Domains Of Sexual Function Research Articles

Genito Urinary Syndrome of Menopause (GSM) or Vulvo-vaginal Atrophy (VVA) an Unspoken Sorrow

GSM includes wide spectrum of vulvovaginal Symptoms and urinary troubles replacing the term vulvovaginal atrophy (VVA). It is a silent epidemic condition affecting 50-60% postmenopausal women. Estrogen withdrawal causes thinning, narrowing, tissue loss & reduced blood supply in vulvo-vaginal area, which results GSM. GSM causes burning in vagina, dyspareunia, urinary urgency, repeated UTI. Dyspareunia affects all the domain of sexual function and deteriorates the quality of life. Irony is, women are oblivious to share and doctors are reluctant to discuss. So women keep continue suffering without knowing the restorative treatment. Repercussion of GSM/VVA intensifies the sorrows, distress and sufferings. It has profound effect on relationship and psychology and quality of life of women. Good history taking and clinical examination do diagnosis. Investigations are done to exclude other causes. Treatment is challenging. Maintenance of optimum body weight, exercise, regular coitus, quitting smoking & excessive alcohol intake are the key factors. Vaginal moisturizers are recommended as 1st line therapy for mild to moderate VVA or women who can’t take estrogen. Ideal moisturizers should have similarity with vaginal secretion of osmolality, pH and composition. Meta analysis shows local estrogen therapy is effective. It restores vaginal pH and maturation index. Systemic absorption is minimal so progesterone needs not to be added. Testosterone improves dyspareunia, sexual desire, lubrication and satisfaction. DHEA (Prasterone) penetrates vaginal wall better. It increases elasticity and vascularity of vagina. RCTs have not shown benefits of it’s systemic therapy. But local daily administration of DHEA reduces dyspareunia and GSM so improves the quality of life. Ospemifene is well tolerated. It’s agonist effect on vaginal mucosa and antagonist effect on endometrium and breast, makes it promising. Lasofoxifene, third generation SERM, is also very effective but it needs FDA approval. Laser is widely being used and very effective. It is simple, faster, painless procedure. It activates dominant fibroblasts, proteoglycans, hyaluronic acid, thereby improves GSM & sexuality. Black cohosh, Botox, G-shot, probiotics, gabapentin are not yet evidence based. Still there is significant unmet need for medical treatment. Women reports GSM but that is only tip of iceberg. Good communication and optimum treatment only can break the sorrows GSM/VVA.

The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study.

ABSTRACTObjectives:to examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters.Materials and Methods:The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed.Results:The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients’ preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages.Conclusion:Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.

A prospective study to compare changes in male sexual function following holmium laser enucleation of prostate versus transurethral resection of prostate.

Introduction:Transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP), both are considered standard endosurgical treatment of benign prostatic hyperplasia (BPH). Many studies have evaluated changes in sexual function following treatment of BPH. However, data are sparse on comparative study between the two standard options of the treatment of BPH.Aim:The aim of this study was to compare changes in sexual function following HoLEP versus TURP using the International Index of Erectile Function-15 (IIEF-15) questionnaire.Materials and Methods:A prospective study carried out for 4 years from May 2013 to April 2017. All patients with bothersome lower urinary tract symptoms due to BPH, who got admitted to the hospital for surgical management, were enrolled for the study and they underwent either HoLEP or TURP. Postoperatively, they were followed for 6 months at 1-, 3-, and 6-month interval.Main Outcome Measures:Statistical testing was conducted with the Statistical Package for the Social Science system version 17.0. Continuous variables are presented as mean ± standard deviation, and categorical variables are presented as absolute numbers and percentage. The comparison of normally distributed continuous variables between the groups was performed using Student's t-test. For within the groups, paired t-test was used at 1 month, 3 months, and 6 months from the baseline.Results:All the five domains of sexual function based on the IIEF-15 questionnaire remained significantly low at 6-month postsurgery in both the groups.Conclusions:By comparing the changes in sexual function between HoLEP and TURP group at the end of our study (6 months), we found no difference between the groups with regard to erectile function or overall sexual function as assessed by total IIEF-15 score.

