Higher Rates Of Sexual Dysfunction Research Articles

Sexual Dysfunctions among Diabetic and Non-diabetic People Attending in Tribhuvan University Teaching Hospital, Kathmandu Nepal.

Sexual dysfunctions including erectile dysfunction among men, a widespread sexual health issue, pose challenges to sexual satisfaction. This cross-sectional study aimed to assess the prevalence and determinants of sexual dysfunctions in both diabetic and non-diabetic individuals aged 30-70. A study at Tribhuvan University Teaching Hospital in Kathmandu, Nepal, surveyed 350 participants (176 men, 174 women), aged 30-70, with 52.6% having diabetes. The structured interviews and validated questionnaires like IIEF-5 for men and FSFI-6 for women to assess the prevalence and factors associated with erectile dysfunction were used. Statistical tools were employed to measure the associations of different variables with Sexual dysfunctions. Overall, the prevalence of sexual dysfunction was 73.7% (95% CI: 72.4- 73.7) with higher rates in men 83.9% (95% CI: 83.1- 84.7) than women 63.6% (95% CI: 62.0 - 65.2). Individuals with diabetes experienced an 81.5% prevalence of sexual dysfunction (95% CI: 80.6-82.4), whereas non-diabetic individuals exhibited a 65.1% prevalence (95% CI: 63.5-66.7). In the diabetic male population, the prevalence of sexual dysfunction was 97.5% (95% CI: 97.4-97.6), while diabetic females had a prevalence of 68.9% (95% CI: 67.5-70.3). Among non-diabetic men, the percentage of erectile dysfunction was 72% (95% CI: 70.7-73.3), and among non-diabetic women, sexual dysfunction remained 56.2% (95% CI: 54.4-58.0). Among individuals with diabetes, those who used tobacco exhibited a sexual dysfunction prevalence of 93.8% (95% CI: 93.5-94.1), while non-tobacco users had a prevalence of 74.8% (95% CI: 73.6-76.0). In non-diabetic individuals, obesity was associated with a higher prevalence of sexual dysfunctions, reaching 84.6% (95% CI: 83.8-84.6). High blood pressure showed a strong association with sexual dysfunctions in both diabetic (83% with 95% CI: 81.9-83.4) and non-diabetic (70% with 95% CI: 67.7-70.1) groups. Individuals with diabetes for more than five years had a higher rate of sexual dysfunction as 87.8% (95% CI: 86.6-89.0) with 100% in men and 79% in women. However, there was no significant difference in the prevalence of sexual dysfunctions related to obesity and alcohol consumption between diabetics and non-diabetics. The research highlights a noteworthy association of sexual dysfunctions with individuals with diabetes, male sex, tobacco use, and hypertension. The observed high prevalence of sexual dysfunctions in both diabetic and non diabetic people is a public health concern, emphasizing the need for culturally tailored approaches to address the sexual health of the affected individuals.

(179) Sexual Dysfunctions in Infertile Tunisian Women

Abstract Introduction Once perceived as a source of pleasure and enjoyment, sexuality has evolved for infertile couples, focusing primarily on a purely procreative objective. Infertility has a direct impact on a woman's sex life, calling into question her femininity and causing significant alterations in the components of her sexual response. Objective The aims of our study were to assess the frequency of sexual dysfunction in Tunisian women facing infertility and to identify the aspects of their sexuality most affected. Methods This was a prospective, cross-sectional, and descriptive study, including a sample of 200 Tunisian infertile women, followed up in a Tunisian Assisted reproduction center over a three-month period, from November 24, 2022 to February 24, 2023. To assess the different dimensions of sexuality in infertile women, we used the Arabic version of the FSFI (female sexual function index) Results The mean age of our women was 30 ± 4 years. The majority had a university educational level (80%), an urban origin (87%), an average socio-economic level (63%), and no medical or gynecological surgery history (62%). Most partners (67%) had no sexual dysfunction (SD). The most frequent male SD was premature ejaculation, observed in 14% of cases. As regards the etiology of infertility, most cases were classified as unexplained (28%), while the remainder were linked to female causes, dominated by PCOS (40%). The majority of women had initially discussed the subject of sexuality (72%) with their partners. In our sample, the mean FSFI score was 20.74, with extremes ranging from 2 to 35.4. The prevalence of female sexual dysfunction (FSD) was 82%. The areas most affected were sexual satisfaction (50%), reaching orgasm (45%), as well as lubrication (44%) and arousal (44%). Lower educational level, secondary infertility, contraceptive use, and a long history of fertility treatment as well as the presence of sexual dysfunction in the male partner, were found to be associated with sexual dysfunction in women suffering from infertility, yet no significant correlation was established. Conclusions Infertility is associated with high rates of sexual dysfunction. Thorough counseling and continuing support of infertile women is therefore indicated. Disclosure No.

