Female Sexual Function Index Domains Research Articles

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 ...

Effect of radiotherapy for rectal cancer on female sexual function: a prospective cohort study.

Abstract Background Clinical experience and limited data show that female sexual function is influenced negatively by preoperative radiotherapy (RT) for rectal cancer. The aim of this prospective study was to investigate the impact of RT on sexual function and ovarian reserve measured by levels of anti-Müllerian hormone (AMH). Methods Women with stage I–III rectal cancer scheduled for surgery with or without preoperative (chemo)RT were included and followed for 2 years. Female Sexual Function Index (FSFI) questionnaire responses and blood samples for hormone analyses, including AMH in women aged 45 years or less, were collected at baseline and during follow-up. Results In the group of 109 women who received preoperative RT, median scores in all FSFI domains decreased over time, as did the total FSFI score (from 18·5 (range 2·0–36·0) at baseline to 10·8 (2·0–34·8) at 2 years; P < 0·001). In the group of 30 women who did not receive preoperative RT, only satisfaction declined over time (from 3·2 (0·8–6·0) to 1·8 (0·8–6·0); P = 0·012). In longitudinal regression analysis, the mean decline in FSFI total score was –9·33 (95 per cent c.i. –16·66 to –1·99; P = 0·013) for women who had preoperative RT compared with those who did not, with adjustment for age, Psychological General Well-being Index score and relationship with partner. A corresponding association was seen for arousal, lubrication, orgasm and pain. Five of six women aged 45 years or less with detectable serum levels of AMH at baseline had undetectable levels after RT. Conclusion Preoperative RT was associated with impairment in sexual function in women with rectal cancer. This needs to be considered when discussing choice of treatment and rehabilitation. In younger women, undetectable AMH levels after RT indicate an irreversible loss of ovarian follicles.

The effect of transobturator tape operation on sexual functions of a patient with stress urinary incontinence and patient's spouse

This prospective study aimed to investigate the effects of transobturator tape (TOT) procedure on patients with stress urinary incontinence (SUI) and their spouses' sexual function. A total of 157 patients with SUI who underwent TOT operation between January 2017 and May 2019 and their spouses were included. All patients enrolled filled out the Incontinence Impact Questionnaire (IIQ-7), the Urogenital Distress Inventory (UDI-6), the Female Sexual Function Index (FSFI), and patients' spouses filled out International Index of Erectile Function (IIEF-5) before surgery and 6 months after the surgery. The mean value of IIQ-7 and UDI-6 questionnaires in the sixth month after the TOT surgery was lower than the mean scores of these questionnaires before surgery (P < .001). The mean value of the FSFI score was 21.84 ± 1.76 before the surgery and 25.43 ± 1.84 in the sixth month after the surgery (P < .001). There was a significant improvement in desire, arousal, lubrication, orgasm, satisfaction, and pain scores on the FSFI domains (P < .001, <.001, <.001, <.001, <.001 and <.05, respectively). The mean value of the IIEF-5 score of patients' spouses was 48.31 ± 5.23 before surgery and 57.87 ± 7.22 in the sixth month after the surgery (P < .001). Significant improvement was observed in IIEF-5 score regarding sexual desire, intercourse satisfaction, and overall satisfaction domains (P = .012, .002, and .006, respectively). TOT surgery significantly improves the sexual functions of both patients and their spouses.

A study on sexual functioning in adults with attention-deficit/hyperactivity disorder.

