Female Sexual Function Index Research Articles

Use of the Knutson's paste for the treatment of perineal wound dehiscence after vaginal delivery: a single-center clinical experience.

The aim of this study was to retrospectively evaluate the therapeutic efficacy of the Knutson's paste, a solution composed of saccharose and povidone-iodine, in the management of perineal dehiscence following repair of post-partum laceration or episiotomy. Thirty-seven women with post-partum perineal dehiscence were included in the study, conducted between September 2020 and December 2022. Patients self-applied the Knutson's paste three times per day for 14-21 days. Clinical evaluation was performed weekly; healing was defined as the closure of the wound margins. Recovery of sexual function was investigated with Female Sexual Function Index (FSFI) questionnaires at 6 months. All women achieved complete healing, and no one required resuturing. Full healing was achieved in 16.9±2.6 days. Second-degree dehiscence required significantly more days (24±2.64) to achieve healing compared to first-degree dehiscence (15.8±2.08). A mean of 3.4 outpatient visits was necessary during follow-up. The healing process and time were not associated with age, Body Mass Index (BMI), or birth weight. Around 50% of patients reported satisfying figures on FSFI questionnaires. The Knutson's paste is a valid medicament for conservative treatment of post-partum perineal dehiscence. Due to its low costs and non-invasiveness, it could represent an alternative to the resuturing approach, especially in low-income countries and for women who refuse surgical revisions.

Design and methodology of the ‘endometriosis and pelvic floor dysfunction’ (EndoPFD) multicenter cross-sectional study

Objective To assess the prevalence and the characteristics of pelvic floor dysfunction (PFD) in women with endometriosis. Methods This is a methodological paper that describes the ‘Endometriosis and Pelvic Floor Dysfunction’ (EndoPFD) multicenter study protocol. It involves three sites: the University Hospital of Pisa, the San Raffaele Hospital of Milan and the Vanvitelli University Hospital of Naples. Women are recruited through web links and are asked whether they want to participate to the clinical evaluation or only to the web survey. The web survey gathers personal history, endometriosis history and symptoms, and performs a subjective evaluation of PFD through questionnaires: Urinary Distress Inventory 6, Colorectal-Anal Distress Inventory 8, Wexner Scale for Fecal Incontinence, Wexner Constipation Scoring System, and Female Sexual Function Index. Those interested in the clinical evaluation will add to the questionnaires the following exams: gynecological and proctological exam, pelvic ultrasound, urodynamic test, and anorectal manometry. Preliminary results Recruitment for the web survey was completed. A total of 1,149 women signed the electronic consent, 329 were excluded due to inclusion/exclusion criteria; hence, 525 completed all the questionnaires (response rate of 64.02%). Recruitment for the clinical evaluation is ongoing. Discussion This study protocol offers the possibility to define the prevalence of PFD in endometriosis patients with a subjective and an objective assessment of signs and symptoms. This may pave the way for changing the approach to patients with endometriosis. Moreover, it demonstrates the validity of the method used (online survey and recruitment) to reach a high number of patients.