A psychoeducational intervention to improve sexual functioning in male rectal and anal cancer patients: A pilot randomized controlled trial study.

Male rectal and anal cancer patients demonstrate high rates of sexual dysfunction. This pilot randomized controlled trial tested a psychoeducational intervention designed to improve psychosexual adjustment. Rectal or anal cancer patients were randomized to a Sexual Health Intervention for Men (intervention) or to a referral and information control (control). The intervention included control activities plus 4 sexual health intervention sessions every 4-6 weeks and 3 brief telephone calls timed between these sessions. Assessments were completed pre-intervention (baseline) and 3 months (follow-up 1) and 8 months (follow-up 2) post-intervention. Differences were assessed with statistical significance and Cohen's d effect sizes (d = 0.2, small effect; d = 0.5, moderate effect; d = 0.8, large effect). Ninety subjects enrolled. Forty-three participants completed at least 1 follow-up assessment (intervention, n = 14; control n = 29). At follow-up 1, men in intervention, compared to control, improved on all domains of the International Index of Erectile Function (IIEF) (p < 0.001 to p < 0.05) and demonstrated large effects (d = 0.8 to d = 1.5). Similarly, at follow-up 2, changes in all domains of the IIEF except the orgasm domain were either statistically significant or marginally statistically significant (p = 0.01 to p = 0.08) and demonstrated moderate to large treatment effects for intervention versus control (d = 0.5 to d = 0.8). Men in the intervention, compared to control, demonstrated decreased sexual bother at follow-up 1 (p = 0.009, d = 1.1), while Self-Esteem and Relationship (SEAR) total scores and the SEAR sexual relationship subscale demonstrated moderate increases for intervention versus control (d = 0.4 to d = 0.6). This study provides initial evidence for combining a psychoeducational intervention with medical interventions to address sexual dysfunction following rectal and anal cancer. Trials register number: NCT00712751 (date of registration: 7/10/2008).

Relationship of insomnia to sexual function and sexual satisfaction: Findings from the sleep and sex survey II

ObjectiveResearch suggests that healthy sleep is a key component of sexual function. When evaluating sexual function, however, poor sleep is often overlooked as a contributing factor. This cross-sectional survey expands prior work by exploring relationships among insomnia severity, sexual satisfaction, and sexual function with an updated battery of measures for the Sleep and Sex Survey. MethodThe sample (N = 1266) consisted of 618 men, 648 women recruited via Prolific, an online survey platform. The Sleep and Sex Survey II included measures addressing insomnia, fear of sleep, nightmares, sexual function, sexual satisfaction, sexual activity, depression, anxiety, posttraumatic stress, and alcohol use. ResultsRecent sexual activity was correlated with better sleep, lower anxiety, and lower scores on a posttraumatic stress disorder screener. Insomnia severity was negatively correlated with sexual satisfaction (r = 0.22, p < .001) and the presence of insomnia was associated with higher rates of sexual dysfunction in women (53.8% vs. 31.8%; p < .001) and men (22.7% vs. 12.5%; p = .036). In regression analyses, after accounting for depression and anxiety, insomnia had a statistically significant association with sexual function for women (β = 0.12; p < .01) but not men (β = 0.11; p = .60). ConclusionFindings support a relationship of insomnia to sexual function and satisfaction with some gender differences. Future work may be enhanced by assessing these relationships in a gender diverse population including objective sleep measures and addressing contributing mechanisms. Clinically, findings support the assessment of sleep when evaluating patients for sexual dysfunction.

Sexuality in Postmenopausal Women with Genital Prolapse.

One of the most common complaints among menopausal women concerns changes in sexual function. This is attributed to various factors, including anatomical defects in the genital tract, with pelvic organ prolapse (POP) being one of the most prevalent problems affecting women during this stage of their lives. Additionally, symptoms resulting from gonadal hypofunction can also contribute to the development of sexual dysfunction during menopause. This research aimed to explore the way in which postmenopausal patients with POP experienced their sexuality in our setting. To achieve the proposed objective, we conducted a descriptive, cross-sectional study involving a total of 133 postmenopausal women with POP. The results of our series are consistent with the scarce literature available in our setting and suggest a high rate of sexual dysfunction in postmenopausal patients with POP. We can conclude that POP is associated with the presence of female sexual dysfunction.

