Impaired Sexual Function Research Articles

Predictors of duty sex frequency in women.

Duty Sex-the act of engaging in sex out of a sense of duty or obligation to a partner-is a commonly reported reason why women have sex, with studies indicating associations between Duty Sex and sexual dysfunction, as well as nonconsensual sexual experiences (NSEs). This study sought to examine the associations between Duty Sex frequency, sexual function, and NSEs using comprehensive, validated measures of sexual function and NSE histories in a large community sample of women. Six hundred and fifty-eight women with (n = 293) and without (n = 365) NSE histories completed measures of sexual function and sexual motivations. Women with NSE histories reported more sexual pain, lower sexual satisfaction, and more frequent Duty Sex. The relation between NSE history and Duty Sex remained after controlling for the variance in sexual function. The type of NSE behavior, but not the timing of the first NSE nor the perceived impact of the experience, predicted Duty Sex frequency. Clinicians should consider sexual motivations, particularly Duty Sex, when treating women with NSE histories or who experience sexual dysfunction. To our knowledge, this was the first study to examine how NSEs relate to all domains of sexual function and sexual motives, revealing a link between NSEs, sexual function, and Duty Sex. However, we were unable to account for what percentage of sexual encounters are considered Duty Sex. Therefore, our measurement of Duty Sex lacks specificity, which may explain the relatively low variance accounted for by the models in our analyses. There are consequences of NSEs, including difficulties with communicating sexual boundaries and impairment of sexual function, that may contribute to the increased likelihood of engaging in Duty Sex.

Building An Android-Based Application For Teenage Women's Reproductive Health Education

Background: Improper nutritional intake during adolescence can cause health problems, such as: impaired physical growth, increased risk of iron deficiency (Iron Deficiency Anemia), decreased intellectual capacity, impaired bone health, impaired sexual organ function, impaired concentration and performance at school, eating disorders and obesity, as well as malnutrition, but teenagers' knowledge about nutrition is very limited. Teenagers easily adapt to digital literacy. Providing digital interventions can have a positive impact on various aspects of health so that efforts to empower teenagers through increasing health promotion and early detection of adolescent health problems digitally are growing rapidly. Aim: The aim of this research is to explore the needs of young women for Android-based nutritional and reproductive health educational applications. Method: The qualitative research method is in-depth interviews via the Zoom application, WhatsApp video call, or WhatsApp voice call. Result: The results of qualitative research show that young women prefer educational media that is easy and fast in providing health information so that educational efforts via smartphones, namely Android-based applications, are an effective solution in providing precise and accurate information about nutritional intake and reproductive health. Keywords: Reproductive Health, Young Women, Application

Urogynecological symptoms and pelvic floor muscle tender points in women with and without fibromyalgia

Aims: To compare the urinary, sexual and vaginal symptoms frequency, pelvic floor muscles (PFM) tender points and pain severity in women with and without fibromyalgia. Methods: Cross-sectional study composed by women with fibromyalgia (FMG) and without it (control group, CG) assessed by: (a) sexual (Female Sexual Function Index - FSFI); (b) vaginal (International Consultation on Incontinence Questionnaire ICIQ-Vaginal Symptoms); (c) urinary (ICIQ: Urinary Incontinence Short Form ICIQ-UI SF and ICIQ-Overactive Bladder ICIQ-OAB); (d) quality of life (King’s Health Questionnaire - KHQ), as well as digital palpation assessment of: tone (normal, increased or decreased); tender points (position by clock-face); and pain severity (numeric rating scale - NRS). Statistical analysis included Student’s t-test, Wilcoxon-Mann-Whitney’s, logistic Regression and Spearman’s Correlation (significance level: 5%). Results: Of the 84 women enrolled, 39 FMG and 39 CG completed the study. No differences in urinary or vaginal symptoms were found. FMG presented lower FSFI (FMG: 7.2; CG: 21.6; p<0.001), more PFM tender points (FMG: 10 (25.6%); CG: 1 (2.6%); p=0.03), greater quality of life impairment (FMG: 5, CG: 4; p=0.01) and sleep/energy (FMG: 5, CG: 2, p<0.01) both KHQ domains. The pain severity was FMG: 4 (1-6); CG: 7(7); p=0.05. Conclusion: More PFM tender points, greater impairment in sexual function, as well as in quality of life were all more frequent in women with fibromyalgia when compared to healthy controls. However, the correlation between sexual function and PFM pain was low.