Transdermal contraception and quality of life

Analysis of the current demographic situation in Ukraine in recent years indicates the presence of a deep demographic crisis on the background of social and economic problems and the military-political situation. In such conditions, one of the aspects of the country’s effective demographic policy should be the improvement of women’s reproductive health which depends on the abortion rate.In Ukraine the frequency of abortions has decreased significantly in recent years and today it is 4.6 per 1,000 women of fertile age, while the rate of childbirth exceeds the rate of abortions. Such outcome is the result of the effective use of modern family planning methods, including hormonal contraception. The patch which contains norelgestromin and ethinyl estradiol is the only contraceptive in Europe with transdermal hormone administration. With its use it is possible to ensure a constant level of ethinyl estradiol and norelgestromin in a woman’s blood without peaks and troughs by passing the digestive tract.The objective: to compare the impact on the quality of life of women, as well as the effectiveness, safety and convenience of using a patch containing norelgestromin and ethinylestradiol with a combined oral contraceptive in women of reproductive age.Materials and methods. 266 women of reproductive age who needed reliable contraception and used various modern hormonal methods of contraception were followed up through 2022.The women were divided into the following clinical groups: I group (main group; n=133) – healthy women of fertile age who used a transdermal hormonal system containing norelgestromin 6.0 mg, ethinyl estradiol 0.60 mg for the contraception; II group (comparison group; n=133) – healthy women of fertile age who used a combined oral contraceptive (ethinyl estradiol 0.02 mg and drospirenone 3 mg in a 24+4 regimen) for the contraception.Evaluation of efficiency, safety, convenience was carried out according to the Perl index, data from the FSFI questionnaire (Female sexual function index), the SF-36 quality of life scale.Results. The results demonstrated that hormonal patch, which contains norelgestromin and ethinyl estradiol, is a highly effective contraceptive drug and does not affect the parameters of hormonal and non-hormonal homeostasis, and is well tolerated by women.During the study the use of transdermal contraception in women of reproductive age prevented unplanned pregnancy in 100 % of cases. Evaluating the convenience of the contraceptive method on a five-point scale, women who used the hormonal patch have estimated the convenience with an average score of 4.98±0.02 points; in the group of women who used combined oral contraceptives, the result of convenience was significantly lower: the average score was 4.3±0.03 points (p<0.05).The transdermal form of the contraceptive avoids the effect of “first passage” through the liver, as a result, women who used transdermal contraception had 3.5 times less complications of the digestive tract.Conclusions. Hormonal patch containing norelgestromin and ethinylestradiol is a modern, easy-to-use and reliable method of hormonal contraception for women of reproductive age. It allows you to avoid the effect of “first passage” through the liver, complications of the digestive tract and thrombosis.The constant level of ethinyl estradiol and norelgestromin in a woman’s blood, which this patch provides, makes it possible to improve the psycho-emotional state, increase libido and positively affects the quality of life of women of reproductive age.

Incidence and risk factors of female sexual dysfunction in urban and rural China: a 4-year prospective cohort study.

This study aimed to investigate the incidence and risk factors for female sexual dysfunction (FSD) in urban and rural China. A prospective cohort study was conducted from February 2014 to January 2016, with follow-up from June to December 2018. Women aged ≽20 years were recruited from urban and rural areas in six provinces of China using a multistage, stratified, cluster sampling method. Sexual function was assessed using the Female Sexual Function Index questionnaire. A total of 16 827 women without sexual dysfunction at baseline participated in this study, 9489 of them (urban, 5321; rural, 4168) who had complete information from baseline to follow-up were included in the final analysis. The rate of follow-up was 68.81%, and the median follow-up time was 4.13 years. The 4-year incidence of FSD was 43.07%, with an incidence density of 12.02 per 100 person-years. In particular, the 4-year incidence and incidence density of FSD were 41.03% and 11.88 per 100 person-years in the urban group and 45.68% and 12.17 per 100 person-years in the rural group. Among women with sexual dysfunction, difficulties in sexual desire, satisfaction, and arousal were the main symptoms. In urban women, the risk factors for FSD included age ≽45 years (adjusted relative risk 1.69, 95% confidence interval 1.57-1.81), hypertension (1.31, 1.14-1.49), previous delivery (1.26, 1.13-1.41), post-menopausal status (1.20, 1.10-1.32), pelvic inflammatory disease (1.13, 1.05-1.21), and multiparity (1.11, 1.03-1.19). In the rural group, the risk factors significantly associated with FSD were age ≽45 years (1.50, 1.40-1.61), previous delivery (1.39, 1.17-1.65), hypertension (1.18, 1.06-1.30), multiparity (1.16, 1.07-1.27), and post-menopausal status (1.15, 1.07-1.23). FSD is a hidden epidemic condition in China, and the development of prevention strategies should consider the distinct risk factors present in rural and urban areas.

The first cross-sectional comparative observational study of sexual dysfunction in Emirati and non-Emirati Parkinson’s disease patients (EmPark-SD) in the United Arab Emirates

Sexual dysfunction (SD) is a common non-motor symptom in people with Parkinson’s disease (PD) yet underreported and undertreated specifically in many ethnic PD groups because of religious, social and personal perceptions. We conducted the first single-centre cross-sectional study in the United Arab Emirates of SD in 513 consecutive patients who agreed to complete the survey questionnaires. Data was collected on SD using the Nonmotor Symptoms Scale (NMSS), Index of Erectile Function, and Female Sexual Function Index. Our results show that the non-Emirati group had higher NMSS-SD scores than the Emirati group. SD was reported independent of ethnicity, race and disease stage (p < 0.001). SD correlated with worsening quality of life (p < 0.001) and anxiety domain, especially in young PD patients (p < 0.001). Our data concludes that there is no significant difference in SD between different ethnicity groups, contrary to common perception. SD appears to be underreported in this population and needs addressing using culturally sensitive bespoke counselling.

