Female Sex Function Research Articles

Abstract PO3-11-06: Return to work in Brazilian women on adjuvant endocrine therapy

Abstract Background: Breast cancer is the most common cancer in women and its diagnosis and treatment may adversely impact the return to work (RTW). Previous work showed that RTW varies from as low at 27% to as high as 93%. There are few data about RTW in Latin America population. This study aims to investigate the RTW in Brazilian woman with early breast cancer treated with adjuvant endocrine therapy (ET) and its relations to patients’ characteristics, duration of ET, healthcare insurance, quality of life (QOL), sexual disfunction and adherence. Methodology: Women with a past history of early-stage estrogen receptor-positive (ER+) invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months were invited to participate in this study and evaluated about RTW. We interviewed patients and asked about employment before cancer diagnosis and about absence from work (yes/no) after diagnosis, return to work (yes/no), time off (< 06 months, 6-12 months, 13-24 months, > 24 months), and difficulties in RTW (yes/no). EORTC QLQ C30 and BR-23, female sex function index questionnaires (FSFI) and adherence to endocrine therapy (MMAS-8) were evaluated. Demographic and medical information, having or not private health insurance (yes versus public), degree of education (completed high school vs not) were reviewed from medical records. Data collection was done with RedCap software. Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used. Multivariable analysis was performed using Poisson regression. P < 0.05 was considered significant. Analyzes were performed in SAS 9.4. Results: From June 2021 to May 2023, a total of 461 women with ER+ early-stage breast cancer from 12 Brazilian institutions were included in this analysis. The mean age was 56.02 years (range 22-93 ), 47.7% were non-white and 38.7% were premenopausal. A total of 233 women (50.6%) had private insurance and the remaning were treated in public institutions. Median duration of ET usewas 2.78 years (range 6 months- 9.61 years). A total of 266 (64.88%) of women worked before cancer diagnosis and were evaluated about RTW. RTW rates at 6 months, 12 months and 24 months after diagnosis were 32.7%, 53% and 69.9% respectively. A total of 31.2% of women did not RTW at 2 years. A total of 53 (37.5%) of woman reported to face difficulties to RTW. Characteristics associated with RTW were age >60 years (p=0.004), white race (p=0.014), higher education level (p< 0.0001), stage I disease (p=0.018), private healthcare insurance (p< 0.0001). In the multivariable analysis, not having private health insurance, yonger age, lower EORTC QLQ-C30 physical functioning score and higher EORTC QLQ-BR23 arm symptoms scores were associated with not returning to work in this population (p < 0.05). Conclusion: Almost one third of the patients who were employed before cancer diagnosis did not RTW after treatment in Brazil. At 12 months, RTW rate was 53% higher than previous data in Latin America. Healthcare insurance, age and quality of life were related to RTW. It is crucial to identify the barriers and improve work conditions to increase RTW after breast cancer treatment as RTW have been shown to be beneficial to patients’ physical, mental health and quality of life. Variables with adjusted prevalence ratios for the occurrence of absence from work XX XX PR: Prevalence ratio; EORTC : European Organisation for Research and Treatment of Cancer XX XX Citation Format: Daniele Assad-Suzuki, Andrea Shimada, Danielle Santos, Cristiano Souza, Fernanda Moura, Sulene Oliveira, Anna Luiza Galvão, Bruno Souza, Amanda Castro, Monalisa Andrade, Yuri Beckedorff, Maria Cristina Magalhães, Carlos Paiva, Heloísa Resende, Daniela Pereira, Angelica Rodrigues, Daniela Rosa, Romualdo Barroso-Sousa. Return to work in Brazilian women on adjuvant endocrine therapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-06.

