Dysfunction In Women Research Articles

Prevalence of Thrombocytopenia and Platelet Dysfunction in Women Delivering at a Tertiary Care Hospital and Prevalence of Platelet Abnormalities in their Neonates with Perinatal Outcomes: A Retrospective Study

Objective: To study the etiology and severity of platelet disorders, clinical manifestations, mode of delivery and neonatal outcome in pregnant women with thrombocytopenia and platelet dysfunction delivering in a tertiary care center in the Middle east. Methods: A retrospective cohort study was done on pregnant women admitted to Sultan Qaboos University Hospital (SQUH) from January 2011 to December 2020 with platelet abnormalities as per the registry were included. Thrombocytopenia associated with drugs, viral infection, pre-eclampsia, and HELLP syndrome were excluded. Results: Total number of deliveries were 39,522 during the study period. Of these 220 patients had thrombocytopenia and platelet abnormalities according to our inclusion criteria. The incidence of platelet abnormalities was 0.56% The mean gestational age at delivery was age 37.53 weeks. The mean platelet count was 90.41cells/dl. The highest two etiologies in this study were gestational thrombocytopenia (GT) (24.6%) and immune thrombocytopenic purpura (ITP) (22.6%). Out of 220, 9.5% were treated with prednisolone. There was a significant correlation between maternal platelet counts and medical treatment was received. No significant correlation between maternal platelet counts and mode of delivery was obtained. Nine neonates had platelet abnormalities, of which 44.4% were born to mothers with immune thrombocytopenic purpura (ITP). Mild to moderate neonatal thrombocytopenia was present in 66.6% of the neonates. 33.3% of the thrombocytopenic neonates had experienced hemorrhagic manifestations with good clinical outcome. Conclusion: The incidence of platelet abnormalities was 0.56% according to our study. ITP was more associated with severe thrombocytopenia and premature delivery.

The co-effect of sensate focus technique and sexual position changing on sexual function of women who use medical treatment for endometriosis

Endometriosis is one of the most common chronic diseases of women. This study aimed to investigate the effect of sensate focus technique and sexual position changing on sexual function of women who used medical treatment for endometriosis. This clinical trial study was performed on 80 women who used medical treatment for endometriosis. Women were randomly assigned to two groups: in the intervention group, 2 h of verbal educational session were held and at the end of the session, an instruction booklet about sensate focus technique was given to them, the control group received routine treatment. The sexual function and the dyspareunia of the participants were evaluated after 4 and 8 weeks. Eight weeks after the intervention, the mean total score of sexual function in the intervention group was significantly improved compared to before the intervention (p < 0.001). The mean score of sexual pain in the follow-up periods in the intervention group was significantly different compared to before the intervention and control groups (p < 0.001). The sensate focus technique and sexual position change simultaneously improve sexual function in women with endometriosis who used medication. Trial registration: Approval number from Iranian Registry of Clinical Trials: IRCT2200617047812N1 (Registration date: 2020-11-05). Impact Statement What is already known on this subject? The role of endometriosis in the genesis of sexual dysfunction in women has been mentioned in several articles. Researches have shown that some sexual positions put less pressure on parts of the pelvis that contain endometrial tissue. The sensate focus technique can improve sexual dysfunction, including hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD), orgasm, dyspareunia, and vaginismus. What do the results of this study add? Have a positive effect on sexual function and dyspareunia in women with endometriosis undergoing medical treatment and improve their sexual function. What are the implications of these findings for clinical practice and/or further research? Medical staff recommended becoming familiar with these techniques to teach sensate focus and sexual position changing to women with endometriosis to improve their sexual function.

