Female Sexual Disorder Research Articles

(075) THE USE OF ONLINE EDUCATIONAL MODULES TO REDUCE FEMALE SEXUAL DYSFUNCTION

Abstract Introduction Sex is fundamental to overall health, well-being, and quality of life yet, the prevalence of female sexual dysfunction is alarmingly high. This could be attributed to multiple factors such as an overall dearth of evidence-based information detailing female anatomy, arousal, orgasm, and sexual disorders. In addition, many women face numerous obstacles that limit their access to a comprehensive sexual and reproductive health education. The unavailability and inaccessibility of knowledge regarding the female sexual experience can prevent many women from truly appreciating and understanding their bodies. This can lead to a variety of negative outcomes, including depression, anxiety, low self-esteem, and decreased well-being. Objective Several of these outcomes are most prevalent in young women; thus, it is critical that we educate this age group using delivery methods best suited for a young demographic. Methods In this study, we created a brief online educational module for women between the ages of 18 and 29 years old, which explained various aspects of the female sexual experience including female anatomy, orgasm responses, and masturbation. The module also shared resources women may use if they are experiencing issues regarding sex or pleasure. We expected to see greater female sexual literacy among women who completed the module (intervention) compared to those who did not (control). 13 women between the ages of 18 and 29 years old who were attending their annual gynecologic well-visit were recruited and randomly assigned to the intervention or control group. Results Although all participants from both groups rated sex education as important (N=13), less than half (N=5) reported having received formal sex education including female sexual functioning. Furthermore, only half (N=6) correctly disagreed when asked if the outer part of the female reproductive system was called “vagina.” However, post-test surveys showed no significant difference in knowledge between those who watched the module and those who did not. We attribute this to the sample size being too small, to the age range being too wide, and to the information presented in the module being too basic for this age group. Conclusions It is imperative that we not only continue to explore the female sexual experience, but that we also continue to improve ways to deliver that information. Further research on the use of online modules for sex education should consider its population’s degree of knowledge, limit their sample’s age range, and focus on issues its population commonly inquires about. Disclosure No.

Female Hypoactive Sexual Desire Disorder: What physicians need to know ?

Female Hypoactive Sexual Desire Disorder: What physicians need to know ?

Commentary on "Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder - a claims database analysis".

Commentary on "Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder - a claims database analysis".

(279) Quantitative Analyze of Psycho Diagnostic Data in the Diagnosis of Female Sexual Dysfunctions

Abstract Introduction Sexual activity is an important aspect of quality of life. It's a fact that mental disorders caused by sexual trauma in past, bullying, strict up bringing, stigmatization, low level of sexual education, playing important role in development of female sexual dysfunctions. Objective The aim of our study was to detect how effective is psycho diagnostic examination for timely diagnosis and adequately treatment of women with sexual dysfunctions. Methods In our research that was conducted from October 2022 to July 2023, at the Z.Marshania’s sexual medicine center participated 75 women with different sexual dysfunctions. The study was quantitative. We used a correlational analysis to assess the association between dependent and independent variables. Independent variables with a p-value < 0.05 were taken as statistically significant with sexual dysfunction. To evaluate psychological characteristics, we took MMPI-1, SSTAI, and Beck Depression Questionnaire. Results All our patients had different sexual difficulties. 55% among 75 had psychological problems that were identified before the sexual dysfunction was discovered. The largest correlation (53%) was found between anxiety disorders and Female Orgasmic Disorder (FOD), as well as between depression and Female Hypoactive Sexual Desire Disorder (FHSDD) which was 34%. It is also worth emphasizing the style of life caused by strict traditional family education, due to which some of the patients had an inadequate perception of sexual life (63%). Conclusions The prevalence of sexual dysfunction among women with mental disorders is quite high, therefore, along with the treatment of sexual dysfunctions, it is important to properly evaluate the psychological state that can be performed effectively by psycho-diagnostic examination. Without it, the treatment of sexual dysfunctions among women will not be managed adequately. Disclosure No.

