Lower Female Sexual Function Index Research Articles

Sexual function in people with multiple sclerosis: a systematic review and meta-analysis.

Sexual dysfunction is prevalent in people with multiple sclerosis (PwMS) and considerably affects their quality of life. Although sexual function (SF) is crucial in PwMS, its relationship with other characteristics remains insufficiently understood. This review aimed to consolidate the evidence comparing SF between PwMS and healthy controls (HCs) and to explore its correlation with various demographic, clinical, and psychological factors. The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were systematically searched up to July 28, 2024, to identify studies comparing SF between PwMS and HCs or assess its correlation with various demographic, clinical, and psychological characteristics. Random effects models were used in R software version 4.4.0 to estimate the pooled standardized mean difference (SMD) and pooled correlations, with their 95% CIs as the effect size metrics. In this review, 61 studies comprising 16 266 PwMS were included. The meta-analysis indicated that SF was significantly reduced in PwMS compared to HCs, with females with MS (FwMS) showing lower Female Sexual Function Index scores (SMD: -0.41, 95% CI, -0.61 to -0.20, P< .0001) and males with MS (MwMS) demonstrating reduced International Index of Erectile Function scores (SMD: -0.77, 95% CI, -1.32 to -0.22, P< .01). Correlation analyses highlighted associations between reduced SF and higher Expanded Disability Status Scale (EDSS), longer disease duration, and depression in gender-aggregated analyses. Reduced SF was also found to correlate with older age, higher EDSS scores, depression, and fatigue in FwMS. The findings of the included studies indicated that SF is lower in PwMS compared to HCs and is influenced by age, disease duration, depression, and the EDSS. Further studies on the effects of comorbidities, medications, and MS classification on the SF of PwMS are warranted.

Menopause is associated with a decrease in sexual function among women with endometriosis

BackgroundMenopause-related endocrinological shifts are linked to sexual dysfunction, and women with endometriosis exhibit lower Female Sexual Function Index (FSFI) scores, indicating impaired sexual well-being.AimTo assess the impact of menopause on sexual function in women with endometriosis.MethodsAn anonymous online survey was conducted among 1586 French women diagnosed with endometriosis. The FSFI questionnaire was used to evaluate sexual function, and menopause was defined as ≥12 months of amenorrhea. Multivariable logistic regression was performed to assess the relationship between FSFI scores and menopause status, adjusting for tobacco use, education, number of symptoms, and history of surgery. Logworth analyses were used to determine the strongest components of FSFI associated with menopause.OutcomesThe primary outcome was the FSFI total score and its six domains (desire, arousal, vaginal lubrication, orgasm, satisfaction, and dyspareunia) in menopausal and non-menopausal women with endometriosis.ResultsMenopausal women had significantly lower FSFI scores (15.3 vs. 16.9, P = 0.021). After adjustment, FSFI remained significantly lower (P = 0.026) in menopausal women but did not reach the established FSFI cutoff for sexual dysfunction (P = 0.451). Stratified analysis by age showed a steep decline in FSFI between 46 and 50 years, partial improvement at 51-55 years, and further decline after 55 years, particularly in arousal, orgasm, dyspareunia, and satisfaction. Arousal (logworth = 4.53, P < 0.001) was the most affected domain, followed by satisfaction (logworth = 1.81, P = 0.015).Clinical ImplicationsArousal appears to be the key determinant of sexual function decline in menopausal women with endometriosis, highlighting the need for targeted interventions such as hormone therapy, pain management, and sexual counseling.Strengths & LimitationsThe study benefits from a large sample size and validated FSFI assessment but is limited by selection bias from online recruitment, self-reported diagnosis of endometriosis, and lack of hormonal status confirmation. The cross-sectional design prevents causal inferences.ConclusionMenopause is associated with a decline in FSFI scores among women with endometriosis, with arousal being the most affected domain, underscoring the need for further research on personalized management strategies for sexual dysfunction in this population.

Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study

Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study

(064) A NOVEL SURGICAL TECHNIQUE TO FACILITATE FEMALE ORGASM

Abstract Introduction Female orgasmic disorder is defined as marked infrequency or absence of orgasm and the distress caused by the situation. The approach to treatment is based on psychosocial treatment models. Directed masturbation, sensate focus exercises, exposure and cognitive behavioral therapy are the psychosocial treatment options defined. Surgical reconstruction and adjustment or cosmetic surgery serve as a different yet limited way for treatment. The evidence shows that the clitoral anatomic topography may affect female sexual function; longer the clitoro-urethral distance was found to be correlated with lower Female Sexual Function Index (FSFI) Orgasm sub scores. Objective We aim to introduce a surgical technique, to be performed to women whose clitoro-urethral distance is more than 25 millimeters and having difficulty in reaching orgasm. Methods The medial faces of the labia minora are planned to be partially excised by drawing rhomboid figures on both sides. Horizontal wound closure was performed via separated suturing technique with 3.0 absorbable monofilament suture. After the clitoro-uretral distance reduction, a crescent incision was performed superficial to clitoris. Separated suturing technique with 3.0 absorbable monofilament suture was preferred for wound closure. Perineal tear due to vaginal delivery was reconstructed by routine colporrhaphy posterior. Results Patient with the complaint of having difficulty in reaching orgasm was evaluated, she had no medical history apart from a vaginal delivery in 2019. She has been sexually active for 8 years and 4 years ago she had cognitive behavioral therapy. The findings were rectocele grade 3 and the distance between the clitoris and urethra was found to be 25 millimeters. Preoperative FSFI score was found to be 17.6, with a remarkable orgasm sub score showing 2. Colporrhaphy posterior, clitoro-urethral distance reduction and clitoral hood reduction was performed. Postoperative healing period was uneventful. Postoperative sixth month FSFI score was 25.8 with an orgasm sub score 4.2. Conclusions Surgical approach the female orgasmic disorder is not the first line approach, however in a chosen group of patients with a clitoral urethral distance longer 25 millimeters, the reduction procedure may serve as an option. Disclosure No.

Effect of COVID-19 on sexual function and activities among reproductive-age women in Ibadan, South-West Nigeria.

Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health. To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria. This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05. Respondents were aged 20 to 50years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers. An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores. Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction. Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results. A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown.

Long-term Sexual Function and Quality of Life in Women Following Substitution Urethroplasty.

To assess the long-term quality of life (QOL) and sexual function (SF) in women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasty for urethral stricture disease. Between January 2016 and September 2022, women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasties and had at least a six-month follow-up been included. Using the Female Sexual Function Index (FSFI) and WHO-QOL bref questionnaires, the QOL and SF were evaluated. Scores were compared between the two groups after being examined for internal validity. A sub-group analysis was carried out based on the procedure's success. With follow-up periods ranging from 6 to 86months, 25 patients who received VI urethroplasty and 10 patients who underwent DO urethroplasty were included. Both scores demonstrated strong internal consistency. The cumulative QOL and FSFI scores were comparable in both groups (p = 0.53 and p = 0.83, respectively). Significantly high scores were noted in the physical health domain (76.5 ± 9.9 vs 62.33 ± 10.97; p = 0.03; (95% CI = 0.72-24.4)) and the environmental domain (75.75 ± 3.84 vs 66.00 ± 4.24; p = 0.01 (95% CI = 2.64-16.85) in patients with successful VI and DO urethroplasties respectively. Addictions, low socioeconomic status and protracted symptom duration were associated with low QOL scores. Old age was related to low FSFI scores. Substitution urethroplasty, despite the approach, showed good QOL and SF scores. Long symptom duration, addictions, and poor socioeconomic status were associated with low QOL whereas old age independently influenced low FSFI scores.