Association Between Domestic Violence and Sexual Dysfunction in Women on Infertility Treatment in Turkey

Infertility is a global problem that closely concerns people of reproductive age. Infertility has many negative effects on the lives of individuals, especially women who are more exposed to violence. The aim of this study is to determine the relationship between the perceptions of domestic violence against women and the sexual functions of women who apply to a clinic for fertility treatment. This descriptive cross-sectional study was conducted with 150 infertile women who applied to the clinic of a university hospital in northern Turkey between August 2018 and February 2019. The data were collected face-to-face using the descriptive information form, the Female Sexual Function Index and domestic-violence-against-women forms. The frequency, percentage, Pearson’s product–moment correlation analysis, linear regression analysis, the Mann Whitney U test, and Cronbach’s alpha methods were used in the analysis of the data. It was found that 54 per cent of the participants had a high school or higher education, 62 per cent of the participants did not work in an income-generating job, the participants were married for an average of 6.08 ± 3.99 years, and the mean age of the participants was 30.69 ± 6.13. The mean score of the domestic violence scale was 65.79 ± 11.16, and the mean score of the sexual function index was determined as 25.24 ± 5.47. Correlation values between domestic violence and sexual function index scores were found to be inversely significant (p &lt; 0.05). The research indicates that infertile women who are exposed to violence experience more sexual dysfunction. It also indicates that women who are not satisfied with their sex life are more exposed to sexual violence.

An evaluation of the prevalence and predictive factors of sexual dysfunction in women with heart failure: A cross-sectional survey.

This study aimed to determine the prevalence and predictive factors of sexual dysfunction and quality of sexual life in women with heart failure. Symptoms of heart failure may cause a decrease in sexual performance, sexual satisfaction and sexual desire. This cross-sectional study was conducted between December 2019 and June 22, 2020. The findings were reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (n=356). The majority of the participants had sexual dysfunction (84.8%), mainly a reduction in sexual desire. Participants had a mean SQOL-F score of 75.49 ± 19.37. More than a quarter of the participants stated that they were afraid of dying during sex (29.2%). There were changes in sexual dysfunction based on the class of medications that participants used regularly. Almost all participants stated that they were never informed by nurses or other healthcare professionals about sex (98%). Menopausal women are seven times more likely to develop sexual dysfunction than non-menopausal women (OR=7.0, p < .001). Women with heart failure are more likely to develop sexual dysfunction. Many factors affect sexual dysfunction and sexual quality of life. Therefore, nurses should take sexual dysfunction into account when caring for women with heart failure. They should monitor them for risk factors and side effects, draw up and implement plans to respond to problems. Sexual dysfunction is quite high in women with heart failure. Nurses should encourage these patients to talk about sexual problems and provide sexual health education and counselling regardless of the level of their sexual problems. The patients evaluated the suitability of the questions at the pre-application stage. We finalised the demographic questionnaires with their suggestions. The patients spent time filling out the questionnaires during the data collection phase and answered the questions sincerely.

Disruption of specificwhite matter tracts is associated with neurogenic lower urinary tract dysfunction in women with multiple sclerosis.

To identify specific white matter tracts (WMTs) whose disruption is associated with the severity of neurogenic lower urinary tract dysfunction (NLUTD) in two independent cohorts of women with multiple sclerosis(MS) and NLUTD. Cohort 1 consisted of twenty-eight women with MS and NLUTD. The validation cohort consisted of 10women with MS and NLUTD. Eleven healthy women served as controls. Participants of both MS cohorts had the same inclusion and exclusion criteria. Both MS cohorts and the healthy controls underwent the same clinical assessment and functional MRI(fMRI) protocol, except that the validation MS cohort underwent 7-Tesla fMRI scan. Fifteen WMTs (six coursing to relevant brainstem areas) involved in bladder control were a priori regions of interest (ROI). Spearman's correlation test was performed between each the Fractional Anisotropy (FA) and mean diffusivity (MD) of each WMT and the clinical parameters. Overall, we found a very high degree of overlap (100% of a priori ROI) in the tracts identified by our correlation analysis as having the greatest contribution to NLUTD symptoms in MS women. The right inferior cerebellar peduncle, left posterior limb of internal capsule, and left superior cerebellar peduncle displayed significant associations to the greatest number of clinical parameters. Our correlation analysis supports the role of specific WMT disruptions in the contribution of symptoms in women with MS and NLUTD, as confirmed in two independent MS cohorts.