(010) Assessment of Cannabis Use Before Partnered Sex on Women who Experience Orgasm Difficulty

Abstract Introduction Up to 41% of women experience female orgasm disorder/difficulty (FOD), a statistic unchanged for 50 years. Despite this, there is a paucity of validated treatments. Research has suggested cannabis as a treatment for female sexual disorders for more than 50 years. Yet a literature review revealed no studies evaluating cannabis as a treatment specifically for FOD and no studies comparing women with and without FOD. This study is the first to evaluate cannabis as a treatment for FOD specifically in women with and without FOD. Objective Evaluate the effect of cannabis use before partnered sex on women with and without FOD. Methods This IRB-approved observational study conducted between March 24, 2022, and November 18, 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before partnered sex. Results Of 1,037 survey responses, the researchers received 410 valid, completed surveys; failure to meet the study’s criteria required excluding 23 (5.6%) surveys. Among the 387 valid survey participants, the majority of women, 52% (n = 202) reported orgasm difficulty, were between the ages of 25–34 (45%, n = 91), reported their race as white (75%, n = 152), and were married or in a relationship (82%, n = 165). Among respondents reporting orgasm difficulty (n = 202), cannabis use before partnered sex increased orgasm frequency (72.8%, n = 147/202, p < .001), improved orgasm satisfaction (67%, n = 136/202, p < .001) or made orgasm easier (71%, n = 143/202, p < .001). Frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD (n = 202, p< .001). Orgasm response to cannabis depended on the reasons for use (n = 202, p = .022). Women with FOD reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were more likely to report sexual abuse history than women without FOD (38.6%, n=74/202). Conclusions Fifty years of sexuality research support use of cannabis for sexual difficulties. This is the first study to look at FOD specifically, demonstrating significant benefit. Randomized controlled studies are needed to evaluate cannabis’ efficacy on FOD sub-types, mental health and physical health conditions and other clinical implications; evaluating dosage, strain, timing, and method of intake. References Laumann et al., 2005 Kontula & Miettinen, 2016 Keiman & Meston, 1997 Dawley et al., 1979 Gorzalka et al., 2010 Klein et al., 2012 Lewis, 1970 Moser et al., 2023. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: inhaleMD.

(180) Female Sexuality of Tunisian Women with Treated Breast Cancer

Abstract Introduction Breast cancer is a major health problem. Several treatment strategies are used to treat it such as lumpectomy or mastectomy surgery, chemotherapy, radiotherapy, and hormone therapy, which leads us to ask the following question: what impact does breast cancer and its treatments have on female sexuality? Objective The aims of our study were to assess the sexuality of Tunisian women with breast cancer in remission, and to determine the prevalence and nature of sexual dysfunction in this population. Methods We carried out a descriptive cross-sectional study, involving women aged under 60, followed up for treated non-metastatic breast cancer currently in remission, and having a regular sexual partner during the last month. Outpatients in the surgery and radiotherapy department of the "Salah-Azaiez" Institute were interviewed using a questionnaire including a validated Arabic version of FSFI (Female sexual function desire). Our study was carried out throughout a period of 3 months, from January 1st, 2023 to March 31st, 2023, this period allowed us to collect our necessary data. Results We included 120 women in our study. The majority were between 40 and 49 years with an average of 46.53. One-third (33.3%) had a university degree and 16.7% were senior executives. More than half of our population (56.7%) were menopausal and 12% were smokers. 85% of the women had children, and only 36% had breastfed their children exclusively. Half of the women had discovered the disease at stage II, and 52% of them had discovered it during breast self-examination. Surgical treatment was radical in 61.7% of women and conservative in 38.3%. Thus, 75% of the population had undergone chemotherapy, 93.3% had undergone radiotherapy and 71.7% were receiving hormone therapy. Only 5% of our study population had a sexual dysfunction prior to the disease and 78% of women had reported a change in their sex life after breast cancer, with the frequency of intercourse as the main parameter affected. Among the most common sexual complaints were decreased or absent sexual desire in 68.1% of cases, lack of sexual initiative (74.4%), vaginal dryness (48.9%), and dyspareunia (42.6%). The majority of interviewed women (83.3%) had presented with global sexual dysfunction, i.e. a total FSFI score ≤26.55 and the areas most affected were pain, lubrication, and orgasm. Radical surgical treatment, chemotherapy, and hormone therapy were significantly associated with impaired female sexuality (respectively p=0.0036; p=0.047 and p=0.001). Conclusions Our study highlighted the impact of breast cancer treatment on women's sex lives. Healthcare providers should acquire the necessary skills in order to explore female sexual disorders and suggest suitable management. Disclosure No.