Sexual function in South African women treated for cervical cancer

Cervical cancer is the second most common cancer in South African women, but the most common cancer in Black women. Despite cervical cancer screening being available, most women present with late stage disease requiring the standard curative treatment of radiotherapy, with or without chemotherapy. Cervical cancer and its treatment have various side effects, which have a negative influence on sexual function. Our study aimed at describing the sexual function of women treated for cervical cancer at an academic hospital, in the third (M3), sixth (M6) and twelfth months (M12) after completing treatment. A cross sectional design, convenience sampling and calculated sample size (n = 147) were used. Structured interviews were conducted to collect the data, and the Female Sexual Function Index (FSFI) served as data collection instrument. Kruskal Wallis H and Chi-square tests were used to determine the relationships between the variables. The data were collected between July and August 2015. The majority of the women (94.6%; n = 139) experienced sexual dysfunction, which persisted over time. The most affected domain was arousal, whilst satisfaction was the least affected. Pain experienced during sexual activity persisted as time progressed. Age, educational level, the type of treatment received and having had sexual counselling before treatment commenced did not influence sexual function. Our study provided evidence that the majority of women treated for cervical cancer live with long lasting sexual dysfunction affecting all sexual function domains. Although sexual dysfunction reached the highest level in the third month after treatment, there was little improvement over time.

Fractional CO2 Laser Treatment for Vaginal Rejuvenation in Post-Menopausal Indian Women

Background Laser vaginal rejuvenation is a minimally invasive fractional carbon dioxide (CO2) laser procedure for the woman with vulvovaginal atrophy (VVA), vaginal laxity and for the enhancement of sexual functioning. It has also been proposed for the woman with urge and stress urinary incontinence. CO2 stimulates collagen/elastin contraction, neocollagenesis, and neovascularization. Aim To study the efficacy of CO2 laser in the improvement of VVA, stress urinary incontinence, urge incontinence and sexual functioning. Materials and Methods Twenty-six patients who were in the menopausal transition to post-menopausal age group who presented with any one of the above-mentioned complaints were enrolled in our study. Prior to the treatment, a vaginal examination was performed to ensure patients’ eligibility for the treatment and to determine the vaginal health index score (VHIS), subjective evaluation of VVA symptoms was provided using the visual analog scale (VAS) and the vaginal tightening and patients’ satisfaction were assessed. They also took a questionnaire regarding their sexual functioning. They underwent 3 sessions of CO2 laser with a 1-month interval. Results Significant improvement in VVA was noted after 12-weeks which was observed in vaginal elasticity, fluid volume, epithelial integrity, and patients noted the reduced intensity of vaginal symptoms, such as vaginal burning, dryness, itching, and dyspareunia which was confirmed by improvement in VHIS and VAS. There was a subjective improvement in some patients for stress urinary incontinence (SUI) and user interface (UI) as per patient feedback. Patients also noted a significant improvement in quality of life (QoL) and sexual functioning as there were improvement in female sexual function index (FSFI) and domain scores (i.e., desire, arousal, lubrication, pain, orgasm, satisfaction). Conclusion Fractional CO2 laser treatment definitely improved symptoms associated with VVA, stress and urge urinary incontinence, sexual functioning and overall QoL. Although various parameters and long-term results are yet to be noted, the treatment gives satisfying, non-surgical, out-patient, non-hormonal treatment for vaginal health.

The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women.

Symptoms of genitourinary syndrome of menopause (GSM) are bothersome to middle-aged and older women, and affect their quality of life (QoL), sexuality, and daily activities. The objective of the study was to evaluate the impact of vaginal symptoms and GSM on the well-being, functioning, and QoL of postmenopausal women from Spain. This study involved 423 postmenopausal women participating in the GENISSE study (a multicenter, cross-sectional, descriptive, observational study) who presented at least 1 vaginal symptom. All women completed the "day-to-day impact of vaginal aging" (DIVA) questionnaire. Analysis of total scores and subdomains of the questionnaire were performed in women diagnosed with GSM and those without the condition. In these women, the highest mean scores on the DIVA questionnaire were found in the sexual functioning domain long version (mean 1.8; SD 1.0), followed by the sexual functioning domain short version (mean 1.7; SD 1.1), self-perception and body image (mean 1.4; SD 1.1), activities of daily living (mean 0.7; SD 0.8), and emotional well-being (mean 0.7; SD 0.8) scales. A total of 299 women (70.7%) had vaginal symptoms with a diagnosis of GSM, whereas 124 (29.3%) had no GSM diagnosis. Scores on the DIVA questionnaire were significantly higher in women with a diagnosis of GSM than in those without this condition. Vaginal symptoms impact the well-being, functioning, and QoL of postmenopausal women, especially sexual function, self-perception, and body image. This impact is significantly higher in women with GSM. Identifying and treating patients affected by vaginal symptoms and GSM may be beneficial for improving their QoL.