Association Between Opioid Use and Risk of Sexual Dysfunction: A Systematic Review

Opioid use disorder (OUD) is defined by negative effects on oneself despite numerous efforts to stop it. Chronic opioid users have sexual dysfunctions such as erectile dysfunction, delayed ejaculation decreased libido, and sexual performance. To explore the association between the use of opioids and the risk of sexual dysfunction. This review was conducted from March 2023 to June 2023, and comprised of search on PsycINFO, MEDLINE, EMBASE, Google Scholar, OvidSP Science Direct, PubMed, Clinical Trials.gov, and Web of Science databases for experimental studies and randomized controlled trials related to OUDs published in peer-reviewed English-language journals between 2013 and 2023 (10 years). Of the 314 studies initially identified, 41(13%) were subjected to full-text assessment, and 10 were reviewed and analyzed (Figure). There were 2(20%) each study done in Egypt and Istanbul and 1(10) each in Germany, Canada, Spain, China, Poland, and Malaysia. All 10 (100%) studies were baes on opioid use and sexual dysfunction. Prospective studies showed that the occurrence of any sexual dysfunction ranged from 40% to 90% of opioid dependence. The most commonly studied observed sexual dysfunction is a lack of desire, erectile dysfunction, erectile dysfunction, and poor satisfaction. Our findings suggest that there is a significant link between opioid use and sexual dysfunction and that people who use opioids have higher rates of sexual dysfunction. Nevertheless, opioids have mind-altering properties that negatively affect various stages of the sexual cycle.

(174) Sexual Health in Young Adult Survivors of Childhood Cancer: A Project REACH Study

Abstract Introduction Sexual health, a key component of general well-being, relies on the successful interplay of physical, psychological, and social development. Although we know cancer treatment early in life disrupts many of these processes, it remains unclear exactly how treatment leads to sexual dysfunction in young adult childhood cancer survivors (YACCS). Our previous research found that approximately one third of YACCS report two or more sexual dysfunction symptoms using five sexual health items on a larger health-related quality of life survey. This research suggests that sexual dysfunction is related to late effects (e.g., fatigue) but not specific cancer treatments (e.g., chemotherapy). However, additional research using validated sexual health measures is required to understand these relationships more fully. Objective To build on previous research by examining the relationship between cancer treatment and sexual dysfunction in YACCS using validated sexual health measures. Methods 252 YACCS enrolled in Project REACH, a prospective cohort study, completed self-report measures on sexual functioning, psychological distress, and physical functioning. To examine proportion of participants experiencing clinically significant sexual dysfunction, participants were classified as a sexual dysfunction “case” if they scored ≥ 19 on the Female Sexual Function Index (FSFI-6) or ≥ 24 on the International Index of Erectile Function (IIEF). Relationships between sexual dysfunction, cancer type, cancer treatment, psychological distress (Brief Symptom Inventory-18; BSI-18), and health-related quality of life (i.e., Short Form-12; SF-12) were examined. Results Almost half (43%) of participants were classified as a sexual dysfunction case, with females significantly more likely (51%) to be a case than males (34%, p=.007). Brain tumor survivors were significantly more likely to be a case (53%) than participants with other types of cancers (36%, p=.009). Participants with a history of bone marrow transplant (BMT) were more likely to be a case (61%) than those without (41%, p=0.061), although this finding was only marginally significant. There were no significant differences in case vs. non-case by age, time since diagnosis, chemotherapy, radiation, or surgery. Sexual dysfunction cases reported significantly worse anxiety and depression (BSI-18) and overall mental and physical health (SF-12) than non-cases. Conclusions Our findings extend previous research by confirming that YACCS, particularly female YACCS, have significant sexual dysfunction according to validated sexual health measures. Findings also confirm strong ties between sexual dysfunction and other common late-effects (e.g., anxiety). Unlike previous research, our current findings link a history of brain cancer and BMT to more significant sexual dysfunction. Additional research is required to understand whether higher rates of sexual dysfunction are related to the more significant disruptions to physical, psychological, and social development during treatment in these two groups. Nevertheless, findings suggest that sexual health screening and treatment is clearly warranted in YACCS, particularly with those who have experienced brain cancer or BMT. Disclosure No