Narcissistic personality traits and sexual dysfunction in women: the role of body image self-consciousness

Narcissistic personality traits and sexual dysfunction in women: the role of body image self-consciousness

Narcissistic personality traits and sexual dysfunction in women: the role of body image self-consciousness

Narcissistic personality traits and sexual dysfunction in women: the role of body image self-consciousness

Investigating the Effect of Stress Management Counseling on the Sexual Function of Infertile Women

Background: Sexual dysfunction is one of the most common causes of family breakdown. In recent years, different approaches have been used to solve this problem. Due to the negative effects of sexual dysfunction in women and its complications. Objective: The present study was conducted to investigate the effect of stress management counseling on the sexual function of infertile women referred to Fatemieh Hospital in Hamadan. Methods: The present study was conducted as a randomized two-group clinical trial with two pretest and post-test stages on 104 eligible women referring to Fatemieh Hospital in Hamadan in 2017-2018. Intervention group subjects received 4 two-hour group counseling sessions with a cognitive- behavioral approach on sexual issues. Data were obtained using two questionnaires of demographic characteristics and the Female Sexual Function Index. To analyze the data, SPSS version 21 software and paired t-test, independent t-test, and analysis of covariance were used. The level of significance was considered to be less than 0.05. Results: The results of the present study showed that the mean scores in all areas of total sexual function did not differ significantly before the intervention in two groups. However, after stress management counseling, a significant increase was observed in all areas and general sexual function in the intervention group compared to the control group (P &lt;0.05). Conclusion: Stress management counseling in infertile women can play a positive and effective role in improving sexual function. Therefore, the effectiveness of this counseling in promoting sexual function can be confirmed with more confidence. Registeration No: The study was registered at the Iranian Registration Clinical Trials (IRCT201704149014N158) by I IRCT.

A new part of life covid: female sexual dysfunction

<h3>Objectives</h3> The purpose of this review study for of the summarizes the effect of COVID-19 on sexual dysfunction in women. <h3>Methods</h3> The articles used for this review were collected based on research results from relevant articles from NCBI, Google Scholar, Web of Science, Scopus. The search terms used; covid, pandemic, sex, sexuality, female sexual dysfunction The results were reviewed for the purposes of the present study. <h3>Results</h3> Social isolation may have significantly contributed to higher rates of sexual dysfunction. Depression, anxiety, and stress are well-established risk factors for sexual dysfunction, and it follows that rates of sexual dysfunction may be increasing given a more distressed. Culture is effective on sexuality during the pandemic; studies show that Turkey and Italy have demonstrated an increase in FSD and decrease in the frequency of intercourse with the onset of the pandemic, however, India, Nepal showed no effect from pandemics to sexuality. <h3>Conclusions</h3> COVID-19 has had a significant impact on the quality of life and sex life of the population. The development of risk for female sexual dysfunction was associated with higher pandemic anxiety and depression. <h3>Conflicts of Interest</h3> There are no conflicts of interest.

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges-a narrative review.

Standard radical cystectomy (RC) in women includes the removal of the bladder, urethra, uterus with the adnexa, and the anterior vaginal wall, thereby severely affecting the urinary, sexual, and reproductive system. To limit these detrimental effects, organ-sparing, including nerve-sparing approaches, have been developed. Health-related quality of life (HRQOL) and functional outcomes are, indeed, becoming increasingly central to the shared decision-making with the patient. The objectives of this narrative review are: (I) to review the current status of RC in women, including the use of different urinary diversions (UDs); (II) to discuss organ-sparing approaches and their impact on oncological and functional outcomes in women; (III) to discuss the impact of RC on HRQOL and sexual function in women. We performed a non-systematic literature review of the available publications in the PubMed database. Over the past years, gender differences in oncological and functional outcomes after RC have received increased attention. According to the currently available literature, organ-sparing approaches can be safely performed in well-selected women without negatively impacting oncological outcomes. The orthotopic neobladder is feasible and oncologically safe in well-selected and informed women. The choice of the UD should be based on comprehensive counseling and the patient's comorbidities and preferences. There still is a lack of data on sexual recovery after the different surgical approaches aimed to mitigate sexual dysfunction in women undergoing RC. Pre-and post-operative counseling and support of females undergoing RC regarding their expectations and experiences in terms of quality of life and functional and sexual outcomes are currently insufficient. Well-designed studies in this field are necessary to further improve outcomes of women treated with RC with an overarching aim to close the gender gap in managing women with bladder cancer.

