Mean Female Sexual Function Index Score Research Articles

Sexual function after surgically corrected menstrual outflow obstruction due to congenital anomalies

Objectives: To enhance evidence-based knowledge about sexual function and the prevalence of sexual dysfunction after surgical therapy for congenital anomalies with menstrual outflow obstruction. Materials and Methods: In this long-term case-control study, all patients underwent surgical correction of an obstructive Müllerian anomaly between 1980 and 2013. At the start of the case-control study, patients were at least 18 years old and were two years post their initial operation. The control group were women without current gynaecological problems. 38 patients (response rate 48.7%) and 54 controls were included. Chi-square test linear-by-linear Association, Fisher’s Exact Test, Mann-Whitney U test and the unpaired sample t-test were used for statistical analysis. Main outcome measures: The following questionnaires were used: the Female Sexual Function Index (FSFI), the Body Exposure during Sexual Activities Questionnaire (BESAQ), and the Endometriosis Health Profile Questionnaire (EHP-30). Results: The mean FSFI score in patients was 27.8 (SD5.4) versus 27.4 (SD6.8) in controls (p=0.858). A total FSFI score ≥26.55, indicating no sexual dysfunction was present in 70.6% of patients and 69.2% of controls (p=1.000). The mean BESAQ score in patients was 30.4 (18.5), compared to 38.3 (SD21.4) in controls (p=0.261), where lower scores denote better body image during intimate sessions. In the EHP-30, a statistically significant difference between patients and controls was found in all items on sexual intercourse. The subscale score of patients was 31.1 (SD26.2) versus 7.0 (SD11.1) in controls (p=<0.001), indicating better sexual functioning in controls. What is new? The study showed that a history of menstrual outflow obstruction had a negative influence on several domains of sexual function, yet the patients total scores on sexual function remained in the normal range. The FSFI score of patients’ post-surgical treatment of obstructive congenital anomalies is similar to the control group.

Davydov-Moore vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome: sexual and surgical outcomes.

The aim of this study was to compare surgical and sexual outcomes after Davidov-Moore vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKH). In the case-series study, we described seven women, at a median age of 22.6 ± and BMI 22.8 ± 2.3kg/m2. We measured peri- and postsurgical parameters, including surgery-related neovaginal length and sexual initiation time. Sexual outcomes were measured using the Female Sexual Function Index (FSFI) before and 6months after vaginoplasty. All surgical procedures were performed successfully, with one minor perioperative bleeding. The mean time of vaginoplasty was 82.1min and the mean duration of hospitalization was six days. After a 6-month follow-up, vaginal length was 8.1-times longer than before surgery (10 vs. 81mm). The time from the surgery to the initiation of vaginal intercourse was between 17 to 22weeks. The mean FSFI score indicated good results, with no women below 23 score, and was 4.3- times higher when compared with the pre-surgical one (6.7 vs 29.1). Contrary to the FSFI score before surgery, the post-surgical FSFI revealed higher scores in all six different domains: desire (2.5-times), arousal (4.1-times), lubrication (3.8-times), orgasm (3.4-times), satisfaction (3.3-times) and comfort (11-times). Laparoscopic Davydov-Moore vaginoplasty might be considered as a safe procedure with satisfactory anatomic and sexual outcomes. It should be considered as a treatment option for the creation of neovagina in women with MRKH.

Comparison of Sexual Function, Satisfaction, and Assertiveness in Genital Cosmetic Surgery Groups: A Randomized-Sampling Cross-Sectional Study.

Sexual dissatisfaction is one of the main motivations for seeking female genital cosmetic surgery (FGCS), though the outcomes of such surgeries are controversial. Evaluation of the sexual function, satisfaction, and assertiveness in FGCS groups. From five clinical centers in Tehran, Iran, 200 women in the study group (women seeking or had undergone labiaplasty (LP), women seeking or had undergone multi-procedure (MP) of FGCS simultaneously) and the control group were randomly selected. Participants completed the Female Sexual Function Index (FSFI), the Global Measure of Sexual Satisfaction (GMSEX), and the Hurlbert Index of Sexual Assertiveness (HISA). The groups were compared using the Chi-square, one-way ANOVA with post hoc analysis. In women seeking LP, the mean FSFI, GMSEX, and HISA score was lower than that of women who had undergone LP (FSFI: 18.41 vs 21.36, p =0.04, GMSEX: 20.36 vs 28.03 p <0.001, HISA: 49.7 vs 62.5 p <0.001). Our finding showed as well that women seeking MP also had lower mean FSFI, GMSEX, and HISA scorecompared to women had undergone MP (FSFI: 23.02 vs 18.02, p <0.001, GMSEX: 19.63 vs 28.94 p <0.001, HISA: 45.72 vs 60.62 p <0.001). Women who had completed FGCS experienced better sexual function, satisfaction, and assertiveness compared with women seeking surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Sexual function of overweight pregnant women with gestational diabetes mellitus: A cross-sectional study.