Sexual dysfunction has been ignored in adults with attention-deficit hyperactivity disorder (A-ADHD). This study examined sexual function in adults with ADHD compared to a healthy control group. The experimental group (N = 63, mean age = 31.11 ± 4.29, females = 31) were recruited among referrals with ADHD to an outpatient A-ADHD clinic. The DIVA-2 (Diagnostic Interview for ADHD in adults) and the schedule for affective disorders and schizophrenia (SADS) were used to assess for A-ADHD and comorbid psychiatric disorders, respectively. The healthy groups (N = 66, mean age = 31.37 ± 4.30, females = 31) were demographically matched and had no psychiatric disorders based on the Conners' Adult ADHD Rating Scales-Self Report, Short Version and SADS. Sexual functions were evaluated using the Female Sexual Function Index (FSFI) for females and International Index of Erectile Function (IIEF) for males. Females with ADHD compared to the control group showed significantly (P < .001) poorer scores in all FSFI domains (desire, arousal, orgasm, satisfaction, pain, and lubrication). The IIEF mean scores in the males with A-ADHD were lower (P = .00) than their counterparts for all the subscales including orgasm, erectile function, intercourse satisfaction, and overall satisfaction, except for the desire (P = .75). The orgasmic function had a significant negative correlation with Conners Adult ADHD Rating Scale-Self Report: Short total scores in males (r = -.48) and females (r = -.40). This study provides preliminary information on greater difficulties with sexual function in adults with ADHD. Assessment of sexual function in referrals with A-ADHD is suggested.

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.

The effect of being diagnosed with human papillomavirus infection on women's sexual lives.

Objective studies that use validated questionnaires are needed to evaluate the changes in the sexual functions of women diagnosed with human papillomavirus (HPV) infection. The study comprised 80 sexually active women diagnosed with a high-risk HPV infection. These patients were divided into four groups as follows: group 1, HPV 16/18-positive and normal cytology; group 2, HPV 16/18-positive and abnormal cytology; group 3, non-16/18 HPV-positive and abnormal cytology; and group 4, non-16/18 HPV-positive and normal cytology. The sexual functions and anxiety statuses of the patients were assessed via the Female Sexual Function Index (FSFI) and Beck anxiety inventory (BAI) questionnaires, respectively, at their first clinical visits and then 2 months later. There was no statistically significant difference among the study groups in terms of the overall FSFI and domain sub-scores at either of the visits. Women who tested positive for the high-risk HPV 16/18 strains had a significantly less sexual desire after being informed about the test results. Those with HPV 16/18 and normal cytology had significantly higher anxiety levels at their second than first visits. The BAI scores of the HPV 16/18-positive women (normal or abnormal cytology) at the second visit were significantly higher than those of non-16/18 HPV-positive women with normal cytology. There was no significant difference between the patients with normal and abnormal cytology results regarding the difference of BAI, overall and domain FSFI sub-scores at the first and second visits. The desire and lubrication domain scores of the HPV 16/18-positive patients significantly decreased after the first visit compared with those of the non-16/18 HPV-positive patients. HPV 16/18 positivity decreases women's total FSFI and desire domain sub-scores.

Direct-acting antiviral drugs improve the female sexual burden associated with chronic HCV infection

ABSTRACTBackground: The impact of patient cure by direct-acting antiviral agents (DAAs) on female sexual dysfunction (FSD) associated with HCV hasn’t been studied.Aim: To study the impact of DAAs on associated FSD in patients with chronic HCV infection.Methods: In patients with chronic HCV infection who were eligible for DAAs, the self-administered female-sexual-function index (FSFI) questionnaire was completed by 300 sexually active females’ patients before treatment and compared to equal number of age and socioeconomically matched controls. FSFI questionnaire results after treatment were compared to patients’ baseline results.Results: The mean total score for the patients was significantly lower than that for controls (16.77 ± 1.36 versus 17.52 ± 0.99, P < 0.001). Patients after treatment with DAAs significantly scored better results than baseline results in the total score and all domains of the questionnaire and significantly less patients had FSD compared to baseline (2.7% versus 29.3% P < 0.05). Patients’ mean FSFI score significantly improved after cure (18.8 ± 0.27 vs. 16.77 ± 1.36, P < 0.001).Conclusion: Hepatitis C has negative impacts on FSF and affecting all domains of FSFI. The DAAS improve the sexual burden associated with hepatitis C in patients who achieved sustained virologic response.

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.