(028) A Comparison of Genital Self-Image and Sexual Functioning among Women with Vulvar and Non-Vulvar Dermatologic Disease

Abstract Introduction Inflammatory dermatologic diseases of the vulva represent a significant morbidity burden for affected women. Genital itching, pain, and skin changes have a profound impact on sexual function. Research also suggests women with generalized, non-vulvar dermatologic diseases have impaired sexual function. The Female Genital Self-Image Scale (FGSIS) was developed and validated in a large sample of American women a decade ago. Despite developers’ suggestion that the FGSIS could be used to further understand the burden of genital disease, there remains a paucity of research in this area. Both vulvar and non-vulvar inflammatory skin disease have yet to be fully characterized with regards to impact on genital self-image (GSI), a key mediator in sexual health and behavior. Objectives The present study describes GSI, sexual function, and sexual behaviors among women with vulvar and non-vulvar inflammatory dermatoses. Methods A 20-minute Qualtrics survey was distributed between September and November 2020 through three primary means: 1) targeted social media ads, 2) relevant social media support groups, and 3) online research volunteer recruitment services. Women in the US over age 18 who have ever been diagnosed with an inflammatory dermatosis persisting longer than one month were eligible to participate. The present data were collected as part of a larger study examining sexual health, quality of life, and health care experiences of women with skin disease. Survey items analyzed included the FGSIS, the Female Sexual Function Index (FSFI), and sexual behavior histories. Results The sample consisted of 320 women with a mean age of 42.7±15.5 (Range=19-81). Most participants were pre-menopausal (n=200; 62.5%), Caucasian (n=278; 86.9%), and heterosexual (n=263; 82.2%). Nearly one-third of women (n=98; 30.6%) reported inflammatory dermatologic disease isolated to the vulva, while 150 (46.9%) had strictly non-vulvar disease, and 72 (22.5%) experienced both vulvar and non-vulvar manifestations. The average FGSIS score among women with any vulvar disease was 16.9±4.1 (range=7-28) and was significantly (p&amp;lt;.01) lower than that of women with non-vulvar disease (M=21.2±4.3; range=9-28), with a higher score indicating a more positive FGSIS. A similar trend was seen with the FSFI, which was significantly (p&amp;lt;.01) different among women with vulvar disease (M=15.4±9.7, range=2.0-35.1) compared to women with non-vulvar disease (M=21.2±10.1, range=2.0-35.1), with higher scores indicating better functioning. When stratified by category, FSFI remained significant for desire (p=.04) and pain (p&amp;lt;.01), but not for arousal, lubrication, orgasm, or satisfaction. Women with vulvar disease were significantly less likely to receive (p=.02) or give (p=.04) oral sex or to engage in vaginal intercourse (p&amp;lt;.01) during the last four weeks. Conclusions This study demonstrates severe sexual health morbidity associated with inflammatory vulvar dermatoses, characterized by very low FGSIS and FSFI scores. Pain and desire shaped sexual function for women with vulvar disease, despite non-significant differences in other domains including satisfaction. Results also indicated low FSFI scores in women with non-vulvar disease, with FGSIS scores similar to previously-described healthy controls. A more precise understanding of the role of GSI in both vulvar and non-vulvar disease will provide opportunities for improved patient-centered disease management in the realm of sexual health. Disclosure No.

Evaluation of sexual function and depression in female patients with fibromyalgia