Development and Validation of a Measure of the Resolution Phase of the Sexual Response Cycle: The Sexual Resolution Scale (SRS)

ABSTRACT We developed and validated a measure of the depth of the resolution experience – the Sexual Resolution Scale (SRS). Portuguese-speaking participants responded to an online survey including the SRS whose eight items were derived from the literature on post-sex states: 1) deeply relaxed, 2) with elevated heart rate, 3) with intensified emotions, 4) more aware of body, 5) in a profound peace, 6) more imaginative, 7) more predisposed to talk about emotionally charged topics, 8) more predisposed to listen to emotionally charged topics. They also reported the intensity of satisfaction, desire, arousal, and orgasm, during the last sexual activity, and completed the Perceived Relationship Quality Components Inventory, and the Female Sexual Function Index or the International Index of Erectile Function. Principal Component Analysis and Confirmatory Factor Analysis revealed two dimensions: Internal Experience (items 1 to 6) and Openness to Communication (items 7 and 8). The two dimensions had good reliability. Invariance was confirmed between women and men. Nomological validity evidence was demonstrated: the two dimensions correlated with better sexual function during the last sexual activity and over the past 4 weeks. The SRS appears to be usable to measure the enjoyable aspects of the resolution phase of sexual intercourse.

Associations between menstrual pain and sexual function: the role of visceral hypersensitivity on developing sexual pain.

Dyspareunia, defined as pain before, during or after intercourse, is a subset of female sexual dysfunction with overlapping gynecologic, urologic and psychosocial etiologies. This study aimed to evaluate the impact of menstrual pain and visceral hypersensitivity on sexual function and to identify risk factors for sexual pain in healthy reproductive-age females. In this prospective cohort study, we evaluated gynecologic and psychologic self-reported histories, validated sexual function questionnaires, and conducted a standardized gynecologic examination enhanced by quantitative sensory testing in reproductive-aged females with menstrual pain versus pain-free controls. Correlation analysis was conducted between the Female Sexual Function Index (FSFI) pain subdomain score and a priori hypothesized risk factors for dyspareunia: menstrual pain severity, experimentally provoked bladder sensitivity, anxiety, depression, pain catastrophizing, and vaginal pressure-pain sensitivity. The primary outcome was severity of sexual pain as measured by the FSFI, comparing participants with moderate-to-severe dysmenorrhea (n = 99), dysmenorrhea with bladder hypersensitivity (n = 49) identified on non-invasive oral water challenge, and pain-free controls (n = 37). In our young (median age 22 [IQR 19, 29]), nulliparous, predominantly heterosexual cohort (78.3%, 144/185), 64.3% (119/185) engaged in sexual intercourse within the four-week recall period. The median total FSFI score was 27.2 (22.0, 30.2). Across groups, only the dysmenorrhea with bladder hypersensitivity phenotype met the threshold for sexual dysfunction as measured by total FSFI score (24.6 [20.0, 28.1], p= 0.008). Dysfunction was driven by difficulties with lubrication and higher pain levels during and after intercourse. On physical examination, those with and without dyspareunia were largely indistinguishable, with little to no tenderness of the pelvic floor, bladder, uterus and uterosacral ligaments. Amongst the six hypothesized risk factors for sexual pain, only experimentally provoked bladder pain was significantly associated with the severity of dyspareunia (r = 0.41, corrected p< 0.001). Young, otherwise healthy individuals with dysmenorrhea and occult visceral hypersensitivity exhibit signs of sexual dysfunction and significantly higher rates of dyspareunia in the absence of reliable clinical examination findings. Strengths include the use of a nonclinical sample of almost exclusively nulliparous females with no co-morbid pelvic pain diagnoses and prospective diary confirmation of dysmenorrhea severity. The study is limited by the narrow heteronormative, cisnormative sexual experience of penile-vaginal intercourse captured by the FSFI. Sexual pain is more prevalent in those with dysmenorrhea with bladder hypersensitivity than isolated dysmenorrhea, suggesting visceral hypersensitivity may be a non-structural mechanistic driver for dyspareunia.

Davydov-Moore vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome: sexual and surgical outcomes.