Abstract PO2-12-04: Suboptimal adherence to adjuvant endocrine therapy (ET) in Brazilian women with early-stage estrogen receptor-positive (ER+) breast cancer

Abstract Background: Adjuvant ET reduces breast cancer recurrence and increases overall survival among patients with early-stage ER+ breast cancer, however a suboptimal number of patients in fact takes oral medicine as prescribed. In Brazil, there is a paucity of data about adherence to adjuvant ET. This study aims to evaluate adherence to adjuvant ET in Brazilian women with early breast cancer and to evaluate clinical and sociodemographic characteristics associated with higher or lower adherence. Methods: Women with history of early-stage ER+ invasive carcinoma of the breast on adjuvant ET for at least 6 months were invited to participate of this study. Adherence was assessed with questionnaire Morisky Medication Adherence Scale (MMAS-8) and high adherence was defined by a MMAS-8 score=8. Demographic and medical information, site of treatment (private versus public), degree of education (completed high school vs not) were reviewed from medical records. Quality of life was assessed using EORTC QLQ C30 and BR-23 forms, sexuality was evaluated with the Female Sex Function Index questionnaire. Additionally, patients were interviewed about return to work. Data collection was done with RedCap software. Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used. Multivariable analysis was performed using Poisson regression. P < 0.05 was considered significant. Analyzes were performed in SAS 9.4. Results: From June 2021 to May 2023, a total of 461 women with ER+ early-stage breast cancer from 12 Brazilian institutions were included in this analysis. The mean age was 56.0 years (range 22-93), 47.7% were non-white and 38.7% were premenopausal. A total of 233 women (50.6%) had private insurance and the remaining were treated in public institutions. Median duration of ET use was 2.78 years (range 6 months- 9.61 years). High adherence to adjuvant endocrine therapy was present in 55.7% of patients. Median age of high adherent woman was higher than low adherent (p=0.005). Factors significantly associated with high adherence were no use of ovarian suppression (p=0.0095), use of anti-Her2 therapy (p=0.0462). Furthermore, higher scores for EORTC QLQ-C30 global health status (p=0.017) and in specific domains, including role functioning (p=0.007), emotional functioning (p< 0.0001), cognitive functioning (p< 0.001), social functioning (p = 0,0005), higher scores for EORTC BR23 body image (p< 0.001) and future perspective (p = 0.0198) were also associated with high adherence. Higher EORTC QLQ-C30 cognitive function score was the only variable associated with high adherence (p < 0.0001) to ET in multivariate model. Conclusion: Using the MMAS-8, only 55.7% of Brazilian women with stage I-III ER+ breast cancer reported high adherence to endocrine therapy. This suboptimal adherence rate leads to important questions such as the impact on the prognosis of this population Charactheristic with adjusted prevalence ratio for the occurrence of High adherence PR: Prevalence ratio; EORTC: European Organisation for Research and Treatment of Cancer Citation Format: Daniele Assad-Suzuki, Heloísa Resende, Danielle Santos, Fernanda Moura, Sulene Oliveira, Andrea Shimada, Anna Luiza Galvão, Bruno Souza, Amanda Castro, Monalisa Andrade, Yuri Beckedorff, Maria Cristina Magalhães, Cristiano Souza, Carlos Paiva, Daniela Pereira, Angelica Rodrigues, Daniela Rosa, Romualdo Barroso-Sousa. Suboptimal adherence to adjuvant endocrine therapy (ET) in Brazilian women with early-stage estrogen receptor-positive (ER+) breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-12-04.

Male reproductive success is not strongly affected by phenological changes in mate availability in monoecious Sagittaria latifolia.

Many plants express their female and male sex roles at different times (dichogamy), with important consequences for mating. Dichogamy can yield mate limitation via biased floral sex ratios, particularly at the beginning and end of the flowering season when many plants simultaneously function as the same sex. This form of mate limitation should be reduced if plants adjust their allocations to female versus male sex functions in a manner that tracks seasonal variability in mating opportunities. For example, under protogyny (i.e. dichogamy with female function expressed first) plants with male-biased sex expression should have enhanced mating opportunities early in the flowering season as other plants begin to flower (in female sex phase). We quantified seasonal changes in sex allocation, patterns of mate availability and realized siring success in a population of protogynous Sagittaria latifolia. Our results were consistent with previous findings that seasonal changes in sex allocation should compensate for lost mating opportunities under the temporally variable mating environments caused by dichogamy. However, patterns of siring success in the population were inconsistent with this interpretation. We suggest that realized siring success might depend more strongly on spatial than on temporal aspects of mate availability.

Is the initiation of selfing linked to a hermaphrodite\u2019s female or male reproductive function?

