Female Sexual Function Index Domain Scores Research Articles

Association of hirsutism and anthropometric profiles with sexual dysfunction and anxiety levels in infertile Indonesian women with polycystic ovarian syndrome

BackgroundHyperandrogenism is frequently found in polycystic ovary syndrome (PCOS) and contributes to physical manifestations like hirsutism and obesity, along with infertility. This condition can result in anxiety, depression, and body image disorders, potentially leading to sexual dysfunction. The objective of this investigation was to assess the correlation among hirsutism, anthropometric characteristics, sexual dysfunction, and anxiety levels among infertile Indonesian women diagnosed with PCOS.MethodsFrom December 2021 to December 2022, a cross-sectional study was undertaken involving 71 infertile women diagnosed with PCOS at Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. Hirsutism was assessed using the modified Ferriman-Gallwey (mFG) score; the anthropometric profile was assessed using BMI and waist-to-hip ratio. The assessment of sexual dysfunction was conducted using the Female Sexual Function Index (FSFI) questionnaire, while the evaluation of anxiety levels utilized the HAM-A questionnaires.ResultsIn this study, it was discovered that 53.3% of subjects experienced sexual dysfunction. However, there was no statistically significant relationship between hirsutism, anthropometric profile, and sexual dysfunction score in infertile women with PCOS (p > 0.05). Analysis of the overall FSFI domain score revealed that lubrication and satisfaction were lower in obese patients (p = 0.02 and p = 0.03), but this did not contribute to an overall sexual dysfunction score. Also, we found that subjects who experienced sexual dysfunction had a higher anxiety score (p < 0.005), with correlation analysis showing that Ferriman-Gallwey (FG) scores have a significant positive correlation with anxiety.ConclusionThere is no correlation between hirsutism, anthropometric profile, and sexual dysfunction in infertile Indonesian women diagnosed with PCOS. However, hirsutism could play a role in causing anxiety in Indonesian PCOS women. Additional investigation is required, as female sexual function is an intricate subject.

(013) More Than Just “Vaginal Dryness”: Addressing an Unmet Need for Sexual Health Intervention in Female Cancer Survivors

Abstract Introduction Female sexual dysfunction (FSD) in cancer survivors is underreported and therefore undertreated. While the impact of cancer treatment on sexual health has been investigated through validated patient-reported outcomes, little work has been done to describe genitourinary anatomical changes in women in this population and how these changes relate to sexual function. Objective This study aims to 1) describe the population of female cancer survivors seeking treatment for sexual dysfunction through a novel sexual health after cancer program and 2) correlate disruptions in genitourinary exam findings to patient-reported sexual function. Methods A retrospective analysis included patients presenting to a sexual health after cancer program at a cancer center in South Florida. Patients received a baseline Female Sexual Function Index (FSFI) and underwent a physical, including abdominopelvic, exam. The FSFI is a validated 19-item survey that assesses desire, arousal, lubrication, orgasm, satisfaction, and pain domains. A total FSFI≤26.55 indicates sexual dysfunction. Genitourinary exam changes were characterized using a novel Adapted Vulvovaginal Exam Score (AVES) which assesses vaginal rugae, vascularity, epithelial integrity, elasticity, and dryness. A high AVES (&amp;gt;3) corresponds to more severe exam disruptions. Mean FSFI total and domain scores were compared between AVES groups (0-3 vs. &amp;gt;3) using t-test. A multivariate binary logistic regression model was fit to identify significant patient factors, treatment characteristics, and FSFI responses associated with high AVES score. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated. Results Between 2020-2021, 139 female cis-gender women with a median age of 46 (range 19-70) at diagnosis were seen in the MUSIC Program that 56.8% identified as Hispanic/Latinx. Most were treated for breast (79.1%) or gynecologic (9.4%) cancer. Common presenting symptoms included vaginal dryness (55%), painful sex (45%), low desire (36%) and hot flashes (22%). Patients who disclosed details about pain (n=62) reported penetration was possible but uncomfortable (14%), possible but painful (58%) or impossible due to pain (11%). Those who disclosed changes with orgasm (n=43, 31%) reported it was more difficult (26%), or impossible (23%). Of those completing the FSFI (n=108, 78%), median Desire Domain score was 1.8 (IQR 1.2), and median Total Score was 9.85 (IQR 13.3), with 97% of patients meeting criteria for FSD. Mean total FSFI score, as well as lubrication, orgasm, satisfaction, and pain domain scores were significantly lower in high AVES. Multivariate analyses revealed that women with poor FSFI satisfaction domain score (&amp;lt;3.6) was significantly more likely to have high AVES (aOR 2.81; 95%CI 1.03-7.65; p=0.044). Conclusions The present study characterizes the range of anatomic changes associated with sexual dysfunction in a diverse cohort of female cancer patients. Future work will describe treatment strategies employed and their effectiveness at symptom resolution and quality-of-life improvement to meet the needs of this growing population. Disclosure No