Sexual function following risk-reducing salpingo-oophorectomy: a prospective cohort study.

Increased access to and indications for genetic testing will lead to more women undergoing risk-reducing salpingo-oophorectomy (RRSO), with a potential impact on sexual function. Our objective was to prospectively investigate (1) sexual function in women with pathogenic variant (PV) in BRCA1/2 genes, before and 1 year after RRSO, and to compare with a healthy age-matched control group and (2) to study if testosterone levels correlate with sexual functioning after RRSO. A prospective observational follow-up study of 43 BRCA1/2-PV carriers planned for RRSO and 73 healthy-age matched controls. Data including personal medical history, the Female Sexual Function Index (FSFI) and blood samples for analysis of testosterone by tandem mass spectrometry and free androgen index (FAI) were collected before and 1 year after surgery or at inclusion (controls). Sexual function and testosterone levels following RRSO. Median age in the RRSO group was 42years at baseline, 55.8% were premenopausal and 53.5% had a history of breast cancer. The RRSO group had significantly lower median FSFI total score (P < .001), lower scores of all 6 FSFI domains (P < .001), as well as a higher proportion of female sexual dysfunction (FSD) (P < .001) compared to the control group at 1 year after surgery. In the RRSO group, users of menopausal hormone therapy (MHT) had a significantly higher median FSFI total score compared with the nonusers both at baseline (P = .023) and follow-up (P = .010). The proportion of FSD was significantly higher in the non-MHT group at both baseline (P = .041) and follow-up (P = .009). FAI was significantly lower in the RRSO group when compared to the controls at 1-year follow-up (P = .041); however, no significant correlations between testosterone levels and FSFI scores were found. The results highlight the need to counsel BRCA1/2-PV carriers before RRSO and offer a structured follow-up and support addressing sexual function and impact of MHT use. The main strength of this study is its prospective design with age-matched controls. Limitation is a small sample size. Our findings show that sexual function deteriorated 1 year after RRSO independent of testosterone levels, and the proportion with impaired sexual function was higher compared to healthy age-matched controls.

Quality of life issues in patients with ductal carcinoma in situ: a systematic review.

Ductal carcinoma in situ (DCIS) of the breast is one of the most common pre-invasive cancers diagnosed in women. Quality of life (QoL) is extremely important to assess in studies including these patients due to the favorable prognosis of the disease. The primary objective of this systematic review was to compile a comprehensive list of QoL issues, all existing QoL assessment tools, and patient-reported outcome measures used to assess DCIS. A search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to August 2023, using keywords such as "ductal carcinoma in-situ", "quality of life", and "patient-reported outcomes." QoL issues and QoL tools in primary research studies were extracted. A total of 67 articles identified issues pertaining to patients with DCIS spanning physical, functional, and psychosocial QoL domains. Physical and functional issues observed in patients included pain, fatigue, and impaired sexual functioning. Psychosocial issues such as anxiety, depression, and confusion about one's disease were also common. QoL tools included those that assessed general QoL, breast cancer-specific tools, and issue-specific questionnaires. The current instruments available to assess QoL in patients with DCIS do not comprehensively capture the issues that are pertinent to patients. Thus, the modification of existing tools or the creation of a DCIS-specific QoL tool is recommended to ensure that future research will be sensitive towards challenges faced by patients with DCIS.

