Function In Women Research Articles

Iodine Nutritional Status of Pregnant Women After 14 Years of Lipiodol Supplementation: a Cross-Sectional Study in Historically Iodine-Deficient Areas of China.

Southern Xinjiang has a history of serious iodine deficiency. Since 2007, pregnant women in this area have taken iodized salt and oral lipiodol preparations to prevent iodine deficiency disorders. However, the current status of iodine nutrition and thyroid function in this population is unknown. A cross-sectional study was conducted on 555 pregnant women from 5 counties (cities) in southern Xinjiang and 429 pregnant women from 3 counties in northern Xinjiang. The participants were given a questionnaire and serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropic stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), and thyroid peroxidase antibody (TPO-Ab), and the urine iodine concentration (UIC) was measured. The median UIC and interquartile range [M (IQR)] of the 984 pregnant women in the study was 189.38 (143.15, 288.77) μg/L. Positive Tg-Ab and TPO-Ab titers were detected in 6.74% and 9.55%, 8.30% and 9.84%, and 7.39% and 10.55% in T1, T2, and T3, respectively. The incidence of subclinical hypothyroidism, clinical hypothyroidism, and isolated hypothyroxinemia in pregnant women in areas where lipiodol pills were taken was 4.32%, 0%, and 1.44%, respectively, which was significantly lower than those in areas where lipiodol pills were not taken. The median UIC (IQR) of pregnant women in the two regions was 213.80 (130.44, 331.77) μg/L and 168.30 (155.0, 254.8) μg/L, the UIC of pregnant women who took lipiodol pills was higher than in those who did not take lipiodol pills, and the difference was statistically significant (p < 0.05). According to WHO standards, all pregnant women in southern Xinjiang are in a state of adequate iodine nutrition. Taking lipiodol pills has improved the iodine nutrition level of pregnant women in this area. The results of this study did not find that oral lipiodol pills had adverse effects on pregnant women's thyroid function, but it is necessary to further study the effect of oral lipiodol pills on the offspring.

Evaluation of women's sexual quality of life, depression, and sexual functions in the pregnancy and postpartum periods: A multi-centered study.

This multi-centered, longitudinal, and prospective study aims to identify women's sexual functions, sexual quality of life, and depression and their relationships with each other in the pregnancy and postpartum periods. The participating pregnant women (n=113) were interviewed six times: once in each trimester, and once in the eighth week third month, and sixth month postpartum. This study was conducted in three regions of Turkey including Marmara, Mediterranean, and Central Anatolia regions. Data were collected through the "Socio-demographic Form," "Female Sexual Function Index (FSFI)," Sexual Quality of Life-Female Questionnaire (SQLQ-F), and "Center for Epidemiologic Studies-Depression Scale (CES-D)." While the first interviews were administered face to face, successive ones were administered via phone. The sexual dysfunction rates of the participants were found to be high in the pregnancy and postpartum periods, and their sexual quality of life, which decreased as the pregnancy months progressed, was found to increase significantly with the progress in the postpartum period. The sexual dysfunction increased and sexual quality of life decreased significantly with the increase in depression symptoms in the pregnancy and postpartum periods. When the depressive symptoms decreased especially in the sixth month postpartum, sexual quality of life was also found to increase. As a result, in the pregnancy and postpartum periods, it is highly important to provide women with diagnosis through a holistic approach by creating available environments to assess their psychological health and sexual functions and refer them to the related physicians when necessary.

The Effects of Physical Health and Functional Status on Cognitive Functions in Women at Ages of 55–64 Years

The Effects of Physical Health and Functional Status on Cognitive Functions in Women at Ages of 55–64 Years

Long-Term Effects on Sexual Function in Women Treated With Scoliosis Correction for Adolescent Idiopathic Scoliosis.