Overweight and obesity are on the rise worldwide and may affect female sexual function. The aim of this study was to investigate the relationship between sexual function in normal and overweight pregnant women with gestational diabetes mellitus (GDM). This cross-sectional study was conducted in overweight and normal-weight pregnant women with GDM in Sari, Iran. Data were collected from 2018 to 2021. The demographic data collected from the participants included age, educational level, occupation, gestational age, duration of marriage, number of births, place of residence (city or village), private house, private bedroom, and insurance status. The General Health Questionnaire, Female Sexual Function Index (FSFI), and Enriched Marital Satisfaction questionnaires were used to assess mental health, sexual functioning, and marital satisfaction, respectively. The study included 200 women with GDM. The mean age of the participants was 29.75 (SD = 4.40) years. Among pregnant women with GDM, 56.50% of them had sexual dysfunction based on FSFI. The mean FSFI score in pregnant women with GDM was 25.60 (SD = 3.61). Among the participants, 50.00% had normal body mass index (BMI). There was no significant difference between BMI status and total sexual function score (p > 0.05). The multivariate analysis revealed that marital satisfaction (β = 0.41, p < 0.001) and BMI status (β = -0.15, p = 0.002) were the only factors significantly associated with overall sexual function, explaining 27% of the variance in the total FSFI score. The results of this study showed that there was no significant relationship between sexual dysfunction and obesity in GDM. Considering that the research in this area is very limited and the negative effects of obesity and GDM have been confirmed in many areas, including sexual desire disorder, necessary planning should be done to control these factors.

Pubic hair removal methods and associated factors on female sexuality in Fayoum Governorate, Egypt

Background Pubic hair removal (PHR) is a popular practice among women. They remove pubic hair by different methods, usually for visual, esthetic, or psycho-sexual aspects, as being more attractive and feminine to affect their sexual life. Objectives To assess the impact of different methods of PHR on sexual function among sexually active females in Fayoum Governorate, Egypt. And to understand factors affecting the choice of methods used in this grooming practice. Patients and methods This cross-sectional study included 500 sexually active women who completed the study structured questionnaire, which included demographics, reproductive and medical history data, assessment of sexual function in the past 4 weeks using Female Sexual Function Index (FSFI), PHR items, and the Patient Health Questionnaire depression scale-9 in the last 2 weeks. Results Almost all the participants (99.2%) preferred to remove pubic hair, and the most frequently mentioned method is shaving and creams (43.8%). The prevalence of female sexual dysfunction was 50.5% of our participants. There was a significant difference in the mean FSFI scores between different methods of PHR; with laser, users, had higher FSFI scores of arousal, lubrication, and satisfaction domains (P&lt;0.05). Wax or sweet users and laser users were more satisfied with their body image than shaving users. Conclusions Female sexual dysfunction is a widespread problem; it may result in depression and may be affected by the type of method used for PHR. Laser users had better sexual functions than users of other methods.

Evaluating Sexual Health in Women with Multiple Sclerosis: A Study on the Interplay of Disability and Quality of Life.

In the context of evolving perceptions of sexuality, particularly within the realm of health and disability, this study investigates the impact of multiple sclerosis (MS) on female sexual function and quality of life. A quantitative study involving 130 female MS patients aged 35 to 50 was conducted, employing measures such as The Female Sexual Function Index (FSFI), The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and The Fatigue Severity Scale (FSS). Results indicate a significant association between greater sexual dysfunction and poorer quality of sex life, alongside the correlation of increased fatigue with diminished sexual satisfaction. Specifically, the mean FSFI score was 20.8 (SD = 9.36), with 83.8% of participants experiencing severe fatigue (FSS score ≥ 36). Sexual dysfunction demonstrated a strong, negative correlation with all FSFI subscales (p < 0.01). Factors such as education level (p = 0.016), time of diagnosis (p = 0.035), and treatment regimen (p = 0.041) also significantly influenced outcomes. Findings underscore the importance of supportive interventions, including counseling, to enhance the quality of sex life for women with disabilities, particularly those with MS.