Risk factors for long-term urination and sexual function impairment following laparoscopic resection of presacral lesions

BackgroundPresacral cysts are rare congenital lesions predominantly affecting females. Surgery is often recommended after diagnosis due to the risk of malignant transformation and complications associated with cyst enlargement. Laparoscopic excision is increasingly favored due to its enhanced visualization and precision. AimTo assess long-term urinary, sexual function outcomes and quality of life in female patients undergoing laparoscopic resection of presacral cysts. MethodsWe conducted a retrospective review of female patients who underwent laparoscopic resection of presacral cysts between August 2012 and May 2020. Patient demographics, surgical outcomes, and postoperative complications were analyzed. The urinary function was assessed using the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS), the sexual function was evaluated using the Female Sexual Function Index (FSFI), and quality of life was assessed using the 36-item Short-Form Health Survey (SF-36). ResultsAmong the 32 female patients included, 10 experienced postoperative urinary incontinence, predominantly of the mixed type. The risk factors for urinary incontinence included abdominal distension and the proximity of the cyst to the rectum. Notably, urinary incontinence significantly impacted the overall lower urinary tract symptoms and quality of life. Additionally, seven patients reported postoperative sexual dysfunction, with previous abdominal or pelvic surgery and cyst location under S3 identified as risk factors, affecting the mental health aspects of their quality of life. ConclusionLaparoscopic cyst resection in females poses risks of urinary and sexual dysfunction, potentially impacting quality of life. Thus, tailored management approaches are crucial.

HIFU with Oral Collagen Vs HIFU Alone in Vaginal Rejuvenation

Introduction: Many treatment options were tried to reach satisfactory results for patients with loose vagina in order to improve their sexual life and urinary symptoms. Methods: 54 patients with loose vagina and impaired sexual function participated in this study. Ultrasound gel was applied to a HIFU cartridge before inserting into the patient’s vagina and radiating the circumference with HIFU radiation. A group of patients was treated with HIFU alone (group I), and another group was treated with HIFU and systemic marine collagen (group II). We evaluated the patient’s vaginal pressure before and after treatment with degree of patient’s satisfaction regarding their sexual function and urinary symptoms

The Impact of Post-traumatic Stress on Sexual Function of Survivors of Hematological Malignancies and Autologous Hematopoietic Stem Cell Transplantation.

Autolοgous Hematopoietic Stem Cell Transplantation (AHSCT) is a treatment οption fοr patients with hematological malignancies that improves prοgnοsis and survival. Thus, it is necessary tο deal with its long-term cοmplications, such as sexual dysfunction and trauma that significantly affect survivors' quality οf life. The aim οf this study was to evaluate the Sexual Function (SF) and the Pοst-traumatic Stress Disorder (PTSD) οf survivοrs οf hematolοgical malignancy and AHSCT. A multicenter, quantitative, crοss-sectional, descriptive, and cοrrelational study was cοnducted from December 2019 to March 2022. Thrοugh cοnvenience sampling, 127 adults and sexually active survivors οf hematolοgic malignancy whο underwent AHSCT frοm 6 mοnths tο 5 years were recruited frοm 5 hοspitals in Athens. The survivοrs cοmpleted questionnaires on demοgraphic and clinical data, a male or female SF assessment tοοl [Internatiοnal Index Erectile Functiοn (IIEF) and Female Sexual Functiοn Index (FSFI), respectively], and the Impact of Event Scale-Revised (IES-R). Patients' mean age was 45.6 (±12.8) years. The median time frοm transplant was 3 years and the majοrity οf the survivοrs had Hodgkin's lymphοma. Accοrding tο the FSFI, wοmen had a mοderate level of SF, with a better functional area the "pain" and wοrse the "οrgasm". Accοrding tο the IIEF, men had a high level of SF, with a better functional area the "erection" and wοrse the "οverall satisfaction". Survivοrs had lοw levels οf PTSD based οn the IES-R, with nο differences between men and women. The subscale οf "hyperarοusal" had the lοwest values and the subscale οf "avοidance" had the highest values fοr bοth men and wοmen survivοrs. There was a lοw tο mοderate negative statistically significant cοrrelation between the IES-R and bοth FSFI and IIEF, suggesting a high level οf PTSD to be correlated with wοrse sexual function. Survivοrs οf AHSCT had impaired SF tο varying degrees and areas of functionality depending οn their gender, but lοw levels of PTSD and lοw correlations between these twο variables. This matter is impοrtant in survivοrship care and needs further investigatiοn.