(191) A Systematic Review of Sexual Health Consequences among Women with Vulvar Lichen Sclerosus

Abstract Introduction Lichen Sclerosus (LS) is a chronic, inflammatory skin condition that predominantly affects the vulva. This condition often leads to scarring involving the clitoris, labia minora, vaginal introitus, and perineum, leading to clitoral phimosis and introital stenosis. Women with LS are less likely to be sexually active than those without the condition. Studies have shown a high rate of sexual dysfunction in vulvar LS; however, the sexual effects of the condition are still poorly acknowledged. Objective To identify sexual health consequences of vulvar lichen sclerosus among women with vulvar lichen sclerosus through systematic review of available literature. Methods A systematic review of the literature was conducted on sexual health consequences of lichen sclerosus among women with lichen sclerosus. PubMed, MEDLINE, and Scopus were queried and results were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies are observational studies evaluating women of premenopausal or postmenopausal status with clinical or biopsy confirmed lichen sclerosus and sexual health, or randomized controlled trials or comparative studies utilizing a validated sexual function measure to evaluate sexual health prior to intervention among the same population. Manuscripts included must have been written in English from January 1991 to April 2022. Selection of studies was done by three independent reviewers and conflicts were resolved by discussion. Systemic reviews and committee guidelines were identified for references review. Results The search produced 683 references for title and abstract screening. Of these, 32 articles met criteria for full-text review. After full-text review, 20 studies met inclusion criteria and were evaluated. Three systematic reviews and three committee guidelines were identified and all references had been identified in the initial search. Eight publications yielded qualitative data regarding sexual health consequences of LS. A negative impact of sexual dysfunction was reported in 16-60% of affected women, and dyspareunia reported by 22-56.7%. LS is also associated with decreased sexual frequency and satisfaction, a negative impact on romantic relationships, and feelings of inadequacy as a sexual partner. Eight publications evaluated the Female Sexual Function Index (FSFI), and all demonstrated a central tendency less than 26.55 among those with LS. Four publications evaluated the Female Sexual Distress Scale (FSDS), and all demonstrated a score greater than 12 among women with LS. Two publications evaluated Female Genital Self-Image Scale (FGSIS) scores in women with LS, and both found decreased FGSIS scores compared to controls. Four publications evaluated the Dermatology Quality of Life Index (DQLI), with LS causing a small to very large impact on quality of life. The subcategory with the greatest impact of quality of life is sexual difficulties. One publication evaluated the Vulval Quality of Life Index (VQLI) in women LS, and found sexuality to be the second highest scoring subgroup. Conclusions The sexual health consequences of LS include sexual pain symptoms, all facets of female sexual function, sexual distress, negative genital self-image, and negative impact on romantic relationships. Women with LS experience a significant impact on quality of life, particularly in relation to sexual functioning. Disclosure No

Ablative minimally invasive surgical therapies for benign prostatic hyperplasia: A review of Aquablation, Rezum, and transperineal laser prostate ablation.

Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting men and can present with bothersome lower urinary tract symptoms (LUTS). Historically, transurethral resection of the prostate (TURP) has been considered the gold standard in the treatment of LUTS due to BPH. However, TURP and other traditional options for the surgical management of LUTS secondary to BPH are associated with high rates of sexual dysfunction. In the past decade, several novel technologies, including Aquablation therapy, convective water vapor therapy (Rezum), and transperineal prostate laser ablation (TPLA), have demonstrated promising evidence to be safe and effective while preserving sexual function. In this review, we discuss three ablative minimally invasive surgeries: Aquablation, Rezum, and TPLA. We review their techniques, safety, as well as perioperative and functional outcomes. We go into further detail regarding sexual function after these ablative minimally invasive surgical therapies. Aquablation is a surgeon-guided, robot-executed, heat-free ablative waterjet procedure with sustained functional outcomes at 5 years while having no effect on sexual activity. Rezum is an innovative office-based, minimally invasive surgical option for BPH that delivers convective water vapor energy into prostate adenoma to ablate obstructing tissue. Rezum leads to significant improvements in Qmax, IPSS while preserving sexual function. TPLA is another office-based technology which uses a diode laser source to produce thermoablation. It leads to improvement in Qmax, IPSS, and QoL while preserving ejaculatory function. Overall, ablative minimally invasive surgical therapies have demonstrated excellent safety and efficacy profiles while preserving sexual function. These modalities should be discussed with patients to ensure informed and shared decision-making. Ablative minimally invasive surgical therapies may be particularly interesting to patients who value the preservation of their sexual function.