There is an ongoing debate about whether simultaneous hermaphrodites capable of selfing should prefer selfing over outcrossing or vice versa. While many theoretical models predict a transmission advantage for alleles that favour selfing, empirical studies often reveal low selfing rates. Despite these considerations, the underlying mechanisms that determine reproductive strategies in simultaneously hermaphroditic animals are poorly understood. In our study on the facultatively selfing free-living flatworm, Macrostomum hystrix, we ask whether the initiation of selfing, as inferred from the differential spatial distribution of received sperm, is linked to an individual’s female or male reproductive function. Specifically, the initiation of selfing could (i) be linked to the male function, when an individual is unable to donate sperm to others and hence donates sperm to self, or it could (ii) be linked to the female function, when an individual fails to receive sperm from others—and hence is unable to fertilize its eggs via outcrossing—thus inducing it to self-fertilize. We experimentally created a social environment that allowed focals to outcross via sperm donation, but simultaneously prevented them from receiving sperm—by pairing them with a partner lacking the male copulatory organ—so that fertilization of the focal’s eggs was restricted to selfing. Our results suggest that such focals generally do not initiate selfing, while we readily observe selfing in isolated worms. This suggests that in isolated M. hystrix, it is the male function that is linked to the initiation of selfing, likely due to a lack of opportunities for sperm donation.Significance statementA variety of simultaneously hermaphroditic animals are capable of reproducing via both selfing and outcrossing. While the reproductive choices of such animals can be modelled by the joint action of genetic (e.g. inbreeding depression) and ecological factors (e.g. partner availability), experimental evaluation of theoretical results is often lacking. By manipulating the social environment of focal individuals, we here provide evidence that explores the respective role that the co-occurring male and female sex functions have on the initiation of selfing in a simultaneously hermaphroditic flatworm species. Specifically, our results suggest that the initiation of selfing is linked to the worm’s male function. Insights about which function is linked to the initiation of selfing may ultimately help to better understand reproductive decisions in simultaneous hermaphrodites.

Assessment of sexual function and related factors in mid-aged sexually active Brazilian women with the 6-item Female Sex Function Index: a cross-sectional study

Aim: To assess sexual function and associated factors in a sample of Brazilian mid-aged sexually active women.

Sex allocation plasticity on a transcriptome scale: Socially sensitive gene expression in a simultaneous hermaphrodite.

Phenotypic plasticity can enable organisms to produce optimal phenotypes in multiple environments. A crucial life history trait that is often highly plastic is sex allocation, which in simultaneous hermaphrodites describes the relative investment into the male versus female sex functions. Theory predicts-and morphological evidence supports-that greater investment into the male function is favoured with increasing group size, due to the increasing importance of sperm competition for male reproductive success. Here, we performed a genome-wide gene expression assay to test for such sex allocation plasticity in a model simultaneous hermaphrodite, the free-living flatworm Macrostomum lignano. Based on RNA-Seq data from 16 biological replicates spanning four different group size treatments, we demonstrate that at least 10% of the >75,000 investigated transcripts in M.lignano are differentially expressed according to the social environment, rising to >30% of putative gonad-specific transcripts (spermatogenesis and oogenesis candidates) and tail-specific transcripts (seminal fluid candidates). This transcriptional response closely corresponds to the expected shift away from female and towards male reproductive investment with increasing sperm competition level. Using whole-mount in situ hybridization, we then confirm that many plastic transcripts exhibit the expected organ-specific expression, and RNA interference of selected testis- and ovary-specific candidates establishes that these indeed function in gametogenesis pathways. We conclude that a large proportion of sex-specific transcripts in M.lignano are differentially expressed according to the prevailing ecological conditions and that these are functionally relevant to key reproductive phenotypes. Our study thus begins to bridge organismal and molecular perspectives on sex allocation plasticity.

Risk factors for sexual dysfunction in BRCA mutation carriers after risk-reducing salpingo-oophorectomy.