The aim of this study was to compare surgical and sexual outcomes after Davidov-Moore vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). In the case-series study, we described seven women, at a median age of 22.6 ± and BMI 22.8 ± 2.3kg/m2. We measured peri- and postsurgical parameters, including surgery-related neovaginal length and sexual initiation time. Sexual outcomes were measured using the Female Sexual Function Index (FSFI) before and 6months after vaginoplasty. All surgical procedures were performed successfully, with one minor perioperative bleeding. The mean time of vaginoplasty was 82.1min and the mean duration of hospitalization was six days. After a 6-month follow-up, vaginal length was 8.1-times longer than before surgery (10 vs. 81mm). The time from the surgery to the initiation of vaginal intercourse was between 17 to 22weeks. The mean FSFI score indicated good results, with no women below 23 score, and was 4.3- times higher when compared with the pre-surgical one (6.7 vs 29.1). Contrary to the FSFI score before surgery, the post-surgical FSFI revealed higher scores in all six different domains: desire (2.5-times), arousal (4.1-times), lubrication (3.8-times), orgasm (3.4-times), satisfaction (3.3-times) and comfort (11-times). Laparoscopic Davydov-Moore vaginoplasty might be considered as a safe procedure with satisfactory anatomic and sexual outcomes. It should be considered as a treatment option for the creation of neovagina in women with MRKH.

Prevalence and Correlates of Sexual Dysfunction in Patients With Type 2 Diabetes at an Endocrine Clinic in Hamadan, Iran

Diabetes is a metabolic disorder associated with severe medical consequences such as mental illness and sexual dysfunction in adults. In this cross-sectional study, 283 patients with type 2 diabetes, aged 20 to 70 and married, were selected in 2022-2023. Women’s sexual function was evaluated with the Female Sexual Function Index (FSFI), and men’s sexual function was evaluated with the International Index of Erectile Function (IIEF). Based on the results, 49.8% were men and 50.2% were women. The mean age of the patients was 48.13±8.90 years. The prevalence of sexual dysfunction among men and women was 100% and 66.2%, respectively. A negative correlation was observed between sexual dysfunction and age in women (P=0.043) and men (P&lt;0.001) and a negative relationship was also found between sexual dysfunction and the duration of diabetes in men (P=0.026). Sexual dysfunction is widespread among women and men with diabetes, and due to its adverse effect on the quality of life and marital relationships, it should be taken into consideration.

Examination of the relationship between dimensions of sexual perfectionism and female sexual function and sexual performance anxiety among Iranian married women of reproductive age: a cross-sectional study

BackgroundPerfectionism is a multidimensional personality trait that manifests itself through various aspects of life as well as sexuality. Yet, the specific nexus between perfectionism and women’s sexual experiences continues to remain unaddressed. Hence, this research aimed to investigate the relationship between the dimensions of sexual perfectionism, sexual function, and sexual performance anxiety (SPA) among Iranian married women of reproductive age in Gonabad, Iran.MethodA cross-sectional study was conducted in Gonabad City in 2021, involving 450 women of reproductive age. Stratified sampling was used to select public healthcare centers, and participants were chosen via simple random sampling. Data were collected online through platforms like WhatsApp and Telegram, using the Multidimensional Sexual Perfectionism Questionnaire (MSPQ), Female Sexual Function Index (FSFI), and Brief Sexual Performance Anxiety Scale (BSPAS). The validity and reliability of these instruments were confirmed through content validity assessments and Cronbach’s α. Hierarchical linear regression was performed using SPSS version 26, with the significance level set at p < 0.05.ResultsLinear regression analysis indicated that self-oriented sexual perfectionism was positively associated with all FSFI domains, including desire, arousal, lubrication, orgasm, satisfaction, total FSFI (p < 0.001), and pain (p < 0.01). Partner-oriented sexual perfectionism was positively associated with satisfaction (p < 0.05). In contrast, partner-prescribed sexual perfectionism was negatively associated with all domains of FSFI, including desire, pain (p < 0.05), arousal, lubrication, total FSFI (p < 0.001), orgasm, and satisfaction (p < 0.01). Socially-prescribed sexual perfectionism was positively associated with desire and negatively associated with pain (p < 0.05). In particular, only partner-prescribed and socially-prescribed sexual perfectionism were positively associated with SPA (p < 0.01).ConclusionThe association found between dimensions of sexual perfectionism, sexual function, and SPA in Iranian women underscores the necessity for educational initiatives tailored to psychologists, psychiatrists, counselors, sexologists, and other healthcare practitioners. These programs would help to build a deeper insight into the origins of women’s sexual complaints and identify and manage them within the context of marital relationships.