Effect of Thyroid Hormone Derangements on Sexual Function in Men and Women.

Sexual dysfunction affects many people, with 33‒60% of women reporting sexual dysfunction and 8‒52% of men with erectile dysfunction or premature ejaculation. In an effort to determine the constellation of factors responsible for sexual dysfunction, the effect of thyroid hormone derangements has been of recent interest. To investigate the associations between thyroid hormones and sexual dysfunction in women and men. Literature was reviewed to examine the effects of hypo- and hyperthyroidism on sexual function. We present a summary of the effects of thyroid dysfunction on domains of sexual functioning. Most studies demonstrate that men with hypo- and hyperthyroidism have increased rates of sexual dysfunction, including erectile dysfunction in men with hypothyroidism. However, studies vary on the strength of correlation between hormonal derangement and level of sexual dysfunction. In both men with hyper- and hypothyroidism, treating the thyroid disorder at least partially reverses sexual dysfunction. In contrast, the current literature provides no consensus on the effect of hypothyroidism, hyperthyroidism, or Hashimoto's thyroiditis on female sexual function. In studies that observed increased rates of sexual dysfunction in women with thyroid disorders, correction of the thyroid derangement resulted in resolution of some sexual dysfunction. Studies arealso conflicted on whether there is a relationship between the degree of sexual dysfunction and the degree ofhormone derangement in women. However, prior work has demonstrated a relationship between thyroid autoantibodies and sexual dysfunction in women. Thyroid dysfunction is an important factor in the pathogenesis of sexual dysfunction in men and possibly women. Evidence suggests a reversibility of sexual dysfunction with correction of thyroid dysfunction, although the exact pathophysiology of thyroid-mediated sexual dysfunction remains unknown. However, current evidence supports thyroid derangements rather than autoantibodies as the causative factor in men, whereas autoantibodies appear to play a more prominent role in women. Bates JN, Kohn TP, Pastuszak AW. Effect of Thyroid Hormone Derangements on Sexual Function in Men and Women. Sex Med Rev 2020;8:217-230.

Is Sexual Function Better Preserved After Water Vapor Thermal Therapy or Medical Therapy for Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia?