Psychiatric disorders among females with prolonged infertility with or without in vitro fertilization/intracytoplasmic sperm injection failure: a cross-sectional study

ObjectivesThe present study seeks to deepen understanding of the negative impacts of infertility, with a spotlight on the experiences of Egyptian women who faced prolonged periods of infertility, and emphasizing the role that faliures of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles may play in exacerbating their psychiatric disorders and impairing their sexual functions.MethodsEmbarking on a cross-sectional approach, this study was operationalized within the outpatient sectors of the Obstetrics and Gynecology Departments, synchronized with Psychiatry Departments, at Tanta University Hospitals from September 1, 2018, to December 31, 2022. The targeted population encompassed women experiencing prolonged infertility (≥ 5 years), categorically divided into two groups for meticulous analysis: Group I (with a history of IVF/ICSI failure) and Group II (without any IVF/ICSI attempts). Diagnostic tools, including the Arabic versions of the Hamilton Depression Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), and the Female Sexual Function Index (FSFI), were deployed to scrutinize the mental health and sexual function outcomes of the participants.ResultsA total of 236 women participated in this study (126 in Group I and 110 in Group II), with primary infertility prevalent in 73.31% of cases, averaging a duration of 9.28 ± 3.40 years. Our findings indicated a substantial presence of depression (58.47%), anxiety disorders (35.17%), and sexual dysfunctions (43.64%). Notably, significant differences (p < 0.0001) emerged between the groups on the HAM-D, HAM-A, and FSFI scales, with endometriosis showcasing the worst effects.ConclusionsThe findings conclusively pinpoint a pronounced link between prolonged infertility and exacerbated mental health conditions, alongside impaired sexual functions, thereby negatively affecting the quality of life of the affected women. This revelation underscores the pressing need for integrated psychiatric consultations in the therapeutic protocols of women grappling with infertility, particularly those with a history of endometriosis or failed IVF/ICSI cycles, to foster a more holistic approach to infertility management and care.

Polycystic ovarian syndrome elevates the distress of sexual pain in Iranian women with infertility

BackgroundSexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility.MethodsThe Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS).ResultsThere were negative correlations between sexual function domains and sexual distress (P < .001) in the total sample. Moderation analysis revealed that higher levels of impaired desire, arousal, and pain elevated sexual distress in the PCOS group. After adjusting for depression and anxiety, only the association between sexual pain and sexual distress was moderated by PCOS condition (P = .008).ConclusionsThe findings suggest that impaired sexual function is associated with increased levels of sexual distress in infertile female patients. Importantly, comorbid PCOS renders patients susceptible to sexual distress where sexual pain is increased. Further research may shed light on the physiological, psychological, and relational aspects of sexual pain and associated distress in infertile female patients with comorbid PCOS.

Sexual health and testosterone concentration in male lymphoma survivors: A systematic review

Advancements in lymphoma treatment have increased the number of long-term survivors who may experience late effects such as impaired sexual function and testosterone deficiency. The aim of this review was to determine the prevalence of testosterone deficiency and sexual dysfunction among male lymphoma survivors; and associations between the two. A systematic search identified 20 articles for inclusion. The prevalence of low total testosterone was 0%–50 %, with mean values within reference levels, and for luteinizing hormone above reference levels in 0%–80 %. Four studies included SHBG and free testosterone, with mixed results. Compromised sexual health was found in 23%–61 %. Overall, total testosterone and sexual health were associated. The risk of bias (ROBINS-E and RoB 2) was high/very high, leading to low/very low overall confidence in the bulk of evidence (GRADE). Longitudinal studies evaluating biologically active testosterone and sexual health are needed, to develop evidence based standard procedures for follow-up of sexual health.

Finasteride and Dutasteride in the Treatment of Androgenetic Alopecia: Risk or Benefit?