Sexual dysfunction among long-term survivors of Hodgkin lymphoma.

Survival rates from childhood cancer continue to increase, with an ongoing interest in long-term survivorship. Although infertility and gonadal failure are well recognized in Hodgkin lymphoma (HL) survivors, sexual dysfunction is less studied. The objective of this study was to compare the prevalence of sexual dysfunction in HL survivors with that in matched community controls. Long-term survivors of HL (n=186; female, 51.61%; mean age at diagnosis. 14.41 years [range, 3.01-22.60 years]; current mean±standard deviation age, 36.73±7.93 years) and matched community controls (n=182; female, 50.55%; mean±standard deviation age, 36.41±9.02 years) completed a comprehensive, in-person clinical assessment, laboratory battery, and the International Index of Erectile Function or the Female Sexual Function Index questionnaire. Male survivors had increased levels of erectile dysfunction (18.89% vs. 6.67%; p=.0239) but indicated no difference in sexual desire. Female survivors had a higher prevalence of sexual dysfunction compared with female controls (46.88% vs. 15.22%; p<.0001) and an increased prevalence of moderate-to-severe loss of sexual desire (38.04% vs. 23.26%; p=.0361). Female survivors with sexual dysfunction indicated increased levels of anxiety (p=.0184), depression (p=.0153), and worse physical and mental health (p=.0141 and p=.0419, respectively). Male survivors with erectile dysfunction had higher rates of anxiety and impaired physical health (p=.0147 and p=.0266, respectively). Sexual dysfunction was prevalent in this childhood and adolescent Hodgkin lymphoma survivor cohort and was associated with effects on quality of life. Health care providers must recognize the need for screening and intervention in this group to hopefully contribute to improved overall quality of life.

Validation of the Brief Index of Sexual Functioning for women and men (BISF-W and BISF-M) in an Italian sample.

The Brief Index of Sexual Functioning for Women (BISF-W) is an international 4-factors tool assessing qualitative and quantitative aspects of sexual experiences in women, both in clinical and experimental settings. The present research aims at validating an Italian version of the BISF-W, to develop a BISF version for men (BISF-M) to fill the gap in the existing sexual function evaluation tools in Italy and to analyze gender and age groups differences in the BISF factors. The research included 6,355 women, aged from 18 to 65 (M = 34.94, SD = 10.52) and 2,207 men, aged from 18 to 80 (M = 38.25, SD = 13.67), who completed the BISF-W and BISF-M. The Quality of Marriage Index (QMI) was administrated to both samples for testing divergent validity, while Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were administered for testing convergent validity. Correlation analysis, MANOVA between gender and age and Confirmatory Factor Analysis were conducted. The CFAs confirmed that the proposed 4-factor model (Dyadic, Solitaire and Anal Sexuality, and Sexual Difficulties) is suitable both for the BISF-W and the BISF-M, demonstrated strong psychometric properties for assessing sexual functioning in both genders, with dyadic sexuality being the most important factor. MANOVA analysis showed significative differences in the factors' scores, according to gender and age. The BISF-W and the BISF-M are promising tools to address sexual functioning in individuals and couples, both in clinical and non-clinical settings. Gender and age differences are discussed regarding the potential use of BISF in the therapeutic context.

Sexual Function and Satisfaction in Young Women with Breast Cancer: A Five-Year Prospective Study.

Young women with breast cancer (YWBC) face unique challenges that can impact their sexual health. This study aimed to identify factors associated with sexual activity, function, and satisfaction in YWBC up to five years post-diagnosis. We conducted a prospective cohort study of 474 women aged ≤40 years diagnosed with non-metastatic breast cancer in Mexico. Sexual function and satisfaction were assessed using the Female Sexual Function Index and the Sexual Satisfaction Inventory, respectively. Factors associated with sexual health outcomes were examined using mixed-effects models. The prevalence of sexual dysfunction increased from 33.6% at baseline to 52.9% at 4-5 years post-diagnosis. Factors associated with worse sexual function included older age (mean predicted FSFI score -1.35, p = .037), treatment-induced amenorrhea (-2.86, p < .001), depression (-4.11, p < .001), and anxiety (-2.13, p < .001). Lower sexual satisfaction was associated with lower educational attainment (mean predicted SSI score -5.61, p = .002), being single (-6.41, p < .001), treatment induced amenorrhea (-3.76, p = .004), bilateral oophorectomy (-8.21, p = .017), depression (-11.29, p < .001), and anxiety (-7.50, p < .001). Quality of life, body image, and systemic therapy side effects significantly impacted both outcomes. Three distinct trajectories of sexual function were identified: high (62.2%), intermediate (24.3%), and markedly declining (13.5%). Four trajectories of sexual satisfaction were found, ranging from intermediate-to-high (57.3%) to progressively worsening (27.5%). Sexual dysfunction is prevalent and persistent among YWBC. Multiple biological, psychological, and social factors influence sexual health outcomes in this population. These findings highlight the importance of routine screening and tailored interventions to address the sexual health of YWBC throughout survivorship.

