Female Sexual Dysfunction In Women Research Articles

Клінічна характеристика жінок із жіночою сексуальною дисфункцією та ендометріозом

Endometriosis is a disease characterized by the presence of endometrial tissue outside the uterine cavity. Endometriosis refers to estrogen-dependent diseases, clinically manifested by dysmenorrhea, dyspareunia, dyschezia. Decreased fertility in women with endometriosis is associated with the presence of chronic inflammation that leads to pelvic pain and infertility. It is believed that endometriosis is associated with mood disorders such as anxiety or depression, which can create a pathological background for sexual dysfunction. Purpose - to establish the relationship between female sexual dysfunction (FSD) and external genital endometriosis in order to optimize women's pregravid preparation. Materials and methods. 100 women of reproductive age were examined. The main group (the Group I) consisted of 70 women who had external genital endometriosis (diagnosed by ultrasound examination of the pelvic organs, ovarian endometrioma size up to 5 cm). The main group was divided into 2 subgroups: IA - 40 women with FSD and endometriosis; IB - 30 women with FSD without endometriosis. The control group (the Group II) included 30 healthy reproductively active women in the pre-gravid stage. In the course of the study, the nosological unit approved by the World Health Organization (1999) was taken into account and taken as a basis - FSD, which include disorders of desire, arousal and reaching orgasm, dyspareunia and vaginismus. The results of clinical and biochemical studies were processed using a specialized package of statistical programs Statistica 8.0 (StatSoft Inc., USA). The following criteria were used for statistical processing of the obtained data: Kruskal-Wallis test, Mann-Whitney U test, Pearson chi-squared (χ2) test, Wilcoxon test. Results. The analysis of the definition of FSD in women with endometriosis clearly indicates the presence of signs of FSD in all areas and is statistically significantly different from the indicator of healthy women. Conclusions. There is a relationship between endometriosis and FSD that can be determined using the FSFI Questionnaire Calculator. Since FSD and endometriosis have a polymorbid background, treatment should be carried out by a multidisciplinary team of doctors and be personalized. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

Urinary symptoms and female sexual dysfunction in women with type 1 diabetes: the role of depression.

Some reports suggest that women with type 1 diabetes (T1D) have a greater burden of female sexual dysfunction (FSD) than women without T1D, but the etiology of this elevated risk is poorly understood. To examine the associations between FSD and urinary incontinence/lower urinary tract symptoms (UI/LUTS) in women with T1D and to evaluate how depression may mediate these relationships. LUTS and UI symptoms were assessed in women with T1D who participated in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study. Multivariable logistic regression models estimated associations between FSD and UI/LUTS (overall and specific domains) and the impact of depression on these associations. FSD was measured with the Female Sexual Function Index-Reduced. In total, 499 self-reported sexually active women completed validated assessments of sexual and urinary function (mean ± SD age, 47.7 ± 7.6 years; T1D duration, 23.4 ± 5.15 years). FSD was reported in 232 (46%) responders. The frequency of UI and LUTS was 125 (25.1%) and 96 (19.2%), respectively. Neither UI nor its subcategories (urge, stress) were associated with FSD. Although LUTS (odds ratio [OR],1.75; 95% CI, 1.09-2.77) and its symptoms of urgency (OR,1.99; 95% CI, 1.09-3.61) and incomplete emptying (OR,2.44; 95% CI, 1.23-4.85) were associated with FSD, these associations were attenuated following adjustment for depression and antidepressant medication use. Depression indicators were independently associated with FSD overall and across domains. The complex interplay of voiding dysfunction, mental health, and sexual function warrants further investigation to understand the potential implications for patient assessment, goal setting, treatment, and care planning. Data are from a prospective study of individuals with T1D. These results are unable to explore cause-and-effect relationships among LUTS, UI, depression, and FSD. The sample may not be representative of the general population of women with T1D. Because participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study are mostly White, generalizing the findings to other races and to type 2 diabetes may not be appropriate. While exclusion of sexually inactive women likely biases our findings toward the null, this design element permitted study of LUTS and UI in relation to aspects of FSD, the primary objective of this study. The significant associations between LUTS/UI and FSD among middle-aged women with T1D were greatly attenuated when depression was considered a mediating factor.

History of infertility and sexual dysfunction in midlife women: Is there a link?