The aim of the study was to identify risk factors for sexual dysfunction in BRCA mutation carriers who have undergone risk-reducing salpingo-oophorectomy (RRSO). A cross-sectional study was performed. BRCA1/2 mutation carriers with and without RRSO were surveyed to determine sexual function (Female Sex Function Index [FSFI]), demographics, medical history, sleep quality, depression, and anxiety scores. Characteristics of patients with the lowest quartile of FSFI scores (<14 ± 8.8) were analyzed to identify risk factors for the most severe phenotype. In the 804 women surveyed, 764 underwent RRSO. Of the 529 (69%) carriers with completed FSFI questionnaires in the RRSO cohort, sexual dysfunction was reported in 77.3%. Poor sleep (P = 0.002), hot flashes (P = 0.002), lack of current systemic hormone therapy (HT) use (P = 0.002), depression (P < 0.001), and anxiety (P = 0.001) were associated with sexual dysfunction. In adjusted analyses, depression (adjusted odds ratio [aOR] 2.4, 95% CI, 1.4-4.1) and hot flashes (aOR 1.9, 95% CI, 1.2-3.0) remained significantly associated with sexual dysfunction. Depression was also a significant risk factor for the most severe degree of sexual dysfunction (OR 2.1, 95% CI, 1.3-3.5) and had the greatest impact on Arousal and Satisfaction domain scores of the FSFI. Current systemic HT use seemed to decrease the risk for sexual dysfunction (aOR 0.6, 95% CI, 0.4-1.0). Sexual dysfunction is highly prevalent in BRCA mutation carriers after RRSO. Depression seems to be a significant risk factor for sexual dysfunction in this patient population and may be under-recognized and undertreated. Patient and provider education on sexual side effects after surgery and risk factors for sexual dysfunction is necessary to decrease postoperative sexual distress. HT may be associated with improved sexual function after surgery.

Experimental evidence for reduced male allocation under selfing in a simultaneously hermaphroditic animal.

Self-fertilization is widespread among simultaneously hermaphroditic animals and plants, but is often only facultatively deployed under circumstances that constrain outcrossing. A central prediction of sex allocation (SA) theory is that because exclusive selfing reduces sperm or pollen competition to zero, this should favour extreme economy in resources channelled to the male sex function. We can therefore expect that organisms switching from outcrossing to selfing should reduce their male allocation. However, to date this prediction has received relatively little support in animal taxa, especially compared to plants. Here we show that isolated individuals (under enforced selfing conditions) have a less male-biased SA than do grouped conspecifics (under outcrossing conditions) in the preferentially outcrossing flatworm Macrostomum hystrix This shift arises from a reduced male allocation (testis area) in isolated individuals, although we did not find any evidence for a re-allocation of these resources to the female sex function (i.e. ovary area was unaffected by selfing/outcrossing conditions). Our results provide some of the clearest experimental evidence to date for reduced male allocation under selfing in simultaneously hermaphroditic animals, extending previous findings comparing SA between populations differing in selfing rates to the level of individual plasticity in gametogenesis.

Life-history trade-offs promote the evolution of dioecy.

Most dioecious plants are perennial and subject to trade-offs between sexual reproduction and vegetative performance. However, these broader life-history trade-offs have not usually been incorporated into theoretical analyses of the evolution of separate sexes. One such analysis has indicated that hermaphroditism is favoured over unisexuality when female and male sex functions involve the allocation of nonoverlapping types of resources to each sex function (e.g. allocations of carbon to female function vs. allocations of nitrogen to male function). However, some dioecious plants appear to conform to this pattern of resource allocation, with different resource types allocated to female vs. male sex functions. Using an evolutionarily stable strategy approach, we show that life-history trade-offs between sexual reproduction and vegetative performance enable the evolution of unisexual phenotypes even when there are no direct resource-based trade-offs between female and male sex functions. This result might help explain the preponderance of perennial life histories among dioecious plants and why many dioecious plants with annual life histories have indeterminate growth with ongoing trade-offs between sexual reproduction and vegetative growth.

Randomized, double-blind, placebo-controlled clinical trial for evaluating the efficacy of fractional CO2 laser compared with topical estriol in the treatment of vaginal atrophy in postmenopausal women.