How does surgery influence female sexuality in patients with endometriosis compared to those with other benign gynecological conditions?

BackgroundEndometriosis is a chronic, estrogen-dependent, benign condition, affecting 10–15% of women of reproductive age. It is associated with a prevalence of sexual dysfunction that is nearly twice as high as that seen in women with other benign gynecological conditions. Our study aimed to assess the effect of surgical intervention on sexual function, as measured by the FSFI (Female Sexual Function Index) score, in women with endometriosis compared to those with other benign gynecological conditions, both before and after surgery.MethodsA comparative analysis was conducted at the Medical University of Vienna from 2015 to 2020. The study included patients suspected of having endometriosis, fibroids, adnexal cysts, and/or infertility. Based on findings during surgery, patients were categorized into two groups: those with endometriosis (n = 64) and control patients (n = 38). All participants completed the FSFI questionnaire before surgery and again 8 to 18 weeks after the operation.ResultsNo significant differences were observed in the preoperative FSFI scores between the endometriosis patients and the control group. Similarly, no significant differences were found between the two groups in postoperative scores. However, in women diagnosed with endometriosis, surgical removal of endometriotic lesions significantly increased their full-scale FSFI score, and resulted in a significant improvement in the areas “desire” and “satisfaction”. Improvements were noted in all other areas as well, though they were not statistically significant.ConclusionsOur research indicates that the surgical removal of endometriotic lesions can lead to an improvement in sexual function, as measured by the FSFI, within 8 to 18 weeks post-surgery. This improvement was not observed in the control group, which underwent surgery for other benign gynecological issues.

Combined effects of high-intensity focused electromagnetic therapy and pelvic floor exercises on pelvic floor muscles and sexual function in postmenopausal women.

This study aimed to explore the impact of high-intensity focused electromagnetic therapy (HIFEMT) on the pelvic floor muscles (PFM), sexual function, and quality of life (QoL) among postmenopausal women. Fifty postmenopausal women with PFM weakness and sexual dysfunction were randomly allocated into two equal groups. The HIFEMT group participated in the PFM training program in addition to HIFEMT, whereas the control group performed PFM training only. For 12 weeks, HIFEMT was scheduled twice a week, while PFM training was performed daily. At baseline and after 12 weeks, PFM strength and endurance were assessed using a perineometer, sexual function was examined using the female sexual function index (FSFI), and QoL was assessed through the menopause-specific quality of life questionnaire (MENQOL). The HIFEMT and control groups showed significant increases in PFM strength and endurance and FSFI scores, and significant declines in MENQOL compared with baseline measures (P<0.05). Compared to the control group, the HIFEMT group showed substantial improvements in all measured variables after 12 weeks (P<0.05). Addition of HIFEMT to PFM training improved the PFM strength, endurance, sexual function, and QoL in postmenopausal women with PFM weakness and sexual dysfunction.

Use of radiofrequency ablation of the vaginal canal for genitourinary syndrome of menopause.