Infertility has been linked with an increased risk of sexual dysfunction in reproductive-aged women, with longer periods of infertility associated with a greater risk. The study's aim was to examine whether a history of infertility treatment in women is linked to sexual dysfunction during midlife. The cross-sectional study was conducted among sexually active women, between the ages of 45 and 65years, who sought consultation at the women's health clinics at a US tertiary care center. History of infertility treatment was assessed with a single question that asked participants if they were treated for infertility in the past. The association between a history of infertility treatment and sexual dysfunction-which was diagnosed by a combination of Female Sexual Function Index score ≤26.55 and Female Sexual Distress Scale-Revised score ≥11-was assessed in a multivariable logistic regression model that adjusted for multiple confounders. The primary outcome was sexual dysfunction in midlife women. The analysis included 5912 women, with a mean age of 54.1years. Nearly 16% of women reported receiving treatment for infertility. More than half the women (55%) had sexual dysfunction: 56.3% of those with previous fertility treatments and 54.4% of those without any fertility treatment (P = .3). Receiving treatment for infertility in the younger years did not significantly increase the odds of sexual dysfunction in midlife in univariate (odds ratio, 1.08; 95% CI, 0.94-1.24; P = .3) and multivariable analyses (odds ratio, 1.11; 95% CI, 0.96-1.29; P = .17). While infertility is known to be predictive of sexual dysfunction in women during their reproductive years, there was no association between a history of infertility treatment and sexual dysfunction in midlife women in the current study. The study used validated questionnaires accounting for sexual complaints and distress and adjusted for multiple confounding factors. Limitations include the selection bias introduced by the study of women presenting for evaluation of sexual dysfunction, which may have been a result of factors stronger than the influence of infertility. Other limitations include the study's cross-sectional nature with suboptimal racial and ethnic representation. Although infertility is commonly associated with female sexual dysfunction in women of reproductive age, the association was not present in midlife women in the current study.

The effects of mirabegron used for overactive bladder treatment on female sexual function

Background/Aim: Overactive bladder (OAB) is a common condition, especially in middle-aged women and can frequently have negative effects on female sexual function (FSD). The aim of the study was to assess the impact of mirabegron on female sexual dysfunction in women affected by OAB. Methods: In this cross-sectional study, 42 women with OAB and FSD were retrospectively enrolled. Patients were evaluated based on a detailed history, physical examination, uroflowmetry and residual urine measurements, 3-day voiding diary, visual analog scale (VAS), and Female Sexual Function Index (FSFI) questionnaire before and 12 weeks after treatment with mirabegron (50 mg/day). Results: At the 12-week follow-up, OAB symptoms improved significantly in all patients. The mean (standard deviation [SD]) FSFI total score significantly improved in 34/42 patients (80.9%) from 16.8 (1.3) to 26.9 (1.6); P<0.001. Mean (SD) scores significantly increased in domains of desire (from 2.1 [0.6] to 4.8 [0.2]), arousal (from 2.6 [0.3] to 4.3 [0.5]), lubrication (from 3.1 [0.6] to 4,1 [0.2]), orgasm (from 3.1 [0.2] to 4.3 [0.1]), and satisfaction (from 2.8 [0.4] to 4.1 [0.5]) after 12 weeks of treatment with mirabegron. Also, mean VAS scores significantly improved from 4.4 (1.4) to 8.8 (1.1); P<0.001. Conclusion: Treatment of OAB with mirabegron yields positive effects on sexual function of OAB patients.

The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China

To investigate the impact and factors of home quarantine life on women’s sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people’s spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.

Prevalence and severity of sexual dysfunction in women experiencing urinary incontinence with and without breast cancer: A matched control study

Symptoms of either female sexual dysfunction (FSD) or urinary incontinence (UI) after breast cancer treatment are reported to be common. Despite this, the prevalence and severity of FSD in women who experience UI after breast cancer treatment has not been investigated. The aim of this study was to compare the prevalence and severity of FSD in women with and without breast cancer who experience UI. A secondary analysis of data from a larger cross-sectional study was undertaken. 21 pairs of sexually active women with and without breast cancer who experienced UI were matched according to age, body-mass index and parity. The severity of FSD was assessed using the Female Sexual Function Index (FSFI). Participant demographics, prevalence of FSD, and FSFI scores were reported descriptively. Differences in prevalence rate of FSD and FSFI scores between women with and without breast cancer and UI were analysed using Wilcoxon signed-rank or McNemar’s tests. Participants with breast cancer who experienced UI reported significantly higher rates of FSD ( n = 19/21, 90%) compared to participants without breast cancer with UI ( n = 10/21, 48% p = 0.0028). Participants with breast cancer and UI had a significantly lower overall FSFI score (median = 18.8, IQR = 12.5) compared to those without breast cancer with UI (median = 25.9, IQR = 10, p = 0.0096). They also reported lower arousal, less lubrication, lower satisfaction and more pain during sexual activity compared to participants without breast cancer who experienced UI. Participants with breast cancer who experienced UI had a higher prevalence and severity of FSD than participants without breast cancer with UI. They reported having lower arousal, lubrication, satisfaction and more pain during sexual activity. These preliminary results suggest larger studies to investigate sexual function in women with breast cancer and UI are warranted.

