Lower Frequency Of Sexual Intercourse Research Articles

The Effect of Frequency of Sexual Intercourse on Symptoms in Women with Fibromyalgia.

Fibromyalgia is known to affect sexual function, but the effect of frequency of sexual intercourse on fibromyalgia symptom severity is unclear. This study investigated how frequently women with fibromyalgia engaged in sexual activity affected how severe the disease was. The depression status of the participants was evaluated with the Beck Depression Inventory (BDI) and the mean monthly frequency of sexual intercourse in the last 3 months was noted. Pain levels of fibromyalgia patients were evaluated with Visual Analog Scale (VAS), pain prevalence Widespread Pain Index (WPI), symptom level Symptom Severity Scale (SSS), and fibromyalgia exposure status with Fibromyalgia Impact Questionnaire (FIQ). A hundred women with fibromyalgia with a mean age of 37.11±6.2 years and 100 healthy female controls with a mean age of 36.53 ± 5.85 years participated in the study. Female patients with fibromyalgia had higher BDI and VAS scores and lower frequency of sexual intercourse (p<0.001). While no significant relationship was observed between the frequency of sexual intercourse and VAS, FIQ, SSS and WPI scores, it was found that BDI was lower in those with an average monthly frequency of 8 or more sexual intercourses (p=0.02). This study revealed that the frequency of sexual intercourse is low in female patients with FM and that depression is less common in women with FM who have a higher frequency of sexual intercourse.

Association between sexual frequency and all-cause mortality in young and middle-aged patients with hypertension: a cohort study of patient data from the National Health and Nutrition Examination Survey 2005-2014.

Sexual activity appears to have protective effects on overall and cardiovascular health. We hypothesized that decreased sexual frequency would be an early predictor of all-cause mortality in young and middle-aged patients (20 to 59years old) with hypertension. A total of 4565 patients with hypertension (55.6% men; mean [SD] age 40.60 [10.81]years) who had completed a sexual behavior questionnaire were enrolled from the National Health and Nutrition Examination Survey of 2005 to 2014. Cox proportional hazards models and Kaplan-Meier survival curves were used to evaluate the relationship between sexual frequency and all-cause mortality. The outcome measure for this study is the relationship between sexual frequency and all-cause mortality in young and middle-aged patients with hypertension. During the 68-month median follow-up period, 109 (2.39%) patients died from any cause. After full adjustment for potential confounders, sexual frequency was an independent predictive factor for all-cause mortality in young and middle-aged patients with hypertension. A marital status difference was identified in the subgroup analysis: among patients with a sexual frequency of <12 times/year, only married patients had higher risks of all-cause mortality than the 12-51 times/year group (HR, 0.476, 95% CI, 0.235-0.963, P < .05) and > 51 (HR, 0.452, 95% CI, 0.213-0.961, P < .05) times/year groups. The association of sexual frequency and all-cause mortality was nonlinear. Increased frequency of sexual activity may have protective effects on overall health and quality of life in patients with hypertension. To our knowledge this is the first observational investigation performed to evaluate the correlation between sexual frequency and all-cause mortality in patients with hypertension. A limitation of the study is that the participants in our analysis were between the ages of 20 and 59 years, and this patient sample may not reflect possible outcomes for patients of other age groups. The association between lower frequency of sexual intercourse and greater all-cause mortality was significant in young and middle-aged patients with hypertension in the United States.

Sexual dysfunction among six months postpartum women in north-eastern Malaysia.

Female sexual dysfunction (FSD) is a common problem among postpartum women. However, little is known about this topic in Malaysia. This study aimed to determine the prevalence of sexual dysfunction and its associated factors in postpartum women in Kelantan, Malaysia. In this cross-sectional study, we recruited 452 sexually active women at six months postpartum from four primary care clinics in Kota Bharu, Kelantan, Malaysia. The participants were asked to fill in questionnaires consisting of sociodemographic information and the Malay Version of the Female Sexual Function Index-6. The data were analyzed using bivariate and multivariate logistic regression analyses. With a 95% response rate, the prevalence of sexual dysfunction among sexually active, six months postpartum women was 52.4% (n = 225). FSD was significantly associated with the older husband's age (p = 0.034) and lower frequency of sexual intercourse (p<0.001). Therefore, the prevalence of postpartum sexual dysfunction in women is relatively high in Kota Bharu, Kelantan, Malaysia. Efforts should be made to raise awareness among healthcare providers about screening for FSD in postpartum women and for their counseling and early treatment.

Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia.

This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents' ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (0R=16.60, 95% CI=2.54-108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (0R=0.13, 95% CI=0.08-0.24). Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.

Sexual Dysfunction in Postmenopausal Women

Nowadays, women have a longer menopausal duration due to the worldwide dramatic life expectancy increase. Sexual dysfunction is one of the most prevalent problems during menopause that affect women`s quality of life, mental health, and interpersonal relationship. This study aimed to investigate sexual dysfunction and its contributing factors amongst married postmenopausal women. This cross-sectional study was conducted among 164 postmenopausal women who attended the menopause clinic of the academic hospitals in Mashhad during 2017-2018. Data were collected using a checklist that included demographic and reproductive information and the validated Persian version of the Female Sexual Function Index questionnaire (FSFI). The mean age of participants was 53.55±6.25 years. The mean FSFI score was 20.06±6.66, and 65.2% of women had sexual dysfunction. The most disturbed sexual domains were; desire (86%, n: 141), arousal (82.3%, n: 135), lubrication (71.3%, n: 117) and sexual satisfaction (70.1%, n: 115), respectively. The partner`s age (P=0.01), time since menopause onset (P=0.01), age at marriage (P=0.02), and frequency of sexual intercourse (P˂0.0001) had a significant relationship with sexual function. The sexual function of postmenopausal women in this study was highly deteriorated. The associated factors were; older age of the spouse, younger age at marriage, longer time since menopause onset, and lower frequency of sexual intercourse. It is important to determine perimenopausal women who are at potential risk of sexual dysfunction and consult them for preventive programs and strategies.

Sexual Activity in Older Adults with Visual Impairment: Findings from the English Longitudinal Study of Ageing

Sexual activity is a central component of intimate relationships and has been shown to have numerous benefits for health and wellbeing. Studies have shown that people with disabilities often report less satisfaction with their sex lives, but none have examined the levels of sexual activity in older adults with visual problems. We investigated associations between self-rated eyesight and sexual activity in a population-based sample of older adults. Analyses were conducted using data from 2587 men and 3238 women participating in the English Longitudinal Study of Ageing. Participants provided information on self-rated eyesight in three domains: overall, at distance, and up close (categorised as: excellent/very good/good/fair–poor), sexual activity (any vs. none in the last year), and frequency of sexual intercourse in the last month (not at all, once, 2–3 times, once a week or more) among those who were sexually active. Associations between self-rated eyesight and sexual activity were examined using adjusted logistic regression. Relative to excellent self-rated eyesight, fair–poor eyesight was consistently associated with significantly lower odds of being sexually active in men (overall eyesight OR 0.41, 95% CI 0.26–0.64, p < 0.001) but not in women (overall eyesight OR = 0.99, 95% CI 0.70–1.41, p = 0.959). However, among women who were sexually active, there was some evidence that fair–poor eyesight was associated with lower frequency of sexual intercourse in the last month (e.g. fair–poor eyesight at distance OR = 0.45, 95% CI 0.31–0.66, p < 0.001). No association between self-rated eyesight and frequency of sexual intercourse was observed for men. Identifying ways to help older patients with impaired vision achieve a more active sex life could help to improve the health and wellbeing of this population group. Visual impairment is associated with lower prevalence of any sexual activity in older men, and lower frequency of sexual intercourse in older women.