Retrospective cohort study with a cross-sectional comparison. To assess sexual function and experience in adult women who had scoliotic correction for adolescent idiopathic scoliosis (AIS). Women ages 18-40years with a history of scoliosis, who were braced or underwent uncomplicated posterior scoliosis correction for AIS, followed for two years or more since treatment were included. Sexual function was assessed using the Female Sexual Distress Scale-Revised (FSDS-R) and the Female Sexual Function Index (FSFI) questionnaires. Participants' scores were compared to those of a control group consisting of age-matched healthy women. Of 115 women who responded to the questionnaires, 40 (35%) had surgical treatment (mean age 25.1; range 19-35years; mean time since surgery 8.2years; range 3-12years) and 35 (30%) were braced (mean age 23.3; range 18-27 years; mean time since treatment 3.6years; range 3-5 years). The control group consisted of a cohort of 40 (35%) aged-matched healthy women. According to the FSDS-R, significantly more women with scoliotic correction for AIS reported sexual distress compared to healthy controls (25% vs 12%, respectively), and the difference in the total mean scores (7.05 vs 5.34, respectively), was significant (P < .001). Additionally, the mean overall FSFI score for scoliotic-corrected women was 24.2 (range 17.5-29.1) within the pathological range (<26.55) of sexual dysfunction. High rates of sexual distress and dysfunction were reported in women with a history of AIS, thus, there appears to be long-term consequences years after deformity correction by brace or surgical correction.

Factors Associated With 10-Year Declines in Physical Health and Function Among Women During Midlife

Women in midlife often develop chronic conditions and experience declines in physical health and function. Identifying factors associated with declines in physical health and function among these women may allow for targeted interventions. To examine the factors associated with clinically important 10-year declines in the physical component summary score (PCS) of the Short Form 36 (SF-36), a widely used patient-reported outcome measure, in women in midlife. This longitudinal cohort study collected data from geographically dispersed sites in the US. Participants were part of the Study of Women's Health Across the Nation (SWAN), a racially and ethnically diverse cohort of women enrolled at or immediately before the menopause transition. Women have been followed for up to 21 years, between 1996 and 2016, with annual visits. Data were analyzed from October 2020 to March 2021. Demographic indicators, health status measures, and laboratory and imaging assessments. The main outcome was a clinically important decline (≥8 points) on the PCS, based on the 10-year difference in scores between ages 55 and 65 years. From the SWAN cohort of 3302 women, 1091 women (median [IQR] age, 54.8 [54.3-55.4] years; 264 [24.2%] Black women; 126 [11.6%] Chinese women; 135 [12.4%] Japanese women; 566 [51.9%] White women) were eligible for analyses based on duration of follow-up and availability of SF-36 data. At age 55, women had a median (IQR) body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 27.0 (23.2-32.6), a median (IQR) baseline PCS of 53.1 (46.8-56.7), 108 women (9.9%) were current smokers, and 938 women (86.3%) had at least 1 comorbidity. Between ages 55 and 65 years, the median (IQR) change in PCS was -1.02 (-6.11 to 2.53) points with 206 women (18.9%) experiencing declines of 8 points or more. In multivariable models, factors associated with clinically important decline included higher baseline PCS (odds ratio [OR], 1.08; 95% CI, 1.06-1.11), greater BMI (OR, 1.06; 95% CI, 1.03-1.09), less educational attainment (OR, 1.87; 95% CI, 1.32-2.65), current smoking (OR, 1.93; 95% CI, 1.14-3.26), osteoarthritis (OR, 1.46; 95% CI, 1.01-2.09), clinically significant depressive symptoms (OR, 2.03; 95% CI, 1.34-3.09), and cardiovascular disease (OR, 2.06; 95% CI, 1.26-3.36). In this cohort study, clinically important declines in women's physical health and function were relatively common between ages 55 and 65 years. Several variables associated with these declines were identified as potentially useful components in a clinical score identifying women at increased risk of physical health and functional declines.

Sexual Self-Concept and Psychological Functioning of Women With a History of Childhood Sexual Abuse in Hong Kong

Sexual self-concept (SSC) is an important component of health that is closely associated with the well-being of survivors of child sexual abuse (CSA). Compared with non-CSA respondents, SSC of CSA survivors was deleteriously affected, resulting in ineffective psychological functioning (negative self-evaluation, psychological ill-health, and difficulties in interpersonal relationships). Negative SSC (sexual anxiety, sexual depression, and sexual fear) played a significant role in mediating the adverse effects of CSA on psychological functioning. Future studies may recruit a sample with greater variation in CSA characteristics and use externalizing problems as outcome measures to cross-validate findings of this study.