BackgroundMen often experience deterioration of sexual function after the use of α-blockers and 5-α reductase inhibitors for the treatment of lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia. Thus, an alternative treatment with water vapor thermal therapy (Rezūm System, Boston Scientific, Marlborough, MA, USA) which is an efficacious minimally invasive surgical treatment that preserves sexual function was examined. AimTo compare sexual function over 3 years after continuous daily treatment with pharmaceutical agents in the Medical Therapy of Prostatic Symptoms (MTOPS) study vs a single thermal therapy procedure (Rezūm study) in subjects with matched criteria for LUTS severity and prostate size. MethodsWe used sexual function data from sexually active cohorts in the MTOPS study (1,209) randomized to doxazosin, finasteride, combination drugs and placebo, and sexually active men who received thermal therapy (86). MTOPS study participants completed the Brief Male Sexual Function Inventory; men in the Rezūm trial completed the International Index of Erectile Function and Male Sexual Health Questionnaire. Main Outcome MeasureEstimated mean changes from baseline for sexual function variables were compared using a linear mixed repeated measures model with fixed effects for treatment and follow-up visits. ResultsWith continued daily drug use, men experienced significant worsening of sexual desire, erectile and ejaculatory function with finasteride and combination drug therapy, and reduced desire and erectile function with doxazosin. Thermal therapy was not associated with significant negative changes in sexual function throughout 3 years after treatment. Clinical ImplicationsWater vapor thermal therapy can result in greater LUTS improvements than either doxazosin or finasteride alone, whereas combination drug therapy may equal that of this Rezūm procedure, but all drug therapies did have a significant negative impact on sexual function in contrast to the preservation of libido, erectile, and ejaculatory function after thermal therapy. Strength & LimitationsThe report includes high-quality data from 2 large randomized controlled trials in subjects with similar baseline inclusion criteria for LUTS severity and prostate size. It is the first longitudinal assessment of sexual function domains restricted to sexually active men treated with drugs or a single minimally invasive surgical treatment with the Rezūm procedure. A limitation of the study is the use of 2 different, although validated sexual function inventories (Brief Male Sexual Function Inventory and International Index of Erectile Function). ConclusionA single water vapor thermal therapy procedure for targeted prostate tissue ablation for LUTS/ benign prostatic hyperplasia had no deleterious effect on 4 sexual function domains compared with appreciable worsening of sexual function after long-term single or combination drug use.McVary KT, Rogers T, Mahon J, et al. Is Sexual Function Better Preserved After Water Vapor Thermal Therapy or Medical Therapy for Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia? J Sex Med 2018;15:1728–1738.

Evaluation of sexual function in Brazilian women with and without chronic pelvic pain.

PurposeThe aim of this study was to evaluate sexual function in women with chronic pelvic pain (CPP) compared to a control group without CPP and to investigate the factors associated with sexual dysfunction in women with CPP.MethodsThis cross-sectional study included 100 women with CPP and 100 controls. Sexual function was evaluated using the Female Sexual Function Index (FSFI) and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS). A generalized linear model was used to compare the groups with respect to the overall FSFI score and the scores obtained for each FSFI domain. Multiple logistic regression analysis was used to identify the factors associated with sexual dysfunction in the study group.ResultsAnxiety was present in 66.0% of women with CPP in the study group compared to 49.0% of the controls (P=0.022). Depression was detected in 63.0% of women with CPP in the study group and in 38.0% of the controls (P=0.001). Sexual dysfunction was identified in 81.0% of the women with CPP in the study group compared to 58.0% of the controls (P=0.003). Following adjustment, the women with CPP had significantly lower mean scores compared to the controls in the FSFI domains of desire (3.0±1.3 vs 3.6±1.3; P=0.038), arousal (2.6±1.6 vs 3.4±1.9; P=0.002), lubrication (3.2±1.9 vs 3.7±2.3; P=0.011), orgasm (3.0±1.9 vs 3.6±2.2; P<0.002), and pain (2.5±1.7 vs 3.4±2.2; P<0.001). There was no difference between the groups for the satisfaction domain (P=0.337) or for the overall score (P=0.252). A positive and independent association was found between depression and sexual dysfunction in the women with CPP (P=0.012).ConclusionIn the women with CPP, sexual dysfunction was more common, and the scores in most of the sexual function domains were poorer than in the control group. Concurrently, depression was found to be positively associated with sexual dysfunction in the women with CPP.

Re: A Prospective Randomised Placebo-controlled Study of the Impact of Dutasteride/Tamsulosin Combination Therapy on Sexual Function Domains in Sexually Active Men with Lower Urinary Tract Symptoms (LUTS) Secondary to Benign Prostatic Hyperplasia (BPH)

Re: A Prospective Randomised Placebo-controlled Study of the Impact of Dutasteride/Tamsulosin Combination Therapy on Sexual Function Domains in Sexually Active Men with Lower Urinary Tract Symptoms (LUTS) Secondary to Benign Prostatic Hyperplasia (BPH)

Comprehensive Validation Study of Quality-of-Life Questionnaire Using Objective Clinical Measures: Breast Cancer Treatment Outcome Scale (BCTOS), Brazilian Portuguese Version