Behçet ve Ailevi Akdeniz Ateşi Hastaliği Olan Çiftlerde Evlilik Doyumu

Evlilik doyumu, bireyin evlilik ilişkisindeki gereksinimlerini, taleplerini karşılama derecesine yönelik algısıdır. Evlilik ilişkisinde yaşanan krizler doyumu etkilemektedir. Kriz yaratabilen faktörlerden biri de hastalıklardır. Bu doğrultuda çalışmanın amacı, Behçet ile Ailevi Akdeniz Ateşi hastası olan çiftlerin evlilik doyumunun irdelenmesidir. Yöntem: Araştırma, tarama modelinde kesitsel bir saha çalışmasıdır. Araştırmanın çalışma grubunu, Behçet ve Ailevi Akdeniz Ateşi hastalığı tanısı alan 68 çift oluşturmuştur. Veri toplamak amacıyla soru kâğıdı ile Golombok-Rust Evlilik Durumu Envanteri kullanılmıştır. Soru kâğıdının birinci bölümünde, sosyo-demografik özelliklere ve hastalığa dair bilgiler sorulmuştur. İkinci bölümdeyse, hastalık sonrasında aile ilişkileri ve sosyal çevreyle ilişkilerin değişimini belirlemek için üçlü Likert tipinde yanıtlanabilecek 13 soru bulunmaktadır. Çalışmada veriler, 1 Şubat 2017- 1 Haziran 2017 tarihleri arasında elde edilmiş ve SPSS programında analiz edilmiştir. Bulgular: Araştırma bulgularına göre, katılımcıların tümü resmi nikâhla evli olup, %69,1’inin isteyerek evlendiği ve %89,7’sinin çocuğunun olduğu belirlenmiştir. Katılımcıların %33,1’i Ailevi Akdeniz Ateşi Hastalığı, %16,9’u Behçet Hastasıdır. %13,2’si hastalık sonrası aile üyeleriyle önemli konuları paylaşmanın azaldığını, %12,5’i aile üyelerine küçük düşürücü söz söyleme davranışlarının arttığını, %17,6’sı aile üyelerinin birbirlerine desteğinin azaldığını, %18,4’ü aile üyeleri arasında kırgınlığın arttığını ve %59,6’sı cinsel ilişki sıklığının azaldığını ifade etmiştir. Ölçek puanlamasında, katılımcıların %4,4’ü tanımsız, % 14’ü çok iyi ve %11’i iyi, %6,6’sı vasat üstü, %20,6’sı vasat ve %8,1’i zayıf puan aralığında yer almıştır. Sonuç: Sonuç olarak, Behçet ve Ailevi Akdeniz Ateşi hastalığı evlilik doyumu üzerinde etki yaratmaktadır ve bu hastalığı olan çiftlere aile danışmanlığı, psikoeğitim ve cinsel danışmanlık hizmetlerinden faydalanmaları önerilebilir.

Effect of Stress Urinary Incontinence on the Sexual Function of Couples and the Quality of Life of Patients

Studies of the effects of stress urinary incontinence on the sexual function of couples are scarce. We prospectively evaluated couple sexual function and the relationship between sexual function and quality of life. We also compared quality of life in females with vs without stress urinary incontinence. Sexually active females at least 21 years old with or without stress urinary incontinence and their partners were recruited for study. To assess sexual function the couples completed GRISS (Golombok Rust Inventory of Sexual Satisfaction) and a 1-item question on overall sexual experience, "Over the past 4 weeks, how satisfied have you been with your overall sexual life?" Additionally, females completed ICIQ-LUTSqol (International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life) to assess quality of life. For sexual function assessment 66 of 134 couples with (49.3%) and 95 of 176 without (54.0%) stress urinary incontinence were recruited. Females with stress urinary incontinence had lower overall sexual function, lower frequency of sexual intercourse, less satisfaction (each p <0.001) and higher avoidance behavior (p = 0.026). Partners of females with stress urinary incontinence had more problems with erectile dysfunction (p = 0.027), less satisfaction (p = 0.006) and lower frequency of sexual intercourse (p = 0.001) but no difference in overall GRISS score (p = 0.093). Couples with stress urinary incontinence had poorer overall sexual experience (p <0.05). Females with stress urinary incontinence had poorer quality of life than those without stress urinary incontinence (120 of 134, response rate 89.6% vs 145 of 176, response rate 82.4%, p <0.001). Sexual function and quality of life did not significantly correlate (r = 0.001, p = 0.997). Stress urinary incontinence in females is negatively associated not only with female quality of life and sexual function but also with partner sexual function.

Risk factors for bacterial vaginosis: results from a cross-sectional study having a sample of 53,652 women.