SUMMARYOBJECTIVE:Fibromyalgia is one of the most important problems, especially for women. Studies point to disorders in the sexual functions of fibromyalgia patients that reduce their quality of life. The aim of this study was to investigate sexual dysfunction and its relationship with disease severity and depression in women with fibromyalgia.METHODS:This study included 98 female patients diagnosed with fibromyalgia and 54 healthy women. The Female Sexual Function Index was used to assess sexual dysfunction. Fibromyalgia disease severity was measured with the Fibromyalgia Impact Questionnaire. Hamilton Depression Scale was filled in to evaluate the depression status of the patients.RESULTS:According to the female sexual function index data, female sexual dysfunction was found in 78 (79.6%) patients with fibromyalgia and only in 12 (22.2%) controls. When the female sexual function index scores of fibromyalgia patients with and without depression were compared, patients with additional depression had lower female sexual function index scores, and this difference was statistically significant (p=0.002). In the correlation analysis, the female sexual function index score showed a significant negative correlation with the hamilton depression scale (rho=-0.235, p=0.020) and fibromyalgia impact questionnaire (rho=-0.215, p=0.033) scores.CONCLUSION:This study highlights the high prevalence of sexual dysfunction in female fibromyalgia patients and the significant correlation between sexual dysfunction and both disease severity and depression.

Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study

Introduction and hypothesisSevere perineal tears can predict bothersome pelvic floor disorders later in life. We have a poor understanding of pelvic floor changes during the third trimester and the first few postpartum months. We aimed to compare women with severe perineal trauma during childbirth with women who experienced minimal trauma, for condition-specific quality of life, sexual function, mental health and overall quality of life in the first 6 months postpartum.MethodsWe recruited primiparous women with third- or fourth-degree tears (obstetric anal sphincter injuries, OASIS) and age-matched controls with no tears or first-degree tears in the immediate postpartum period. Participants completed validated questionnaires at baseline, 2, 4 and 6 months postpartum. Mixed effects linear regression or quantile regression adjusted for baseline score were used to compare the groups as appropriate.ResultsA total of 74 women completed at least one questionnaire (35 OASIS, 39 controls). Both groups had similar demographics. Women with OASIS tended to have worse Pelvic Floor Distress Index-40 scores at month 2; median scores were similar in the two groups by month 6. They also had significantly lower Female Sexual Function Index scores (mean difference: −6.1; 95% CI: −11.9, −0.2, p=0.043) at month 2. There were no mental health group differences and quality of life improved over time, mainly in the OASIS group. Six-month participant attrition rate was 52%.ConclusionsWomen with OASIS encounter specific pelvic floor challenges during the first 6 months postpartum. Although our recruitment rate was high, the attrition rate was also high, demonstrating challenges with retention of postpartum women into longitudinal research.

Sexual dysfunction in female patients of reproductive age group with recurrent urinary tract infection—a cross-sectional study

Sexual dysfunction in female patients of reproductive age group with recurrent urinary tract infection—a cross-sectional study

Depression and obesity, but not mild obstructive sleep apnea, are associated factors for female sexual dysfunction.

Mild obstructive sleep apnea (OSA) is more prevalent than moderate and severe OSA and is more frequent in men than women. The association between OSA and female sexual dysfunction (FSD) is still poorly explored inpublished studies. Our aim was to investigate the prevalence of FSD in women with mild OSA and assess the impact of OSA on FSD, as well as to determine the predictors for FSD risk. The sample comprised 70 women aged 26-65years: a control group (N = 28) with no sleep complaints, and a group with mild OSA (an apnea-hypopnea index of 5or more and less than 15 events/hour, N = 42), who had been diagnosed using polysomnography performed in the sleep laboratory of a sleep research institute. All participants volunteered to take part in the study and completed the female sexual function index (FSFI), the Beck depression index (BDI), the Kupperman menopausal index (KMI), and the Epworth sleepiness scale (ESS). Their socioeconomic group was assessed using the Brazilian Economic Classification Criterion. Polysomnography and serum levels of free testosterone and total testosterone were analyzed. We found low FSFI scores (< 26.55) in the mild OSA (18.1) and control (21.7) groups (p = 0.97). There was no statistically significant difference between the mild OSA group and the control group. However, a higher BMI (p = 0.04), a higher BDI (p = 0.02), and being sexuality inactive (p = 0.001) were risk factors for FSD. There was a high prevalence of FSD in the entire sample. The presence of mild OSA did not affect sexual function in this sample. Depressive symptoms and a high BMI were associated risk factors for FSD. Being sexually activemay protect female sexual function.