IntroductionWhen evaluating a quality-of-life questionnaire (QLQ), many validation studies do not correlate quality-of-life scores with objective measurements of complications associated with treatment. Patients and MethodsWe performed a cross-sectional observational study with 300 patients submitted to breast-conserving therapy. The patients answered the European Organization for Research and Treatment of Cancer (EORTC) QLQs C-30 and BR23, as well as the Brazilian Portuguese version of the Breast Cancer Treatment Outcome Scale (BCTOS) questionnaire. Retest, internal consistency, factorial analysis, convergent/divergent analysis, and Rasch evaluation were performed. All patients underwent physical evaluations to assess lymphedema, handgrip strength, shoulder range of motion, breast cosmesis, and breast pain, and these groups were compared on the basis of BCTOS scores. Receiver operating characteristic curve determined the predictive value of BCTOS scores associated with clinical practice. ResultsThe internal consistencies of the BCTOS domains ranged from 0.785 to 0.895. Factor analysis grouped according to the original questionnaire. Convergent validation showed differences in the sexual functioning and sexual enjoyment domains of the EORTC BR23. Analysis of known groups found that in most domains, the scores were higher in patients with lymphedema, strength deficit, shoulder range-of-motion alteration, poor breast cosmesis, breast pain, and axillary lymphadenectomy. Using a cutoff of 1.26, lymphedema was associated with the edema domain; using a cutoff of 1.33, Late Effects Normal Tissue Task Force/Subjective, Objective, Management, Analytic pain was associated with the pain domain; and using a cutoff of 2.37, the cosmetic domain was associated with subjective cosmesis. ConclusionThe association of objective measurements in a validation study of quality of life qualified the study and allowed us to develop better parameters for comparisons of results of breast-conserving therapy between populations.

Influence of 980-nm Diode Laser Vaporization on Sexual Function: A Short-Term Follow-Up Study.

The aim of this study was to assess changes in sexual function after 980-nm diode laser vaporization of the prostate. A total of 82 benign prostatic hyperplasia (BPH) patients underwent 980-nm diode laser vaporization from May 2013 to December 2016, and were followed up for 12 months. The following outcomes were assessed at baseline, 6, and 12 months postoperatively: international prostate symptom score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), five-item version of international index of erectile dysfunction questionnaire (IIEF-5), male sexual health questionnaire ejaculatory function domain Short Form (MSHQ-EjD Short Form), and retrograde ejaculation. Significant improvements at 6 and 12 months were noted postoperatively using IPSS, QoL, and Qmax compared with the preoperative values. Considering both patients and subgroups, the mean postoperative IIEF-5 scores at 6 and 12 months were unchanged compared with baseline. Regarding the MSHQ-EjD Short Form, at 6 and 12 months follow-up, postoperative total score of ejaculation function was decreased because the volume of ejaculation was decreased significantly. The frequency of ejaculation and force of ejaculation were also decreased, but the difference was not statistically significant. No significant difference in ejaculation bother item was observed after the operation. Patients with retrograde ejaculation at 6 and 12 months follow-up increased from 6/82 (7.3%) to 38/82 (46.3%), 42/82 (51.2%). The sexual function of patients could be maintained after 980-nm diode laser vaporization of prostate with the exception of reduction of ejaculatory volume and retrograde ejaculation.

Systematic review of the psychometric properties of instruments to measure sexual desire

BackgroundSexual desire is one of the domains of sexual function with multiple dimensions, which commonly affects men and women around the world. Classically, its assessment has been applied through self-report tools; however, an issue is related to the evidence level of these questionnaires and their validity. Therefore, a systematic review addressing the available questionnaires is really relevant, since it will be able to show their psychometric properties and evidence levels.MethodA systematic review was carried out in the PubMed, EMBASE, PsycINFO, Science Direct, and Web of Science databases. The search strategy was developed according to the following research question and combination of descriptors and keywords, including original studies with no limit of publication date and in Portuguese, English, and Spanish. Two reviewers carried out the selection of articles by abstracts and full texts as well as the analysis of the studies independently. The methodological quality of the instruments was evaluated by the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.ResultsThe search resulted in 1203 articles, of which 15 were included in the review. It identified 10 instruments originally developed in the English language. Unsatisfactory results on methodological quality were evidenced in cultural adaptation studies with no description of the steps of the processes and inadequacy of techniques and parameters of adequacy for models. The Principal Component Analysis with Varimax rotation predominated in the studies.ConclusionsThe limitation of the techniques applied in the validation process of the reviewed instruments was evident. A limitation was observed in the number of adaptations conducted and contexts to which the instruments were applied, making it impossible to reach a better understanding of the functioning of instruments. In future studies, the use of robust techniques can ensure the quality of the psychometric properties and the accuracy and stability of instruments. A detailed description of procedures and results in validation studies may facilitate the selection and use of instruments in the academic and/or clinical settings.Systematic review registrationPROSPERO CRD42018085706.