(073) SEXUALITY IN WOMEN WITH TRAUMATIC AND NON-TRAUMATIC SPINAL CORD INJURIES: KEY PREDICTORS AND CHARACTERISTICS

Abstract Introduction Female sexual response is influenced by numerous biopsychosocial factors. Spinal cord injuries (SCIs) can significantly impact sexual function, activity, and satisfaction. Understanding the various aspects that contribute to sexual dysfunction and overall sexual satisfaction in women with SCI is crucial for improving patient care and outcomes. Objective The objective of the present study was to identify characteristics of sexual function, satisfaction, and predictive factors of sexual activity among women with SCI of different etiologies. Methods In this cross-sectional study, women over 18 of age with an SCI (traumatic or non-traumatic) with more than one year of evolution were evaluated at an academic referral specialty hospital. Sociodemographic data, including age, marital status, cause of SCI, time since injury or diagnosis, severity of neurological impairment, and self-perceived sexual activity before and after SCI were assessed. Sexual function was evaluated using the Female Sexual Function Index (FSFI) with scores ≤26.55 indicating sexual dysfunction. The NBSS-SF was used to assess bladder management and urinary incontinence. WHOqol-bref Question 21 was used to measure women’s sexual satisfaction regardless of activity level. The study received approval from our hospital’s Research Ethics Committee, and all participants provided informed consent. Results The mean age of 98 participants was 42.5 ± 12.1 years with 42.9% married/stable partner. Among the women, 14 (14.3%) had traumatic SCI while 84 (85.7%) had non-traumatic SCI, with a mean duration of neurological condition of 12.6 ± 8.0 years. Thirty-eight (38.8%) participants were ambulatory without assistance, and 21 (21.4%) were wheelchair-bound. Before SCI, 76 (77.5%) women reported being sexually active, and 48 (48.9%) after SCI (p = 0.005). Table 1 illustrates perceived changes in sexual activity before and after SCI. Mean FSFI score was 22.0 ± 10.1, with 28 (58.3%) classified as having sexual dysfunction (≤ 26.55). The most affected domains were desire, arousal, and orgasm (Fig. 1). Of all 98 women, 65 (66.3%) had spontaneous voiding, and 25 (25.5%) performed self-catheterization. Urinary incontinence was reported by 14 (29.2%) of 48 sexually active women and 37 (74.0%) of 50 inactive ones. Being married increased the chance of sexual activity (OR 12.8 [95% CI 4.8-33.9, p &amp;lt; 0.001], while being older, post-menopausal or having urinary incontinence decreased the chance (OR 0.1 [95% CI 0.1-0.4], p = 0.003 and OR 0.12 [95%CI 0.0– 0.3], p &amp;lt; 0.001, respectively). Thirty-seven (37.7%) women reported being moderately to very satisfied with their overall sexual life, with 29 (78.4%) being sexually active and 8 (21.6%) inactive. Conclusions Sexual activity declined significantly pos-SCI and sexual dysfunction were highly prevalent among those women. Predictors for sexual activity included younger age, pre-menopausal status, being married and urinary continence. Higher level of satisfaction was reported by those who were sexually active. Our results highlight the need to address sexual health and improve quality of life for women with SCI. Disclosure No.

Efficacy of in-office lysis of clitoral adhesions with excision of keratin pearls on clitoral pain and sexual function: a pre-post interventional study.

Keratin pearls are foci of central keratinization within concentric layers of squamous cells that can form under the clitoral prepuce and cause pain (clitorodynia); in-office removal of keratin pearls may reduce clitoral pain and improve sexual function. This study aims to investigate clitoral pain and sexual function in women with partial clitoral phimosis and keratin pearls before and after in-office lysis of clitoral adhesions with keratin pearl excision (LCA-KPE). A pre-post interventional study evaluated patients who underwent LCA-KPE between January 2017 and February 2023 in 2 metropolitan gynecology clinics specializing in vulvar pain. Patients presenting with keratin pearls and partial clitoral phimosis identified through retrospective chart review were asked to complete postprocedure questionnaires and provide subjective responses on clitoral discomfort, sexual function, sexual distress, and their experience with in-office LCA-KPE. Bivariate analyses with paired t tests were conducted to determine the effect of LCA-KPE. Qualitative data were analyzed with thematic coding. An 11-point pain visual analog scale was utilized to determine pre- and postprocedure clitoral discomfort and difficulty with orgasm. Female sexual dysfunction was measured with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised. A total of 32 of 74 patients who met inclusion criteria completed postprocedure surveys (43% response rate). Mean clitoral pain for respondents was 6.91 at baseline and 2.50 after LCA-KPE (P < .001). Mean difficulty with orgasm was significantly decreased from 5.45 at baseline to 3.13 after LCA-KPE (P < .001). Participants had a mean FSFI total score of 17.68 after treatment compared with a mean total baseline FSFI of 12.12 (P = .017). The mean FSFI score for pain was 2.43 at follow-up compared with 1.37 at baseline (P = .049). There was no significant difference in the mean Female Sexual Distress Scale-Revised score before vs after the procedure (P = .27). Qualitative themes described the procedure as painful but worthwhile, with 77% of participants reporting the overall experience as positive. Recurrence rate overall was 28%, with a median of 2 repeat procedures. Recognizing keratin pearls as a structural cause of clitoral pain and offering in-office treatment is an important tool in addressing clitorodynia and improving sexual function. This is the largest study to date documenting the occurrence, identifying associated pain conditions, and evaluating procedural outcomes for clitoral keratin pearls. This study was limited by a relatively small sample size. In-office LCA-KPE significantly reduced clitoral discomfort and difficulty with orgasm.