Genital Pain and Numbness and Female Sexual Dysfunction in Adult Bicyclists

IntroductionBicycle seat pressure on the perineum may impair arousal and clitoral erection, likely contributing to genital pain and numbness experienced by female cyclists. AimWe aimed to identify the association between genital pain and numbness experienced by female cyclists and female sexual dysfunction (FSD). MethodsFemale cyclists were recruited to complete an online survey using the Female Sexual Function Index (FSFI), a validated questionnaire to assess FSD. Cyclist demographics, experience, preferred riding style, use of ergonomic cycle modifications, and genital discomfort while riding were also queried. Multivariate logistic regression analysis was used to evaluate risk factors of FSD. Main Outcome MeasuresThe main outcome was FSFI score, which is used to diagnose FSD when the FSFI score is <26.55. ResultsOf the survey respondents, 178 (53.1%) completed the survey and FSFI questionnaire. Mean age was 48.1 years (±0.8 standard error [SE]), and the average riding experience was 17.1 years (±0.9 SE). Overall, 53.9% of female cyclists had FSD, 58.1% reported genital numbness, and 69.1% reported genital pain. After adjusting for age, body mass index, relationship status, smoking history, comorbidities, and average time spent cycling per week, females who reported experiencing genital numbness half the time or more were more likely to have FSD (adjusted odds ratio [aOR], 6.0; 95% CI, 1.5–23.6; P = .01), especially if localized to the clitoris (aOR, 2.5; 95% CI, 1.2–5.5; P = .02). Females that reported genital pain half the time or more while cycling also were more likely to have FSD (aOR, 3.6; 95% CI, 1.2–11.1; P = .02). Cyclists experiencing genital pain within the first hour of their ride were more likely to have FSD (aOR, 12.6; 95% CI, 2.5–63.1; P = .002). Frequency and duration of cycling were not associated with FSD. Analysis of FSFI domains found that the frequency of numbness was correlated with decreased arousal, orgasm, and satisfaction during intercourse, whereas the frequency of pain significantly reduced arousal, orgasm, and genital lubrication. Clinical ImplicationsFemale cyclists that experience numbness and/or pain have higher odds of reporting FSD. Strengths & LimitationsOur study includes a validated questionnaire to assess FSD and queries specific characteristics and symptoms of genital pain and genital numbness; however, the study is limited by its cross-sectional survey design. ConclusionThis study highlights the need for cyclists to address genital pain and numbness experienced while cycling, and future studies are required to determine if alleviating these symptoms can reduce the impact of cycling on female sexual function.Greenberg GR, Khandwala YS, Breyer BN, et al. Genital Pain and Numbness and Female Sexual Dysfunction in Adult Bicyclists. J Sex Med 2019; 16:1381–1389.

Effect of a multi-ingredient based food supplement on sexual function in women with low sexual desire

BackgroundStudies have demonstrated that women with low desire and low excitement have negative feelings regarding their physical and emotional satisfaction, as well as their happiness. In this study, we evaluate the efficacy of Libicare® - a multi-ingredient food supplement - to improve sexual function in postmenopausal women.MethodsThis was an exploratory, prospective, non-controlled, observational study. Postmenopausal women aged 45–65 with a risk of sexual dysfunction (Female Sexual Function Index (FSFI) < 25.83) were included during routine clinical visits and treated with 2 tablets of Libicare® daily for 2 months. Libicare® is an oral food supplement containing Trigonella foenum graecum, Turnera diffusa, Tribulus terrestris, and Ginkgo biloba dry extracts. Primary endpoint: change vs. baseline in FSFI score. Secondary endpoints: 1) changes in testosterone and serum steroid levels of free testosterone and sex hormone-binding globulin (SHBG) levels and 2) tolerability.ResultsA total of 29 patients (mean age: 54.69 years) were included. FSFI mean (SD) score showed a significant increase: 20.15 (4.48) vs 25.03 (6.94), baseline vs final; p = 0.0011, paired t-test. Most patients (86.2%) increased their FSFI score. All FSFI domains, except dyspareunia, showed significant increases. The highest increase was observed in the desire domain (p = 0.0004). Testosterone and SHBG levels were assessed in 21 patients. A significant increase in testosterone level was observed: 0.41 (0.26) vs. 0.50 (0.34) pg/mL, baseline vs. final; p = 0.038, Wilcoxon test. 52.4% of patients increased their testosterone levels. Finally, a significant decrease was observed in SHBG level: 85 (32.9) vs. 73 (26.8) nmol/L, baseline vs. final; p = 0.0001; paired t-test. 95.2% of patients decreased their SHBG levels.ConclusionIn this pilot study, a significant improvement in sexual function and related hormone levels was observed with Libicare®. Further studies must be conducted to confirm these exciting results.Trial registrationCurrent Controlled Trial ISRCTN12928573. Date of registration: 28/March/2019. Retrospectively registered.