Kombinasi Aromaterapy Jasmine Sambac dan Loving Yoga terhadap Disfungsi Seksual pada Akseptor KB Suntik DMPA

One of the side effects of the 3-Month Injectable KB is impaired sexual function caused by the high level of the hormone progesterone, resulting in vaginal drying, which causes pain during sexual intercourse, which can lead to a decrease in sexual desire or dysfunction in women. Jasmine Sambac is an effective and gentle way to promote a healthy body and for relaxation. Loving yoga is a type of yoga developed by researchers, with a focus on Kegel exercises and pelvic muscles that function to increase blood flow, so that the body feels relaxed which can increase libido in sexual intercourse. The purpose of this study was to identify the effect of the combination of Aromatherapy Jasmine Sambac and Loving Yoga on sexual dysfunction in DMPA injection family planning acceptors. The research method used is a quasi-experimental approach with a one group pre-post test design approach. Measurement of pre-test and post test was carried out using the FSFI (Female Sexual Function Index) instrument. The results showed that jasmine sambac aromatherapy and loving yoga had a significant effect on increasing the total libido, including its 6 aspect domains, on DMPA injection acceptors.

The relationship between human papilloma virus and anxiety, depression and sexual dysfunction in women

The relationship between human papilloma virus and anxiety, depression and sexual dysfunction in women

Evaluation of Disparity in Physician Assessment of Sexual Dysfunction in Women vs. Men Receiving Brachytherapy for Genitourinary Cancers

<h3>Purpose/Objective(s)</h3> Brachytherapy is an integral component of treatment for genitourinary cancers, but comes with long-term risk of sexual dysfunction, with 90% of women and 50% of men experiencing sexual dysfunction after brachytherapy for gynecologic malignancies and prostate cancer, respectively. We hypothesized that women's sexual health was not being assessed in clinic at the same rate as their male counterparts receiving prostate brachytherapy. We similarly hypothesized that our institutional data would be representative of clinical investigators nationally, with lower rates of sexual function assessment in women compared to men enrolled on clinical trials. <h3>Materials/Methods</h3> Patients with cervical or prostate cancer evaluated for brachytherapy between 2010 and 2021 at a single academic institution were included in this retrospective analysis. Consult notes were reviewed to assess if patients were asked about baseline sexual function with or without patient-reported outcomes (PRO). Chi-square test was used to determine statistically significant differences between the two groups (p<0.05). For a more robust national comparison, we also queried the NIH Clinical Trials Database to determine the proportion of clinical trials assessing sexual function as a primary or secondary endpoint after brachytherapy for prostate or cervical cancer. <h3>Results</h3> We analyzed 126 female and 75 male patients who were evaluated for cervical and prostate cancer brachytherapy, respectively. More men than women were asked about sexual function at time of consult, even though the female cohort was younger (Table 1). Rates of assessment of sexual function were similar in men who were and were not offered ADT [45 (88%) vs. 22 (92%); p=0.65]. Prostate cancer brachytherapy trials were also more likely to assess sexual function compared to those in cervical cancer. <h3>Conclusion</h3> We demonstrate a significant difference between men and women in the ascertainment of sexual function both in our clinic and on brachytherapy clinical trials nationwide. We have previously shown that 79% of women believed that sexual function was an important component of their overall health. Even though brachytherapy has a highly deleterious impact on sexual function, women are not being evaluated for this important functional outcome at the same rate as men. Further studies are warranted to fulfill this unmet need and to understand the barriers to assessing and treating sexual dysfunction in women receiving brachytherapy as part of treatment.

