Female Sexual Health Research Articles

075 Sex & Relationship Peer Support Groups: A Mixed Method Study on the Impact on Female Sexual Health

075 Sex & Relationship Peer Support Groups: A Mixed Method Study on the Impact on Female Sexual Health

063 Brain Dynamics of Female Hypoactive Sexual Desire Disorder (HSDD)

Hypoactive sexual desire disorder (HSDD) is one of the most prevalent female sexual health problems. Because of its negative impact on health and well-being, there is a crucial need to better understand its nature and dynamics. The top-down neurofunctional self-attention-model (SAM) of desire suggests that HSDD is partly modulated by a specific cognitive interference that inhibits sexual desire and arousal. Recent neuroimaging research reinforced SAM in patients with HSDD by demonstrating not only lower brain activity in brain network of sexual desire, but also higher brain activation in the self-referential brain network—suggesting that inspecting, monitoring, and evaluating a public perspective of oneself (rather than sensory experience) before or during sexual activities interfere with sexual desire. Because of the temporal limitation of functional magnetic resonance imaging (fMRI), the spatiotemporal dynamics of the HSDD brain network remains unresolved. Here, we investigated the spatio-temporal dynamics of female HSDD by combining a behavioral desire decision task with high-performance electrical neuroimaging.

Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes.

Erectile dysfunction is recognized as an opportunity for preventing cardiovascular (CV) events, and assessing the impairment of penile vascular flow by Doppler ultrasound is an important tool to ascertain CV risk. Conversely, the role of genital vascular impairment in the pathophysiology of female sexual dysfunction (FSD) remains contentious. To focus on the current scientific support for an association between CV risk factors and female sexual health in the 1st part of a 2-part review. A thorough literature search of peer-reviewed publications on the associations between CV risk factors and FSD and their underlying mechanisms was performed using the PubMed database. We present a summary of the evidence from clinical studies and discuss the possible mechanisms providing the pathophysiologic bases of vasculogenic FSD syndromes. The peripheral sexual response in women is a vascular-dependent event, and evidence suggests that cardiometabolic-related perturbations in endothelial function can determine vascular insufficiency in female genital tissues. Although epidemiologic and observational studies demonstrate that the prevalence of FSD is higher in women with diabetes mellitus, a cause-effect relation between these clinical conditions cannot be assumed. Evidence on the effect of obesity, metabolic syndrome, and polycystic ovary syndrome on sexual function in women is controversial. Data on the associations of dyslipidemia and hypertension with FSD are limited. Common cardiometabolic alterations could affect vascular function in the female genital tract. Based on limited data, there is an association between CV risk factors and female sexual health in women; however, this association appears milder than in men. Maseroli E, Scavello I, Vignozzi L. Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev 2018;6:508-524.

Female adolescents and sexual health

Female adolescents and sexual health

Female adolescents and sexual health: "I think I'm okay, but am I?"

Female adolescents and sexual health: "I think I'm okay, but am I?"

An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction.

The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10years) is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

Future of Genetic Studies in Women's Sexual Health

The past quarter century has seen an increase of genetic studies in women's sexual health and reproduction. Contrary to other research areas, research progress has been slow and insights gained from the few quantitative and molecular genetic studies have been minimal. Several reasons could explain this lack of genetic research progress and include the high costs associated with such studies, the notorious underfunding of sexual medicine, the continuing debate about the medicalization of female sexual problems, the misunderstanding of what genetic “determinism” actually means, and the lack of accurate objective and subjective outcomes that can be used as valid research phenotypes and/or endophenotypes. Realistically, researchers in female sexual health are a long way from conducting the research that is currently possible or using the resources that are available. Therefore, before fundamental genetic research progress can be achieved, we need more basic research to obtain more accurate phenotypes or endophenotypes and need to focus on using synergies and increasing sample size by working collaboratively. By achieving this, novel insights into biological pathways contributing to disease risk can be unraveled and eventually new treatment approaches might be indicated.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction

The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

Linking Patterns of Substance Use With Sexual Risk-Taking Among Female Adolescents With and Without Histories of Maltreatment

PurposeThis study aimed to determine the associations between patterns of substance use and sexual risk-taking among female adolescents with and without histories of maltreatment. MethodsData are from a prospective cohort study examining the impact of maltreatment on subsequent female adolescent sexual health (N = 504). Participants averaged 18.24 years in age (SD = 1.12), and approximately 63% had substantiated incidences of maltreatment filed with Child Protective Services prior to age 18. The present study used latent class analysis to examine patterns in adolescent substance use, and negative binomial regression models to examine the links between patterns of substance use and sexual risk-taking and to determine whether these associations were moderated by adolescents' maltreatment status. ResultsSix classes emerged from latent class analysis labeled as follows: abstainers (25% of sample); polysubstance users—early initiators (13%); polysubstance users—late initiators (23%); alcohol and cannabis users—late initiators (9%); alcohol users—late initiators (18%); and tobacco users (12%). Patterns of adolescent polysubstance use were associated with the highest levels of sexual risk-taking, and patterns of late-initiated polysubstance use, late-initiated alcohol use, and tobacco use were more strongly related to sexual risk-taking for female adolescents with histories of maltreatment. ConclusionsThis study is the first to determine the specific patterns of substance use that are more strongly related to sexual risk-taking for maltreated female adolescents. By doing so, this study demonstrates how a person-centered approach can facilitate our understanding of how to best leverage sexual risk-taking prevention efforts.

RELATIONSHIP BETWEEN ORPHANHOOD STATUS, LIVING ARRANGEMENTS AND SEXUAL DEBUT: EVIDENCE FROM FEMALES IN MIDDLE ADOLESCENCE IN SOUTHERN AFRICA.

This study examined the relationship between orphanhood status, living arrangements and sexual debut. The study is important in the context of southern Africa, where a substantial number of children live apart from their parents because the parent is dead or living elsewhere, and where female adolescents face disproportionate sexual and reproductive health risks. Data for female adolescents were taken from Demographic and Health Surveys conducted in seven southern African countries. Unadjusted and adjusted hazard ratios of sexual debut were estimated using Cox Proportional Hazard models. The results from multivariate analyses showed that non-co-residence with biological parents was significantly associated with higher risk of sexual debut in five of the seven countries. Using pooled data, the results showed that father absence was associated with higher risk of sexual debut - whether the father was deceased or living elsewhere. Interventions to delay sexual debut among female adolescents should seek to promote father-adolescent co-residence and improve access to education.

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention

ObjectivesSexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support...

Female Masturbatory Practices and Sexual Health: A Qualitative Exploration of Women's Perspectives

Women’s sexuality has long been repressed, and many studies still find that women experience restraint and negativity regarding masturbation and their right to sexual pleasure (Hogarth & Ingham, 2009; Kaestle & Allen, 2011). Previous work looking at women’s masturbation has failed to understand how it is related to sexual health. This qualitative exploratory research’s aim is to better understand how women’s regular masturbation (defined as once per month or more) modulates their sexual health through the development of their sexual self-concept (Deutsch & al., 2014). Thirteen women between the ages of 18 and 30 who masturbate regularly participated in individual semi-directed interviews. Preliminary analysis, through sexual self-concept and feminist theory, indicate that these women have a better understanding of their sexual selves in that they more easily recognize and acknowledge their sexual needs. For example, they were confidant in naming exactly what brought them pleasure in partner sex. However, women seem to refrain from talking to each other about their masturbatory practices, which only escalates their impression of being the only ones to do it and their feelings of guilt. These last findings suggest that social pressures and norms compromise women’s ability to share freely about their sexual practices. Herein lies the importance and pertinence of openly discussing female masturbation and to include this subject matter in future sexuality education curricula.