Postmenopausal sexual function and steroid hormone levels: a hospital-based cross-sectional study

Objective Steroid hormone levels, particularly androgens, play an important role in sexual function in premenopausal women, but this relationship is not so well determined after menopause. This study aimed to assess the association between steroid hormone levels and sexual function in postmenopausal women. Methods A total of 84 postmenopausal women with intact ovaries, who had never used systemic hormone therapy, were enrolled in a cross-sectional study. Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire and serum levels of steroid hormones were quantified by gas chromatography and tandem mass spectrometry. Associations between estradiol, testosterone, dehydroepiandrosterone, androstenedione and FSFI domain scores were evaluated. Results After adjustment for confounding variables, the analysis revealed a statistically significant association between androstenedione and overall sexual function (β = 1.23, 95% confidence interval [CI] [0.37; 1.98], p = 0.010), arousal (β = 0.19, 95% CI [0.02; 0.37], p = 0.034), orgasm (β = 0.33, 95% CI [0.15; 0.45], p = 0.001) and satisfaction (β = 0.25, 95% CI [0.11; 0.36], p = 0.001). No associations were found between the other hormones and FSFI domains. Conclusion The main finding of this study is the association of androstenedione with sexual function in postmenopausal women, not verified for other steroid hormones. Further studies are necessary to determine the importance of androstenedione for postmenopausal sexual function.

Platelet-rich plasma: An effective modality to improve sexuality in FGM/C

Now, accepted treatments for Female Sexual Dysfunction (FSD) are limited to surgical, psychological, behavioral, hormonal and psychopharmacologic interventions. Because of the complex and multifactorial nature of FSD, current therapeutic options may leave a subset of women suffering with sexual dysfunction without clinical improvement and may be with side effects of the procedures. This is a study to evaluate the effect of platelet rich plasma (PRP) in treating FSD FGM/C. PRP was administered to the anterior vaginal wall (1 session), clitoris of 45 females with FGM/C and non-FGM/C with sexual dysfunction and orgasmic disorder [Female Sexual Function Index (FSFI) total score ≤ 26 orgasmic subdomain score ≤ 3.75]. The correlation between PRP sessions and FSFI domain scores was done with Pearson's correlation and linear regression analysis. Following the application of the PRP, the total FSFI score was converted significantly in both FGM/C and non-FGM/C ( P < 0.05). A significant change was observed in all sub-domains of FSFI score after PRP ( P < 0.05). The total FSFI score increased in all 45 females [16 non-FGM/C and 29 FGM/C] ( P < 0.05). That correlations between all sub-domains of FSFI score before and after PRP injection were significantly positive ( P < 0.05). Also, there were statistically significant positive correlations between total FSFI scores before and after PRP injection, and sociodemographic and obstetric characteristics of the study population in both FGM/C and non-FGM/C. As a minimally invasive method, PRP administration to the distal anterior vaginal wall may improve female sexuality with high satisfaction in FGM/C.

Impact of Androgens on Sexual Function in Women With Rectal Cancer – A Prospective Cohort Study