The female sexual function index: reliability and validity in Spanish postmenopausal women.

To examine the reliability and validity of the Spanish version of the Female Sexual Function Index (FSFI) and its ability to discriminate between women with and without female sexual dysfunction (FSD) among Spanish postmenopausal women. A total of 152 postmenopausal women completed the Spanish version of FSFI. Internal consistency, test-retest reliability, and construct validity (exploratory factor analysis) were analyzed. Concurrent and divergent validity were assessed using a visual analog scale for overall satisfaction with sexual life and the Hospital Anxiety and Depression Scale, respectively. To determine the ability and the accuracy of the FSFI total score in discriminating between women with and without FSD, a receiver-operating characteristic curve analysis was performed. Factor analysis suggested a three-factor structure (explained variance 77.77%). The Spanish FSFI showed substantial-to-excellent test-retest reliability, with good internal consistency in the FSFI total score (Cronbach's alpha = 0.964), and also in its three dimensions. The FSFI total and domains scores showed strong (r > 0.50) and significant correlations (P < 0.01) with overall satisfaction with sexual life (concurrent validity), and low correlations with anxiety and depression (divergent validity). The Spanish FSFI total score and dimensions were significantly able to discriminate between women with and without FSD (P < 0.05), with an optimal cut-off point of <24.95 for the FSFI total score (64.15% sensitivity and 75.76% specificity). The Spanish FSFI is a valid and reliable instrument for assessing and discriminating for FSD among Spanish postmenopausal women.

Sexual satisfaction and sexual function in women with gynecologic cancer: validation of the Sexual Satisfaction Scale for Women in Taiwan.

To date, there are few validated multidimensional measures of sexual satisfaction that have been translated and empirically validated among Chinese speaking women with gynecologic cancer. The study was undertaken to validate the Sexual Satisfaction Scale for Women and to examine sexual satisfaction and sexual functioning in a sample of women with gynecologic cancer. A cross-sectional survey was conducted in 209 women, of which 106 had gynecologic cancer and 103 were in the non-cancer group with no history of cancer. Self-evaluations included the Female Sexual Function Index and Sexual Satisfaction Scale for Women Traditional Chinese version. Analyses for internal consistency, test-retest reliability, and construct validity were performed. Analysis of variance was conducted for group comparison on sexual satisfaction and sexual functioning. The Sexual Satisfaction Scale for Women Traditional Chinese version showed good internal consistency reliability (Cronbach's α=0.965) and acceptable test-retest reliability (r=0.954). The confirmatory factor analysis on the Sexual Satisfaction Scale for Women Traditional Chinese version suggested the goodness of fit indices (χ²/df, root mean square residual, goodness of fit index, normed-fit index, comparative fit index, and adjusted goodness of fit index) were good. The women with gynecologic cancer gave significantly lower ratings (mean 102.18) than those without cancer (mean 118.09) for each of the Sexual Satisfaction Scale for Women Traditional Chinese version domains and total score. Significant differences between women with cancer (mean 13.08) and without cancer (mean 22.92) were noted for each of the Female Sexual Function Index domains and total scores (all p<0.0001). This translated version of the Sexual Satisfaction Scale for Women appears to be a reliable and valid instrument for measuring multifaceted components of sexual satisfaction in the general and clinical population of women rooted in Chinese culture.