The aim of this study was to estimate the risk factors of bacterial vaginosis (BV) among rural married women of childbearing age in Anhui Province of China. A cross-sectional study was conducted and the method of stratified cluster sampling was used to identify a sample of 53,652 married women aged 18-49 years. All women were asked to complete an interviewer-administered standardized questionnaire, covering sociodemographic characteristics, history of menstruation, marriage and procreation, sexual life, personal hygienic behaviors, and reproductive tract infections (RTIs) knowledge, followed by the gynecological examination and laboratory inspection. A total of 53,286 married women aged 18-49 years were included in this analysis. The prevalence of BV was 11.99 % (6,391/53,286). Risk factors for BV included the minority nationality, women's lower education levels, husband's elder age, over 35 days of menstrual cycle, less than 3 days of menstruation, dysmenorrhea, usage of an intrauterine device (IUD), lack of RTIs knowledge, higher frequency of washing genitals before having sex with husband and changing underwear, lower frequency of sexual intercourse per month, and suffering from other RTIs. The results suggest that BV can be affected by many factors among rural married women of reproductive age, so comprehensive, scheduled programs at healthcare educations should be provided for women in order to prevent BV.

Sexual desire disorder in female healthcare personnel in Malaysia

The aim of this study was to determine the prevalence and risk factors for female sexual desire disorder (FSDD) among healthcare personnel at selected healthcare facilities in Malaysia. Two hundred and one female healthcare workers from three large tertiary hospitals were selected by stratified random sampling to participate in this cross-sectional study. Validated questionnaires were used to assess depression, anxiety, and sexual function in women and erectile dysfunction (ED) in their partners. The prevalence of FSDD was 18.9%. Women with low sexual desire were more likely to have higher educational attainment (OR = 3.06; 95% CI; 1.22-7.66), lower frequency of sexual intercourse (OR = 12.81; 95% CI; 4.43-37.83), two or more children (OR = 3.05; 95% CI; 1.02-9.09), duration of marriage of 20 years or more (OR = 2.62; 95% CI; 1.27-5.40), and a spouse with ED (OR = 2.86; 95% CI; 1.08-7.56). FSDD is common among female healthcare personnel in Malaysia, affecting nearly one in five women. The implication of low sexual desire is important in terms of contributing to a meaningful sexual relationship, and indirectly affects the quality of life of the healthcare personnel.

Prevalence and risk factors of female sexual dysfunction among healthcare personnel in malaysia

ObjectiveTo determine the prevalence and risk factors of female sexual dysfunction (FSD) among healthcare personnel in selected healthcare facilities in Malaysia. MethodsThis was a cross-sectional study carried out at three large healthcare facilities that were selected by convenience sampling. Within each facility, stratified random sampling was used to select suitable candidates to participate in the study (n=201). Validated questionnaires were used to assess depression, anxiety, sexual function in women and erectile dysfunction (ED) in their partners. ResultsThe prevalence of FSD was 5.5%. Women with sexual dysfunction were more likely to be married longer (OR=4.08; 95% CI; 1.15–4.50), had lower frequency of sexual intercourse (OR=5.00; 95% C; 1.05–23.76) and had a spouse with ED (OR=24.35; 95% CI; 4.55–130.37). Multivariate analysis showed that ED was the strongest predictor for FSD (AOR=27.30; 95% CI; 4.706–159.08). ConclusionOne in eighteen female healthcare personnel suffered from FSD and presence of ED in the partner strongly impacted her sexual function, negatively. The findings highlight the importance of including the male partner in clinical assessment of FSD.

The Effects of Fibromyalgia Syndrome on Female Sexuality: A Controlled Study

Fibromyalgia may have negative effects on sexual function in women. To evaluate the sexuality of women with fibromyalgia and healthy control subjects, and to investigate the relation between sexuality and clinical parameters of fibromyalgia. Female Sexual Function Index (FSFI), Tender Points Count (TPC), Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire (FIQ), and Visual Analog Scale (VAS). Clinical evaluation and surveys were done with 126 women with fibromyalgia and 132 healthy women. Patients with fibromyalgia had higher BDI scores and lower frequency of sexual intercourse than control subjects. The mean FSFI scores (total and all domains) were significantly lower in patients with fibromyalgia than control subjects. Mean FSFI scores (total and most domains) were significantly lower in patients with fibromyalgia who had BDI score≥17 than those who had BDI score<17. In women with fibromyalgia, a significant negative correlation was noted between total FSFI score, and both FIQ and BDI scores. Fibromyalgia has negative effects on female sexual function that are aggravated by depression.