Prevalence of pelvic floor dysfunction and sexual dysfunction in cervical cancer survivors: a systematic review and meta-analysis.

Pelvic floor dysfunction (PFD) and female sexual dysfunction (FSD) are symptoms that affect the quality of life of patients with cervical cancer (CC) after treatment. Our purpose was to estimate the prevalence of urinary incontinence (UI) and fecal incontinence (FI) associated with PFD and prevalence of FSD in CC patients. We searched PubMed, Embase, and the Cochrane Library from database inception to 31 January 2021 and selected articles assessing UI, FI and FSD in women with CC. Observational studies were included if they investigated UI, FI, and FSD. We included 14 of the 1,233 studies: 7 investigated FSD, 9 UI, and 3 FI. The results were highly heterogeneous because of the different populations and treatment methods. The prevalence of FSD, UI, and FI in CC patients after treatment was 45.0% (95% CI, 21.8-68.3%), 34.1% (95% CI, 25.5-42.7%), and 11.1% (95% CI, 4.8-17.3%). The results showed that different countries were the source of high heterogeneity of UI and FI (P<0.001). In this meta-analysis, the prevalence of PFD and FSD was high. These results are important for drawing attention to PFD and its early prevention and rehabilitation.

Evaluating the Link Between Self-Reported Endometriosis and Female Sexual Dysfunction

BackgroundStudies have found that women with endometriosis have a higher risk of female sexual dysfunction (FSD). AimTo evaluate the relationship between self-reported endometriosis and FSD utilizing validated surveys. MethodsA cross-sectional analysis was conducted among sexually active women aged 18–90 who presented to 3 Mayo Clinic sites from 2015 to 2021. FSD was determined utilizing a combined endpoint of Female Sexual Function Index score ≤ 26.55 and Female Sexual Distress Scale-Revised score ≥ 11. Associations between history of endometriosis and FSD were evaluated by fitting 3 multivariable logistic models and were stratified by menopause status. In the first model, the association was adjusted for age, BMI, race/ethnicity, marital status, and education. The second model adjusted for the variables in Model 1 and hormone therapy, hormonal contraceptive use, self-reported history of abuse within the last year, and co-morbidities including the history of diabetes, heart disease, hypertension, osteoporosis, and stroke. The third model adjusted for the variables in Model 1, Model 2, and anxiety, depression, relationship satisfaction, and SSRI/SNRI use. OutcomesThe outcomes included self-reported endometriosis and female sexual dysfunction determined utilizing a combined endpoint of Female Sexual Function Index score ≤ 26.55 and Female Sexual Distress Scale-Revised score ≥ 11. ResultsOf 7118 patients (mean age 51.3), 92.2% were white, 78.4% were peri- or postmenopausal, 8.7% reported endometriosis history, and 57.2% met the criteria for FSD. Women with endometriosis were more likely to be overweight or obese, be smokers, have had a history of heart disease and osteoporosis, have had anxiety and depressed mood, have had a hysterectomy and bilateral salpingo-oophorectomy, and have used hormone therapy. Compared to those without endometriosis, women with endometriosis were significantly more likely to have FSD only among premenopausal women (74.2% vs 57.4%). Similarly, in multivariable analysis the relationship was only seen for premenopausal women in all 3 models (Model 1: OR 2.74 (95% CI 1.43–5.27); Model 2: OR 2.55 (95% CI 1.30–5.04); Model 3: OR 2.30 (95% CI 1.13–4.68)). Clinical ImplicationsThese findings highlight the opportunity for healthcare practitioners to evaluate sexual function in premenopausal women with endometriosis. For peri and postmenopausal women with endometriosis, the risk of FSD was lower than for premenopausal women with endometriosis. Strengths and LimitationsThis study analyzed the association between endometriosis and FSD in women by menopause status using validated tools that included a measure of distress associated with sexual dysfunction. Limitations include its cross-sectional design which does not allow for determination of the direction of this association. ConclusionThe risk for FSD associated with endometriosis depends on menopause status. Endometriosis increased the odds of FSD only in premenopausal women.Kling JM, Ghaith S, Smith T, et al. Evaluating the Link Between Self-Reported Endometriosis and Female Sexual Dysfunction. J Sex Med 2022;19:1533–1561.