BackgroundWomen treated for rectal cancer are at risk of sexual dysfunction and impaired ovarian androgen production. AimTo investigate a possible association between serum levels of endogenous androgens and sexual function in women with rectal cancer. MethodsWomen diagnosed with stage I–III rectal cancer were consecutively included and prospectively followed with the Female Sexual Function Index (FSFI) questionnaire from baseline to 2 years postoperatively and blood samples for hormone analyses, baseline to 1 year. Androgens were measured with liquid chromatography−mass spectrometry and electrochemiluminescence. The associations between the 4 measured androgens (testosterone, free testosterone, androstenedione, and dehydroepiandrosterone sulphate) and sexual function were assessed with generalized least squares random effects regression analysis in sexually active women. OutcomesThe primary outcome measure was the mean change observed in the FSFI total score when the serum androgen levels changed with one unit. Secondary outcomes were the corresponding mean changes in the FSFI domain scores: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort. ResultsIn the 99 participants, the median FSFI total score decreased from 21.9 (range 2.0 – 36.0) to 16.4 (3.5 – 34.5) and 11.5 (2.0 to 34.8) at 1 and 2-years follow-up. After adjustment for age, partner, psychological well-being, preoperative (chemo)radiotherapy, and surgery, total testosterone and androstenedione were significantly associated with FSFI total score (β-coefficients 3.45 (95% CI 0.92 – 5.97) and 1.39 (0.46 – 2.33) respectively). Testosterone was significantly associated with the FSFI-domains lubrication and orgasm, free testosterone with lubrication, androstenedione with all domains except desire and satisfaction, and dehydroepiandrosterone sulphate with none of the domains. Strengths and LimitationsThis is the first study investigating whether androgen levels are of importance for the impaired sexual function seen in women following rectal cancer treatment. The prospective design allows for repeated measures and the use of the FSFI for comparisons across studies. No laboratory data were collected at the 2-year follow-up, and the missing data could have further clarified the studied associations. Conclusion and Clinical ImplicationTestosterone and androstenedione were associated with sexual function in female rectal cancer patients. The results are of interest for future intervention studies and contribute to the understanding of sexual problems, which is an essential component of the rehabilitation process in pelvic cancer survivors.Svanström Röjvall A, Buchli C, Flöter Rådestad A, et al. Impact of Androgens on Sexual Function in Women With Rectal Cancer – A Prospective Cohort Study. J Sex Med 2021;18:1374–1382.

"Two wavelengths endovaginal laser system": Clinical evaluation of a new device for mild SUI and vaginal atrophy treatment.

Menopause is the condition when a woman no longer manifests menstrual periods. Genitourinary syndrome (GSM) is the acronym to describe possible symptoms of this condition. Vaginal dryness can be a particular problem for women entering menopause, it can make the intercourse painful and may cause the increase in the need to urinate. Aim of this study is to evaluate the efficacy of combined fractional CO2 (10 500 nm) ablative and 1540 nm nonablative lasers on these symptoms. About 40 postmenopausal nonestrogenized women with moderate to severe vaginal atrophy referring symptoms related to GSM were recruited. A treatment cycle included three laser applications (every 4 weeks), was performed. Time points of the study were baseline (T1), week 4 (T2), week 8 (T3), and week 12 (T4).. Results evaluation was done with a modified female sexual function index (FSFI) and a modified stress urinary incontinence (SUI) scale. A significant improvement both of FSFI total score and each individual FSFI domain score was observed. No undesired side effects or short-term or long-term complications were shown. This study shows that the "two wavelengths endovaginal laser treatment" is a safe and effective technique to treat signs and symptoms related to GSM syndrome. For the treatment of women with severe urogenital symptoms who do not benefit from lifestyle changes, vaginal moisturizers, or local estrogen therapy, clinicians should consider the use of vaginal fractional laser treatment.

Effects of mode of delivery on sexual functions of parturients in Nigeria: a prospective cohort study.

Female sexual function disorders (FSFDs) have received less attention than male sexual function disorders, despite being more prevalent. Furthermore, most available literature is on the effect of vaginal delivery (VD) on sexual function, and studies on the effect of caesarean section (CS) are generally lacking. This study determined the comparative effect of CS and VD on FSFDs. A prospective cohort of postnatal mothers at two hospitals in Nigeria was studied. In the intervention group women delivered via CS whereas women in the control group had a VD. Both groups were followed up to 3months to determine the time to first coitus and other FSFs using a validated questionnaire. At 6weeks postpartum, mean time (days) to first coitus was shorter in the CS than in the VD group (29.2 ± 4.3 vs 32.1 ± 4.9; t = 2.38; p = 0.02). However, no difference was observed at 3months (37.3 ± 8.7 vs 40.9 ± 9.9; t = 1.83; p = 0.07). Also, there were no differences in mean Female Sexual Function Index (FSFI) total scores at 6weeks and 3months (p > 0.05). Mean FSFI domain scores at 6weeks for orgasm, satisfaction, and pain were significantly higher in the CS group (p < 0.05). However, there were no differences in any of the domain scores at 3months (p > 0.05). Mode of delivery does not affect time to resumption of coitus after childbirth, and FSF disorders by 3months postpartum. Caesarean section should therefore not be recommended to women merely for early resumption of coital activity or preservation/maintenance of sexual function after childbirth.

Prevalence of Hypoactive Sexual Desire Disorder Among Sexually Active Postmenopausal Women With Metabolic Syndrome at a Public Hospital Clinic in Brazil: A Cross-sectional Study.