Modified Internal Pudendal Artery Perforator Flap Interposition for Rectovaginal Fistula.

Rectovaginal fistula (RVF) is a challenging condition associated with recurrences and significant functional impairment. The internal pudendal artery perforator (IPAP) flap has become a viable option for reconstructing the vagina and perineal regions. This study aims to introduce a modified technique of IPAP flap interposition and evaluate its postoperative outcomes in the treatment of low RVF. Sixteen patients with RVF who underwent modified IPAP flap interposition between 2016 and 2021 were retrospectively enrolled. Recurrence rate, the satisfaction of vulvar appearance (Visual Analog Scale), and quality of sexual life (Female Sexual Function Index score) were followed up and analyzed. All patients presented with low fistula with a mean diameter of 8.3 mm. The mean width and length of the IPAP flaps were 3.8 and 6.2 cm, respectively. The mean follow-up period was 14.1 months. All patients achieved successful healing without recurrence. High satisfaction was reported for the cosmetic effect of the vulva with a mean Visual Analog Scale score of 8.4. The proportion of female sexual disorder exhibited a statistically significant reduction, decreasing from 100% preoperatively to 38% after surgery ( P < 0.05). The modified IPAP flap interposition is a reliable and safe option for repairing low RVF, with high success rates and minimal donor site morbidity. Moreover, this procedure provides a suitable volume flap and preserves the vaginal physiological environment, which benefits postoperative sexual function.

Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant

Type 2 diabetes mellitus (T2DM) is a multisystemic disease with a high global burden and chronic complications. Sexual dysfunction (SD) in patients with T2DM is an often-overlooked complication, despite its high impact on quality of life (QoL). Female sexual disorders can affect women of reproductive age as well as menopausal women. Proposed mechanisms are intertwining a variety of physiological, neurological, vascular, hormonal, and psychological variables. The impairment of sexual function has been linked to hyperglycemia, insulin resistance, chronic low-grade inflammation, endothelial dysfunction, neuropathy, and hormonal abnormalities. There are many different manifestations of female sexual dysfunction, such as insufficient sexual desire, diminished arousal, difficulty in eliciting orgasm, and pain during sexual engagement. Numerous studies have shown that the QoL of patients living with diabetes mellitus (DM) is lower than that of those without DM. SD in women with T2DM leads to deteriorated QoL. Treatment must be individualized based on the diagnosis and the sexual dysfunction as well as underlying medical, psychological, and interpersonal issues. The goal of modern medical care for patients living with diabetes is not to delay death but to improve their health and QoL. The present review article aimed to raise awareness about female sexual dysfunction in patients with T2DM and to provide an overview of its impact on QoL.

Association of perceived male sexual dysfunction and sexually transmitted disease to female sexual function among Indonesian women

BACKGROUND Male sexual dysfunction (MSD)’s impact on female partners is challenging to understand. Male erectile dysfunction (ED) and ejaculation disorder likely affect female sexual function. This study aimed to examine the prevalence of female sexual dysfunction and disorder as well as the relationship between perceived MSD and female sexual function using the validated Indonesian short version of the 6-item Female Sexual Function Index (FSFI-6).&#x0D; METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from February 2018 to February 2019. About 702 Indonesian married women, including patients, visitors, and medical and nonmedical staff, provided the sociodemographic, FSFI-6, quality of life, and sexual function (ED, ejaculation disorder, and desire problems), and sexually transmitted disease (STD) data. The association between categorical variables was evaluated using Fisher’s test. Logistic regression was used for multivariate analysis, and a p-value of 0.05 was considered statistically significant.&#x0D; RESULTS Among 702 women, about 242 had sexual dysfunction (34.5%), 20 had sexual disorder (2.8%), 172 had low desire (24.5%), 72 had low arousal (10.3%), 253 had orgasmic function (36.0%), and 575 had sexual pain (81.9%). The respondents reported their partners’ STD, desire problems, ED, and ejaculation disorder. Female sexual disorder and low desire were associated with perceived ED. Female sexual disorder was associated with STD (Wald = 10.3, p = 0.001) and desire problems (Wald = 6.89, p = 0.008). No other MSD was associated with female sexual function.&#x0D; CONCLUSIONS Perceived STD and male desire problems affected female sexual disorder.

