is recommended during pregnancy for detection and consulting.

MON-LB002 Compounded Testosterone Preparations Raise Testosterone Levels to Premenopausal Ranges in Postmenopausal Women With Hypo-Sexual Desire Disorder (HSDD)

IntroductionTestosterone (T) in women declines with age. T levels cannot differentiate women with or without HSDD. T therapy approximating upper physiologic premenopausal levels improves all domains of sexual desire, libido, and decreases sexual distress1,2. As of 2020, there are no FDA-approved T preparations for women. Male preparations of T are frequently used off-label to treat HSDD. No peer-reviewed data exists on T levels achieved with compounded testosterone preparations from a single reliable source. This study assesses efficacy of four compounded T preparations to raise T levels, using typically recommended doses. T was obtained from a single Pharmacy Compounding Accreditation Board (PCAB)-certified pharmacy.MethodsTwenty-six matched baseline and post-treatment T levels were obtained as part of standard care for post-menopausal women (age 61±6 years) 3 months after being prescribed T for HSDD. T was obtained from the Women’s International Pharmacy. T doses were 0.5-2.0 mg/day, 6 days a week, using 4 methods of administration based on patient’s preferences: 1) cutaneous cream to skin (CS) behind the knees (n=12); 2) intravaginal suppositories (IVS) (n=5); 3) intravaginal oil-capsules (IVoil-C) (n=7); and 4) vulvar cream (VC) (n=2). Mean T dose was 1.5±0.6 mg/day. All patients gave consent for use of their T data, and were compliant with treatment for a week prior to testing. Measures of total T were performed by MS/LC, and of free T by equilibrium dialysis. Normal ranges for total T is 15-70 ng/dl and free T is 0.5-6.5 pg/ml. Paired T-tests comparisons between baseline and treatment values where done within each group where n was sufficient. (*p<0.05, **p<0.01).Results:Baseline and treatment total T (ng/dl) were 18.3±3.6 and 55.3±5.2** for CS, 19.8±4.3 and 56.6±15.9 for IVS (p=NS), 23.0±3.2 and 89.2±23* for IVoil-C, and 25.0±3.0 and 182±47 for VC. Baseline and treatment free T (pg/ml) were 1.18±0.26 and 4.16±0.6** for CS, 1.12±0.2 and 3.46±1.3 for IVS, 1.60±0.2 and 5.95±1.2* for IVoil-C, and 1.36±0.4 and 9.45±1.2 for VC. Testosterone administration by CS or IVoil-C significantly increased testosterone levels to the upper normal premenopausal range in women with HSDD.ConclusionTreatment of HSDD in postmenopausal women with compounded T via CS or IVoil-C, at doses of 0.5-2.0 mg, effectively raises T levels to upper premenopausal range. Vaginal oil capsules may be particularly useful in avoiding accidental hormone contact by other household members. A FDA-approved form of T replacement would be a welcome treatment for women with HSDD.1. Islam RM et al. Lancet Diabetes-Endocrinology (7):754-66, 2019.2. Davis SR. Climacteric, 22:5,429-434, 2019.