AimsTo evaluate the prevalence of hypoactive sexual desire disorder (HSDD) among postmenopausal women diagnosed with metabolic syndrome (MS) and to compare it to that of a control group without MS.MethodsThis is a cross-sectional study carried out in 2 public tertiary hospitals in the state of São Paulo, Brazil, with a sample of 291 postmenopausal women aged between 40 and 65 years. Sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria and was related to the diagnosis of MS, which was determined according to the guidelines defined by the Adult Treatment Panel.Main outcome measuresAnalysis of sexual function with emphasis on sexual desire (HSDD), the incidence of MS, and the components of MS.ResultsThe prevalence of HSDD was significantly higher among women diagnosed with MS than among women without MS (P = .01). Women diagnosed with high blood pressure (P < .01) and increased triglycerides (P = .03) also had a higher prevalence of HSDD than did women without these conditions. The FSFI domain scores for desire, arousal, lubrication, orgasm, and satisfaction and the total FSFI score were significantly lower for postmenopausal women with MS, whereas the pain domain score was not significantly different between the groups (P = .913). The incidence of female sexual dysfunction was significantly higher among women with MS, regardless of the diagnostic criteria used (P < .05).ConclusionPostmenopausal women diagnosed with MS have higher rates of HSDD than do women without MS.Clinical Trial Registration: ID NCT02430987.Dutra da Silva GM, Rolim Rosa Lima SM, Reis BF, et al. Prevalence of Hypoactive Sexual Desire Disorder Among Sexually Active Postmenopausal Women With Metabolic Syndrome at a Public Hospital Clinic in Brazil: A Cross-sectional Study. J Sex Med 2020;8:545–553.

PD36-06 TWO-ARM, PROSPECTIVE, OPEN-LABEL, PILOT STUDY OF FLIBANSERIN VERSUS FLIBANSERIN AND SEX THERAPY IN WOMEN WITH HSDD

You have accessJournal of UrologySexual Function/Dysfunction: Female (PD36)1 Apr 2020PD36-06 TWO-ARM, PROSPECTIVE, OPEN-LABEL, PILOT STUDY OF FLIBANSERIN VERSUS FLIBANSERIN AND SEX THERAPY IN WOMEN WITH HSDD Sue Goldstein*, Rose Hartzell-Cushanick, Caroline Cochran, Noel Kim, and Irwin Goldstein Sue Goldstein*Sue Goldstein* More articles by this author , Rose Hartzell-CushanickRose Hartzell-Cushanick More articles by this author , Caroline CochranCaroline Cochran More articles by this author , Noel KimNoel Kim More articles by this author , and Irwin GoldsteinIrwin Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000907.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The most common sexual dysfunction in women is Hypoactive Sexual Desire Disorder (HSDD) with both biologic and psychologic components. Flibanserin was the first FDA-approved medication indicated for safe and effective treatment of HSDD in premenopausal women, but it has also been studied in postmenopausal women with results. Psychological and medical assessments are routinely performed in our sexual medicine practice. The aim of this pilot study was to compare the efficacy of flibanserin alone versus flibanserin with concomitant sex therapy in treating pre- and post-menopausal women with HSDD. METHODS: This open-label, prospective, 2-arm study was conducted at a single research center. Subjects (n = 17) with HSDD meeting inclusion and exclusion received flibanserin 100 mg qhs for 8-weeks. After this run-in period, flibanserin responders were randomized 1:1 to receive study medication alone (n = 5) versus study medication and nine sex therapy sessions (n = 4) over an additional 12 weeks. Responders were defined by a score of 1- 3 on the Patient Global Impression of Improvement (PGI-I). Validated outcome measures, including the Female Sexual Function Index (FSFI) and Female Sexual Distress Score (FSD-DAO) were completed at baseline, 8 weeks and end of study (12 weeks after randomization). Changes in FSFI from the flibanserin responder group at 8 weeks to the end of study (20 weeks) were compared with changes in the flibanserin responder and sex therapy group from the same time period. RESULTS: All subjects showed improvement of HSDD as only responders were randomized. Subjects receiving sex therapy had relationship issues that traditionally respond to sex therapy. FSFI total scores were significantly higher for patients who were in the combined flibanserin/sex therapy group compared to flibanserin alone (p = 0.03). FSFI domain scores in sexual desire, arousal, lubrication and orgasm were consistently higher in the combined group than flibanserin alone, although differences were not statistically significant. Distress, satisfaction and pain assessments were similar for both treatment groups. CONCLUSIONS: The addition of sex therapy to flibanserin treatment for HSDD in women who initially had some response to flibanserin significantly increased overall sexual function compared to flibanserin treatment alone. Although more research is needed, these pilot data suggest that use of a multidisciplinary treatment paradigm may result in better treatment outcomes in patients with HSDD. Source of Funding: Funded by an Investigator Initiated Research Grant from Valeant Pharmaceuticals. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e725-e725 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sue Goldstein* More articles by this author Rose Hartzell-Cushanick More articles by this author Caroline Cochran More articles by this author Noel Kim More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement PDF downloadLoading ...