Regulation of female sexual behavior and possibilities of drug therapy

Female sexual behavior is under the complex influence of psycho-emotional, neuroendocrine and social factors. The realization of normal sexual activity in women is possible if many conditions are met and, first of all, ensuring a positive psycho-emotional background, safety, a satisfactory state of health, as well as comfortable interpersonal relationships for most women. In addition to significant psychological and social impact, accumulated modern scientific data confirm the important role of neuro-hormonal regulation of sexual behavior and suggest the potential effectiveness of pharmacological therapy. Unfortunately, however, medical strategies for correcting female sexual disorders are limited. Currently, in some countries, several drugs that increase female sexual activity are allowed for use, however, all of them are not registered and are not approved for use on the territory of the Russian Federation. The article briefly describes the neural mechanisms of the main areas of the central nervous system underlying receptivity and sexual attraction, namely the olfactory and limbic systems, the neocortex. The main attention is paid to the function of neurotransmitters and hormones that are critically involved in the modulation of emotions and sexual behavior, including the inhibitory mediator of gamma aminobutyric acid (GABA), estrogens, testosterone, and the excitatory mediator glutamate. The stages of development, the results of experimental and clinical studies to assess the effectiveness and safety of the unique Russian neuropeptide drug Desirex, which is a stimulant of sexual behavior due to the mechanism of reversible suppression of the GABAergic system, nonspecific stimulation of the dopaminergic system of motivation and reinforcement of positive emotions and disinhibition of the controlling function of the neocortex, are presented in detail.

Careful, Women! Is Orgasm Worth the Cost of Your Cerebellum? Flibanserin-Induced Cerebellar Dysfunction

AbstractIntroductionFlibanserin, a serotonin antagonist currently indicated for treatment of female sexual dysfunction disorder, has not heretofore been described to worsen cerebellar function. Such a case is presented.MethodsA 60-year-old woman, 8 months prior to presentation, had an acute onset of fainting and hitting her head into a wall without loss of consciousness. She could not stand up, had left-sided weakness, and vomiting, with garbled, slow speech and severe headache. Findings in the emergency room showed a left cerebellar parenchymal hemorrhage of 3.2 x 3.1 x 2 cm with the epicenter at the dentate nucleus, extending medially towards midline into the cerebellar vermis, with surrounding perilesional edema extending into the middle cerebellar peduncle. Also, 5.2 cm of the hemorrhage extended from the petrous of the tentorium to the cerebellar vermis. Moreover, a ventral left thalamic hemorrhage with subependymal clot at the foramen of Monroe extended into the dependent portion of lateral ventricles without midline shift. Post one month of physical therapy, speech, walking, and coordination improved but she continued to have delayed speech and trouble getting up, with a wide stance.ResultsNeurologic Examination: Cranial Nerve (CN) Examination: CN XI: Sternocleidomastoid hypertrophy, horizontal titubation. Motor examination: Drift test: L pronator drift with L abductor digiti mini sign. Gait examination: heel walking, dystonic posture of L hand. Tandem gait: unstable, wide based. Cerebellar examination: Both (B) finger-to-nose dysmetria, Left &gt; Right. Slow rapid alternating movements (RAM) L Upper Extremity (UE). Due to absent sexual desire she started 100 mg of flibanserin nightly. Maintaining this for 5 weeks, her coordination markedly worsened with poor balance and a need for a cane to ambulate. She would stumble, with a wider gait, and found climbing stairs challenging. Physical examination displayed worse cerebellar function: prominent horizontal titubation. Finger-to-nose—dysmetria L&gt;R. Decreased RAM, L UE. Markedly positive Holmes Rebound phenomenon, Bilateral UE. Tandem gait: unstable. A week post stopping flibanserin, gait and cerebellar examination returned to baseline.DiscussionThe temporal correlation between the use of flibanserin and transient worsening of cerebellar function strongly suggests that this is the causative agent. Since serotonin is essential in cerebellar function, including its action on the cerebellar cortex and deep cerebellar nuclei, it strongly suggests that its action as a serotonin antagonist is the mechanism whereby flibanserin is causing cerebellar symptoms. In those on flibanserin, investigation to detect the presence of cerebellar dysfunction is warranted. Assessment for the presence of cerebellar dysfunction in those who are on anti-serotonin drugs, such as cyproheptadine and methysergide, may be worthwhile.FundingNo Funding