Female Sexual Dysfunction in Women After Treatment of Cervical Dysplasia.

Cervical cancer is the fourth most common cancer worldwide and accounted for approximately 570,000 new cancer cases and 311,000 cancer deaths in 2018. Despite advances in screening algorithms many US women undergo excisional cervical procedures for the treatment of cervical dysplasia. The effects of loop electrosurgical excisional procedure (LEEP) and cold knife conization (CKC) on sexual function are relatively unknown. To conduct a comprehensive review of the literature regarding the effects cervical cancer screening and treatment on female sexual function and satisfaction METHODS: We conducted a review of the medical literature up to and including November 2021 on PubMED using search terms related to cervical dysplasia and sexual health. We identified 831 articles and selected 39 articles for inclusion in our review. Nine studies were included that specifically focused on the effect of loop electrosurgical excisional procedure (LEEP) on female sexual function. Multiple studies demonstrated adverse psychologic and sexual effects in patients with cervical dysplasia and after colposcopy. Some studies reported that women experience decreased arousal and interest 6 months following colposcopy. Several studies documented adverse effects on lubrication, sexual pain, and desire following LEEP. There is a lack of high quality research on the effect of LEEP and colposcopy on female sexual function. Important limitations in the review of the current literature include, a small sample size, inconsistent comparison groups, observer bias, and lack the use of standardized questionnaires. Clinicians should continue to provide patients education regarding the risks and benefits of different treatment modalities and potential for effects on sexual function should be included in comprehensive counseling. Ethan Litman. Female Sexual Dysfunction in Women After Treatment of Cervical Dysplasia. Sex Med Rev 2022;10:360-366.

Vaginal non-ablative Er:YAG laser sexual dysfunction therapy in women with interstitial cystitis/bladder pain syndrome: A Case Series

ABSTRACT Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disease characterized by urinary frequency, urgency, and pelvic pain. Different studies have evaluated sexual well-being and e female sexual dysfunction (FSD) in IC/BPS patients. FSD in women with IC/BPS consists of dyspareunia, altered sexual desire, reduced orgasm frequency and vaginal insufficient lubrication. Recently, it has been repeatedly demonstrated that vaginal non-ablative erbium YAG laser (VEL) therapy can improve objective and subjective symptoms in different conditions. In our experience, VEL was very effective in various indications (stress urinary incontinence, mixed urinary incontinence, overactive bladder, genitourinary syndrome of menopause and FSD). In this study we evaluated the effects of VEL on FSD in women suffering from IC/BPS. Materials and methods This is case series study in which women with IC/BPS were also reporting FSD. The patients were treated with VEL with protocol in which the laser firstly irradiated the whole anterior vaginal wall and then also the entire vaginal canal. Local topical anesthesia was applied to the vagina before the laser irradiation. The therapy consisted in 1 treatment every 30 days, for 3 months. For the assessment of treatment effects we evaluated the personal history including: age at onset of IC/BPS and FSD, type of IC/BPS, bladder IC/BPS surgeries, the numeric rating scale-11 (NRS-11), O'Leary-Sant interstitial cystitis symptom and problem indexes (ICSI and ICPI), functional bladder capacity, daily urinary frequency, female sexual function index (FSFI) and vaginal health index score (VHIS). Follow-up was done 6 months from the first laser session. Potential adverse effects were observed at every visit as well as at 6 months follow-up. Results Six women were treated with the three sessions of VEL and followed for 6 months. The FSFI and VHIS significantly improved in all patients. The NRS-11 scores and the part of pain question of ICSI and ICPI improved as well. The bladder capacity and daily urinary frequency showed a marginal improvement. The therapy effects lasted for 6 months from the first treatment. All observed adverse effects were mild and transient. Conclusion Women suffering from IC/BPS have often impaired sexual life. Our data suggest that, besides being safe, VEL treatment can improve sexual life reducing also pain symptoms in IC/BPS patients. Further larger studies are needed in order to ascertain the relations between vaginal conditions and bladder pain, evaluating the possible role of VEL as a new approach for the treatment of FSD in IC/BPS women. Disclosure Work supported by industry: no.

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review.