Aquablation Treatment for Benign Prostatic Obstruction

Aquablation Treatment for Benign Prostatic Obstruction Abstract: The surgical BPH treatment is one of the most common urological procedures. With our reference methods: transurethral resection of the prostate (TUR-P), open surgical adenomenucleation over a transabdominal access, and also modern laser procedures. Various effective surgical options are available. However, the quality of the surgical outcome is highly dependent on the surgeons' experience. At the same time, all of the above-mentioned reference methods are associated with a high rate of sexual dysfunction, especially postoperative anejaculation, a symptom complex which is relevant for men, regardless of age [1]. Robotic Aquablation® was developed with the goal to reduce the dependency of the surgical outcome on the expertise of the surgeon, but at the same time achieving a comparable outcome and reduced morbidity. After the "first in human treatment" by Peter Gilling in 2013, the Aquabeam® robot has been used in its current form in clinical studies since 2015 (Water, Water II and Open Water Study) and finally was introduced in clinical routine in August 2017 by Thorsten Bach in Hamburg. The safety and effectiveness of Aquablation® therapy has been proven in various studies and in everyday clinical practice.

A systematic review of sexual health consequences among women with lichen sclerosus

Abstract Introduction Lichen sclerosus (LS) is a chronic inflammatory skin condition predominantly affecting the vulva. Studies have shown high rates of sexual dysfunction in patients with LS; however, the sexual effects of the condition are poorly acknowledged. Objectives We sought to identify sexual health consequences among women with vulvar LS through systematic review of available literature. Methods A systematic review of the literature was conducted to find reports on sexual health consequences among women with LS. PubMed, MEDLINE, and Scopus were queried. Included articles were observational studies evaluating women with LS and their sexual health and randomized controlled trials or comparative studies utilizing a validated sexual health measure before intervention among the same population. Articles must have been written in English and published from January 1991 to April 2022. Results The search produced 683 references, including 32 articles that met criteria for full-text review and 20 reported studies that met inclusion criteria. Two studies investigated the impact of LS on interpersonal relationships, 6 studies evaluated sexual symptoms, 16%-60% reported sexual dysfunction, and 22%-56.7% reported dyspareunia. Also described were decreased sexual frequency and satisfaction, negative impact on sexual relationships, and feelings of inadequacy. Eight publications evaluated the Female Sexual Function Index (FSFI); all described studies that demonstrated a central tendency less than 26.55. Four publications evaluated the Female Sexual Distress Scale (FSDS); all demonstrated average scores greater than 12. Two publications evaluated the Female Genital Self-Image Scale (FGSIS), both found decreased scores compared to controls. Four publications evaluated the Dermatology Life Quality Index (DLQI); impact on quality of life was small to very large, with sexual difficulties affecting most study patients. One publication evaluated the Vulvar Quality of Life Index (VQLI); sexuality was the second highest-scoring subgroup. Conclusions Sexual health consequences of LS include sexual pain, dysfunction, and distress; negative genital self-image; and negative impact on sexual relationships. Women with LS experience a negative impact on quality of life, particularly related to sexual functioning.

A comparative cross-sectional study investigating prevalence and patterns of sexual dysfunction among hypertensive and non-hypertensive men

Background and Aims: Erectile dysfunction is prevalent among men with hypertension, but there is paucity of data on prevalence of other domains of sexual dysfunction (SD) in hypertensives and the general population. The study compared the prevalence and patterns of SD among treated hypertensive male patients with normotensive men. The effect of antihypertensive drugs on different domains of sexual function was also investigated in our study. Methods: A total of 195 participants (95 hypertensive and 100 non-hypertensive men) were recruited from the medical out-patient department of a secondary health care facility in Lagos, Nigeria. Sexual function was assessed using International Index of Erectile Function (IIEF) which measures erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Results: Sexual dysfunction affecting at least one domain was present in 82.1% of the hypertensive subjects and 52% of non-hypertensive controls (P&lt;0.001). The hypertensive patient had more severe dysfunction in the multiple domains (p&lt; 0.001). The use of methyldopa, furosemide and ß-blockers were associated with significantly lower scores while there was no significant difference in scores with the use calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, thiazide and potassium sparing diuretics. SD was higher in the older age group and with longer duration of hypertension and treatment. Conclusion: SD is common in the adult male population with hypertension significantly increasing the risk. Hypertension is associated with involvement of multiple domains for sexual dysfunction. Use of methyldopa, furosemide and ß-blockers were associated with higher rates of SD in the hypertensive population.