The Prevalence and Associated Factors of Female Sexual Dysfunction in Korean Premenopausal Women: A Community-Based Study

=A bstract = Purpose: To estimate the prevalence of and factors associated with female sexual dysfunction (FSD) in Korean women. Materials and Methods: A total of 629 married women in the Chonnam and Gwangju area were randomly included in this study. They were asked to complete a questionnaire on FSD, which consisted of the Female Sexual Function Index (FSFI), as well as psychological, physiological, and demographic factors. Results: The mean age of the women was 36.97 years and the mean FSFI score was 25.56 out of a total score of 36. Based on the total FSFI score, 42.9% of the women had scores less than the cut-off point of 25, the assessed definition of FSD. The prevalence of FSD by age group was: 31.3% for 20 ∼29 year olds, 41.6% for 30∼39 year olds, and 51.8% for 40∼49 year olds. A stepwise regression analysis found that women with higher levels of sexual distress, lower frequency of sexual intercourse, lower levels of life satisfaction, a less important appraisal of sex, a higher likelihood of depression, more conservative attitude toward sex, irregular menstrual cycle, higher age, chronic disease, and a smoking habit were more likely to suffer from FSD. Conclusions: The prevalence of FSD in Korean women was common and comparable to those reported worldwide. Sexual distress, frequency of sexual intercourse, and life satisfaction were important associated factors of FSD.

Stigma, discrimination, and sexual (dis)satisfaction among people living with HIV: results from the “AIDES et toi” survey

The effects of HIV-related stigma and discrimination have been studied in several areas, such as access to testing, quality of care quality, and access to work. Nevertheless, the effects of stigma and discrimination on the sexual life of people living with HIV/AIDS (PLWHA) have not been studied enough. AIDES, a French community-based organization, has developed a biannual survey which assesses several socioeconomical and psychosocial dimensions of the people in contact with this organization. A focus on the results concerning sexual (dis)satisfaction and the factors associated are presented here. A convenience sample of 521 HIV-positive men having sex with men, heterosexual men and women was analyzed. A logistic regression was performed to examine which factors were significantly associated with sexual dissatisfaction. Results showed that being older, not having a full-time job, not having a steady sexual partner, lower frequency of sexual intercourse, discrimination in the sexual relationship setting, and the perception of loneliness were independently associated with sexual dissatisfaction. A quality health approach must include the aspects linked to sexual life and sexual satisfaction. Given the potentially harmful effects that HIV-related stigma and discrimination have on PLWHA's well-being, more specific actions and advocacy in this direction should be developed and implemented.

Impact of diabetes mellitus on the sexuality of Peruvian postmenopausal

Aim. To evaluate sexual function among postmenopausal diabetic women.Patients and methods. A total of 72 postmenopausal women, 36 diabetic, with a stable partner were included in this study. Sexual functioning was assessed using the Female Sexual Functioning Index (FSFI) and depression using the Beck Depression Inventory scale.Results. There was no difference between diabetic and control women regarding age, years of schooling, number of children, age at menarche, age at first sexual experience, years postmenopausal or body mass index. Diabetics had a worse score for depression (11.5 ± 5.6 vs. 8.9 ± 4.7, p < 0.03), a lower frequency of sexual intercourse per month (2.7 ± 2.8 vs. 4.4 ± 2.9, p < 0.01) and a more deteriorated marital relationship (scale of 0–20: 13.4 ± 2.9 vs. 15.1 ± 1.9, p < 0.009). Diabetics demonstrated worse scores globally (19.3 ± 8.1 vs. 26.8 ± 4.5, p < 0.0001) and in all domains of the FSFI: desire (2.6 ± 1.4 vs. 3.8 ± 1.1, p < 0.0001), arousal (3.5 ± 1.9 vs. 4.7 ± 0.8, p < 0.002), lubrication (3.2 ± 1.9 vs. 4.5 ± 1.3, p < 0.003), orgasm (3.2 ± 1.8 vs. 4.5 ± 1.1, p < 0.002), satisfaction (3.8 ± 1.3 vs. 4.8 ± 0.9, p < 0.0005) and pain (3.1 ± 1.7 vs. 4.6 ± 1.3, p < 0.0001) (values all mean ± standard deviation). Considering sexual dysfunction as a score higher than 26.55, the prevalence of sexual dysfunction among diabetics was 75.0% vs. 30.6% in the control group (p < 0.001). After adjusting for depression, years of schooling, hysterectomy, marital relationship and age, diabetes mellitus remained an important risk factor for sexual dysfunction (odds ratio 6.2, 95% confidence interval 2.0–19.6, p < 0.02).Conclusion. Diabetes mellitus affects all areas of female sexuality and this condition is independent of depression.