The aim of the study was to evaluate efficacy of fractional CO2 vaginal laser treatment (Laser, L) and compare it to local estrogen therapy (Estriol, E) and the combination of both treatments (Laser + Estriol, LE) in the treatment of vulvovaginal atrophy (VVA). A total of 45 postmenopausal women meeting inclusion criteria were randomized in L, E, or LE groups. Assessments at baseline, 8 and 20 weeks, were conducted using Vaginal Health Index (VHI), Visual Analog Scale for VVA symptoms (dyspareunia, dryness, and burning), Female Sexual Function Index, and maturation value (MV) of Meisels. Forty-five women were included and 3 women were lost to follow-up. VHI average score was significantly higher at weeks 8 and 20 in all study arms. At week 20, the LE arm also showed incremental improvement of VHI score (P = 0.01). L and LE groups showed a significant improvement of dyspareunia, burning, and dryness, and the E arm only of dryness (P < 0.001). LE group presented significant improvement of total Female Sex Function Index (FSFI) score (P = 0.02) and individual domains of pain, desire, and lubrication. In contrast, the L group showed significant worsening of pain domain in FSFI (P = 0.04), but FSFI total scores were comparable in all treatment arms at week 20. CO2 vaginal laser alone or in combination with topical estriol is a good treatment option for VVA symptoms. Sexual-related pain with vaginal laser treatment might be of concern.

Exploring the sexual diversity of flatworms: Ecology, evolution, and the molecular biology of reproduction.

Flatworms exhibit huge diversity in their reproductive biology, making this group an excellent model system for exploring how differences among species in reproductive ecology are reflected in the physiological and molecular details of how reproduction is achieved. In this review, I consider five key "lifestyle choices" (i.e., alternative evolutionary/developmental outcomes) that collectively encompass much of flatworm sexual diversity, beginning with the decisions: (i) whether to be free-living or parasitic; (ii) whether to reproduce asexually or sexually; and (iii) whether to be gonochoristic (separate-sexed) or hermaphroditic. I then examine two further decisions involving hermaphroditism: (iv) outcrossing versus selfing and (v) the balance of investment into the male versus the female sex function (sex allocation). Collectively, these lifestyle choices set the basic rules for how reproduction occurs, but as I emphasize in the second part of the review, the reproductive biology of flatworms is also greatly impacted by the near-pervasive and powerful pressure of sexual selection, together with the related phenomena of sperm competition and sexual conflict. Exactly how this plays out, however, is strongly affected by the particular combination of reproductive strategies adopted by each species. Mol. Reprod. Dev. 84: 120-131, 2017. © 2016 Wiley Periodicals, Inc.

Condition dependence of male and female reproductive success: insights from a simultaneous hermaphrodite.

Sexually selected traits are predicted to show condition dependence by capturing the genetic quality of its bearer. In separate-sexed organisms, this will ultimately translate into condition dependence of reproductive success of the sex that experiences sexual selection, which is typically the male. Such condition dependence of reproductive success is predicted to be higher in males than females under conditions promoting intense sexual selection. For simultaneous hermaphrodites, however, sex allocation theory predicts that individuals in poor condition channel relatively more resources into the male sex function at the expense of the female function. Thus, male reproductive success is expected to be less condition dependent than female reproductive success. We subjected individuals of the simultaneously hermaphroditic snail Physa acuta to two feeding treatments to test for condition dependence of male and female reproductive success under varying levels of male-male competition. Condition dependence was found for female, but not for male, reproductive success, meaning that selection on condition is relatively stronger through the female sex function. This effect was consistent over both male-male competition treatments. Decomposition of male and female reproductive performance revealed that individuals in poor condition copulated more in their male role, indicating an increased male allocation to mate acquisition. These findings suggest that sex-specific condition dependence of reproductive success is at least partially driven by condition-dependent sex allocation. We discuss the implications of condition-dependent sex allocation for the evolution of sexually selected traits in simultaneous hermaphrodites.

Sexual function of women surviving cervical cancer.