Association of antithyroid peroxidase antibodies with cardiac function in euthyroid women with type 1 diabetes mellitus - assessment with two-dimensional speckle‑tracking echocardiography

The presence of diabetes is associated with loss of cardioprotection in premenopausal women; however, the mechanisms involved remain unknown. Autoimmune factors are suspected to play a role in cardiovascular complications, especially in type 1 diabetes (T1DM). The aim of this pilot study was to explore whether antithyroid peroxidase antibody (aTPO) as a marker of increased immune activity is related to cardiac dysfunction in young, asymptomatic women with T1DM. Eighty-eight euthyroid women (59 with T1DM and 29 healthy controls) underwent physical examination, laboratory tests, thyroid ultrasound, and two-dimensional speckle-tracking echocardiography. According to the antiperoxidase antibodies (aTPO) titre, the T1DM women were divided into an aTPO positive (T1DM aTPO+) (n = 34) and an aTPO negative (T1DM aTPO-) (n = 25) group. The relationship between thyroid autoimmunity parameters and echocardiographic parameters was evaluated. Global longitudinal strain (GLS) was slightly reduced in the T1DM aTPO+ group compared to T1DM aTPO- and significantly compared to controls (p = 0.051 and p = 0.015, respectively). Although, the lower values of longitudinal strain of left ventricular were found in the majority of segments in the T1DM aTPO+ group in comparison to T1DM aTPO- and controls, significant differences were only found in the two-chamber view (specifically in the anterior segments) between the T1DM aTPO+ and T1DM aTPO- groups (p = 0.030) and in the four-chamber view (specifically in the anterolateral segments) between the T1DM aTPO+ group and controls (p = 0.021). Echocardiographic parameters of diastolic and systolic function of both ventricles were significantly correlated with parameters of thyroid autoimmunity. A logistic regression analysis showed that Hashimoto's thyroiditis (HT) duration [odds ratio (OR): 0.997, 95% confidence interval (CI): 0.995-0.999, p = 0.008), the dose of levothyroxine (OR: 0.814, 95% CI: 0.689-0.960, p = 0.013), and reduced echogenicity on thyroid ultrasound (OR: 0.309, 95% CI: 0.120-0.793, p = 0.013) had a significant influence on reduced GLS. Our results suggest that coexistence of aTPO with T1DM was associated with poorer myocardial function, particularly in the anterior and anterolateral segments, which may be related to an autoimmune factor. The impaired function of these segments is probably the first sign of myocardial systolic dysfunction in women with T1DM, which needs to be confirmed in further studies.

Occurrence and impact of pelvic floor dysfunction in women with and without breast cancer: a cross-sectional study

BackgroundOne of the sequalae of breast cancer treatments may be pelvic floor (PF) dysfunction such as urinary incontinence (UI), faecal incontinence (FI), and pelvic organ prolapse (POP). ObjectiveThe aim of this study was to compare the occurrence and related distress and impact of PF dysfunction between women with and without breast cancer. MethodsWomen with and without breast cancer participated in this cross-sectional study. The Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire were used to quantify the prevalence and related distress, and impact of PF dysfunction. Factors associated with PF outcomes were examined using logistic and linear regressions while controlling for known risk factors for PF dysfunction (age, body mass index, and parity). Results120 women with breast cancer, and 170 women without breast cancer responded. The occurrence of any type of UI was higher in women with breast cancer than women without breast cancer (percentage difference=17%; 95% CI: 7, 29). Women with breast cancer experienced higher impact of urinary symptoms (mean difference=18.2; 95% CI: 8.9, 27.7) compared to those without. Multivariable analysis indicated that having breast cancer (β 0.33; 95%CI: 0.08, 0.51) was the strongest predictor of greater impact of urinary symptoms. ConclusionWomen with breast cancer reported a higher occurrence and impact of urinary symptoms than women without breast cancer. While further studies are required to confirm our findings, routine screening and offering treatment for urinary symptoms may be indicated for women with breast cancer.