Genitourinary syndrome of menopause (GSM) is a prevalent condition with a constellation of symptoms including burning, dryness, dyspareunia, and irritative lower urinary tract symptoms that result from vulvovaginal atrophic changes. Though hormonal therapy is a mainstay of treatment in GSM, some patients may pursue nonhormonal therapies. To determine the efficacy of radiofrequency ablation of the vaginal canal with the MorpheusV applicator in reducing the symptoms of GSM. We conducted a multicenter prospective case series of women with GSM as confirmed by Vaginal Health Index Score (VHIS). Subjects received 3 treatments of radiofrequency ablation ~4weeks apart with follow-up to 6-month posttreatment. The primary endpoint was VHIS at 6-month posttreatment. Secondary endpoints were VHIS at 3 months, Visual analog scale (VAS) pain with each treatment, 3- and 6-month measurements of urogenital distress inventory-6 (UDI-6), and female sexual function index (FSFI) questionnaires. From 2021 to 2023, 71 women were enrolled in the study with 51 followed to the 6-month follow-up time point. Treatments were found to be low in VAS pain score with mean values of 2.13 ± 2.1, 2.55 ± 2.38, and 2.18 ± 2.14 at treatments 1, 2, and 3 respectively. An improvement in VHIS score was seen from baseline to 3 months after the last treatment (15.00 ± 5.37 vs. 19.62 ± 4.44) and sustained at 6 months (20.23 ± 4.12) (P < .001). Significant improvements in both UDI-6 and FSFI were also noted. Between baseline and 6 months after treatment (FSFI: 18.81 ± 9.57 vs. 22.81 ± 10.34, P < 0.001; UDI-6: 39.58 ± 15.98 vs. 22.42 ± 14.03, P < 0.001). No adverse events were encountered by any subject during this study. A therapy that is safe and effective in the treatment of both GSM and lower urinary tract symptoms without the use of hormonal methods is clinically impactful for the many patients who cannot receive or do not desire to receive these medications. Strengths of this study include the utilization of 3 treatment sessions, with follow-up of subjects to 6-month posttreatment with a comprehensive assessment of patient symptoms. Limitations include the unblinded nature of the study and the lack of a comparator group. The data from this study suggests that radiofrequency ablation of the vaginal canal by the MorpheusV applicator is a safe and effective intervention for GSM. It also shows subjective improvements in stress urinary incontinence, urge urinary incontinence, and sexual function.

Sexual dysfunctions in inflammatory bowel disease: role of Mediterranean diet and quality of life.

Dietary factors and chronic gastrointestinal diseases are frequent determinants of sexual dysfunctions (SD). Whether inflammatory bowel diseases (IBD) are associated with SD is not well known as well as the role of diet and quality of life (QoL). To evaluate the prevalence of SD in a cohort of IBD patients and assess the role of clinical-demographic variables, adherence to Mediterranean diet (MD) and QoL. This is a cross-sectional observational study involving 301 patients (134 females and 167 males); 119 had Crohn's Disease and 182 had ulcerative colitis. SD were assessed through the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Adherence to MD was evaluated by the MD Score. QoL was investigated by the 12-item Short-Form Health Survey (SF-12) which yields summary scores of physical (PCS) and mental (MCS) health. Multiple logistic regression was used to identify predictors of SD. Prevalence of SD in females was 61.9%, while 52.1% of males had erectile dysfunction. No differences in the prevalence of SD were found between CD and UC in both males and females. IBD activity, as defined by patient-reported outcomes, was significantly associated with SD in both sexes. In females, MD adherence score (OR 0.8, 95% CI 0.653-0.974, p=0.027), PCS (OR=0.936, CI 95%=0.891-0.983, p=0.008), and MCS (OR 0.9, 95% CI 0.906-0.985, p=0.008) were protective against SD, whereas in males a higher PCS was associated with a lower probability of SD (OR 0.9, 95% CI 0.891-0.978, p=0.004) DISCUSSION: IBD patients had a significant prevalence of SD which occurred more frequently in females than in males. Disease activity is associated with a higher likelihood of SD in both sexes, whereas dietary factors are differentially associated with SD in males and females. A better QoL is associated with a lower risk of SD. SD is prevalent among men and women with IBD. Adherence to MD, PCS and MCS in females as well as PCS in males were protective against SD. The assessment of sexual function in IBD patients could be relevant in order to reach an early diagnosis and a timely treatment.

Comparison of Sexual Function, Satisfaction, and Assertiveness in Genital Cosmetic Surgery Groups: A Randomized-Sampling Cross-Sectional Study.