Fear of Sexual Intercourse in Patients with Coronary Artery Disease: A Pilot Study of Associated Morbidity

Sexual fear is a known cause for avoidance of intercourse, especially in patients with chronic conditions. Given the significant impact of fear of intercourse on the quality of life, we herein report our pilot results regarding the differences in the demographic, clinical, marital, and psychological characteristics of coronary artery disease (CAD) patients with and without sexual fear. In this cross-sectional study conducted in Baqyiatallah Hospital, Tehran, Iran, in 2006, 87 married CAD patients were assessed for the presence of sexual fear. Subjects with and without sexual fear were compared for demographic and clinical data as well as for Hospital Anxiety and Depression Scale (HADS) and Revised-Dyadic Adjustment Scale (R-DAS) scores. Demographic and clinical data, sexual fear (Relationship and Sexuality Scale), symptoms of anxiety and depression (HADS), and marital relation quality (R-DAS). Twenty-nine subjects were reported to have some degrees of fear of sexual intercourse and a lower frequency of sexual intercourse. Age, socioeconomic status, education level, tobacco smoking, and history of myocardial infarction were significantly different between those with and the ones without sexual fear. Body mass index, extent of coronary involvement, chronic obstructive pulmonary disease, hypertension, stroke, hyperlipidemia, history of diabetes, and the use of beta-blockers were not statistically different in the two groups. The subjects with sexual fear reported higher HADS depressive and R-DAS scores but not higher HADS anxiety scores. Among different nonmodifiable and modifiable correlates of fear of sexual intercourse in CAD patients, marital relationship and depressive symptoms should be highlighted in future interventional studies with the aim of allaying such fears.

Reproductive effects of male psychologic stress.

Male psychologic stress can affect semen quality and couple fecundability. We conducted a prospective study of 430 Danish couples who were trying to become pregnant for the first time. In each menstrual cycle, both partners filled out a 12-item version of the General Health Questionnaire (GHQ-12), an assessment of psychologic stress. A blood sample was drawn from both partners. The men collected a semen sample at enrollment and each month during follow up. Semen quality was not related to the man's GHQ score in either within-subject analyses or between-subject analyses. There were no consistent associations between stress and serum concentration of luteinizing hormone, follicle-stimulating hormone, inhibin B, testosterone, or estradiol. The pregnancy rate was 14% in cycles with an absolute GHQ-12 score in the highest quartile, compared with 18% in low-stress cycles. Odds of pregnancy decreased moderately with increasing score. The effect was confined to 77 men with a sperm density below 20 million/mL (adjusted odds ratio = 0.06; 95% confidence interval = 1.01-0.58 for highest distressed quartile vs. lowest distressed quartile in this low sperm density group). In within-subject analyses, cycle-specific changes in male stress did not change the odds of pregnancy. High absolute score was associated with a lower frequency of sexual intercourse, but adjustment for frequency had little effect. The effect of a man's daily life psychologic stress on his semen quality is small or nonexistent. Our results indicate an effect of stress only on fecundability, and this only among men with low sperm concentration.

Psychosocial and sexual functioning in women with Turner syndrome.