Sexual function and depressive symptoms in primary infertile women with vitamin D deficiency undergoing IVF treatment

ObjectiveTo investigate the prevalence of female sexual dysfunction (FSD) and depression in primary infertile women with 25-Hydroxyvitamin D3 (25-OH VD) deficiency undergoing in-vitro fertilization (IVF)–intracytoplasmic sperm injection (ICSI) treatment. Materials and methodsA total of 80 women with 25-OH VD3 deficiency (<20 ng/mL = group 1), 80 women with 25-OH VD3 insufficiency (20–29.9 ng/mL = group 2), and 80 women with a normal 25-OH VD3 level (30–60 ng/mL = group 3) were included the study. Female sexual function and depression were measured using the Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI). ResultsNo statistically significant differences were found among the groups in terms of demographic characteristics, baseline and laboratory parameters. Statistically significant differences were observed among the groups with regard to FSD and depression. The FSFI (group 1 = 22.46 ± 2.13, group 2 = 25.82 ± 2.13 and group 3 = 28.66 ± 2.13, respectively) and sexual domain scores were low in women with 25-OH VD deficiency, and the number of women with depression (BDI score ≥ 17) was high (p < 0.05). Correlation analysis showed that the sexual domain scores were positively correlated with the 25-OH VD level, and the BDI score showed a significant negative correlation with the total FSFI score and 25-OH VD levels. ConclusionThe 25-OH VD status was associated with FSD and depression and that the degree of sexual dysfunction could depend on the severity of 25-OH VD levels. Further studies are needed to elucidate this issue.

Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence.

IntroductionStress urinary incontinence (SUI) is often associated with female sexual dysfunction. We investigated which pelvic floor muscle (PFM) parameters (strength, power, and endurance) are associated with improvement of sexual function after 8 weeks of transcutaneous electrical stimulation (TES) training.AimThis study was performed to determine the effects of TES in the seated position on PFM parameters and female sexual function and to identify correlation between improved PFM parameters and sexual function after 8 weeks of TES training in women with SUI.MethodsThe present study was performed between August 2018 and November 2018 in women with SUI who were randomized into a TES group (n = 17) or a control group (n = 17). One subject in each of the TES and control groups ultimately withdrew during the intervention due to a lack of time. Both groups were measured at baseline and after 8 weeks of intervention.Main Outcome MeasureAs outcome measures, PFM parameters (strength, power, and endurance) and female sexual function were assessed using a perineometer and the Female Sexual Function Index (FSFI), respectively.ResultsThe final study population consisted of 32 women with SUI. There were significant differences in PFM strength, power, and endurance and FSFI domain scores (desire, arousal, orgasm, satisfaction, and total score) in both between-group analyses (TES vs control group) and within-group analyses (pre-TES vs post-TSE). Change in PFM endurance had the highest association with change in total FSFI total score (r = 0.437; P = .006), and change in PFM power had the highest association with change in FSFI satisfaction (r = 0.420; P = .008).ConclusionTES in a seated position showed a beneficial effect on sexual function in females with SUI. Consideration of PFM parameters associated with FSFI domain scores may be important when developing intervention guidelines to improve female sexual function.Hwang UJ, Lee MS, Jung SH, et al. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019;7:505–513.

Contraceptive use and sexual function: a comparison of Italian female medical students and women attending family planning services

Objectives: The aims of the study were to understand how education relates to contraceptive choice and how sexual function can vary in relation to the use of a contraceptive method.Methods: We surveyed female medical students and women attending a family planning service (FPS) in Italy. Participants completed an online questionnaire which asked for information on sociodemographics, lifestyle, sexuality and contraceptive use and also included items of the Female Sexual Function Index (FSFI).Results: The questionnaire was completed by 413 women (362 students and 51 women attending the FPS) between the ages of 18 and 30 years. FSFI scores revealed a lower risk of sexual dysfunction among women in the control group who did not use oral hormonal contraception. The differences in FSFI total scores between the two study groups, when subdivided by the primary contraceptive method used, was statistically significant (p < 0.005). Women using the vaginal ring had the lowest risk of sexual dysfunction, compared with all other women, and had a positive sexual function profile. In particular, the highest FSFI domain scores were lubrication, orgasm and satisfaction, also among the control group. Expensive contraception, such as long-acting reversible contraception, was not preferred by this young population, even though such methods are more contemporary and manageable. Compared with controls, students had lower compliance with contraception and a negative attitude towards voluntary termination of pregnancy.Conclusion: Despite their scientific knowledge, Italian female medical students were found to need sexual and contraceptive assistance. A woman’s sexual function responds to her awareness of her body and varies in relation to how she is guided in her contraceptive choice. Contraceptive counselling is an excellent means to improve female sexuality.