Androgenetic alopecia, also known as male pattern hair loss or female pattern hair loss, is the most common form of alopecia worldwide and occurs due to an excessive response to androgens. Its etiology is chronic and influenced by genetic and environmental factors. For these reasons, this condition can be extremely difficult to treat. The main form of treatment currently involves the use of finasteride or dutasteride, which have the ability to inhibit the enzyme 5-alpha-reductase, responsible for the conversion of testosterone into DHT, and consequently prevent the progression of androgenetic alopecia. Concurrently with the dissemination of this treatment, various concerns have arisen regarding the potential side effects caused by this class of medication, particularly impairments in sexual function and possible psychological disorders observed in a portion of users. With the emergence of new methodologies aiming at the treatment of androgenetic alopecia, there is much debate in the scientific community about whether the use of finasteride and dutasteride is the best way to treat this condition. In this article, we will discuss how 5-alpha-reductase inhibitors act in the treatment of androgenetic alopecia, focusing on their risks and benefits.

The diagnosis and prevalence of hypoprolactinemia in patients with panhypopituitarism and the effects on depression and sexual functions

PurposeWe aimed to investigate the prevalence and the diagnostic criteria of hypoprolactinemia in patients with panhypopituitarism and the effects of hypoprolactinemia on depression and sexual functions.Materials and methodsForty-eight patients with panhypopituitarism and 20 healthy volunteers were included. Basal hormone levels were measured and a TRH stimulation test was performed. For the evaluation of sexual functions, questionnaries of Female Sexual Functional Index (FSFI) for females and International Erectile Functional Index for males were performed to the subjects. Depressive symptoms were evaluated by Beck Depression Envontory score (BDI-II).ResultsThe peak PRL response to TRH stimulation test at 5th percentile in the control group was 18.6 ng/ml in males and 41.6 ng/ml in females and accepted as the cut-offs for sufficient response of PRL. Prolactin was insufficient in 42(87.5%) patients. A basal PRL level of ≤ 5.7 ng/ml in males and 7.11 ng/ml in females was 100% specific in predicting an inadequate response to TRH stimulation test with 80% and 70% sensitivity respectively. A basal PRL level of ≥ 8.5 ng/dl in males was 100% specific and 76% sensitive, and in females a level of ≥ 15.2 ng/dl was 96% specific and 66% sensitive in predicting an adequate response to TRH. PRL deficient patients with panhypopituitarism had higher depression scores compared to the controls, lower sexual function scores in males.ConclusionPRL deficiency is prevalent among individuals with panhypopituitarism, with the potential to result in elevated depression scores in both sexes and impaired sexual functions in males. A basal PRL level seems to be sufficient for the diagnosis of hypoprolactinemia in routine clinical practice.

Sexual function and pelvic floor function in men with systemic sclerosis compared to healthy controls: a cross-sectional study

Objectives This cross-sectional study aimed to compare the sexual function (SF) and pelvic floor function of men with systemic sclerosis (SSc) with age-matched healthy controls (HC) and to identify the implications of clinical features on SF. Material and method Twenty SSc males and 20 HC aged 18–70 years completed eleven questionnaires assessing SF [International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire (MSHQ)]; sexual quality of life: Sexual Quality of Life Questionnaire-Male (SQoL-M); pelvic floor function: Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7), fatigue, depression, physical fitness, functional disability, and quality of life. Clinical data were collected. Results Significantly worse SF was observed in patients (median IIEF erectile function 12 in SSc versus 29 in HC, p < 0.001), with 70% reporting erectile dysfunction (ED) compared to 15% in HC. However, no significant difference was observed regarding pelvic floor function (median PFIQ7 8.8 in SSc versus 7.0 in HC, p = 0.141). Impaired SF was associated with higher disease activity, increased systemic inflammation, more pronounced fatigue, reduced physical fitness, severe depression, impaired overall quality of life, dyspepsia, and arthralgias (p < 0.05 for all). Conclusions Sexual dysfunction is highly prevalent in our SSc patients, whereas pelvic floor dysfunction is unlikely to be associated with these problems.

Pelvic floor disorders and impact on sexual function: a cross-sectional study among non-sexually active and sexually active women.