A new part of life covid: female sexual dysfunction

<h3>Objectives</h3> The purpose of this review study for of the summarizes the effect of COVID-19 on sexual dysfunction in women. <h3>Methods</h3> The articles used for this review were collected based on research results from relevant articles from NCBI, Google Scholar, Web of Science, Scopus. The search terms used; covid, pandemic, sex, sexuality, female sexual dysfunction The results were reviewed for the purposes of the present study. <h3>Results</h3> Social isolation may have significantly contributed to higher rates of sexual dysfunction. Depression, anxiety, and stress are well-established risk factors for sexual dysfunction, and it follows that rates of sexual dysfunction may be increasing given a more distressed. Culture is effective on sexuality during the pandemic; studies show that Turkey and Italy have demonstrated an increase in FSD and decrease in the frequency of intercourse with the onset of the pandemic, however, India, Nepal showed no effect from pandemics to sexuality. <h3>Conclusions</h3> COVID-19 has had a significant impact on the quality of life and sex life of the population. The development of risk for female sexual dysfunction was associated with higher pandemic anxiety and depression. <h3>Conflicts of Interest</h3> There are no conflicts of interest.

Knowledge of obstetrician and family medicine doctors in Saudi Arabia about women with epilepsy

BackgroundWomen have a slightly lower prevalence of epilepsy and unprovoked seizures than men; however, women with epilepsy have several exceptional dilemmas, including the use of anti-seizure medications (ASMs) in addition to the effects of ASMs on sexual function, contraception, pregnancy, childbirth, congenital fetal malformations, and breastfeeding. This study assessed the knowledge of obstetricians and family medicine physicians about relevant topics and concerns of women with epilepsy (WWE) in Saudi Arabia.ResultsOut of 108 participants recruited for the study, the largest percentage (62%) was residents, while 17.6% were consultants and the remaining 20.4% were specialists or fellows. In terms of specialty, 61.1% of the participants were obstetricians, while the remaining 38.9% were family medicine physicians. The participants showed varied levels of knowledge about important health issues ranging from 71.3% (ASMs and breastfeeding) to 11.5% (percent of children at risk for major birth defects) for WWE. Knowledge scores of health issues for WWE were significantly higher among obstetricians compared to family medicine physicians (6.16 ± 2.75 vs. 4.29 ± 1.95; p < 0.001). Similarly, scores were significantly higher among consultants/fellows compared to residents/specialists (7.27 ± 1.62 vs. 4.65 ± 2.56; p < 0.001).ConclusionsInadequate knowledge about several vital WWE issues was observed, particularly the hormonal influence of estrogen and progesterone on the control of convulsions, high likelihood of osteomalacia among WWE, and high rate of sexual dysfunction among them. This insufficient knowledge among healthcare providers could negatively influence epilepsy-related counseling for WWE.

Human Papillomavirus Infection and the Risk of Erectile Dysfunction: A Nationwide Population-Based Matched Cohort Study.

Background: Male patients with genital warts are known for higher rates of sexual dysfunction. This study was conducted to investigate whether human papillomaviruses (HPV) infection is associated with an increased risk of erectile dysfunction (ED). Methods: Patients aged over 18 with HPV infection (n = 13,296) and propensity score-matched controls (n = 53,184) were recruited from the Longitudinal Health Insurance Database (LHID). The primary endpoint was the diagnosis of ED. Chi-square tests were used to analyze the distribution of demographic characteristics. The Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of ED in both groups, after adjusting for sex, age, relevant comorbidities, co-medication, and surgery. Results: ED developed in 181 patients of the study group. The incidence density of ED was 2.53 per 1000 person-years for the HPV group and 1.51 per 1000 person-years for the non-HPV group, with an adjusted HR (95% CI) of 1.63 (1.37–1.94). In stratification analysis, adjusted HR of diabetes-, chronic obstructive pulmonary disease (COPD-), and stroke-subgroup were 2.39, 2.51, and 4.82, with significant p values for interaction, respectively. Sensitivity analysis yields consistent findings. Conclusions: The patients with HPV infection had a higher risk of subsequent ED in comparison to the non-HPV controls. The mechanism behind such association and its possible role in ED prevention deserves further study in the future.