Гинекологические аспекты сексуальной дисфункции в постменопаузальном периоде

Sexuality is defined as a physical, emotional, psychological, and social welfare state associated with sexual desires. The prevalence of sexual dysfunction among postmenopausal women is estimated to be 68% to 87%. The most significant causes of sexual disorders in this period are physiological changes of female body, psychological problems, lack of special knowledge, and male health status. Sexual function is linked to the complex neurotransmitter-hormone interaction both at the central and peripheral levels. The major cause of sexual dysfunction in postmenopausal women is genitourinary menopausal syndrome. Most commonly, gynecologist becomes a first contact physician dealing with female sexual disorders. Sexual dysfunction diagnosis in postmenopause includes the use of validated questionnaires, the assessment of the type and severity of menopausal disorders, the impact of somatic diseases and psychological issues, as well as a thorough physical examination. As sexual dysfunction in postmenopausal women is caused by multiple factors and has a complex pathogenesis, it is necessary to set up a multidisciplinary approach to problem solving. According to the biopsychosocial model, gynecologist has a wide range of therapeutic options for dealing with sexual disorders — pharmacotherapy (hormonal and non-hormonal agents), rational psychotherapy, and multimodal treatment methods. KEYWORDS: sexual dysfunction, postmenopause, sexual hormones, estrogens, androgens, genitourinary menopausal syndrome, biopsychosocial model of healthcare. FOR CITATION: Sandakova E.A., Zhukovskaya I.G. Gynecological aspects of sexual dysfunction in the postmenopausal women. Russian Journal of Woman and Child Health. 2023;6(1):26–30 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-26-30.

The Optimization and Evaluation of Flibanserin Fast-Dissolving Oral Films.

Flibanserin (FLB) is a drug used for female hypotensive sexual desire disorder approved by the FDA in August 2015. FLB exhibits extensive hepatic first-pass metabolism and low aqueous solubility, hence poor oral bioavailability. In this study, beta hydroxypropyl cyclodextrin-FLB inclusion complexes were incorporated into orally fast dissolving films. This dosage form was expected to improve FLB aqueous solubility, which would give fast onset of action and decrease presystemic metabolism, hence improving oral bioavailability. The inclusion complex at a ratio of 1:1 was prepared by the kneading method. Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and powder X-ray diffractometry (XRD) were used to confirm complex formation. The Box–Behnken design (15 different formulae of FLB fast-dissolving oral films (FLBFDOFs) were utilized for the optimization of the prepared films. The Expert Design 11 program was utilized to examine the effects of three selected factors, polymer concentration (X1), plasticizer concentration (X2), and disintegrant concentration (X3) on four responses: disintegration time (DT), initial dissolution rate (IDR), dissolution efficiency (DE), and film quality (QF). Numerical optimization was performed by minimizing disintegration time (Y1), while maximizing the initial drug dissolution rate (Y2), dissolution efficiency (Y3), and the quality factor (Y4). The statistical analysis showed that X1 has a significant positive effect on the disintegration time and a significant negative effect on IDR. While X2 and X3 produced a nonsignificant negative effect on IDR. Dissolution efficiency was maximized at the middle concentration of both X2 and X3. The best film quality was observed at the middle concentration of both X1 and X2. In addition, increasing X3 leads to an improvement in film quality. The optimized film cast from an aqueous solution contains hydroxypropyl cellulose (2%) as a hydrophilic film-forming agent and propylene glycol (0.8%) as a plasticizer and cross povidone (0.2%) as a disintegrant. The prepared film released 98% of FLB after 10 min and showed good physical and mechanical properties. The optimized formula showed a disintegration time of 30 s, IDR of 16.6% per minute, DE15 of 77.7%, and QF of 90%. This dosage form is expected to partially avoid the pre-systemic metabolism with a fast onset of action, hence improving its bioavailability that favors an advantage over conventional dosage forms.