Sexual functioning in females with depression in remission receiving escitalopram

Background & objectives:Sexual functioning is a strong determinant of quality of life. Sexual dysfunction has been widely reported due to depressive disorder as well as selective serotonin reuptake inhibitors. Thus, treatment with antidepressants can culminate in a double-edged sword, leading to drug discontinuation and symptom relapse. The objective of this study was to assess the sexual functioning of sexually active females with depression, currently in remission, receiving escitalopram and to compare with healthy controls.Methods:Fifty female patients with depression, currently in remission, with self-reported normal pre-morbid sexual function and receiving escitalopram for at least three months, were assessed on female sexual function index (FSFI) questionnaire and compared with healthy controls.Results:Half of the patients (n=25, 50%) in group A were found to have sexual dysfunction (FSFI score <26.55), while, 90 per cent (n=45) had decreased desire, 86 per cent (n=43) had decreased arousal, 54 per cent (n=27) had decreased lubrication, 68 per cent (n=34) had decreased orgasm, 62 per cent (n=31) had decreased satisfaction and 32 per cent (n=16) had pain during sexual activity. Patients receiving escitalopram had significantly higher sexual dysfunction as compared to healthy controls in mean total FSFI score (P<0.001) and all mean domain scores of FSFI except pain.Interpretation & conclusions:A significant proportion of sexually active females with depression currently in remission, receiving escitalopram, reported dysfunction in all domains of sexual function; thus, routine screening for sexual dysfunction during follow up is advisable for early identification and prompt treatment.

Preliminary Validation of a German Version of the Sexual Complaints Screener for Women in a Female Population Sample.

BackgroundTo date, neither the original English nor any of the translated versions of the Sexual Complaints Screener for Women (SCS-W) have been tested for their psychometric properties.AimTo evaluate the validity and utility of the German version of the SCS-W by assessing content, convergent, and discriminant validity.MethodsA population sample of 309 women (mean age = 26.9 years) completed the online survey and had matching data available on the SCS-W and the Female Sexual Function Index (FSFI). Spearman bivariate correlations between the SCS-W and FSFI domain scores and exploratory factor analysis with principal component analysis were conducted.OutcomesConvergent validity was excellent for the domain of orgasm, good for satisfaction, dyspareunia, and the total questionnaire score, and acceptable for desire, lubrication, arousal, and vaginismus. Discriminant validity was present for all domains apart from arousal, lubrication, and vaginismus. Varimax rotation suggested an 8-factor model was the most robust.Clinical ImplicationsThis brief screener seems suitable to provide a brief overview of female patients' sexual problems in a clinical setting.Strengths and LimitationsThis is the 1st study to assess the psychometric properties of the German version of the SCS-W. However, available information on the psychometric properties of the German SCS-W was limited because the validity of the screener could not be counterchecked against a clinical diagnosis of female sexual dysfunction.ConclusionOur results provide preliminary evidence of good validity of the German version of the SCS-W. Overall, the SCS-W can offer support for clinicians who are less familiar with sexual medicine and who might not routinely discuss sexual issues with their patients.Burri A, Porst H. Preliminary Validation of a German Version of the Sexual Complaints Screener for Women in a Female Population Sample. Sex Med 2018;6:123–130.

Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study.

IntroductionMenopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in low density lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes. The aim of this study was to evaluate the effect of a preparation of isoflavones, calcium vitamin D and inulin in menopausal women.Material and methodsWe performed a prospective, randomized, placebo-controlled, parallel-group study. A total of 50 patients were randomized to receive either oral preparations of isoflavones (40 mg), calcium (500 mg) vitamin D (300 UI) and inulin (3 g) or placebo (control group). Pre- and post-treatment assessment of quality of life and sexual function were performed through Menopause-Specific Quality of Life Questionnaire (MENQOL) and Female Sexual Function Index (FSFI); evaluations of anthropometric indicators, body composition through bioelectrical impedance analyser, lumbar spine and proximal femur T-score and lipid profile were performed.ResultsAfter 12 months, a significant reduction in MENQOL vasomotor, physical and sexual domain scores (p < 0.05) and a significant increase in all FSFI domain scores (p < 0.05) were observed in treatment group. Laboratory tests showed significant increase in serum levels of HDL (p < 0.05). No significant changes of lumbar spine and femur neck T-score (p > 0.05) were found in the same group.ConclusionsAccording to our data analysis, isoflavones, calcium, vitamin D and inulin may exert favourable effects on menopausal symptoms and signs.

Sexual function and satisfaction in Mexican young women undergoing breast cancer treatment.

e21714 Background: Compared to other regions, the burden of breast cancer (BC) in Mexico is disproportionately borne by younger women. Yet, their particular needs and concerns have remained understudied, including treatment-related sexual adverse effects. We aim to assess the sexual function and satisfaction in Mexican young women with BC undergoing treatment. Methods: This is a prospective sexual assessment study in BC patients of the pilot phase of the Joven y Fuerte Mexican cohort (N=96). Sexual health was assessed using the Female Sexual Function Index (FSFI) and the Sexual Satisfaction Inventory (SSI) at two points in time: baseline (BL) and 6-months follow-up (6-FU). FSFI and SSI scores lower than 26.55 and 111, respectively, were defined as sexual morbidity. Differences between proportions of BL and 6-FU were examined with Pearson chi-square test. Matched t-tests were used to test for differences in the domains of the FSFI and in the SSI total score. Results: 70 women completed the FSFI at both time points and 69 the SSI. Our results showed a high percentage of sexual dysfunction among Mexican women at BL and 6-FU (61.4% and 74.3%, respectively, p&lt;0.001), as well as an elevated proportion of sexual low satisfaction at both time lines (40.6% and 43.5%, p=0.004). Most 6-FU FSFI domain scores were significantly worse than those at BL (Table 1). There were no significant differences in the SSI total score (102.31 [BL] vs 96.11 [6-FU], p=0.16). Conclusions: Mexican young patients with BC report significant sexual morbidity at BL, which even worsens after the first short follow-up. Reasons for the low sexual performance among Mexican women remain understudied and should be actively sought. In this prospective study, data will be annually collected for five years. This information will provide valuable information in an often-neglected matter of BC patients’ care. [Table: see text]

Effect of Flibanserin on Sexual Functioning: An Analysis of Female Sexual Function Index Domains [24H

INTRODUCTION: Flibanserin, a 5-HT1A agonist and 5-HT2A antagonist, is indicated for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. The Female Sexual Function Index (FSFI) is a validated self-report questionnaire comprising 6 domains of sexual functioning: desire, arousal, lubrication, orgasm, satisfaction, and pain. This post hoc analysis evaluated the effect of flibanserin treatment across the 6 FSFI domains. METHODS: Patient-level data were pooled from three 24-week, double-blind, placebo-controlled studies of flibanserin 100 mg once daily (qhs) in premenopausal women with HSDD. Between group differences in change from baseline to week 24 (last observation carried forward [LOCF]) on FSFI domain and total scores were evaluated using analysis of covariance. RESULTS: This analysis included 2368 women (flibanserin, n=1165; placebo, n=1204) who had at least one on-treatment efficacy assessment. The least-squares mean differences (standard error of the mean) in change scores from baseline to week 24 (LOCF) for flibanserin versus placebo were 0.3 (0.1) for the FSFI desire domain, 0.4 (0.1) for the arousal domain, 0.3 (0.1) for the lubrication domain, 0.3 (0.1) for the orgasm domain, 0.3 (0.1) for the satisfaction domain, 0.2 (0.1) for the pain domain, and 1.9 (0.3) for the total score; all P less than 0.0001 except P less than 0.01 for pain. CONCLUSION: Treatment with flibanserin produced significant improvement not only in the FSFI desire domain (a key outcome in clinical trials of HSDD) but also across the other domains of sexual function assessed by the FSFI.

Prevalence and correlates of female sexual dysfunction among Turkish pregnant women.