The objective of this study was to evaluate the sexual function of survivors of cervical cancer (CC) in comparison to the control group of women without a history of cancer. This was an observational, analytical, case-control study. In the cancer group, women subjected to CC treatment of at least 3 months in the past were included (n = 37). For each survivor, one random selection from a base population control group was made (n = 37) of a woman without a history of cancer and with similar socioeconomic and demographic characteristics. The sexual function was evaluated through the female sex function index (FSFI) instrument. Data collection occurred through the application of questions in a face-to-face interview. In the cancer group, 64.9 % related vaginal stenosis or shortening; 59.5 % were not sexually active and of those which had sexual relations, 80 % showed dysfunction. The total FSFI score varied between 9.60 and 35.10 in the cancer group and 23.90 and 36.00 in the control group. The means of the cancer group were statistically inferior (P < 0.05) to the control group in all the FSFI domains and in the total score. The mean total score was 21.72 in the cancer group, classified as sexual dysfunction when considering a score of 26 as the cutoff point. CC treatment was found to have a negative impact on the sexual function of women. Further, sexual function should be monitored routinely by interdisciplinary teams to provide comprehensive care with the objective of an improved quality of life post-cancer.

Consequences of clonality for sexual fitness: Clonal expansion enhances fitness under spatially restricted dispersal

Clonality is a pervasive feature of sessile organisms, but this form of asexual reproduction is thought to interfere with sexual fitness via the movement of gametes among the modules that comprise the clone. This within-clone movement of gametes is expected to reduce sexual fitness via mate limitation of male reproductive success and, in some cases, via the production of highly inbred (i.e., self-fertilized) offspring. However, clonality also results in the spatial expansion of the genetic individual (i.e., genet), and this should decrease distances gametes and sexually produced offspring must travel to avoid competing with other gametes and offspring from the same clone. The extent to which any negative effects of clonality on mating success might be offset by the positive effects of spatial expansion is poorly understood. Here, we develop spatially explicit models in which fitness was determined by the success of genets through their male and female sex functions. Our results indicate that clonality serves to increase sexual fitness when it is associated with the outward expansion of the genet. Our models further reveal that the main fitness benefit of clonal expansion might occur through the dispersal of offspring over a wider area compared with nonclonal phenotypes. We conclude that, instead of interfering with sexual reproduction, clonal expansion should often serve to enhance sexual fitness.

Environment-Dependent Sexual Selection: Bateman's Parameters under Varying Levels of Food Availability.

Sexual selection is a potent evolutionary force that has been shown to vary in strength and direction depending on demographic factors such as density and sex ratio. However, the effect of other environmental factors on the mode of sexual selection remains largely unexplored. Here, we tested experimentally how food restriction affects the potential for sexual selection in the male and the female sex function of the simultaneously hermaphroditic freshwater snail Physa acuta. We manipulated food availability and compared Bateman's metrics of sexual selection between groups of five well-fed and five food-restricted snails. Food-restricted individuals had a reduced female reproductive output, suggesting that we successfully manipulated the reproductive resources. Importantly, food restriction reduced the male opportunity for sexual selection (in terms of a lowered variance in male mating success) and led to diminishing returns of mating in both sexes (in terms of nonsignificant Bateman gradients). Furthermore, we observed significant changes in the relative contribution of different fitness components, suggesting stronger postcopulatory selection in the male sex role and stronger fecundity selection in the female sex role under restricted food conditions. This study highlights the need to incorporate ecological factors to better understand how sexual selection operates in the wild.

Sexual conflict in hermaphrodites.

Hermaphrodites combine the male and female sex functions into a single individual, either sequentially or simultaneously. This simple fact means that they exhibit both similarities and differences in the way in which they experience, and respond to, sexual conflict compared to separate-sexed organisms. Here, we focus on clarifying how sexual conflict concepts can be adapted to apply to all anisogamous sexual systems and review unique (or especially important) aspects of sexual conflict in hermaphroditic animals. These include conflicts over the timing of sex change in sequential hermaphrodites, and in simultaneous hermaphrodites, over both sex roles and the postmating manipulation of the sperm recipient by the sperm donor. Extending and applying sexual conflict thinking to hermaphrodites can identify general evolutionary principles and help explain some of the unique reproductive diversity found among animals exhibiting this widespread but to date understudied sexual system.