Beneficial effects of Pilates exercise on female sexual dysfunction: A prospective pilot study

ObjectiveFemale sexual dysfunction (FSD) is a significant public health issue, and it has a high global prevalence. Few effective treatment options are available for the treatment of FSD. We conducted a prospective clinical pilot study to investigate the beneficial effects of Pilates exercise on sexual function in women with FSD. MethodsWomen aged between 20 and 50 years and who had regular menstrual cycles and sexual relationships and participating Pilates exercise program were asked to complete Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) questionnaires before starting the Pilates exercise program. If the total FSFI score was less than 26.55, which is the cut-off for FSD, the subject was invited to participate in the study. Primary endpoints were changes in total and individual domain scores on the FSFI and BDI. ResultsA total of 36 premenopausal women were included in the study. After a 12-week Pilates program, all domains of the FSFI were significantly improved, with mean±SD total FSFI scores increasing from 12.0±4.9 to 29.3±3.4 (P<0.0001). BDI scores were significantly decreased from 25.1±14.3 to 1.6±3.7 (P<0.0001) after the exercise program. ConclusionsThis pilot study showed that Pilates exercise could improve sexual functions in women with FSD. Pilates may facilitate the treatment of sexual dysfunction in women.

Sexual Dysfunction in Women and Men with Psoriasis: A Cross-Sectional Questionnaire-Based Study.

Background and objectives: Psoriasis can lead to feelings of stigmatization, hinder social functioning, and impair quality of life. Psoriasis can also affect sexual activity, but there is still little research on this topic. The present study investigated whether and to what extent psoriasis, its severity, location and extent of skin lesions affect sexual dysfunction. Materials and Methods: A total of 45 women and 64 men aged 18 to 73 years hospitalized for psoriasis exacerbations were included in the study. Psoriasis severity, as assessed by the Psoriasis Area and Severity Index (PASI), ranged from 0.2 to 65 points (mean: 17.0 ± 14.9 points). After collecting demographic and clinical data, each subject was asked to complete the Dermatology Life Quality Index, the 11-item Sexual Life Questionnaire and the International Index of Erectile Function (only men). Results: Our study found that more than 90% of the patients surveyed felt at least a slight unattractiveness due to psoriasis. In approximately 80% of the subjects, the skin lesions at least occasionally affected their sex life, and more than 50% at least sometimes avoided sexual contact. The location of psoriasis, particularly in the genital area (p = 0.01), on the face (p = 0.03) and hands (p = 0.05), also had a significant impact on the level of sexual problems. Psoriasis has a significant impact on the quality of life (QoL), and a deterioration in QoL was strongly correlated with sexual dysfunction (r = 0.6, p < 0.001), PASI scores (r = 0.36, p < 0.001), self-assessment of psoriasis severity and location of psoriatic lesions. Conclusions: Psoriasis leads to various limitations, especially in the sphere of sexual life. Patients with psoriasis feel stigmatized, have lowered self-esteem and consequently experience significant sexual problems. Awareness of the co-occurring psychological aspect of psoriasis and the routine use of validated scales in dermatology practice should contribute to the rapid identification of patients with sexual dysfunction.

Treatment Strategies for Sexual Dysfunction Associated With Psychotropic Medications

&#x0D; For antipsychotic-related sexual dysfunction, 1 guideline recommends switching to aripiprazole or another non-hyperprolactinemic antipsychotic as the first option. Alternatively, the guideline recommends adjunctive treatment with aripiprazole, or switching to antipsychotics that have less impact on sexual function. Another guideline recommends adding estrogen or testosterone treatment to the antipsychotic medication to assist sexual dysfunction in women.&#x0D; For antidepressant-related sexual dysfunction, 1 guideline recommends switching to agomelatine or to a non-serotonergic drug or fluvoxamine as first option. Alternatively, the guideline recommends switching to a partially non-serotonergic antidepressant, adding antidotes, or using vaginal lubricants.&#x0D;

Sexual Dysfunction in Women after Traumatic Pelvic Fracture Negatively Affects Quality of Life and Mental Health