Cancer and its treatment negatively affect female sexual health and function. The prevalence of female sexual dysfunction after cancer is between 33% and 43%. Numerous studies have addressed treatment options for sexual dysfunction in women with cancer, but it still remains a challenge to select the most efficacious option for patients. To compile and appraise recent evidence of any interventions for managing sexual dysfunction in female cancer survivors. A literature search of the electronic databases MEDLINE, EMBASE, PsycINFO, and Cochrane Central Register of Controlled Trials (January 2011 to February 2021) was conducted using general search terms of "women", "cancer", "intervention", "sexual dysfunction". We included randomized controlled trials (RCTs) and uncontrolled before-after studies that evaluated the efficacy of intervention for female sexual dysfunction in women with history of cancer. Methodological quality of studies was assessed using Risk of Bias (RoB) 2.0 for RCTs and National Institutes of Health (NIH) assessment tools for uncontrolled before-after studies. Thirty-six studies were included for qualitative synthesis (14 RCTs (n = 1284), 17 uncontrolled trials (n = 589), and 5 cohort studies (n = 497). Only four studies were at low risk of bias. Topical interventions (vaginal gels or creams) were able to alleviate vaginal dryness and dyspareunia, with intravaginal dehydroepiandrosterone (DHEA) (6.5 mg) gel showing evidence of improved sexual function. Evidence for estriol-lactobacilli vaginal tablets was unreliable due to a small-scale study. Psychoeducational therapy (internet-based cognitive behavioral therapy [CBT]) studies typically were at high risk of bias, but all displayed significant improvements of sexual function. Both laser therapy (fractional CO2 and erbium) and multimodal approach studies were at concerning risk of bias, although suggesting beneficial effects on sexual function. The most reliable evidence for improvement was from a study of DHEA vaginal gel, but in general, gels or creams were useful in reducing dyspareunia. Pharmacological, psychoeducational, laser therapy, and multimodal approaches demonstrated potential in managing cancer-related sexual issues, but most were small in size (10-70 participants), with moderate to high risk of bias. Therefore, large-scale, double-blind, RCTs with long-period follow-up, and at low risk of bias are needed to show efficacy for these interventions.

Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction.

Mild obstructive sleep apnea (OSA) is more prevalent than moderate and severe OSA and is more frequent in men than women. The association between OSA and female sexual dysfunction (FSD) is still poorly explored inpublished studies. Our aim was to investigate the prevalence of FSD in women with mild OSA and assess the impact of OSA on FSD, as well as to determine the predictors for FSD risk. The sample comprised 70 women aged 26-65years: a control group (N = 28) with no sleep complaints, and a group with mild OSA (an apnea-hypopnea index of 5or more and less than 15 events/hour, N = 42), who had been diagnosed using polysomnography performed in the sleep laboratory of a sleep research institute. All participants volunteered to take part in the study and completed the female sexual function index (FSFI), the Beck depression index (BDI), the Kupperman menopausal index (KMI), and the Epworth sleepiness scale (ESS). Their socioeconomic group was assessed using the Brazilian Economic Classification Criterion. Polysomnography and serum levels of free testosterone and total testosterone were analyzed. We found low FSFI scores (< 26.55) in the mild OSA (18.1) and control (21.7) groups (p = 0.97). There was no statistically significant difference between the mild OSA group and the control group. However, a higher BMI (p = 0.04), a higher BDI (p = 0.02), and being sexuality inactive (p = 0.001) were risk factors for FSD. There was a high prevalence of FSD in the entire sample. The presence of mild OSA did not affect sexual function in this sample. Depressive symptoms and a high BMI were associated risk factors for FSD. Being sexually activemay protect female sexual function.

Impact of a high visceral adiposity index on female sexual dysfunction in sexually active women? Results of a cross-sectional study.

To our knowledge, this is the first study investigating the impact of high visceral adiposity index (VAI) on female sexual dysfunction (FSD). We aimed to show the impact of increased levels of VAI on FSD compared with body mass index (BMI) and waist circumference (WC) particularly in those with metabolic syndrome (MeTS). We included 158 participants in two groups: Group 1 (n=68 with normal sexual function) and Group 2 (n=90 with sexual dysfunction). Demographic, clinic data, presence of MeTS and comorbidities were recorded. The BMI, WC and the VAI were calculated. Sexual function was assessed using the female sexual function index. The mean age and all the anthropometric variables were similar between the groups (P>.05). MeTS was associated with lower arousal and lubrication scores than those without MeTS (P=.023). The higher VAI was associated with lower desire, lubrication and orgasm scores (P<.05). Each integer increase of the VAI weakly predicted decrease of desire (P=.015), arousal (P=.015), lubrication (P=.005) and satisfaction (P=.046). The WC and BMI were not a good predictor for FSD in women (OR=1.019, P=.318). The VAI was linked with lower scores in some female sexual function subdomains, but the correlation coefficient was low, indicating a weak association. Further studies with a higher number of participants are needed to conclude that the VAI may increase the risk of FSD, particularly in patients with MeTS.