Risk factors for sexual dysfunction in BRCA1 and BRCA2 (B1/2) mutation carriers following risk-reducing salpingo-oophorectomy (RRSO)

Risk factors for sexual dysfunction in BRCA1 and BRCA2 (B1/2) mutation carriers following risk-reducing salpingo-oophorectomy (RRSO)

Effects of mating status on copulatory and postcopulatory behaviour in a simultaneous hermaphrodite

Mating status is one of the most important predictors of the mating propensity of an individual. This is because mating lowers the amount of sperm cells and seminal fluids available to donate for males and increases the amount of ejaculate received by females, which may both have an effect on the mating propensity. In simultaneous hermaphrodites with reciprocal copulation, the mating status is expected to affect the mating propensity in both the male and the female sex function within a single individual, but empirical evidence is scarce. We experimentally tested the effect of the mating status of an individual and its partner on copulatory and postcopulatory behaviour in the free-living flatworm Macrostomum lignano, an outcrossing simultaneous hermaphrodite. These worms have frequent reciprocal copulations and often display a postcopulatory suck behaviour, potentially involved in removing ejaculate components from their own sperm-receiving organ. Virgin pairs copulated more, earlier and for longer than sexually experienced pairs. Moreover, we observed fewer sucks in virgin than sexually experienced pairs, all consistent with a higher willingness both to donate and to receive sperm in virgins. We investigated whether the lower suck frequency in virgin pairs depends on the mating status of the focal individual or on that of its partner. Surprisingly, the results suggested that the suck frequency depends on the mating status of the partner. We discuss these results in the context of potential sexual conflicts over the performance of the suck behaviour.

Assessment of sexual function and related factors in mid-aged sexually active Spanish women with the six-item Female Sex Function Index

The aim of this study was to assess sexual function and related factors (menopause-related quality of life and mood included) in mid-aged Spanish women. This was a cross-sectional study in which 179 sexually active women (40-65 y old) completed the six-item Female Sexual Function Index (FSFI-6), the Menopause Rating Scale (MRS), the Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire containing personal and partner data. Median age was 51 years; 55.3% of the women were naturally postmenopausal, 47.5% had increased body mass index, and 6.7% had hypertension. Currently, 4.5% and 19.6% of the women used hormone therapy and psychotropic drugs, respectively. A total of 87.7% had a stable partner; 1.3% of partners abused alcohol and 8.3% had erectile dysfunction. Of the surveyed women, 36.9% displayed total FSFI-6 scores of 19 or less (lower sexual function); 40.2%, mood morbidity (total HADS scores ≥11); and 23.5%, impaired quality of life (severe total MRS scores ≥17). Cronbach α for the FSFI-6 was 0.91. Total FSFI-6 scores positively correlated with female and partner education and inversely with female age and scores on the MRS and the HADS (total and subscale values). Multiple linear regression analysis found that total FSFI-6 scores positively correlated with partner educational level and inversely (worse sexual function) with female age, partner issues (alcohol abuse and erectile dysfunction), and total HADS and urogenital and somatic MRS scores. In this mid-aged Spanish sample, as assessed with a short and consistent tool, lower sexual function was related to menopausal and mood symptoms and several women and partner factors. Further research using this instrument is warranted.

Trade‐offs between clonal and sexual reproduction in Sagittaria latifolia (Alismataceae) scale up to affect the fitness of entire clones

Many plants combine sexual reproduction with vegetative propagation, but how trade-offs between these reproductive modes affect fitness is poorly understood. Although such trade-offs have been demonstrated at the level of individual shoots (ramets), there is little evidence that they scale up to affect genet fitness. For hermaphrodites, reproductive investment is further divided between female and male sexual functions. Female function should generally incur greater carbon costs than male function, which might involve greater nitrogen (N) costs. Using a common garden experiment with diclinous, clonal Sagittaria latifolia we manipulated investment in reproduction through female and male sex functions of 412 plants from monoecious and dioecious populations. We detected a 1:1 trade-off between biomass investment in female function and clonal reproduction. For male function, there was no apparent trade-off between clonal and sexual reproduction in terms of biomass investment. Instead, male function incurred a substantially higher N cost. Our results indicate that: trade-offs between investment in clonal propagation and sexual reproduction occur at the genet level in S. latifolia; and sexual reproduction interferes with clonal expansion, with investment in female function limiting the quantity of clonal propagules produced, and investment in male function limiting the nutrient content of clonal propagules.