Effects of the COVID-19 pandemic on sexual\xa0functioning and activity: a systematic review\xa0and meta-analysis

BackgroundSince December 2019, when it was first reported in Wuhan, province of Hubei, China, the new virus SARS-CoV-2 has spread rapidly around the world and has become a global pandemic. During the COVID-19 pandemic, due to the public health measures implemented, people’s sexual activity has also been affected. Restrictions on people’s activities, reduced sports activities, economic issues, increased psychological stress, and reduced entertainment have, indeed, dramatically impacted sexual activity and functioning. The purpose of this study was tosystematically identify, collect and summarize the existing body of evidence from published studies on the effects of COVID-19 pandemic on sexual activity and functioning.MethodsSeveral scholarly databases, namely MEDLINE (via PubMed interface), Web of Science (WOS), Embase, CINAHL, the Cochrane Library, Scopus, and PsycINFO databases, were mined from December 2019 to the end of January 2021. We utilized a random-effect meta-analytical model to analyze all the data. More in detail, the Standardized Mean Difference (SMD) was used in order to estimate and evaluate the effects of the COVID-19 pandemic on sexual activity and functioning.ResultsTwenty-one studies were included in the present study. In total, 2454 women and 3765 men were evaluated. In the present meta-analysis, sexual functioning and activity were assessed by means of two standardized and reliable tools, namely the “Female Sexual Function Index” (FSFI) and the “International Index of Erectile Function-5 items” (IIEF-5). A total of 5 studies reported the FSFI score before and after the COVID-19 pandemic in female participants. Based on the random-effect model, the SMD was computed to be − 4.26 [95% confidence interval or CI: − 7.26, − 1.25], being statistically significant. A total of 3 studies reported the IIEF-5 score before and after the COVID-19 pandemic in male participants. Based on the random-effect model, the SMD was computed to be − 0.66 [CI 95%: − 0.99, − 0.33], being statistically significant. In the majority of these studies, participants reported a reduction in the number of sexual relations and an increase in the frequency of solo sex activity, especially masturbation, compared to the time prior to the COVID-19 pandemic.ConclusionThe results of the present study showed that COVID-19 related restrictions were correlated with higher rates of sexual dysfunction and reduced sexual activity; however, results of the current meta-analytical study show that this change in sexual functioning was greater in women compared to men. Sex is one of the dimensions of every person’s life; therefore, researchers should identify the factors that lead to sexual dysfunction due to COVID-19 pandemic in their community. In this regard, sexologists should design and implement effective programs to reduce the heterogeneous causes affecting sexual functioning, given the psychological strain that the COVID-19 pandemic puts on individuals.

Impact of assisted reproduction treatment on sexual function of patients diagnosed with infertility.

This study aims to update and systematize the existing evidence on the prevalence of sexual dysfunction and depression in infertile couple Renatos undergoing assisted reproduction treatments. A bibliographic search regarding sexual dysfunction in infertile couples was performed on PubMed and LILACS, with no restrictions on the date of publication of the article. The Newcastle-Ottawa Scale (NOS) was used to evaluate studies quality. Data collection process was conducted using a form previously planned and tested, extracting the goal information in a descriptive way. From 111 records, only eight prospective studies were included in the synthesis. Although most of the selected studies assessed only women, three studies assessed the couple. All of them used questionnaires that showed that infertile couples experienced a higher number of sexual dysfunctions during the infertility treatment process, especially women. Regarding depression, going through the infertility process and its treatment leads to significant emotional damage to the patient or couple. Of the eight studies analyzed, six reached the conclusion that infertility is related to higher rates of sexual dysfunction. Seven studies also concluded that anxiety and depression are more prevalent in infertile patients. The treatment of sexual dysfunction is multidisciplinary, with the team being a general practitioner, gynecologist, psychologist and specialized nurse. If an organic disorder is detected, there may be a need to include specialists such as urology, gastroenterology and anesthesia. Psychological approaches often include some combination of sex education, identification of emotional and cultural factors, and eventually, couples therapy.