Role of Psychosocial Job Stressors on Sexual Function of Male Nurses: The Mediator Role of Work Ability.

There is limited information on the specific psychosocial risks at work that can impact sexual function. The general aim of this study was to investigate the effects of multiple dimensions of psychosocial work stressors on the male sexual function. This was a cross-sectional study conducted among 153 male nurses working in two hospitals in Iran. Sexual function and psychosocial job stressors were measured using the Persian version of the International Index of Erectile Function (P-IIEF) and the Persian version of the Health and Safety Executive (P-HSE) Management Standards Indicator Tool. The Persian version of the Work Ability Index (P-WAI) was used to assess the mediating effect of work ability on the relationship between overall stress and subscales of sexual function. The data were analyzed using Pearson product–moment correlation, one-way analysis of variance (ANOVA), and multiple linear regressions. The subscales of psychosocial job stressors, especially the subscale of role, had a significant correlation with several domains of sexual function. The regression modeling indicated that the subscales of role and job demands were significant predictors of various domains of sexual function. The effect of overall stress on intercourse satisfaction was fully mediated by WAI. In the other indicators of sexual function, overall stress score had only a significant direct effect, not mediated by WAI. Intervention programs to improve sexual function should focus on increasing nurses’ involvement in making decisions related to jobs and on using ergonomic principles related to balancing job demands and the level of nurses’ capabilities.

Effects of vaginal estradiol tablets and moisturizer on menopause-specific quality of life and mood in healthy postmenopausal women with vaginal symptoms: a randomized clinical trial.

Compare the effects of a vaginal estradiol tablet and a vaginal moisturizer, each to placebo, on menopause-related quality of life and mood in postmenopausal women with moderate-severe vulvovaginal symptoms. A total of 302 postmenopausal women enrolled in a 12-week, double-blind, placebo-controlled randomized trial were assigned to vaginal 10 μg estradiol tablet plus placebo gel (n = 102), vaginal moisturizer plus placebo tablet (n = 100), or dual placebo (n = 100). We measured change from randomization to 12 weeks in total score of the Menopause-Specific Quality of Life (MENQOL) questionnaire. We also evaluated the four MENQOL domains, depressive symptoms as measured by the Patient Health Questionnaire 8, and anxiety symptoms as measured by the Generalized Anxiety Disorder (GAD-7) questionnaire. Treatment with vaginal estradiol resulted in significantly greater improvement in total MENQOL scores compared to dual placebo (mean difference between arms -0.3 at 12 weeks (95% confidence interval [CI] -0.5, 0.0; P = 0.01). A statistically significant group mean difference favoring vaginal estradiol was observed for the MENQOL sexual function domain (-0.4 at 12 weeks; 95% CI -1.0, 0.1; P = 0.005), but not for any of the other domains. Treatment with vaginal moisturizer did not provide greater improvement compared to placebo in total MENQOL scores (mean difference 0.2 at 12 weeks; 95% CI -0.1, 0.4; P = 0.38) or in any of the MENQOL domains. Neither treatment group showed improvement compared with placebo in the Patient Health Questionnaire 8 or Generalized Anxiety Disorder Questionnaire . Treatment with low-dose vaginal estradiol, but not vaginal moisturizer, modestly improved menopause-related quality of life and sexual function domain scores in postmenopausal women with moderate-severe vulvovaginal symptoms.