The Effect of Exposure to Sexual Violence on Sexual Dysfunction and Sexual Distress in Pregnant Women

BackgroundSexual dysfunction and sexual distress are common during pregnancy, but the effects of exposure to sexual violence on sexual dysfunction and sexual distress in pregnant women is unknown. AimThe aim of this study was to determine the effects of sexual violence on female sexual dysfunction and sexual distress. MethodsThis is a descriptive study. Data were collected between December 2019 and April 2020 from 605 pregnant women. OutcomesThe data were collected with a Data Collection Form (The socio-demographic and obstetric characteristics and exposure to sexual violence were evaluated with questions.), Female Sexual Function Index, and Female Sexual Distress Scale-Revised. ResultsIn our study, sexual dysfunction was found in 72.9% of the pregnant women, and sexual distress was found in 38.2%. It was found that 11.6% of the women were exposed to sexual violence in their then-current pregnancy. While the rate of sexual distress was found to be significantly higher in women who were exposed to sexual violence during pregnancy (P < .001), no significant difference was found between sexual violence and female sexual dysfunction (P = .572). Sexual violence during pregnancy was found to be a risk factor for sexual distress (P = .006). Clinical ImplicationsThis study may be an opportunity for nurses and physicians to determine the effects of sexual violence experienced by pregnant women on female sexual dysfunction and sexual distress during pregnancy. Strength & LimitationsThis is the first and only study that determines the effects of sexual violence on female sexual dysfunction and sexual distress. Our findings cannot be generalized to the entire population of Turkey. ConclusionThe presence of female sexual dysfunction in women during pregnancy is quite high, and the rate of sexual distress is moderate. Sexual violence from partner/spouse during pregnancy is a risk factor for sexual distress.Alan Dikmen H, Çankaya S. The Effect of Exposure to Sexual Violence on Sexual Dysfunction and Sexual Distress in Pregnant Women. J Sex Med 2020;17:2394–2407.

Sexual dysfunction and its determinants in women with rheumatoid arthritis.

To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to examine factors that are predictors of female sexual dysfunction including sociocultural factors, disease activity, and psychological status. We conducted across-sectional study including 71women with aconfirmed diagnosis of RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) criteria. Clinical and sociodemographic characteristics were collected. The participants were asked to complete the Female Sexual Function Index (FSFI), which contains 19questions, assessing six areas of female sexual function in the previous 4weeks. Sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The psychosocial status was evaluated by the Hospital Anxiety and Depression (HAD) scale. Prevalence of sexual dysfunction and predictors of sexual difficulties were assessed. The prevalence of female sexual dysfunction in women with RA was 49.3%. All areas were altered especially desire (2.92 ± 1.3), arousal (3.27 ± 1.5), and orgasm (3.77 ± 1.5). In univariate analysis, sexual dysfunction was correlated with the age of patients (p = 0.049), the age of partners (p = 0.013), pain (p = 0.001), number of night awakenings (p = 0.02), morning stiffness (p = 0.010), tender joints (p = 0.05), disease activity score (DAS28 ESR) (p = 0.043), fatigue (p = 0.028), and Health assessment questionnaire (HAQ) (p = 0.02). In multivariate analysis, the age of patients and pain were predictive factors of sexual dysfunction. By analyzing each area of the FSFI score, the age of patients was the independent variable associated with desire. Tender joints were associated with lubrication and the age of partners with arousal, orgasm, and satisfaction. Our study suggests that rheumatoid arthritis has anegative impact on patients' sexuality. Age of patients and partners, pain, and tender joints appear to be the main factors influencing sexual function.

Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis.

Polycystic ovarian syndrome (PCOS) is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction (FSD) adversely affects quality of life and interpersonal relationships. We aimed to compare the prevalence of FSD in women with and without PCOS. We pooled data from 28 observational studies involving 6256 women. Apart from the total prevalence of FSD, subgroup analyses based on different PCOS diagnostic criteria and obesity status (body mass index [BMI] ≥ 25kg/m2) were performed. The differences in total and subscale scores of the Female Sexual Function Index (FSFI) among women with and without PCOS were also compared. Women with PCOS were younger (mean ± SD 28.56 ± 3.0 vs 31.5 ± 3.2years, p < 0.001) with higher BMI (28.5 ± 4.2 vs 27.0 ± 6.1kg/m2, p < 0.001), Ferriman-Gallwey score (10.0 ± 3.2 vs 4.0 ± 2.1, p < 0.001), and serum total testosterone level (2.34 ± 0.58nmol/L vs 1.57 ± 0.60nmol/L, p < 0.001) compared with women without PCOS. The prevalence of FSD among women with and without PCOS was 35% and 29.6%, respectively. There was no significant difference in total FSFI score (24.59 ± 3.97 vs 26.04 ± 3.05, p = 0.237) between the two groups. Women with PCOS, however, had significantly lower scores in the pain (p < 0.001) and satisfaction subscales(p = 0.010) compared with women without PCOS. Women with PCOS had 1.32 higher odds (95% CI 1.07, 1.61) of having FSD than women without PCOS. Women with PCOS have a higher risk of FSD than those without PCOS. Although total FSFI scoreswere not significantly different, women with PCOS tended to report dyspareunia and lack of sexual satisfaction.