Survey data on the sexual and social functioning of 80 adult women with Turner syndrome are described, as well as data regarding health status and self-concept. Each woman completed the Tennessee Self-Concept Scale, sections of the Derogatis Sexual Functioning Inventory, and a questionnaire covering a wide range of demographic and medical information. The women with Turner syndrome reported lower self-concept compared to a normative sample. Sexual attitudes, gender role identity, and body image were assessed. The women with Turner syndrome tended to exhibit more conservative sexual attitudes and a more negative body image. In contrast to a normative sample, the women with Turner syndrome were less likely to have been sexually active. In addition, those currently involved in a stable relationship reported a lower frequency of sexual intercourse compared to a normative sample, although they generally reported moderate to high levels of sexual satisfaction. Regression analyses revealed that health status was associated with self-concept, and that sexual satisfaction was related to both a higher frequency of intercourse and a higher self-reported health status.

Fertility in Adolescent Women Previously Treated for Genitourinary Chlamydial Infection

496 women participating in a longitudinal study of chlamydial infection were separated into groups for analysis; 1) more than one documented chlamydial infection (68 women); 2) a single infection and at least one follow-up negative genital culture (109 women); and 3) at least two visits to one of the clinics with cultures obtained and no positive culture (319 women). Pregnancy during the follow-up period was ascertained using self-report during a telephone survey that contained questions about sexual activity contraception interim sexually transmitted disease pregnancy and live births. 104 (37.0%) women responded to the phone survey. The racial composition of the three groups did differ significantly (p = 0.014) with a lesser proportion of White women in the group with multiple infections (20.8%) than in the single-infection (33.7%) or no-documented-infection (42.8%) groups. The proportion of women who had been pregnant at least once during the follow-up period differed among the three groups (p = 0.029). The overall proportion of women with a documented pregnancy was 47.4%. In the year before the survey the single-infection group had a lower frequency of sexual intercourse than the other two groups (p = 0.049). Condom use at least 75% of the time was reported by 15-20% of the women in all three groups in the 6 months before the survey. During the previous year fewer members of the group without a positive culture used contraceptives than the other two groups (p = 0.02; no positive culture 51.6%; single infection 71.4%; multiple infections 84.2%). Those who did not become pregnant were more likely to use oral contraceptives 7-18 months before the survey (75.8%) than those who were pregnant during the follow-up period (54.9% p = 0.042). Five of the women appeared at the emergency room with pelvic inflammatory disease three from the uninfected group and two from the single-infection group. In addition two other women had emergency room diagnoses of ectopic pregnancy (both from the single-infection group).

Man-to-woman sexual transmission of the human immunodeficiency virus. Risk factors related to sexual behavior, man's infectiousness, and woman's susceptibility. Italian Study Group on HIV Heterosexual Transmission

To investigate the risk factors for man-to-woman sexual transmission of the human immunodeficiency virus (HIV), we carried out a cross-sectional study of 368 women who were steady partners of HIV-infected men attending 16 Italian clinical centers. Information was collected from the medical records of the infected men and by direct interviews with the women. In a logistic regression analysis, the woman's awareness of her partner's seropositivity (odds ratio [OR], 0.2; 95% confidence interval [CI], 0.0 to 1.1), use of condoms (OR, 0.3; 95% CI, 0.1 to 1), and oral contraceptive use (OR, 0.5; 95% CI, 0.3 to 1.0) were negatively associated with transmission of the HIV infection. An increased risk was found in women having sexual intercourse more than twice a week (OR, 2.4; 95% CI, 1.2 to 4.9) and in women who had been sexually exposed to HIV for between 2 and 5 years (OR, 3.5; 95% CI, 1.8 to 6.7). The transmission rate was higher in couples who engaged in anal sex (OR, 2.8; 95% CI, 1.3 to 6.3); in women reporting vaginitis (OR, 4.9; 95% CI, 2.4 to 10.2) or genital warts (OR, 33.3; 95% CI, 4.5 to 244.1); and in those using intrauterine devices (OR, 3.1; 95% CI, 1.4 to 7.1). The risk for women was also associated with a CD4+ cell count lower than 400/mm3 in their partners. Knowledge of the HIV status of the partner led to increased condom use but did not induce a lower frequency of sexual intercourse or an avoidance of anal sex.