Evaluation of Sexual Function in Breast Cancer Survivors Using Female Sexual Function Index: A Systematic Review

Objectives: Breast cancer is known as one of the most common women’s neoplasms and the Diagnosis and Treatment of cancer has a great effect on women’s sexual function. Considering the high survival rates of breast cancer, attention to sexual function is very important as a domain in the quality of life. Therefore, this research aimed to review studies on women’s sexual function using the female sexual function index (FSFI). Materials and Methods: To this end, PubMed, Web of Science, Scopus, and ProQuest databases were considered and Iranian studies on sexual function in breast cancer, which were in Persian or English and used the FSFI tool, were selected in this regard. In addition, these studies were methodologically evaluated and the keywords included "breast cancer" and "sexual function", along with their synonyms. Results: A total of 128 studies were identified out of which 5 cases having the inclusion criteria were selected after reviewing the title, abstract, and quality assessment. The rate of sexual dysfunction in the survivors of breast cancer varied between 52.5% and 100%. Based on the domains of FSFI, the lack of desire and lubrication dysfunction were the most common disorders while satisfaction with sexual life obtained the highest score. Conclusions: Overall, it is necessary to systemically measure sexual dysfunction after cancer diagnosis and treatment employing an appropriate tool. Finally, effective interventions are required to improve sexual function.

The effect of overactive bladder treatment with anticholinergics on female sexual function in women: a prospective observational study.

The aim of the study was to determine the effect of anticholinergics used for overactive bladder treatment on the sexual function of women. Between January 2016 and August 2018, over 18years old, 216 sexual active women with OAB and 165 healthy women as control group were prospectively enrolled in the study. Five different anticholinergics were used for the treatment. Female Sexual Function Index (FSFI), eight-item overactive bladder awareness tool (OAB-V8), and Beck Depression Inventory form were completed before and after 3months. Baseline and post-treatment scores were compared with a control group of age-matched healthy women. Patients with OAB reported at baseline significantly worse sexual function in all FSFI domains compared to healthy control group (21.47 ± 3.22 vs. 26.79 ± 5.56, p < 0.01). Three months after treatment, over 85% of participants reported clinically relevant improvements in sexual function, with statistically significant changes in mean FSFI scores. Treatment of OAB with anticholinergics can improve sexual function of sexual active women with OAB. Patients may be informed about this potential benefit of anticholinergic treatment, to improve their sexual function.

Evaluation of sexual function in Brazilian women with and without chronic pelvic pain.

PurposeThe aim of this study was to evaluate sexual function in women with chronic pelvic pain (CPP) compared to a control group without CPP and to investigate the factors associated with sexual dysfunction in women with CPP.MethodsThis cross-sectional study included 100 women with CPP and 100 controls. Sexual function was evaluated using the Female Sexual Function Index (FSFI) and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS). A generalized linear model was used to compare the groups with respect to the overall FSFI score and the scores obtained for each FSFI domain. Multiple logistic regression analysis was used to identify the factors associated with sexual dysfunction in the study group.ResultsAnxiety was present in 66.0% of women with CPP in the study group compared to 49.0% of the controls (P=0.022). Depression was detected in 63.0% of women with CPP in the study group and in 38.0% of the controls (P=0.001). Sexual dysfunction was identified in 81.0% of the women with CPP in the study group compared to 58.0% of the controls (P=0.003). Following adjustment, the women with CPP had significantly lower mean scores compared to the controls in the FSFI domains of desire (3.0±1.3 vs 3.6±1.3; P=0.038), arousal (2.6±1.6 vs 3.4±1.9; P=0.002), lubrication (3.2±1.9 vs 3.7±2.3; P=0.011), orgasm (3.0±1.9 vs 3.6±2.2; P<0.002), and pain (2.5±1.7 vs 3.4±2.2; P<0.001). There was no difference between the groups for the satisfaction domain (P=0.337) or for the overall score (P=0.252). A positive and independent association was found between depression and sexual dysfunction in the women with CPP (P=0.012).ConclusionIn the women with CPP, sexual dysfunction was more common, and the scores in most of the sexual function domains were poorer than in the control group. Concurrently, depression was found to be positively associated with sexual dysfunction in the women with CPP.