Sexual Functioning in Women with Breast Cancer: Role of Depression, Anxiety and Coping Styles

Sexual dysfunction encompasses a broad spectrum of issues, all of which are susceptible to insult after treatment for cancer. Sexual dysfunction affects up to 90% of women treated for breast cancer, and sexual quality of life is a significant concern for breast cancer survivors. This study investigated role of depression, anxiety and coping styles in developing sexual dysfunctions in 210 women with breast cancer, one year after diagnosis. The median age was 58. Female Sexual Functioning Index (FSFI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Coping Inventory for Stressful Situations (CISS) were used for this purpose. All women stated that before breast cancer they did not have significant sexual problems that would interfere with sexual pleasure. It is noticeable that women included in this study report high levels of pain and discomfort during and after vaginal penetration have low levels of sexual arousal and have significant difficulty achieving orgasm and lubrication, which is significantly associated with high levels of anxiety and moderate to high levels of depression. They are more likely to use a task-oriented coping strategy, and within avoidance as a coping strategy, they are more likely to use a distraction. More frequent use of avoidant strategies and less propensity for emotion-oriented strategies is associated with greater sexual desire. Women who used emotion-oriented coping strategies have more pronounced symptoms of depression and anxiety. Lower levels of overall sexual function were found in women who had a mastectomy (total and partial). Breast reconstruction after mastectomy has a positive influence on sexual functioning, especially on sexual arousal and pleasure, and women who have not had a mastectomy report greater sexual desire and arousal, and less pain during sexual intercourse. Participants who were not exposed to radiotherapy during treatment expressed greater satisfaction with achieving orgasms and lubrication during sexual intercourse. Hierarchical regression analysis indicated that depression, anxiety and coping styles significantly contribute to all domains of sexual functioning. These results add to growing evidence that sexual quality of life is a multidimensional construct with aspects differentially affected by variables related to cancer survivorship.

Association of own and spousal intra- and extra-familial adverse childhood experiences with cognitive function and the role of depression in middle-aged and older Chinese women

ObjectiveTo explore the associations of own and spousal intra- and extra-familial adverse childhood experiences (ACEs) with cognitive function and the role of depression in women. MethodsData were from the China Health and Retirement Longitudinal Study. ACEs included 11 intra-familial and 3 extra-familial domains. Principal component analysis was used to divide ACEs into mild, moderate, severe, and most severe. Depression was assessed using CESD-10 (cutoff≥10). Global cognition included episodic memory and mental intactness, with values ranging from 0 to 31. Adjusted multiple generalized linear regression models (GLM) were used to investigate the associations of own or spousal ACEs with women's cognitive function and the role of their depression in general women in Analysis 1 and married women in Analysis 2, respectively. ResultsAmong 4613 women aged 59.0 (52.0–65.0) in Analysis 1, depression mediated 12.3%, 14.6%, and 9.5% the effects of most severe overall ACEs on global cognition, episodic memory, and mental intactness. In Analysis 2, most severe spousal overall ACEs were associated with women's mental intactness, with β (95% CI) of −0.120 (−0.217 to −0.023), which was mediated by women's depression by 19.8%. Furthermore, most severe spousal extra-familial ACEs were associated with women's global cognition, episodic memory, and mental intactness (β = −0.210, 95% CI -0.297 to −0.123; β = −0.150, 95% CI -0.241 to −0.060; β = −0.211, 95% CI -0.302 to −0.121), which was 7.6%, 9.4%, and 6.0% mediated by their depression. ConclusionDepression mediated the effects of own and spousal extra-familial (not intra-familial) ACEs on women's cognitive function.

Professional Role Functions of Women in Social Service: Results of a Sociological Survey in Moscow

Introduction. Women predominate among the employees in the social service sector, they occupy various positions and perform relevant functions, but the specifics and problems of their work have not been sufficiently studied. Based on the materials of the conducted sociological survey, the article analyzes how social workers perform the main work tasks, how well they manage to combine professional role functions with family ones, which contributes to their satisfaction with their work. Materials and Methods. The applied research, conducted by the author in the autumn of 2020 in Moscow, used official documents, statistical data, her own sociological survey, and a comparative analysis of the results of secondary empirical studies. 107 employees of state social service organizations took part in the survey, almost equally representing the management staff, specialists, and ordinary employees. This made it possible not only to generalize various status and gender positions regarding the role of women in the implementation of social service in the relevant institutions, but also, based on the results of the analysis, to suggest possible ways to improve the professional qualifications of female employees for more effective implementation of their work functions. Results. A comparison of the responses of representatives of different status and gender groups showed that the range of professional functions of the object of this research is quite wide: from the head to the service personnel, from working with documents to providing specific social services to various groups of people in need or in a difficult life situation. At all the levels, women are represented in accordance with their professional and personal qualities. However, according to the self-assessment, combining professional and family responsibilities is most difficult for a female senior or middle-level manager. Discussion and Conclusion. The author proposes to create conditions for optimizing the workload, for preventing physical fatigue and emotional burnout of women providing social services, as well as for effective combining their professional roles with family ones, and for professional development. The article will be useful to employees providing social services, those who specialize in the field of gender issues of employment, senior personnel of the social protection system of the population at the regional level, teachers engaged in further vocational education.