Sexual dissatisfaction is one of the main motivations for seeking female genital cosmetic surgery (FGCS), though the outcomes of such surgeries are controversial. Evaluation of the sexual function, satisfaction, and assertiveness in FGCS groups. From five clinical centers in Tehran, Iran, 200 women in the study group (women seeking or had undergone labiaplasty (LP), women seeking or had undergone multi-procedure (MP) of FGCS simultaneously) and the control group were randomly selected. Participants completed the Female Sexual Function Index (FSFI), the Global Measure of Sexual Satisfaction (GMSEX), and the Hurlbert Index of Sexual Assertiveness (HISA). The groups were compared using the Chi-square, one-way ANOVA with post hoc analysis. In women seeking LP, the mean FSFI, GMSEX, and HISA score was lower than that of women who had undergone LP (FSFI: 18.41 vs 21.36, p =0.04, GMSEX: 20.36 vs 28.03 p <0.001, HISA: 49.7 vs 62.5 p <0.001). Our finding showed as well that women seeking MP also had lower mean FSFI, GMSEX, and HISA scorecompared to women had undergone MP (FSFI: 23.02 vs 18.02, p <0.001, GMSEX: 19.63 vs 28.94 p <0.001, HISA: 45.72 vs 60.62 p <0.001). Women who had completed FGCS experienced better sexual function, satisfaction, and assertiveness compared with women seeking surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Spousal Postpartum Social Support and Association with Sexual Function and Sexual Quality of Life among Breastfeeding Women

Background: The present study investigated the relationship between spousal support during postpartum period and the sexual function and sexual quality of life among lactating women. Methods: A cross-sectional study was carried out from October to March 2021 comprising 301 breastfeeding women referred to comprehensive health centers in Qazvin, Iran. The sampling method was performed in two stages. First, via cluster sampling, ten comprehensive health centers were randomly selected. Then based on the list of lactating mothers, 31 mothers in each center were randomly selected and invited to complete the survey. The survey included three psychometric instruments (i.e., Postpartum Partner Support Scale [PPSS], Female Sexual Function Index [FSFI] and Sexual Quality of Life-Female version [SQOL-F]) as well as a reproductive and demographic information questionnaire. The findings were analyzed using univariable and multivariable regression models at a significance level of p&lt;0.05. Results: The participants had a mean age of 30.33 years and a mean length of marriage of 7.99 years. A total of 219 women were exclusively breastfeeding (72.8%), and 82 used a combination of breastfeeding and formula milk to feed their infants (27.2%). The mean (standard deviation) scores in the postpartum period were 61.34 out of 80 (SD=11.41) on the PPSS, 86.52 out of 108 (SD=19.68) on the SQOL-F, and 22.78 out of 36 (SD=6.20) on the FSFI. Based on adjusted multivariable regression models, spousal support in the postpartum period was a significant predictor of sexual quality of life (β=0.39, p&lt;0.001) but not a significant predictor of sexual function. Sexual quality of life was a significant predictor of sexual function (β=0.44, p&lt;0.001). Conclusion: Given the importance of spousal support during the postpartum period in relation to sexual quality of life and sexual function, designing and implementing counseling programs based on the role of spousal support during postpartum sexual life would be helpful.

Practical Guidance on the Use of Vaginal Laser Therapy: Focus on Genitourinary Syndrome and Other Symptoms.

Genitourinary syndrome of the menopause (GSM) is a chronic, often progressive condition, characterised by symptoms relating to oestrogen deficiency including; vaginal dryness, burning, itching, dyspareunia, dysuria, urinary urgency and recurrent urinary tract infections. GSM affects up to 70% of breast cancer survivors with a tendency to particularly severe symptoms, owing to the effects of iatrogenic menopause and endocrine therapy. Patients and clinicians can be reluctant to replace oestrogen vaginally due to fear of cancer recurrence. Vaginal laser is a novel therapy, which may become a valuable nonhormonal alternative in GSM treatment. There are currently 6 published studies regarding Erbium:YAG laser treatment for GSM, 41 studies regarding CO2 laser treatment for GSM and 28 studies regarding vaginal laser treatment for GSM in breast cancer survivors. Number of participants ranges from 12 to 645. The majority of studies describe a course of 3 treatments, but some report outcomes after 5. Significant improvements were reported in vaginal dryness, burning, dyspareunia, itch, Vaginal Health Index Scores (VHIS), Quality of Life, and FSFI (Female Sexual Function Index). Most studies reported outcomes at short-term follow-up from 30 days to 12 months post-treatment. Few studies report longer-term outcomes with conflicting results. Whilst some studies suggest improvements are sustained up to 24 months, others report a drop-off in symptom improvement at 12-18 months. Patient satisfaction ranged from 52% to 90% and deteriorated with increasing time post-procedure in one study. The findings in this review must be validated in robust randomised sham-controlled trials of adequate power. There remain a number of unanswered questions in terms of which laser medium to use, optimal device settings, ideal interval between treatments, pre-treatment vaginal preparation, as well as safety and efficacy of repeated treatments long term. These issues could be addressed most efficiently with a mandatory registry of vaginal laser procedures.