The impact of Date Palm Pollen Capsule on Vaginal Iubrication and Dyspareunia In Menopausal Woman

Background & aim: Estrogen and androgen deficiency in menopause leads to poor vulvovaginal blood flow, vaginal dryness, and dyspareunia which can reduce the quality of life among the women. In this regard, this study investigated the impact of date palm pollen capsules on vaginal lubrication and dyspareunia in postmenopausal women. Methods: The present triple-blinded, placebo-controlled clinical trial was conducted on 60 ‌menopausal women aged 40-65 years, who referred to the health centers affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, in 2015. The subjects were randomly assigned to two groups of intervention and placebo (n=30), receiving date palm pollen and placebo capsules (350 mg, daily), respectively, for 35 days. The data were collected at two stages (at the baseline and after treatment) using the Female Sexual Function Index, a part of which evaluated vaginal lubrication and dyspareunia. Data analysis was performed in SPSS (version 16) using the independent t-test, Mann-Whitney U test, and ANCOVA. Results: There was a significant difference between the two groups after the intervention in terms of vaginal lubrication (p <0.001) and dyspareunia (P=0.048). The results of the ANCOVA revealed a significant difference between the intervention and placebo groups regarding the two investigated domains of sexual function by controlling the effect of the confounding factors. Conclusion: As the findings indicated, the administration of date palm pollen could improve vaginal lubrication and reduce dyspareunia in the postmenopausal women.

Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Although medical comorbidities are widely recognized to be associated with erectile dysfunction, less research has been done on their association with female sexual dysfunction (FSD). The purpose of this study was to assess whether FSD is associated with comorbidities; we hypothesized that there is an association. This is a secondary analysis of the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a prospective stratified probability sample of individuals aged 16-74. We assessed for association between sexual function scores and heart attack, heart disease, hypertension, stroke, diabetes, chronic lung disease, depression, other mental health condition, other neurologic conditions, and incontinence, as well as menopause and smoking status. Correlation between comorbidities and specific domains of sexual function was also assessed. A total of 6777 women, with an average age of 35.4 (14.1), responded to the survey and reported sexual activity in the past year. There was an association between sexual function score and age, menopause, hysterectomy, heart disease, hypertension, diabetes, obesity, smoking, depression, other mental health condition, stroke, other neurological condition, and homosexual attraction (p < 0.05). On multivariate analysis, age, sexual attraction, smoking status, depression, and other mental health conditions remained significantly correlated with sexual function (p < 0.05). Comorbidities were found to be correlated with specific domains. Comorbidities were associated with FSD and specific comorbidities associated with dysfunction in specific domains. Urogynecologists and urologists must assess for comorbidities, as women presenting with sexual dysfunction may provide an opportunity for early diagnosis of life-threatening conditions.

Interstitial Cystitis and Sexual Dysfunction: Diagnostic Accuracy Is Essential

To review the current literature regarding sexual dysfunction and interstitial cystitis/bladder pain syndrome (IC/BPS). Our goal was to review the epidemiology and overlap of these two conditions as well discuss the success of various IC/BPS treatment modalities with improving sexual function. Women with IC/BPS have a much higher incidence of sexual dysfunction as compared to controls, and this is often a significant predictor of poor quality of life. IC/BPS is thought to have various phenotypes and is associated with a number of overlapping chronic conditions which may contribute to sexual dysfunction thus making an accurate diagnosis imperative. Various treatments for IC/BPS may improve certain domains of sexual function. It is not surprising that IC/BPS, a chronic pelvic pain condition, negatively affects sexual function. More research is needed not just on the prevalence of sexual dysfunction in this patient population, but specifically on treatment options and ways to improve sexual function in these distressed patients.