Female Sexual Functioning in Women With a Symptomatic Pelvic Organ Prolapse; A Multicenter Prospective Comparative Study Between Pessary and Surgery

Female pelvic organ prolapse (POP) has a negative effect on female sexual functioning and with an increasing life expectancy female sexual dysfunction caused by POP will be an arising global issue. Improvement in female sexual functioning, measured with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire IUGA-Revised (PISQ-IR), 24-months after pessary or surgery, for both sexually active (SA) and sexually inactive women (NSA) presenting with POP. A multicenter prospective comparative cohort study was conducted in 22 Dutch hospitals. Women referred with moderate to severe POP symptoms and POP stage ≥ 2 were included and chose either pessary therapy or surgical intervention. The PISQ-IR was filled in at baseline and 24-months, the delta of change was calculated and compared between both groups. Multivariate linear regression was performed to adjust for potential confounding factors in the association between the summary score of the PISQ-IR and therapy. Change in PISQ-IR between pessary and surgical intervention. The delta of change at 24-months was calculated for 198 women in the pessary group and 129 women in the surgery group. SA women in the surgery group reported statistically significant more improvement on the condition-specific (-0.19 95%CI -0.35; -0.03, P = .02), and condition-impact (-0.48 95%CI -0.69; -0.28, P < .001) domains as well as on the summary score (-0.15 95%CI -0.23; -0.08, P < .001) as compared to the pessary group. No significant differences between pessary and surgery were found on the domains for NSA women. After controlling for potential baseline confounders, surgery still had a statistically significant effect on the summary score (B = 0.08; 95%CI interval 0.007-0.15, P = .03). Women having surgery had 2.62 times higher odds of changing from NSA to SA than pessary therapy. SA women who clearly express that POP-related symptoms limit their sexual functioning should be counseled that surgery results in a more remarkable improvement. Our strengths include the large sample size, long-term follow-up, the use of the PISQ-IR as a validated outcome tool evaluating both SA and NSA women, and this study reflects real-life clinical practice that enhances the external validity of the findings. A limitation of our study is the considerable proportion of non-responders at 24-months follow-up. Sexual function in SA women with POP is superior in case surgery is performed as compared to pessary therapy.

Effect of Vaginal Stretching and Photobiomodulation Therapy on Sexual Function in Women With Pelvic Floor Myofascial Pain - A Randomized Clinical Trial

BackgroundSpasm or increased tonus of the pelvic floor muscles (PFM) can cause myofascial pain (MP), which may result in painful intercourse and sexual dysfunction. AimThe effect of vaginal stretching (VS) with photobiomodulation therapy (PBMT) is compared to VS with sham PBMT in overall sexual function, rate and severity of painful intercourse at baseline and after treatment in women with pelvic floor MP. MethodsA double-blind randomized clinical trial of 103 women with MP: 1 group received 10 sessions of VS with PBMT (4 Joules of near-infrared light-808 nm at 3 points), and the other group received VS with sham PBMT. OutcomesImpact of treatment was measured by the number of women experiencing painful intercourse, Pain severity was measured by Visual Analog Scale and sexual function was assessed by the FSFI questionnaire. Variables were assessed at baseline and after ten sessions in the intervention groups. ResultsAfter treatment, the number of women experiencing painful intercourse was significantly lower in both the VS with PBMT group (90.2–55%, P = .001), and VS with sham PBMT group (86.6–46.2%, P < .001). There was a significant reduction in pain measure by Visual Analog Scale (P < .001, [VS with PBMT group: P = .002; VS with sham PBMT group: P < .001]). There was a significant decrease in the number of participants with sexual dysfunction (FSFI score ≤26.55) after the treatment in the VS with PBMT group (92.2–74.5%, P = .003) and in the VS with sham PBMT group (90.4–76.9%, P = .035). Both groups showed improvement in the FSFI pain domain after treatment (P < .001, [VS with PBMT group: P = .038; VS with sham PBMT group: P = .005]). Only the VS with sham PBMT group had a significant increase in FSFI desire and total score (P < .001) after treatment. Clinical ImplicationsWe found that VS associated or not with PBMT may be effective in reducing complaints of painful intercourse, alleviating pain severity, and reducing the number of women with pelvic floor MP suffering from sexual dysfunction. Strengths & LimitationsStrengths of this study are the randomized design and use of validated questionnaires. Limitation of the study is the lack of a long follow-up period and the lack of a usual care comparison group hampers generalizability of the results. ConclusionVS only and VS with PBMT have short-term efficacy in reducing painful intercourse and reducing a number of women with sexual dysfunction.Frederice CP, de Mira TAA, Machado HC, et al. Effect of Vaginal Stretching and Photobiomodulation Therapy on Sexual Function in Women With Pelvic Floor Myofascial Pain - A Randomized Clinical Trial. J Sex Med 2022;19:98–105.