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

Predictors of Sex-Induced Crisis, Sexual Function and Marital Satisfaction in Women With Sickle Cell Disease

Sex-induced and orgasm-induced crisis, sexual dysfunction, and marital satisfaction among women with sickle cell disease (SCD) is under-reported. This study assessedsexualfunction in women with SCD and comparedsexualfunction in women with SCD to women without SCD. This was a descriptive and comparative cross-sectional survey that involved 435 women with SCD and 406 women without SCD (as controls). This study demonstrates the predictors of sex-induced crisis, sexual function and marital satisfaction in women with sickle cell disease. The prevalence of dyspareunia and marital dissatisfaction was higher in women with SCD than those without SCD. In addition, SCD was significantly associated with multiple sexual dysfunctions, with reported symptoms of sexual desire disorder (HSDD), female sexual arousal disorder (FSAD), and female sexual orgasm disorder (FSOD). Genotype, age, age at puberty, dyspareunia, and duration of infertility were the observed independent predictors of sexual dysfunction in women with SCD. Also, most (54.02%) of the SCD subjects experienced sex-induced and orgasm-induced crises. Although water intake before and after sex was reported to be beneficial in preventing sex-induced and orgasm-induced crisis in women with SCD, it was not a predictor of sexual dysfunction. SCD patients are at risk of sex-induced and orgasm-induced crisis as well as sexual dysfunction. No study has ever reported the incidence of sex-and orgasm-induced crisis and sexual dysfunction in women with SCD. Also, we used a reasonably large sample size and utilized widely acceptable validated and reproducible tools like ENRICH Marital Satisfaction (EMS) and Female Sexual Function Index (FSFI) to assess the marital satisfaction and sexual function of the studied participants. This allows for the generalization of our findings. The limitations of the present study include recall bias and the inability to document real-time occurrences of sex-and orgasm-induced crisis and the incidence of female sexual dysfunction. Furthermore, though the risk factors of sexual dysfunction as perceived by women with SCD were elicited, biological risk factors and the possible associated mechanisms were not determined in this study. Our study shows that sex-induced and orgasm-induced crisis and sexual dysfunction are significant morbidities in women with SCD, and fluid/water intake before and after sexual activity may be beneficial. Adesoye OB, Akhigbe RE. Predictors of Sex-Induced Crisis, Sexual Function and Marital Satisfaction in Women With Sickle Cell Disease. J Sex Med 2022;19:1625-1633.

The negative impact of timed intercourse in infertile couples: A prospective cohort study

Objective: To study the differences in sexual dysfunction and time to pregnancy (TTP) between infertile couples pursuing timed intercourse (TI – around the time of ovulation) and regular intercourse (RI – at least twice a week). Methods: In this prospective cohort study, we recruited all infertile couples presenting to the regional infertility clinics from January 2016 to December 2018, pursuing TI ( n = 283) or RI ( n = 88), and having no pre-existing sexual or psychiatric illness, and no medical contraindications to frequent intercourse. Sexual dysfunction was assessed using the Arizona Sexual Experience Scale and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The couples for whom natural conception was possible were followed up to determine TTP using Kaplan–Meier analysis. Results: TI significantly increased the risk of sexual dysfunction than RI for both males and females, even after adjusting for age, medical disorders, obesity, smoking, cause of infertility, and previous assisted reproductive techniques. TI increased the risk of erectile dysfunction, premature ejaculation, male hypoactive sexual dysfunction, female sexual interest-arousal disorder, and female orgasmic disorder. The TTP for natural conception was similar between them. Conclusion: TI increased the risk of sexual dysfunction without accelerating the time to achieve pregnancy, compared with RI. Level of evidence: Not applicable

P-118 Timed Intercourse exacerbates the risk of sexual dysfunction in men &amp;amp; women without an improvement in time to pregnancy