Pelvic floor disorders are common and associated with impaired sexual function in women. To assess women with pelvic floor disorders and describe factors associated with not being sexually active and those associated with sexual function in sexually active women. A cross-sectional study was conducted that included nonpregnant women with symptoms of pelvic floor disorders who were referred to the urogynecologic and surgical outpatient clinic at 2 Norwegian university hospitals: St Olavs Hospital, Trondheim University Hospital, and the University Hospital of Northern Norway, Tromsø. Women answered a questionnaire anonymously. Pelvic Organ Prolapse Incontinence Sexual Questionnaire-IUGA Revised. Of 157 respondents, 111 (71%) reported being sexually active (with or without a partner), and 46 (29%) reported not being sexually active. As compared with sexually active women, not sexually active women were older (mean ± SD, 60.2 ± 13.3 vs 51 ± 12.1 years; P < .001), more were menopausal (78% vs 47%, P = .001), and more had symptom debut <1year (31% vs 9%, P < .001). They reported more distress related to pelvic floor disorders, especially pelvic organ prolapse. In a multivariate logistic regression analysis, menopausal women and women with symptom debut <1year were 4 times more likely to be not sexually active than premenopausal women (odds ratio, 4.0; 95% CI, 1.7-9.2) and women with symptom debut ≥1year (odds ratio, 4.0; 95% CI, 1.5-10.7). In sexually active women, colorectal-anal distress was negatively associated with 5 of 6 domains of sexual function: arousal/orgasm (ß = -0.36; 95% CI, -0.02 to -0.005), partner related (ß = -0.28; 95% CI, -0.01 to -0.002), condition specific (ß = -0.39; 95% CI, -0.002 to -0.009), global quality (ß = -0.23; 95% CI, -0.02 to -0.002), and condition impact (ß = -0.34; 95% CI, -0.02 to -0.006). Health care professionals should discuss sexual function in patients with pelvic floor disorders, especially menopausal women and women with colorectal-anal symptoms. The study used condition-specific measures and recruited women from 2 university hospitals with wide range of age. Limitations include the small sample size and wide confidence intervals. The number of women who considered themselves not sexually active was low, and item nonresponse levels among these women where somewhat high. Of 625 eligible women, 200 (32%) answered the questionnaire. Sexual health and sexual function are still surrounded with taboo, and some women were probably not comfortable answering the questions. Menopausal women and women with recent onset of symptoms of pelvic floor disorders are more likely to be sexually inactive, and colorectal-anal symptoms have the most negative impact on sexual function in sexually active women.

Impairment of sexual function in patients with pemphigus.

Impairment of sexual function in patients with pemphigus.

(115) Side Effect Profile of Collagenase Clostridium Histolyticum for Peyronie’s Disease Significantly Affects Long-term Patient Satisfaction

Abstract Introduction Collagenase Clostridium histolyticum (CCH) is the only FDA-approved medication for Peyronie’s Disease (PD) in the United States. While treatment-related side effects are commonly considered mild or moderate in severity, including bruising, pain, and swelling, there is currently limited literature on how these side effects affect patient satisfaction, especially long-term satisfaction, with CCH treatment. Objective The aim of this study was to better understand the side effect profile of CCH treatment for PD and its effects on long-term satisfaction with CCH treatment. Methods An Institutional Review Board approved retrospective chart review and standardized questionnaire was conducted for all patients with PD who received CCH from 2009-2022. Patients who received CCH before presenting to our institution were excluded. The questionnaire utilized the Treatment Satisfaction Questionnaire for Medication (TSQM), which is validated across the subdomains of satisfaction with effectiveness, side effects (SE), convenience, and global satisfaction (GS), and summed to generate the TSQM total score. Statistical analyses were performed in R using Wilcoxon rank sum test and independent T-test to compare continuous variables with TSQM scores, and Spearman’s rank correlation to compare categorical variables with TSQM scores. Results Of the 243 eligible patients, 80 (32.9%) responded (Table 1). Of these, 34 (42.5%) reported satisfaction with CCH treatment. On average, surveys were completed 4.7 (SD 2.3) years after last CCH injection. Patients experienced an average of 2.2 (SD 1.5) notable side effects, and increased number of side effects was significantly correlated with decreased scores of SE subdomain, convenience subdomain, and TSQM total (Spearman's ρ= –0.46, –0.29, –0.28; p&amp;lt;0.009 for all). Most common side effects noted were bruising, swelling, and pain with injection (Table 2). Other than swelling, all SE noted were associated with significantly lower SE subdomain scores (p&amp;lt;0.03 for all). New erectile dysfunction (ED) was correlated with the largest reduction in the TSQM total score (mean 105.4 ED vs. 192.1 no ED, p=0.006). Hematoma and pain with injection were the only other side effects associated with significant reductions in the TSQM total score (p=0.03 for both), and experiencing no SE was correlated with significantly increased TSQM total scores (mean 256.1 no SE vs. 166.7 SE, p=0.003). When rating pain with injection on a scale 1 to 5, mean rating was 3.1 (SD 1.2), and rating was significantly associated with scores of SE subdomain, convenience subdomain, and TSQM total (Spearman's ρ= -0.33, –0.52, –0.33; p&amp;lt;0.003 for all). Conclusions Our data suggests that impairment of sexual function through new ED has the most significant negative impact on long-term overall satisfaction with CCH treatment, followed closely by pain with injection and hematoma. Though the latter two side effects are typically considered mild to moderate in severity, they continue to profoundly impact overall satisfaction nearly five years after completion of CCH treatment. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: M.K. acts as a consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast. M.K. is an investor of Sprout. L.L. acts as a consultant for AbbVie, Aytu BioScience, Contraline, Lipocine. L.L. acts as an advisor for Inherent Bioscences. L.L. acts as consultant/speaker for Endo Pharmaceuticals. L.L. acts as a speaker for American Medical Systems/Boston Scientific.