Hypertensive Retinopathy Is Associated With Worse Cognitive Function in Women: The SWAN Study

Based on the 2018 American Academy of Neurology guideline, the prevalence of mild cognitive impairment (CI) increases from 6.7% at 60-64 years to 25.2% at 80-84 years. There is interest to identify potential biomarkers in the retina for CI and dementia. The aims of this analysis was to test whether hypertensive retinopathy (HR) was associated with cognitive function using data from the Study of Women’s Health Across the Nation (SWAN), Michigan cohort. SWAN, launched in 1996/97, is a longitudinal study of women traversing midlife and into late adulthood. Starting in 2000, cognitive function tests were administered: East Boston Memory Test immediate (EBMTi) and 10-minute delay (EBMTd) for verbal episodic memory; digit span backwards (DSB) for working memory; and symbol digits modalities test (SDMT) for perception speed, motor speed, and visual scanning. Z-scores were calculated for EBMTi, EBMTd, DSB and SDMT and averaged at follow-up visit 15 (2015/16). Eye exams were performed on 255 women (66 + 2.6 years) at follow-up visit 16 (2016/17). HR was based on presence/absence of arteriovenous nicking. Logistic regression showed a statistically significant association of lower average cognitive Z-score with HR (p-value 0.03, beta=-0.21 [95% confidence interval: -0.40 to -0.02]) adjusting for measured hypertension or anti-hypertensive drugs, years of measured hypertension, race, education, and age. Preliminary results indicate that HR is associated with lower cognitive test scores in women in their 60s-70s. This association between a simple ophthalmic exam finding of systemic hypertension, i.e., arteriovenous nicking, and lower cognitive function is consistent with a cerebrovascular mechanism of CI.

Effects of primary Sjögren's syndrome on female genitalia and sexual functions.

Sexual dysfunctions in patients with rheumatological diseases can negatively affect human sexual life, and thus lead to the deterioration of quality of life. This study aimed to determine the effects of primary Sjögren's syndrome (pSS) on female sexual organs and sexual functions. A total of 68 women with pSS and 135 healthy female patients were included in the study. All the women in the study and control groups were evaluated gynaecologically, and genital findings during the examination and variables related to pSS were recorded. The women's sexual functions were evaluated with the Female Sexual Function Index (FSFI) and quality of life was evaluated using the Health Status Questionnaire-Short Form 36 (QoL-SF 36). There was no difference in terms of the ages of the patients between the pSS and control groups [50 (25-70) and 49 (23-70) years, respectively] (p=0.487). The FSFI and QoL-SF 36 scores of the pSS group were significantly lower than the control group (p<0.05). Although the age of the patients, duration of menopause, and presence of atrophy on genital examination significantly correlated with sexual dysfunction, there was no significant correlation between pSS activity-related variables and sexual dysfunction. It was determined that pSS led to sexual dysfunction by causing genital atrophy and vaginal dryness in women. Moreover, mood changes associated with the disease, especially depression, were revealed to be an independent risk factor for this condition.