553 The ‘heat’ goes away: sexual disorders of married women with female genital mutilation /cutting in Kenya

This study investigated the sexual experiences among married women living with FGM/C in Mauche Ward, Nakuru County, Kenya. This was a mixed method study. Quantitative data were obtained from 318 married women selected through multistage sampling then categorized into: cut before marriage, cut after marriage and the uncut. A questionnaire was used to collect demographic information while psychometric data were obtained using a female sexual functioning index (FSFI) tool. Qualitative data were obtained from five FGDs and two case narratives. The data were organized into themes, analyzed and interpreted. The mean age of the respondents was 30.59 ± 7.36 years. The majority (74.2%) had primary education and 76.1% were farmers. Age (p = 0.008), number of children (p = 0.035) and education (p = 0.038) were found to be associated with sexual functioning. The cut women reported lower sexual functioning compared to the uncut. ANOVA results show the reported overall sexual functioning to be significantly (p = 0.019) different across the three groups – cut before marriage, cut after marriage and married uncut. Women cut after marriage (mean = 22.81 ± 4.87) scored significantly lower (p = 0.056) than the uncut (mean = 25.35 ± 3.56). However, in comparison to the cut before marriage there was no significant difference (mean = 23.99 ± 6.63). Among the sexual functioning domains, lubrication (p = 0.008), orgasm (p = 0.019) and satisfaction (p = 0.042) were significantly different across the three groups. However, desire, arousal and pain were not statistically different.

MP74-16 MEASURING SEXUAL FUNCTION AFTER TREATMENT FOR PROSTATE CANCER IN MEN WHO HAVE SEX WITH MEN: A HIDDEN DOMAIN EMERGES

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II1 Apr 2018MP74-16 MEASURING SEXUAL FUNCTION AFTER TREATMENT FOR PROSTATE CANCER IN MEN WHO HAVE SEX WITH MEN: A HIDDEN DOMAIN EMERGES Channa Amarasekera, Vincent Wong, James Burns, Kyle Tsai, David Victorson, and Shilajit Kundu Channa AmarasekeraChanna Amarasekera More articles by this author , Vincent WongVincent Wong More articles by this author , James BurnsJames Burns More articles by this author , Kyle TsaiKyle Tsai More articles by this author , David VictorsonDavid Victorson More articles by this author , and Shilajit KunduShilajit Kundu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2400AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment for prostate cancer (PCa) can lead to significant impairments in sexual function (SF). Assessing SF both pre- and post-treatment provides an assessment of baseline function and helps measure progress with recovery. Several validated questionnaires exist for measuring SF. However, these instruments were validated using cohorts of men that were predominantly heterosexual. Men who have sex with men (MSM) have different sexual repertoires compared to heterosexual men (HSM) and current instruments may not apply to this population. Our objective was to determine if there are SF domains relevant to MSM that are missed by existing tools. METHODS We administered an online self-reported questionnaire to a cohort of 618 men from across the US (285 MSM, 333 HSM) regarding the applicability of the sexual function domain in the validated Expanded Prostate Cancer Index Composite (EPIC) questionnaire. These men were then queried about areas of concern in SF that may have missed by this instrument. Continuous variables were analyzed with a t-test, and a chi-square test was utilized for categorical variables. RESULTS The two cohorts were well matched with regard to demographics, including age, race, and education. MSM and HSM found EPIC-SF equally applicable at measuring erectile function (72.61% of MSM and 73.34% of HSM, p=.74). With regard to currently unmeasured domains, a larger number of MSM felt that prostate stimulation was a source of sexual satisfaction for the receptive partner during receptive anal intercourse (RAI) compared to HSM (61.9% vs. 12.77%, p<.0001). A larger proportion of MSM also felt it important to measure sexual satisfaction with RAI when assessing sexual function after PCa treatment (50.0% MSM vs. 12.2% HSM, p=.0002). When stratifying for MSM who engaged in RAI in the preceding year (MSM-RAI) vs. MSM who did not, a larger proportion of MSM-RAI felt that prostate stimulation was a source of sexual satisfaction during RAI (87.5% vs. 66.3%, p=.001), and more MSM-RAI thought it important to measure sexual satisfaction as it relates to RAI after PCa treatment (75.3% vs. 53.94%, p<.001). CONCLUSIONS Currently used instruments measuring SF are applicable to MSM and HSM with regard to erectile function, but fail to measure sexual satisfaction as it relates to RAI, an important area of sexual function for MSM, particularly in MSM who engage in RAI. Our findings highlight the need to add a domain relating to sexual satisfaction from RAI, to help care for and follow sexual minorities treated for PCa. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1005-e1006 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Channa Amarasekera More articles by this author Vincent Wong More articles by this author James Burns More articles by this author Kyle Tsai More articles by this author David Victorson More articles by this author Shilajit Kundu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...