(031) Effects of Gender Affirming Hormone Therapy vs. Puberty Blockers on Sexual Function and Desire

Abstract Introduction Many transgender and nonbinary (TGNB) individuals seek out puberty blockers (PB) to stop the progression of unwanted changes from endogenous puberty and/or gender affirming hormone therapy (GAHT) to aid in their medical transition. There has been limited research assessing the effect of these hormone therapies on sexual function and desire, especially in comparing GAHT and PB+GAHT. Objective Our aim was to compare the effect of GAHT and PB+GAHT on sexual function and desire of TGNB individuals during or following hormone therapy. Methods We performed an IRB approved two institutional study on the effect of GAHT and/or PB on sexual function and desire in adults. The GAHT group (n=12) included individuals who started GAHT (estrogen or testosterone) &amp;gt;18 years old. The PB group (n=10) included subjects with current or past history of GnRH agonist use (&amp;gt;10 years old). Enrolled subjects completed the validated Changes in Sexual Functioning Questionnaire (CSFQ). The CSFQ was validated in adults to assess medication-related changes in sexual functioning. The questionnaire is specific to sex assigned at birth with a male and female version. The answers were scored in total and separated into sexual function and sexual desire subscales. Scores in each group were compared using unpaired t-tests. Results A total of 22 TGNB (16 assigned male at birth and 6 assigned female at birth: 14 transgender women, 5 transgender men, 3 non-binary) subjects ages 18-25 completed the CSFQ about the effect hormone therapy had on sexual function and desire. There was no difference between groups in total scores (t = 0.8, p = 0.05) or in categories of sexual function (t = 0.3, p = 0.05) and desire (t = 0.8, p = 0.05). There were an equal number of participants in both groups whose results showed sexual dysfunction in total (n=2 per group) and in categories of sexual function (n=7 per group) and desire (n=3 per group). The cause of their dysfunction is unclear at this time and is to be investigated in the future. Interestingly, despite meeting quantitative criteria for sexual dysfunction, 6 participants answered that their sexual life brings them “much” or “great” enjoyment or pleasure. Conclusions Based on our results, while there were &amp;gt;70% of subjects in each group with impaired sexual function, there were no differences in effect on sexual function and desire between subjects on GAHT vs. PB+GAHT. Additionally, the scores for both groups did not differ substantially from scores of cisgender individuals (Keller, et al 2006). In fact, both the GAHT and PB+GAHT groups scored higher on average in the sexual desire category compared to cisgender individuals. Prospective data collection will help us clarify further whether starting age of pubertal blockers and hormone therapy affects sexual function and desire. Disclosure No.