Comparison of the Effect of Intermittent and Continuous Aerobic Physical Training on Sexual Function of Women With Polycystic Ovary Syndrome: Randomized Controlled Trial

BackgroundPolycystic ovary syndrome (PCOS) is a common condition characterized by hyperandrogenism, anthropometric changes (increased weight and waist-to-hip ratio [WHR]), behavioral changes (sexual dysfunction, anxiety, and depression), and reduced quality of life. Physical exercise may reduce many of the adverse effects of PCOS. However, no studies have yet evaluated the effects of aerobic exercise on the sexual function of women with PCOS. AimTo compare the effects of continuous and intermittent aerobic physical training on the sexual function and mood of women with PCOS. MethodsThis is a secondary analysis of a controlled clinical trial in which women with PCOS (18–39 years of age) were randomly allocated to 1 of 3 groups for 16 weeks: continuous aerobic training (CAT, n = 23), intermittent aerobic training (IAT, n = 22), or no training (control group, n = 24). The Female Sexual Function Index (FSFI) was used to assess sexual function, and the Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Main Outcome MeasureThe main outcome measure used was the FSFI. OutcomesThe primary outcomes were changes from baseline in total FSFI score and HAD scores at week 16 to prove the superiority of intermittent aerobic exercise compared with continuous aerobic exercise. ResultsAfter 16 weeks, the CAT group had a significant increase in the total FSFI score, improvements in the FSFI domains of satisfaction and pain, and a reduction in the WHR. The CAT and IAT groups also had significantly lower levels of testosterone after 16 weeks. The IAT group had a significant increase in the total FSFI score and improvements in the desire, excitation, lubrication, orgasm, and satisfaction FSFI domains. The CAT and IAT groups both had significant reductions in anxiety and depression scores after 16 weeks. Clinical ImplicationsAerobic physical training protocols could be indicated to promote mental and sexual health in women with PCOS. Strength & LimitationsThis is one of the first studies to examine the effects of different physical training protocols on the sexual function of women with PCOS. The limitations of this study are that we did not consider diet or the frequency of sexual relations of participants with their partners. These factors could have interfered with the outcomes. ConclusionThe CAT and IAT protocols improved the sexual function and reduced the anxiety and depression of women with PCOS. Both protocols were similar to improve FSFI domain scores.Lopes IP, Ribeiro VB, Reis RM, et al. Comparison of the Effect of Intermittent and Continuous Aerobic Physical Training on Sexual Function of Women With Polycystic Ovary Syndrome: Randomized Controlled Trial. J Sex Med 2018;15:1609–1619.

OnabotulinumtoxinA detrusor injection improves female sexual function in women with overactive bladder wet syndrome

ObjectivesThe correlation between changes in sexual function and improvements in LUTD in patients treated with OnabotulinumtoxinA (onaBoNT-A) detrusor injection is unclear and limited only to women with neurogenic OAB. The aim of this study was to evaluate the impact of OnabotulinumtoxinA (onaBoNT-A) injection on sexual function in women undergoing this treatment for idiopathic wet overactive bladder (OAB). Study designThis is a pilot three-center observational study including women affected by idiopathic wet overactive bladder refractory to standard conservative treatments and underwent onaBoNT-A injection. Sexuality was assessed using the Female Sexual Function Index (FSFI). A 3-day voiding diary, OAB screener questionnaire (OAB-S), and the international consultation on incontinence questionnaire short form (ICIQ-sf) were completed before and 3 months after onaBoNT-A injection to evaluate OAB symptoms. ResultsAll the 32 enrolled patients were included for statistical analysis. These patients received 100U of onaBoNT-A. Significant improvement of many FSFI domains was found. Only desire and pain domains had no significant improvements. The FSFI total score showed a significant improvement (P 0.0008). Clinical efficacy has been documented by voiding diaries, OAB-S scores, and ICIQ-sf scores. Correlation between UUI episodes and FSFI total score was statistically significant (r = −0.73; p = 0.04) while no significant correlation was found between the number of micturition and FSFI total score. ConclusionWomen who underwent successful OnaBoNT-A detrusor injection to treat wet OAB, showed an improvement in sexual function due to the significant correlation between the improvement of urinary urge incontinence and a better gratification of sexuality.