SY-22 Female Sexual Health: Brazilian Federation of Gynecology and Obstetrics CONSIDERATIONS (SBRASH & FEBRASGO Symposium)

SY-22 Female Sexual Health: Brazilian Federation of Gynecology and Obstetrics CONSIDERATIONS (SBRASH & FEBRASGO Symposium)

Retrospective Analyses of Female Sexual Health Care at a Public Hospital

Retrospective Analyses of Female Sexual Health Care at a Public Hospital

The Visibility of Female Sexual Health: A Rapid Test Approach

Female sexual dysfunction (FSD) is the inability for women to have satisfying sexual intercourse and is poorly diagnosed in clinical practice. This study demonstrated the applicability of a rapid testing approach and follow-up results. Demonstrate the creation of a brief screening test capable of diagnosing female sexual dysfunction. Implement a score to detect the need for referral to a specialist. A total of 404 patients who presented to a Public hospital in Porto Alegre, Brazil between March 2011 and March 2016 were identified, in a retrospective cross-sectional study. Screening consisted of four questions rated on a Likert scale to assess sexual frequency, frequency of orgasm, pain and sexual initiative. Chi-squared test, Fisher's exact test and analysis of variance (ANOVA) were applied to the data (p = 0.05). The four parameters were evaluated and a score between 4 and 16 was assigned to each patient before and after follow up. The mean pre-treatment score was 7.7 points (± 2.6) and increased to 12 points (± 2.3) post-treatment (p <0.001). Weekly sexual frequency and number of orgasms increased significantly, while pain during intercourse decreased. The patients’ sexual satisfaction was positively impacted even with a brief approach to sexual health (53.1%). An increase in post-treatment scores indicate a way of measuring these positive results. Those patients who had experienced sexual violence and those with primary anorgasmia had poorer prognoses, while those with higher education levels, greater frequency of orgasm, or who engaged in masturbation and fantasizing, had better prognoses.

Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors.

We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program and identify improvements of physical symptoms, per patient and clinical evaluation. Evaluability criteria included gynecologic exam at initial visit, at least one follow-up with gynecologic exam within 8months of initial visit, and all consecutive follow-ups <6months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least one follow-up from 09/12 to 10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n=90, 53%), gynecologic (n=54, 32%), or colorectal/anal (n=15, 9%) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Mean number of visits was 3.43. Mean age was 55.4years; 92% (n=155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises, and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy, and function) associated with cancer treatment and support. At last assessment, 89% had complied with the clinical recommendation (moisturize 2-5+ times/week). Vaginal pH scores >6.5 declined over time (p=0.03). VAS scores improved by last assessment (p<0.001), as did VuAS scores (p=0.001). Sexual function scores significantly improved (p<0.001), confidence about future sexual activity increased (p=0.004), and sexual/vaginal health concerns decreased (p=0.00003). Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in elevated vaginal pH and pain with exams, enhanced sexual function, and increasedintimacy confidence. These findings have high clinical relevance for symptom management with improvement of sexual function using simple strategies and clinical tools in the oncology setting.

Effects of Immunomodulators and Biologic Agents on Sexual Health in Inflammatory Bowel Disease