Sexual Function in Women With Differences of Sex Development or Premature Loss of Gonadal Function

Previous studies have suggested that sexual function may be compromised in women born with differences of sex development (DSD) or early loss of gonadal function. To describe sexual function and sexual wellbeing in women with complete androgen insensitivity syndrome (CAIS), complete gonadal dysgenesis (GD) and premature ovarian insufficiency (POI) in relation to gynecological measures and in comparison with unaffected women. A cross sectional study including 20 women with CAIS, 8 women with 46,XY GD, 8 women with 46,XX GD, 21 women with POI, and 62 population-derived controls. Study participants underwent gynecological examination for anatomical measurements and evaluation of tactile sensitivity. They responded to the validated Sexual Activity Log (SAL), Profile of Female Sexual Function (PFSF), and the Personal Distress Scale (PDS). The women with CAIS, XY GD, XX GD and POI showed overall satisfying sexual function in comparison to unaffected age-matched population female controls with a median of 1 to 2 satisfying sexual episodes per week among both the patients and the controls depending on available partner. Women with CAIS had shorter vagina and smaller clitoris and women with XY GD had a significantly shallower vagina in comparison to controls. Clitoral width was also significantly smaller among women with XX GD compared to controls. However, results showed overall good genital touch sensitivity with no significant differences between groups. Women with DSD or POI can be informed on overall satisfactory sexual function and normal genital touch sensitivity. The strength is the use of age-matched population-based controls to these rare conditions of DSD and POI. Limitations are the nonresponder rate of recruited controls, as well as the small groups of women with DSD. Women with differences of sex development or early loss of gonadal function show overall good sexual well-being, however clinicians have to make efforts to optimize caretaking and treatment to ensure good sexual quality of life for all patients.

Women, Writing and the Iraqi Baʿthist State. Contending Discourses of Resistance and Collaboration, 1968–2003

Women, Writing and the Iraqi Baʿthist State. Contending Discourses of Resistance and Collaboration, 1968–2003

Mapping changes in women's visual functions during the menstrual cycle: narrative review.

This article systematically updates the literature on changes in visual functions during the phases of the normal menstrual cycle in women. To update Guttridge's 1994 review of visual structures and functions associated with the menstrual cycle and broaden the search through psychophysical, neuroimaging and neurobehavioral measurements covering 1994-2020. Narrative review conducted in a neurosciences and behavior laboratory in Brazil. The PubMed, Cochrane Clinical Answers and Google Scholar databases were searched. After screening and applying the eligibility criteria, 32 articles were examined. Through this analysis, the following information was extracted: (1) geographical distribution of the study; (2) sample size (according to age and phase of the menstrual cycle); (3) type of measurements according to psychophysical, neuroimaging and neurobehavioral instruments; (4) vision testing model; (5) visual subcategory evaluated; (6) categories of processed visual stimuli; and (7) main findings. The menstrual phases give rise to significant changes in visual functions, including in relation to orientation and spatial attention, visual campimetry and visual sensitivity. These relate specifically to the follicular and luteal phases. These findings theoretically expand the effects of menstrual cycles on visual functions found by Guttridge (1994). Despite some inconsistencies in the studies analyzed, it was found that visual processing during the follicular and luteal phases of the normal menstrual cycle of healthy women can explain physiological, cognitive, behavioral and social modulations.

The Effect of Mindfulness-Based Cognitive-Behavioral Sex Therapy on Improving Sexual Desire Disorder, Sexual Distress, Sexual Self-Disclosure and Sexual Function in Women: A Randomized Controlled Clinical Trial

Sexual desire disorder is the most common form of sexual dysfunction among women and is associated with problems like sexual distress and reduced sexual self-disclosure. As a result, this RCT study was conducted with 70 reproductive-age women in the form of 4 weekly group educational sessions. Compared to the control group, the mindfulness-based cognitive-behavioral sex therapy (MBCST) intervention significantly improved sexual -desire, -distress, self-disclosure and -function immediately, 4 and 12 weeks after the educational sessions were completed in the intervention group (p < 0.001). Overall, our findings underscore the significance of the MBCST intervention on improving sexual dysfunction among women. Trial registration number: Iranian registry of clinical trials. IRCT Id: IRCT20160808029255N4. Trial registration date: 17th September 2018. Date of first patient’s enrollment: 19th September 2018. Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.2008075

Reply: Does a Capsulectomy Really Improve Pulmonary Function in Women with Breast Implant Illness?