Sexual Outcomes after Conservative Management for Patients with Localized Penile Cancer.

Men with localized invasive penile cancer (PC) can be treated with organ-sparing treatments with different functional and aesthetical outcomes. Thus, the aim of this study is to investigate sexual outcomes in patients with PC confined to the glans that underwent wide local excision (WLE) vs. glansectomy with urethral glanduloplasty. Complete data from 60 patients with PC were analyzed at our institution from 2017 to 2022. Patients were asked for personal habits and clinical features. PC was assessed with a clinical visit and imaging techniques. At the outpatient follow-up visit or phone call, all patients compiled the Changes in Sexual Function Questionnaire (CSFQ) and the International Index of Erectile Function in its short 5-item form (IIEF-5). Erectile function (EF) impairment was categorized using Cappelleri's criteria. Overall, 34 patients with PC confined to the glans (c ≤ T2N0) were included. Of those, 12 underwent WLE and 22 underwent glansectomy with urethral glanduloplasty. Using multivariable logistic regression, glansectomy (OR: 3.49) and diabetes (OR: 2.33) were associated with erectile disfunction (IEEF < 22). Meanwhile, using multivariable linear regression analysis, younger patients (Coeff: -2.41) and those that underwent glansectomy (Coeff: -7.5) had a higher risk of sexual function impairment, according to the CSFQ. Patients with PC ≤ T2N0 that underwent WLE have better outcomes in terms of sexual functioning than the patients who underwent glansectomy and uretheral gladuloplasty. Further research is needed to clarify the outcomes of penile-sparing surgery, to inform patients in pre-surgical counseling more comprehensively, and to meet their post-operative expectations more effectively.

The impact of COVID-19 and long COVID on sexual function in cisgender women.

Research suggests that COVID-19 impairs sexual function in men, but little is known about the impact of COVID-19 (or long COVID) on sexual function in women. We sought to compare the sexual function of cisgender women who had never had COVID-19, who had COVID-19 but not long COVID, and who had long COVID, and assessed whether long COVID symptoms and/or emotional distress mediate the relationship between COVID-19 history and sexual function. In total, 2329 adult cisgender women were recruited online as study participants. Half of these women reported having had COVID-19, and the other half reported never having had COVID-19. Of those who had COVID-19, 25% (n= 170) reported having long COVID. We compared the mean Female Sexual Function Index (FSFI) scores by using t-tests for each of the primary comparison categories (never COVID vs COVID and only COVID vs long COVID). Four path models were used to test the hypotheses that (1) long COVID symptoms or (2) depression, anxiety, and/or stress assessed with the subscales of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) mediated the relationship between COVID-19 and sexual function. Sexual function was measured with the FSFI, long COVID symptoms were assessed using the Centers for Disease Control working symptom set, and emotional distress was measured with the DASS-21. In total, 1313 participants provided data suitable for analysis. The never-COVID group (n= 645, 49.1%) had higher scores on the Desire, Arousal, Lubrication, and Satisfaction subscales of the FSFI (mean [M] [SD] FSFI total Mnever COVID = 27.98[4.84] vs MCOVID = 27.05[5.21]) than the combined only-COVID (n= 498, 37.9%) and long-COVID (n= 170, 12.9%) groups. The FSFI subscale scores were significantly higher in the only-COVID group than in the long-COVID group for the Arousal, Lubrication, and Orgasm and lower for the Pain subscales and higher for overall sexual function (FSFI total Monly COVID = 27.49[5.00] vs Mlong COVID = 25.77[5.61]. None of the proposed mediation models had adequate model fit. Clinicians treating cisgender women who have COVID-19 should consider proactively discussing sexual function with their patients and offering available resources. In this study we used a large and diverse sample, but this sample did not include transgender or gender-diverse persons. This study was also correlational; as such, causal conclusions cannot be drawn. Further, the mechanism of action remains unexplained. The study findings suggest the following: (1) COVID-19 infection is associated with impaired sexual function in cisgender women, and (2) that women with long COVID experienced incrementally more impaired sexual function than women with COVID-19 who did not develop long COVID.