Sexual Function and Depressive Symptoms in Middle-Aged Women with LongLasting Type 1 Diabetes – A Cross-Sectional Study

Background &amp; aim: Women and men with diabetes, type 1 (T1D) and type 2 (T2D) develop complications in small and large blood vessels as well as in nerve pathways over time. In men, erectile dysfunction is a well-documented complication. However, sexual dysfunction in women with different types of diabetes is less studied. Sexual dysfunction is associated with lowered health-related quality of life and depression. The aim of the study was to investigate self-reported sexual function and signs of depression in middle-aged women with long-lasting T1D. Methods: A cross-sectional questionnaire study including the Female Sexual Function Index (FSFI) and the Patient Health Questionnaire (PHQ-9) together with background questions was designed. The sample was women aged 45-66 with T1D for at least 15 years, identified from clinical medical records at four hospitals in southern Sweden. Descriptive statistical analysis of background factors, depression, and self-reported sexual dysfunction, as well as correlation and regression analysis, are presented. Results: A total of 212 women completed the questionnaire, mean age 54.1 (SD: 5.83), mean years with T1D 36.2 (SD: 11.42). Almost half of the women had sexual dysfunction (45.2%; FSFI &lt; 26.55, max 36) and the mean full score was 23.73 (SD: 10.57). The FSFI domains are desire, arousal, lubrication, orgasm, satisfaction and pain. Symptoms of depression measured by PHQ-9 were reported by 39.8%. A low FSFI was significantly associated with severe depression (p&lt;0.001). Conclusions: Problems with sexual dysfunction and depression in middle-aged women with long-lasting T1D are common and may be unreported unless addressed in clinical care. Nurses could start asking women about problems with lubrication and vaginal pain in relation to sexual activity. Lubricants or local estrogen therapy could prevent those problems. Routinely assessing depressive status is equally important in improving quality of life for women with T1D.

Effects of water pilates on urinary loss, genital self-image and sexual function of elderly women

Descriptive, quasi experimental study with pre and post-test, which aimed to investigate the effects of Water Pilates (PA) on urinary incontinence, genital self-image and sexual function of elderly women. The sample consisted of seventeen elderly women aged 60 years or over, from a city in the interior of Rio Grande do Sul. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) was used as instruments to assess the impact of UI in quality of life and qualify urinary loss, the Female Sexual Function Index (FSFI) to assess sexual function and Female Genital Self-Image Scale (FGSIS) to assess women's perception of their own genitalia. The PA protocol was performed twice a week for 50 minutes performed for eight weeks, totaling 16 sessions. The protocol was divided into warm-up, strengthening exercises and stretching. It was observed that the sample was composed of young elderly women (69.5 ± 5.9 years), overweight and with low FSFI and FGSIS scores. There was no significant change in the mean values before and after the intervention of the ICIQ-SF, FGSIS and FSFI scores. It was concluded that the PA method had no effect on urinary loss, sexual function and genital self-image.

Genital self-image as predictor of sexual dysfunction in women with pelvic organ prolapse in Indonesia

Background:The incidence of sexual dysfunction increases in women with pelvic organ prolapse. In addition to physical factors, other important components that influence each other in sexual dysfunction are psychological aspects and genital self-image. Sociocultural factors also affect individual sexuality and sexual behavior. Until now, there are no data and the relationship between genital self-image and sexual dysfunction in pelvic organ prolapse is not known in Indonesia.Objective:This study aims to analyze the correlation of genital self-image with sexual dysfunction in women with pelvic organ prolapse.Methods:In this cross-sectional study, 113 consecutive women with pelvic organ prolapse were selected in urogynecology referral centers in Jakarta. Demographic data, physical examination, and guided interviews were filled in to complete the Female Sexual Function Index and Female Genital Self-Image Scale-7 questionnaires. Preliminary research has been carried out in the form of language translation and cultural validation of the Indonesian version of the Female Genital Self-Image Scale-7 questionnaires.Results:There is a significant correlation between genital self-image and sexual dysfunction, where the lower Female Genital Self-Image Scale-7 score significantly predicts the lower Female Sexual Function Index score (p < 0.000; odds ratio: 14.17).Conclusion:Genital self-image is the main variable that affects sexual function in women with pelvic organ prolapse. It is necessary to evaluate and treat genital self-image because sexual function is an integrated component of quality of life.

Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality

Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality

Comparison of female sexual function and sexual function of their partners between groups of pregnant and non-pregnant women

To compare the female sexual function index and sexual function of their partners between groups of pregnant and non-pregnant Turkish women. This was a cross-sectional study of 321 women, including 252 healthy pregnant and 69 healthy nonpregnant women. Assessment of female sexual function index (FSFI), ARIZONA scores of their partners were compared in relation to some of the sociodemographic characteristics and pregnancy trimesters. Comparison of the groups revealed a significantly higher FSFI score in the non-pregnant group whereas the ARIZONA score was significantly higher in the pregnant group (p < 0.001). Age, gravidity, parity and smoking rate adjusted mean differences of scores remained statistically significant (p < 0.001). Higher ARIZONA (> 11) score rate was significantly higher in pregnant groups (55.6% vs 23.2%, p < 0.001). Pregnancy was a risk factor for high ARIZONA score [OR: 4.1 (95% CI 2.2-7.6, p < 0.001)]. Lower FSFI score rate was significantly higher in the pregnant group (26.4% vs 69.4%, p < 0.001). Pregnancy was a risk factor for low FSFI score [OR: 6.4 (95% CI 3.5-11.7, p < 0.001)]. Both female sexual function index and ARIZONA scores of their partners were found to be significantly different between groups of pregnant and nonpregnant Turkish women which indicated altered sexual function of couples during pregnancy.

Sexual Dysfunction in Patients with Multiple Sclerosis from Argentina: What are the Differences Between Women and Men?

Sexual dysfunction (SD) has been reported in people with multiple sclerosis (pwMS). However, SD is commonly underdiagnosed in clinical practice. We aimed to assess SD frequency (primary, secondary and tertiary) in pwMS in both genders and to investigate possible associated risk factors. A cross-sectional study (pwMS = 202 and healthy volunteers (HV) = 200, matched for sex and age) based on self-administered questionnaires such as Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19), The Hospital Anxiety and Depression Scale, Fatigue Severity Scale and self-reported disability was performed in pwMS and controls. In addition, the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF5-ED) were obtained in women and men, respectively. Factors associated with SD were analyzed in a multivariate model. The frequency of primary, secondary and tertiary SD in pwMS was 81%, 87.3% and 75.2%, respectively. Both erectile dysfunction (ED) and female SD were significantly higher in pwMS than in HV (89% vs. 26% and 54% vs. 21%, respectively). Only 45 (22.2%) pwMS had addressed sexual problems with their neurologist and 33 (16.3%) pwMS received counselling about their sexual problems. Higher MSISQ-19 total scores were significantly correlated with fatigue, anxiety, depression, self-reported disability and lower FSFI and IIEF5-ED scores. Furthermore, female SD was independently associated with primary SD, but no associated factors were found in male pwMS (multivariate analysis). In conclusion, SD is extremely common in pwMS from Argentina. The previously mentioned physical and neuropsychological factors have a negative impact on sexual function.