Introduction: Although much knowledge has been gained in regards to medical and surgical management of IBD, their remains a paucity of information on psycosexual issues related to IBD. Our aim was to evaluate the sexual health of IBD patients receiving immunomodulators and/or biologics versus those not on that regimen, utilizing validated male and female sexual health questionnaires. Methods: Consecutive consented patients at one large academic IBD outpatient clinic received a validated sexual health questionnaire, the Female Sexual Function Index (FSFI) (19 questions, 6 domains: arousal, desire, lubrication, orgasm, pain, satisfaction) or the International Index of Erectile Function (IIEF) (15 questions, 5 domains: erectile function, orgasmic function, desire, intercourse satisfaction, and overall satisfaction) to assess the subjective perception of IBD on the different domains of sexual function over the prior one-month time period.Figure 1Figure 2Results: Consented patients included: 23 females, 13 on immunomodulators or biologics and 10 not on either. There were 19 males, 10 on immunomodulators or biologics and 9 not on either. There were no statistically significant differences between any of the female demographics or any of the male demographics and immunomodulator or biologic and non-immunomodulator or non-biologic. Demographics included: anxiety, comorbid disease, depression, active disease, disease complications, IBD side effects, location of disease, other medications, history sexual assault, smoking status, type of disease, type of sex, surgical intervention, improvement of sex. For both females and males, both individual questions, domain type scores, and total scores showed no statistically significant differences between the two treatment groups. Conclusion: Our results suggest that immunomodulator/biologic use does not specifically hinder the sexual well-being of the IBD-laden patient. Although sexual health scores are overall lower in specific domains in IBD patients, our data does not suggest worsening domain scores in patients on immunomodulator/biologic therapy.Treatment must be individualized based on the aggressive nature of a patient's disease, their treatment goals, and their tolerability of various medications.

Comparing Sexual Function in Females of Reproductive Age Referred to Rural and Urban Healthcare Centers in Ahvaz, Iran

Background: Healthy sexual function can be considered as an important element to improve personal and public hygiene. The sexual desire plays an important role in mental health and improving the quality of life. Objectives: The current study aimed to compare sexual function of females in urban and rural areas. Methods: The current descriptive study adopted 800 females of reproductive age (range 15 - 45 years) referred to rural and urban healthcare centers in Ahvaz, Iran, in 2015. Samples were randomly selected. Applied instruments in the study were demographic information and female sexual dysfunction questionnaires (FSFI). Independent T-test, Chi-square and logistic regression were employed to analyze data by SPSS ver. 22. Results: The result showed a significant statistical difference between females in urban and rural areas in terms of sexual desire, vaginal lubrication, intercourse pain and sexual function (P 0.05). Frequency of sexual dysfunction was 59.9% in females in rural and36.5% in urban areas and the difference between the groups was statistically significant (0.000). In both groups, the highest sexual disorder frequency was related to intercourse pain. Conclusions: According to the obtained results, females in the rural areas had lower sexual function than the ones in the urban areas. It is suggested to establish female sexual health units in healthcare centers to give female sexual function consultation adjusted with awareness and culture of females and consider the existing problems.

Attitudes and Decision Making Related to Pregnancy Among Young Women with Cystic Fibrosis.

Introduction The number of female patients with CF able to consider pregnancy has increased with improved therapies. This study explored attitudes and decision making regarding pregnancy among young women with CF. Methods Twenty-two women with CF ages 18-30 years completed semi-structured, in-person interviews exploring experiences with preconception counseling and reproductive care in the CF setting. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. Results Participants indicated CF is a major factor in pregnancy decision making. Although women acknowledged that CF influences attitudes toward pregnancy, many expressed confusion about how CF can affect fertility/pregnancy. Many perceived disapproval from CF providers regarding pregnancy and were dissatisfied with reproductive care in the CF setting. Discussion Young female patients with CF reported poor understanding of the effect of CF on fertility and pregnancy and limited preconception counseling in CF care. Improvements in female sexual and reproductive health care in CF are warranted.

Praying until Death: Apostolicism, Delays and Maternal Mortality in Zimbabwe.

Religion affects people’s daily lives by solving social problems, although it creates others. Female sexual and reproductive health are among the issues most affected by religion. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. We explored apostolic beliefs and practices on maternal health using 15 key informant interviews in 5 purposively selected districts of Zimbabwe. Results show that apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. It causes delays in recognizing danger signs, deciding to seek care, reaching and receiving appropriate health care. The existence of a customized spiritual maternal health system demonstrates a huge desire for positive maternal health outcomes among apostolics. We conclude that apostolic beliefs and practices exacerbate delays between onset of maternal complications and receiving help, thus increasing maternal risk. We recommend complementary and adaptive approaches that address the maternal health needs of apostolics in a religiously sensitive manner.