Sexual dysfunction in people treated with long‐acting injectable antipsychotics in monotherapy or polypharmacy: a naturalistic study

Sexual dysfunction, psychosis, and antipsychotics are known to be related, but the precise association between them is still unknown. Most evidence about the prevalence of sexual dysfunction in people treated with antipsychotic drugs comes from studies with restrictive samples. That is why our main objective was to determine the prevalence of sexual dysfunction in a real-life sample of outpatients treated with antipsychotics, considering gender. A cross-sectional naturalistic study was developed, including people treated with long-acting injectable antipsychotics, with or without other psychotropic drugs. Participants were interviewed to assess sexual satisfaction through a Likert scale (0 to 10) and the presence of sexual dysfunction (the Psychotropic-Related Sexual Dysfunction Questionnaire, PRSexDQ-SALSEX). The participants also had a blood test to determine prolactin (men and women) and testosterone levels (men only). A total of 131 people participated in the study (90 men and 41 women). Some extent of sexual dysfunction was found in 62.2% of men and 51.2% of women. The most frequent sexual dysfunction symptom for both genders was the loss of libido (45%). Hyperprolactinemia was present in 56% of men and 61% of women. The presence of sexual dysfunction was associated with higher doses of antipsychotics, hyperprolactinemia, and smoking in men and with smoking and hyperprolactinemia in postmenopausal women. This study provides real-life evidence of sexual dysfunction and hyperprolactinemia in persons treated with long-acting injectable antipsychotics segregated by gender. The high rates of sexual dysfunction and hyperprolactinemia detected corroborate the need to consider these aspects in clinical practice.

Incidence of sexual dysfunction within two years postpartum - cross-sectional study

Background: Several factors are responsible for making the pelvic floor muscles weak, among them is pregnancy, a period in which several changes occur in the woman's body. Female sexual dysfunctions are disorders that can appear in some of the phases of a woman's sexual response cycle, making it difficult to achieve pleasure during intercourse. Aims: Investigate the incidence of sexual dysfunction in women who had a single birth in less than two years. Method: This is a quantitative, descriptive exploratory study, data collection was performed through questionnaires: sample characterization, FSFI (Female Sexual Function Index) and QS-F (sexual quotient-female version). Results: 40 women participated in the study with a mean age of 26.2 years in which 80% of the sample does not have sexual dysfunction. Conclusion: sexual dysfunction was uncommon in the two-year postpartum period. However, when we consider the questionnaires developed by the researchers, there is a higher rate of sexual dysfunction.

The Long-Term Impact of Vaginal Surgical Mesh Devices in UK Primary Care: A Cohort Study in the Clinical Practice Research Datalink.

PurposeStress urinary incontinence (SUI) and pelvic organ prolapse (POP) may be treated with surgical mesh devices; evidence of their long-term complications is lacking.Patients and MethodsRates of diagnoses of depression, anxiety or self-harm (composite measure) and sexual dysfunction, and rates of prescriptions for antibiotics and opioids were estimated in women with and without mesh surgery, with a diagnostic SUI/POP code, registered in the Clinical Practice Research Datalink (CPRD) gold database.ResultsThere were 220,544 women eligible for inclusion; 74% (n = 162,687) had SUI, 37% (n = 82,123) had POP, and 11% (n = 24,266) had both. Women undergoing mesh surgery for SUI or POP had about 1.1 times higher rates of antibiotic use. Women with no previous history of the outcome, who underwent mesh surgery had 2.43 (95% CI 2.19–2.70) and 1.47 (95% CI 1.19–1.81) times higher rates of depression, anxiety, or self-harm, 1.88 (95% CI 1.50–2.36) and 1.64 (95% CI 1.02–2.63) times higher rates of sexual dysfunction and 1.40 (95% CI 1.26–1.56) and 1.23 (95% CI 1.01–1.49) times higher opioid use for SUI and POP, respectively. Women with a history of depression, anxiety and self-harm had 0.3 times lower rates of these outcomes with SUI or POP mesh surgery (HR for SUI 0.70 (95% CI 0.67-0.73), HR for POP 0.72 (95% CI 0.65-0.79)). Women with a history of opioid use who had POP mesh surgery had about 0.09 times lower rates (HR 0.91 (95% CI 0.86–0.96)) of prescriptions. Negative control outcome analyses showed no evidence of an association between asthma consultations and mesh surgery in women with POP, but the rate was 0.09 times lower (HR 0.91 (95% CI 0.87–0.94)) in women with SUI mesh surgery, suggesting that study results are subject to some residual confounding.ConclusionMesh surgery was associated with poor mental and sexual health outcomes, alongside increased opioid and antibiotic use, in women with no history of these outcomes and improved mental health, and lower opioid use, in women with a previous history of these outcomes. Although our results suggest an influence of residual confounding, careful consideration of the benefits and risk of mesh surgery for women with SUI or POP on an individual basis is required.