Sexual Dysfunction Is a More Common Problem in Young Women with Type 1 Diabetes than in Healthy Women

The aim of the study was to analyze the relationship between the presence of type 1 diabetes and sexual dysfunction among young women. The study group consisted of 230 women, including 70 healthy and 160 with diabetes mellitus type 1 (DM1). All the participants voluntarily filled anonymous questionnaire. The results regarding sexual function were obtained using a Female Sexual Function Index (FSFI) questionnaire. Statistical analysis was performed for sexually active people. In the study group, 180 women declared sexual activity: 62 healthy (88%) and 118 with DM1 (82.5%). Women with DM1 in comparison with healthy women were older, had higher BMI, weight, and had more pack-years of cigarette smoking. Women with DM1 had lower results in FSFI and more often achieved scores below the clinical cutoff point. In a multiple linear regression model, the presence of diabetes predicted lower FSFI results. DM1 is independently associated with the presence of impaired sexual function. Sexual dysfunctions are more common among young women with DM1 than in healthy controls. The relationship is significant despite of the age, duration of diabetes, body weight, and presence of angiopathy.

Intraoperative monitoring of pelvic autonomic nerves during laparoscopic low anterior resection of rectal cancer

BackgroundSome patients with low rectal cancer experience anorectal and urogenital dysfunctions after surgery, which can influence the long-term quality of life. In this study, we aimed to protect nerve function in such scenarios by performing intraoperative monitoring of pelvic autonomic nerves (IMPAN).Patients and methodsWe retrospectively investigated a series of 87 patients undergoing laparoscopic low anterior resection of rectal cancer. Nerve-sparing was evaluated both visually and electrophysiologically. IMPAN was performed by stimulating the pelvic autonomic nerves under processed electromyography of the internal anal sphincter. Urination, defecation, sexual function, and the quality of life were evaluated using validated and standardized questionnaires preoperatively and at follow-up, 12 months after surgery.ResultsAmong a total of 87 patients (53 male and 34 female patients), IMPAN with simultaneous electromyography of the internal anal sphincter was performed in 58 (66.7%) patients. Bilateral positive IMPAN results for both measurements, indicating successfully confirmed pelvic autonomic nerve preservation, were obtained in 45 (51.7%) patients. No significant difference was found in terms of urogenital and anorectal functions between preoperative and postoperative patients with bilateral positive IMPAN (P>0.05). Compared to preoperative patients with IMPAN (unilateral) or without IMPAN, these patients exhibited higher International Prostate Symptom Score, a lower International Index of Erectile Function-5, and a lower Female Sexual Function Index score at 12 months postoperatively (P<0.05).ConclusionIMPAN is an appropriate method with which to laparoscopically protect nerve function.

Frequency and Correlates of Sexual Dysfunction among Women Attending Outpatient Gynecological Clinics

Background and purpose: Female sexual dysfunction (FSD) is a high-frequent multifactorial problem and may have a major effect on the quality of life. This study was conducted to investigate frequency of female sexual dysfunction and its correlated factors in women attending outpatient gynecological clinics.Methods: A total of 300 married women attending four gynecological outpatient clinics in Rasht, Iran were assessed. Sexual function was evaluated through Female Sexual Function Index (FSFI) questionnaire. Demographic characteristics, obstetric and surgical history, some medical conditions and body mass index (BMI), life style variants, knowledge about sexuality, and help-seeking behavior were assessed by a self-created questionnaire. Statistical analysis included Fisher exact test Chi-square and Spearman’s correlation coefficients.Results: 76.67% of all women in this study reported sexual dysfunction in at least one domain. The total frequency of FSD according to the low total FSFI score was 18.3%. The most frequent dysfunction was desire disorders (63.7%). The frequencies of other sexual disorders were as follows: pain disorders (35.7%), arousal disorders (34.7%), orgasmic disorders (16%), lubrication disorders (10.7%), and satisfaction disorders (10.7%). Age, number of deliveries, number of children, number of abortions, menopause, mode of delivery, episiotomy, anemia, psychiatric disease, psychotropic medication use, poor sexual knowledge, and husband’s age showed a significant statistical correlation with low total FSFI score. Women who thought they had a sexual problem involved 15.3% of all subjects, of which 67.4% have had no professional consultation about it.Conclusion: FSD is highly frequent in women referred to gynecological clinics. Thus, more attention to the state of women’s sexual health is recommended.