The aim of the present study was to determine the prevalence and associated factors of female sexual dysfunction together with the concerns of women about sexuality during pregnancy. A total of 207 healthy, sexually active pregnant women were enrolled in the study. Demographic data of all participants were noted and sexual functions were evaluated by Female Sexual Function Index (FSFI). Each FSFI domain score was calculated and mean scores were noted. Concerns of women about sexuality were also investigated. Mean age of participant women was 27.0±5.9 (range 15-44) years. Prevalence of sexual dysfunction was found to be 87% in study population. Mean FSFI score was 18.6±1.21. The rate of sexual dysfunction was higher in the first (87%) and third (92.6%) trimesters when compared to the second (80.6%) trimester (p=0.243). Among demographic variables, education levels of partners and preconceptional sexual dysfunction were found to be significantly related to FSD. The most common concerns of women about sexual relationship have been reported as the fear of having pain (35%), risk of abortion (21.3%) and religious factors (10%). Prevalence of sexual dysfunction is relatively high among pregnant women. Educational levels and preconceptional sexual functions were found to have an impact on this high rate. Accurate counseling of partners about sexuality during pregnancy may help to reduce misbeliefs, concerns and, thereby, decrease this high rate of female sexual dysfunction.

Vaginal extension improves sexual function in patients receiving laparoscopic radical hysterectomy

ObjectiveTo investigate as to whether vaginal extension (VX) following laparoscopic radical hysterectomy (LRH) improves sexual function in patients with early-stage cervical cancer patients. MethodsA total of 216 patients with stage Ia1–IIa2 cervical cancer were recruited, 115 of them received LRH concurrently with VX (group VX) and the other 101, LRH only (group C). Demographic, clinicopathological, and peri-operative data were collected. The Female Sexual Function Index (FSFI) questionnaire was administrated before and one year after surgery. Serum estrogen and follicle-stimulating hormone levels were also measured one year after surgery. The total and domain-wise FSFI scores before and after surgery were compared. ResultsIrrespective VX or not, all 6 domains of the FSFI scores in women with early-stage cervical cancer were significantly reduced one year after LRH. VX, however, significantly attenuated this reduction and improved all 6 FSFI domain scores, at the only cost of <20min longer operating time. In addition, more ovarian reserve and better pre-operational sexual function also contributed to the attenuation. The ovarian reserve was improved if ovarian preservation procedure was performed during LRH. ConclusionsWhile the sexual function in patients receiving VX procedure does not fully achieve the pre-operational level, the improvement is nonetheless global and significant. Ovarian preservation procedure during LRH may also help improve the sexual function. Therefore, VX and ovarian preservation may be desirable for patients with early-stage cervical cancer who undergo RH.

Sexual Function after Childbirth according to the Mode of Delivery

Sexual Function after Childbirth according to the Mode of Delivery Background Female sexual dysfunction (FSD) is the inability to achieve or enjoy orgasm. It can influence physical, mental, and social aspects of individuals’ live. More attention is given to the sexual health nowadays. Aim of the study To investigate sexual behavior in the postpartum period according to the mode of delivery Subjects and methods Three hundred married females were enrolled in this study. A cross sectional study design was used. Each woman was asked to answer the female sexual function index (FSFI) with 2 answers one for before pregnancy and one for after delivery. Five modes of delivery were defined. Results Desire decreased in vaginal delivery without episiotomy significantly (3.3 ± 0.42) and improved in vaginal delivery with episiotomy and elective cesarean section (CS) significantly (3.6 ± 0.4, 3.6 ± 0.4 respectively). Arousal decreased in vaginal delivery without episiotomy and elective CS significantly, while it increased in vaginal delivery with episiotomy and instrumental delivery significantly (3.8 ± 0.4, 3.5 ± 0.3 respectively). Lubrication decreased in vaginal delivery without episiotomy (4.1 ± 0.4) and in emergent and elective CS significantly (4 ± 0.5, 4.2 ± 0.3 respectively). Orgasm decreased in vaginal delivery without episiotomy and in emergent CS significantly (3.9 ± 0.6, 4.2 ± 0.3 respectively), while improved in case of vaginal delivery without episiotomy significantly (3.9 ± 0.6). Satisfaction decreased significantly in vaginal delivery without episiotomy (3.9 ± 0.6), while improved significantly in vaginal delivery with episiotomy (3.7 ± 0.6). Pain was worse in all groups significantly. Total score decreased significantly in the group delivered vaginally without episiotomy and with elective CS (23 ± 1.5, 23 ± 1 respectively), while improved in vaginal delivery with episiotomy and with instrumental delivery (23 ± 4.1, 22 ± 1). Conclusion We can conclude that female sexual dysfunction is an important health problem. The FSFI total score was <26 in all modes of deliveries. Most of the FSFI domain scores were significantly different across all modes of deliveries. Further, change in total score of FSFI among all groups after delivery was significant except in emergent CS..