Abstract Study question Investigate the differences in sexual dysfunction and time to pregnancy between infertile couples pursuing timed intercourse and Regular Intercourse (RI at least twice a week). Summary answer TI significantly increased the risk of SD compared to RI for both males and females after adjusting all other contributing factors. What is known already Timed Intercourse (TI) involves aligning sexual intercourse to the time around ovulation to increase the chance of conception in couples trying to conceive. Whilst TI is often advocated to increase conception rates and potentially accelerate the time to pregnancy (TTP) for infertile couples, the stressful nature of this approach may be associated with adverse effects such as sexual dysfunction (SD) within the couple. Study design, size, duration This prospective cohort study recruited 371 infertile couples who had been trying to conceive for more than a year, presenting to three regional infertility clinics between January 2016 and December 2018. 283 couples pursued TI and 88 couples pursued RI for a year, with all couples having no pre-existing sexual or psychiatric illness, and no medical contraindications to frequent intercourse. Participants/materials, setting, methods The SD score of both partners was assessed at the first visit using the validated Arizona Sexual Experiences Scale (ASEX) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). TTP was determined using Kaplan Meier Analysis in couples for whom natural conception was possible and no reversible fertility pathology was identified. Main results and the role of chance Timed Intercourse (TI) involves aligning sexual intercourse to the time around ovulation to increase the chance of conception in couples trying to conceive. Whilst TI is often advocated to increase conception rates and potentially accelerate the time to pregnancy (TTP) for infertile couples, the stressful nature of this approach may be associated with adverse effects such as sexual dysfunction (SD) within the couple. TI significantly increased the risk of SD compared to RI for both males (Odds ratio [OR] 15.24, 95% confidence interval [CI] 7.96-29.15) and females (OR 5.52, 95% CI 2.38- 12.78), after adjusting for age, medical disorders, obesity, smoking, cause of infertility, and previous assisted reproductive techniques. TI carried a higher risk of developing erectile dysfunction, premature ejaculation, male hypoactive sexual dysfunction, female sexual interest-arousal disorder, and female orgasmic disorder. The TTP for natural conception was similar between TI and RI (p = 0.1365). Limitations, reasons for caution TI, a well-known strategy for increasing conception rates, did not improve time to natural conception compared to regular sexual intercourse. In contrast, the risk of sexual dysfunction in both men and women was significantly higher in TI, compared with RI. Wider implications of the findings This large study raises the question of effectiveness of the long-held belief that TI (intercourse limited around the ovulation-time, based on different methods of ovulation-prediction) improves pregnancy outcomes. Trial registration number N/A

SexTreatverse: Avatar-Based Virtual Reality for the Treatment of Female Sexual Disorders.

SexTreatverse: Avatar-Based Virtual Reality for the Treatment of Female Sexual Disorders.

Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review.

Many possible factors impact sexual wellbeing for women across the lifespan, and holistic approaches are being utilized to promote health and to address sexual concerns. Female sexual dysfunction disorders, including female orgasmic disorder, female sexual interest/arousal disorder and genito-pelvic pain/penetration disorder, negatively impact quality of life for many women. To reduce distress and improve sexual functioning, numerous behavioral therapies have been tested to date. Here, we present a state-of-the-art review of behavioral therapies for female sexual dysfunction disorders, focusing on empirically validated approaches. Multiple psychotherapies have varying degrees of support, with cognitive-behavioral and mindfulness-based therapies arguably having the most empirical support. Nonetheless, several limitations exist of the studies conducted to date, including the frequent grouping together of multiple types of sexual dysfunctions in randomized clinical trials. Thus, additional research is needed to advance treatment development for female sexual dysfunctions and to promote female sexual health.

Testing the effectiveness of an online CBT intervention with the S-ONapp method for both partners to reduce postpartum female sexual disorders

Objective: The research evaluates the effectiveness of an online CBT program through the S-ONapp method addressed to both partners in order to decrease female sexual problems and increase the sexual satisfaction of both partners in the postpartum period. Method: In a randomized clinical trial, participants - women in the first 3 months postpartum with sexual problems revealed by FSFI scale scores - were randomly assigned to two groups: experimental group (CBT online intervention for both partners) and control group (intervention CBT online standard for women). For both groups, scores on the FSFI (female sexual disorder), NSSS-S (sexual satisfaction) scales for both partners, and DAS (couple satisfaction) scales for both partners are measured on pretest, posttest, and 6-month follow-up. Expected results: Regarding the control group, we expect that in the experimental group there will be: 1) a lower level of postpartum sexual problems reported by women in the posttest; 2) a higher level of sexual satisfaction reported by women in the posttest; 3) a higher level of sexual satisfaction reported by partners in the posttest; 4) a higher level of couple satisfaction reported by women in the posttest; 5) a higher level of couple satisfaction reported by partners in the posttest. The results are maintained 6 months after the intervention. Conclusions: An online CBT intervention program for both partners, based on a multidimensional approach to postpartum female sexual problems, is effective in improving the sexual life of both partners by increasing sexual satisfaction and couple satisfaction, with direct implications for the clinical field. Keywords: female sexual disorders, postpartum, sexual satisfaction, CBT online S-ONapp interventions.