Effect of Single-Session, Cryogen-Cooled Monopolar Radiofrequency Therapy on Sexual Function in Women with Vaginal Laxity: The VIVEVE I Trial.

Objective: This subanalysis of the VIVEVE I trial aimed to evaluate the impact of cryogen-cooled monopolar radiofrequency (CMRF) therapy, for the treatment of vaginal laxity, on the domains of sexual function included in the Female Sexual Function Index (FSFI).Materials and Methods: The VIVEVE I clinical trial was prospective, randomized, single-blind, and Sham-controlled. Nine clinical study centers in Canada, Italy, Spain, and Japan were included. This subanalysis included premenopausal women with self-reported vaginal laxity who had ≥1 term vaginal delivery and a baseline FSFI total score ≤26.5, indicating sexual dysfunction. Enrolled subjects were randomized (2:1) to receive CMRF therapy [Active (90 J/cm2) vs. Sham (≤1 J/cm2)] delivered to the vaginal tissue. Independent analyses were conducted for each FSFI domain to evaluate both the mean change, as well as the clinically important change for Active- versus Sham-treated subjects at 6 months post-intervention.Results: Subjects randomized to Active treatment (n = 73) had greater improvement than Sham subjects (n = 35) on all FSFI domains of sexual function at 6 months postintervention. The analysis of covariance change from baseline analyses showed statistically significant improvements, in favor of Active treatment, for sexual arousal (p = 0.004), lubrication (p = 0.04), and orgasm (p = 0.007). In addition, Active treatment was associated with clinically important and statistically significant improvements in sexual desire [Odds ratio (OR) = 3.01 (1.11–8.17)], arousal [OR = 2.73 (1.06–7.04)], and orgasm [OR = 2.58 (1.08–6.18)].Conclusions: This subanalysis showed CMRF therapy is associated with statistically significant and clinically important improvements in sexual function in women with vaginal laxity. These findings provide the first randomized, placebo-controlled energy-based device evidence for functional improvements associated with a nonsurgical modality for a highly prevalent and undertreated condition.

The relationship between female sexual function index domains and premature ejaculation.

The aim of this prospective, observational study was to investigate the relationship between premature ejaculation (PE) and female sexual response cycle, using the female sexual function index (FSFI). The FSFI evaluates female sexual function in six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. All men were considered to have PE if they fulfilled the criteria of the second Ad Hoc International Society for Sexual Medicine (ISSM) Committee. All men were also assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculatory latency time (IELT) using stopwatch which was held by the partner. All women completed the FSFI. A total of 181 couples who had regular sexual intercourse with one partner for the past 6months were enrolled the study. By the definition of ISSM Committee, there were 117 men with PE and 64 men without PE. Partners of men with PE had significantly lower total FSFI scores than did partners of men without PE (21.8 ± 3.5 for PE and 26.4 ± 3.1 for non-PE, p < 0.001). Moreover, all the domains of the FSFI scoring system were separately associated with PE. According to the mean FSFI scores, the 48.43% of women had sexual dysfunction in the non-PE group, and all women had sexual dysfunction in PE group. PE is associated with female sexual dysfunction and all of the female sexual dysfunction domains, as determined by FSFI scores.