Sir: We thank Dr. E. Swanson for his comments regarding our recent publication.1 The purpose of studying respiratory function in this group of breast implant illness patients was due to the clinical observation that they could breathe better and more deeply with less effort after implant removal and capsulectomy. We developed a quantitative symptomatic data tool to study the outcomes of explantation with capsulectomy.1 These studies were our attempt to provide evidence-based information about this specific group of patients.2,3 The improvement in pulmonary function experienced by these patients may have many complex etiologies. One of these may be the weight on the chest. The effect of breast hypertrophy on pulmonary function has been studied in multiple studies.4–8 The relief of weight can have a beneficial effect on pulmonary function. Another etiology for improvement may be the relief of scarring on chest wall in improving chest wall mechanics in breathing. It is important to note that for these patients, the decision to explant is challenging. Not only do they feel that they have to undo an augmentation surgery that they once desired, but they also have to face potential deformity resulting from years of implantation. Their decision is purely based upon the possibility that their health could be improved. The diagnosis of breast implant illness is also not an easy one. These 11 symptoms can mimic Lyme disease, hypothyroidism, menopause, autoimmune disease, or multiple sclerosis. The diagnosis of breast implant illness is based upon a diagnosis of exclusion and improvement of symptoms following implant removal and capsulectomy. This study is not a randomized controlled study comparing implant removal with capsulectomy versus implant removal without capsulectomy. This type of study is ideal, but clinically challenging to execute practically. Total capsulectomy can be associated with increased complications. We did not report any complications from the 750-patient or 72-patient cohort related to pneumothorax complication. There is a clearly defined plane between the capsule and the external intercostal muscle. When you separate the capsule from the external intercostal muscle and you preserve this muscle, pneumothorax can be avoided. Bleeding complications have occurred, but in less than 1% of the group. The selection criteria for the respiratory study3 are well-defined in our methods section. Only those patients who were able to return for a repeat spirometry after explantation were included. We have excluded patients with pre-existing airway and parenchymal disease such as asthma and COPD. That leaves 69 patients for statistical analysis. The exclusion rate is 4%. We did not use a t-test for independent samples of means because the variables that we were testing, before and after capsulectomy, came from the same patient. Therefore, the paired t-test was more appropriately utilized. The online t-test or independent samples t-test is a less powerful and ideal t-test for this study because the same individuals are being measured before and after explant. The paired t-test was used to account for within patient variations. TheP values in the paired t-test for FVC (P = 0.008), FEV1 (P = 0.009), and PEFR (P = 0.001) have all met the rigorous level of less than 0.01. In the multivariate and univariate analysis, both FEV1 P values of 0.009 for univariate analysis and 0.018 P value for multivariate analysis for the textured versus smooth implants are considered significant. We look forward to future study of this under characterized patient population to better answer the thoughtful critiques and questions described by Dr. Swanson and many other accomplished surgeons caring for patients with symptomatic breast implants. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

Does a Capsulectomy Really Improve Pulmonary Function in Women with Breast Implant Illness?

Does a Capsulectomy Really Improve Pulmonary Function in Women with Breast Implant Illness?

Effect of Post Marriage Marital Skills Educational Program on Sexual Function of Women Referring to the Marriage Counseling Center of Mehriz City

Introduction: Sexual health is an important aspect of public health, especially in women. Healthy and satisfying sexual intercourse is an important factor in maintaining family health and preventing sexual disorders. In Iran, the prevalence of women sexual disorders was reported 31-72% in different age groups. The purpose of this study was to investigate the effect of a post marriage marital skills educational program on sexual function of women referring to the marriage counseling center of Mehriz City in 2020. Methods: This quasi-experimental study was conducted on 72 women who had been married for 6 months to one year. The participants were divided into the control (n = 36) and intervention (n = 36) groups. The data were collected using female sexual function index (FSTI) questionnaire. The intervention group was educated in 4 sessions of 120 minutes. Data analysis was performed by SPSS version 22 using descriptive and analytical statistics. Results: The mean age of the subjects in the intervention group was 22.58±4.83 and in the control group was 21.83±4.01years. The results showed that after the educational intervention, the mean score of sexual function increased significantly from 22.9 to 27 in the intervention group (p &lt;0.05). There was also a significant increase in sexual desire, psychological stimulation, vaginal moisture, orgasm, satisfaction and a decrease in sexual pain (p &lt;0.05). In the control group, the mean score of sexual function did not change significantly. Conclusion: It seems that the designed intervention of marital skills education on women's sexual function had a significant effect on all dimensions of sexual function. It is recommended that educational-counseling interventions be performed after marriage in health centers.