PD36-12 DOES MIRABEGRON HAVE A POSITIVE IMPACT ON SEXUAL FUNCTION IN FEMALES WITH OVERACTIVE BLADDER?

You have accessJournal of UrologySexual Function/Dysfunction: Female (PD36)1 Apr 2020PD36-12 DOES MIRABEGRON HAVE A POSITIVE IMPACT ON SEXUAL FUNCTION IN FEMALES WITH OVERACTIVE BLADDER? Samer Morsy, Hussein Hussein*, Dalia Abdel Azim, Sarah Hassan, and Eman Hussein Samer MorsySamer Morsy More articles by this author , Hussein Hussein*Hussein Hussein* More articles by this author , Dalia Abdel AzimDalia Abdel Azim More articles by this author , Sarah HassanSarah Hassan More articles by this author , and Eman HusseinEman Hussein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000907.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) may be associated with unpleasent effect on female sexual function. Mirabegron, a β3 receptor agonist, improves OAB symptoms, but there is limited information about its role on female sexual dysfunction (FSD). Aim of the study was to assess the impact of Mirabegron on FSD in women affected by idiopathic OAB. METHODS: One hundred sexually active women suffering from idiopathic OAB were included in the study. Patients were assessed by means of a urogynecologic physical examination and were asked to complete the 3-day voiding diary, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), the Female Sexual Function Index (FSFI) questionnaire and VAS, before and 12 weeks after treatment with Mirabegron 50 mg once daily dose. In addition, at the same time points, patients underwent uroflowmetry with the measurement of post- void residual volume (PVR). RESULTS: At baseline all patients were affected by OAB symptoms, with 98/100 patients (98%) presenting with FSD. At 12- weeks follow- up, OAB symptoms improved significantly in all patients, with 59.5% of subjects achieving a complete urinary continence. FSFI Total Score significantly improved in 84/100 patients (84%) from 18.9 ± 4.3 to 21.8 ± 4.5 (p < 0.0001). Thirty two cases (32%) presented with no FSD. Also mean ± SD scores of ICIQ-SF and VAS significantly improved (from 17.1 ± 5 to 7.9 ± 4.8 and from 3.9 ± 1.2 to 6.9 ± 1.2 respectively, p < 0.000). CONCLUSIONS: Mirabegron 50 mg control urinary symptoms in women with OAB, and also induces a significant improvement in their sexual life. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e727-e727 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samer Morsy More articles by this author Hussein Hussein* More articles by this author Dalia Abdel Azim More articles by this author Sarah Hassan More articles by this author Eman Hussein More articles by this author Expand All Advertisement PDF downloadLoading ...

198 Associations Between Domains of Urinary Symptoms and Female Sexual Dysfunction in Women with Type 1 Diabetes

The prevalence of female sexual dysfunction (FSD) in women with type 1 diabetes mellitus (T1DM) is significant, but the etiology remains poorly understood. Our objective was to determine the influence of urinary symptoms on FSD in women with T1DM. Sexually active women with T1DM participating in the urological ancillary study of the Epidemiology of Diabetes Interventions and Complications Study (UroEDIC) completed an abbreviated version of the Female Sexual Function Index measuring FSD, the American Urological Association Symptom Index measuring lower urinary tract symptoms (LUTS), the Sandvik Severity Index and other validated questionnaires measuring urinary incontinence (UI). Women were deemed to be symptomatic or non-symptomatic in each condition overall and in domains within each condition using standard cutpoints. Associations between symptoms of UI and LUTS and FSD were examined using logistic regression models adjusting for hemoglobin A1c, body mass index, age, and marital status. Among sexually active women (N=499) in the study the prevalence of FSD was 46.5% (N=232), of UI was 25.1% (N=125), and of LUTS was 19.2% (N=96). UI was not associated with FSD, whereas LUTS were significantly associated with FSD overall (OR=1.74, 95% CI 1.09, 2.77) and lower scores within the orgasm (OR=1.88, 95% CI 1.15, 3.07) and satisfaction domains (OR=2.09, 95% CI 1.13, 3.87). Incomplete emptying was the urinary symptom most strongly associated with FSD (OR=2.69, 95% CI 1.36, 5.30), primarily via the satisfaction (OR=2.74, 95% CI 1.25, 6.01) and pain (OR=4.81, 95% CI 2.14, 10.81) domains. Of the women with FSD, 75% were symptomatic in the interest domain, 57% in the orgasm domain, 45% in the lubrication domain, 34% in the arousal domain, 25% in the satisfaction domain and 23% in the pain domain.