BackgroundWhile the impact of female sexual dysfunction (FSD) on mental health and overall health-related quality of life (HrQOL) has been previously documented, no prior work has evaluated this relationship in women following traumatic pelvic injuries. AimThis study aims to understand the relationship of FSD with HrQOL and depression in women with a history of traumatic pelvic fracture. MethodsData were collected with an electronic survey that included queries regarding mental and sexual health. Inverse probability weighting and multivariate regression models were utilized to assess the relationships between sexual dysfunction, depression and HrQOL. OutcomesStudy outcome measures included the Female Sexual Function Index (FSFI) to evaluate sexual functioning, the 8-item patient health questionnaire (PHQ-8) to assess depression symptoms, and the visual analog scale (VAS) component of the EuroQol 5 Dimensions Questionnaire (EQ-5D) to determine self-reported HrQOL. ResultsWomen reporting FSD had significantly higher PHQ-8 scores with a median PHQ-8 score of 6 (IQR 2, 11) relative to those without FSD who had a median score of 2 (IQR 0, 2) (P < .001). On multivariate linear regression, presence of FSD was significantly associated with higher PHQ-8 scores (β = 4.91, 95% CI 2.8–7.0, P < .001). FSFI score, time from injury, and age were all independently associated with improved HrQOL, with FSFI having the largest effect size (β = 0.62, 95% CI 0.30–0.95, P < .001). Clinical ImplicationsThese results underscore importance of addressing not just sexual health, but also mental health in female pelvic fracture survivors in the post-injury setting. Strengths and LimitationsThis study is one of the first to examine women with traumatic pelvic fractures who did not sustain concomitant urinary tract injuries. Study limitations include low response rate and the inherent limitations of a cross-sectional study design. ConclusionPatients with persistent, unaddressed FSD after pelvic fracture are at unique risk for experiencing depression and reporting worse health-related quality of life due to complex biopsychosocial mechanisms.Gambrah HA, Hagedorn JC, Dmochowski RR, et al. Sexual Dysfunction in Women after Traumatic Pelvic Fracture Negatively Affects Quality of Life and Mental Health. J Sex Med 2022;19:1759–1765.

Does the Ketogenic Diet Improve the Quality of Ovarian Function in Obese Women?

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, the prevalence of which ranges from 8 to 13%. It is characterized by metabolic, reproductive, and psychological alterations. PCOS prevalence is related to body mass index (BMI). Women with BMI < 25 kg/m2 have a prevalence of 4.3%, whereas women with BMI > 30 kg/m2 have a prevalence of 14%. Moreover, women with PCOS have a risk of type 2 diabetes mellitus (T2DM) two-fold higher than controls, independently of BMI. Both PCOS and T2DM are also consequences of lower serum sex-hormone-binding globulin (SHBG) levels, which is currently considered a biomarker of metabolic disorders, in particular T2DM. Aim: To evaluate the effect of the very-low-calorie ketogenic diet (VLCKD) on markers suggested to be predictive of metabolic and ovulatory dysfunction. These comprehend SHBG, anti-Mullerian hormone (AMH), and progesterone levels on day 21 of the menstrual cycle in a cohort of obese non-diabetic women with PCOS and regular menses. Methods: Twenty-five patients (mean age 25.4 ± 3.44 years) with obesity and PCOS underwent VLCKD for 12 weeks. Each of them underwent measurements of anthropometric parameters (body weight, height, and waist circumference) and blood testing to evaluate serum levels of SHBG, AMH, and progesterone before and after 12 weeks of VLCKD. Results: At enrollment, all patients had high BMI, WC, and AMH, whereas SHBG and progesterone levels were low. After VLCKD, the patients showed a significant reduction in BMI, WC, and HOMA index. In particular, 76% of patients (19/25) switched from obesity to overweight, and the HOMA index normalized, reaching values lower than 2.5 in 96% (24/25) of patients. In addition, serum AMH levels significantly decreased, and progesterone and SHBG significantly increased after VLCKD. Conclusions: This is the first study documenting the effects of VLCKD on ovarian reserve and luteal function in women with PCOS. VLCKD could be used to improve metabolic and ovulatory dysfunction in women with PCOS. Further studies are needed to understand the reasons for the AMH reduction.