Comparison of sexual function in Tunisian women with rheumatoid arthritis and healthy controls.

To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to compare it with that in voluntary healthy controls. We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 Criteria and 71 healthy age-matched controls. Clinical and sociodemographic characteristics were collected. Patients and controls were asked to complete the Female Sexual Function Index (FSFI). It contains 19 questions, assessing six areas of female sexual function in the previous 4weeks. The sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The patients' self-perception of their sexuality was assessed, and the frequency of sexual intercourse was noted. The prevalence of female sexual dysfunction in women with RA was 49.3% versus 23.9% in controls, with a significant difference (p = 0.002). Comparison between both groups as regards the mean of area scores of FSFI revealed that desire, arousal, and satisfaction in patients with RA were significantly lower than those in the control group (p = 0.05, p = 0.038, and p = 0.024, respectively). The score of lubrification, orgasm, and pain was comparable between the two groups. In univariate analysis, a significant association was found between sexual dysfunction and pain (p = 0.001), tender joint counts (p = 0.04), DAS28 ESR (p = 0.043), fatigue (p = 0.028), and functional disability (p = 0.02). No association was found between sexual dysfunction and treatment. In multivariate analysis, only pain was a predictive factor of sexual dysfunction in patients (p = 0.05, OR = 1.26 [1.16-1.3]). Based on patients' self-perception of their sexual function, 26.1% of patients reported a negative impact of RA on their sex life. According to them, the main factors influencing sexuality were joint pain (60.6%) and fatigue (51%). Moreover, 59% of patients reported a decrease in the frequency of sexual intercourse after the diagnosis of RA. However, no statistically significant difference was found between patients and controls in the frequency of sexual intercourse (p = 1). Our study suggests that patients with RA experience high level of impairment of sexual function in comparison with a control group. Health providers must consider sexual function as an important part of quality of life. A therapeutic education directed towards a patient could be proposed to approach sexuality.Key Points• The prevalence of female sexual dysfunction is higher in women with rheumatoid arthritis than in controls.• In multivariate analysis, the global pain intensity visual analog scale was the only predictive factor of sexual dysfunction in patients.• Based on patients' self-perception, joint pain and fatigue are the main factors influencing sexuality.

Quality of Life and Female Sexual Dysfunction in Croatian Women with Stress-, Urgency- and Mixed Urinary Incontinence: Results of a Cross-Sectional Study.

Background and objectives: Urinary incontinence is defined as the involuntary leakage of urine. Studies have reported that the severity of urinary incontinence symptoms can cause decreased quality of life and female sexual dysfunction in women, but the association between the duration of the incontinence and the aforementioned disturbances has not been evaluated. The objective of this study was to evaluate the differences in the occurrence of decreased quality of life and female sexual dysfunction in Croatian women with urinary incontinence, with regard to the duration and subtype of urinary incontinence. Materials and Methods: We conducted a cross-sectional study from March 2017 to July 2018 at our neurourology and urodynamics outpatient clinic, among 120 women with urinary incontinence symptoms. Based on medical history, physical exam and urodynamic assessment, participants were divided into groups with stress-, urgency- and mixed urinary incontinence. Several quality of life and female sexual dysfunction questionnaires were used for evaluation. The differences between the three UI groups were tested by the Kruskal–Wallis test. All p values were two-sided. The level of significance was set to Alpha = 0.05. Results: The mixed urinary incontinence group had a significantly inferior quality of life (p = 0.003) and lower scores on the female sexual dysfunction questionnaires (p = 0.02). The longer the duration of incontinence King’s Health Questionnaire total score was worse (p = 0.003) and Female Sexual Function Index total score was worse (p < 0.001). Conclusions: Our results showed that there was a statistically significant difference in the occurrence of decreased quality of life and female sexual dysfunction considering the duration and subtype of incontinence in Croatian women.