(181) Female Sexuality During the Menopausal Transition: The Experience of Tunisian women

Abstract Introduction The menopausal transition is a gradual passage from pre-menopause to menopause. It is characterized by hormonal changes that affect a woman's reproductive and sexual health. Understanding the impact of the menopausal transition on sexual functioning is important for providing comprehensive care to these women. Objective Objective: In this study, we aimed to evaluate female sexuality in middle-aged Tunisian women using the female sexual function index (FSFI) Methods This was a descriptive and analytic transversal study, conducted at the Hammam-Lif sexual and reproductive health center over a period of 06 months from February 1st to July 31st, 2022. We included 162 women aged between 40 and 65 years old. We used a validated Arabic version of the Female Sexual Function Index to assess female sexual function. Results The average age of women included in our study was 48.27 years. The majority of questioned women were peri-menopausal, i.e. 40.74%, 35.8% were in pre-menopause and 23.6% were in post-menopause. Moreover, among postmenopausal women, only one patient took hormone replacement therapy. The mean gestity was 3.6 and mean parity was 2.5 in our study population. The majority of women had a gestation greater than or equal to three [0 to 8] and a parity greater than or equal to 2 [0 to 8], i.e. in 80.25% of cases. The mean FSFI score was 18.83 ±7.19, with extremes ranging from 2 to 30.4. The prevalence of sexual dysfunction in our study was as high as 88.9 %. The analysis of our results showed a degradation of the FSFI score from perimenopause to postmenopausal: it went from 21.21±6.4 in pre-menopause, to 18.56±7.33 in perimenopause and 15.65±7.11 in postmenopausal. The difference between the three periods was statistically significant (p=0.030). This decline was statistically significant for three domains namely desire (p=0.033), arousal (p=0.047), and orgasm (p&amp;lt;0.01). Conclusions The prevalence of female sexual dysfunction is quite high and tends to increase with age. The role of healthcare professionals is essential in caring for women and helping them overcome sexual health problems that arise during the menopausal transition period. Disclosure No.

(179) Sexual Dysfunctions in Infertile Tunisian Women

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

The impact of premature ovarian insufficiency on sexual function; which domain is mostly disrupted?

This study aimed to compare the sexual function (SF) and its domains between women with idiopathic premature ovarian insufficiency (POI) and healthy control. A cross-sectional study was conducted on 63 married women with idiopathic POI, referred to the reproductive endocrinology research center (Tehran, Iran), and 784 married women with regular menstrual cycles who visited for routine annual gynecological exams in 2021-2022. The Female Sexual Function Index (FSFI) questionnaire was used to assess the SF of participants. Linear regression and factor analysis were used to analyze the data. Characteristics were similar in both study groups except for body mass index, hip circumference, job status, and number of deliveries. The mean score (standard deviation) of FSFI in women with POI and control were 21.70 (9.0) and 24.30 (5.0), respectively (P < 0.001). All domains' scores of FSFI were significantly lower in POI women than in the control group (P < 0.05). After adjusting for potential confounders, these findings remained unchanged. Factor analysis demonstrated the arousal and lubrication domains as the most influential factors SF among POI women, while the desire domain played the lowest role. In addition to various health conditions threatening POI women's future lives, sexual disturbances must be addressed in their routine care.

Prevalence and associated factors of sexual dysfunction in female hemodialysis patients: first report from Somalia

BackgroundSexual dysfunction is frequent in female hemodialysis patients and is related to poorer quality of life. It is often a neglected topic associated with marked distress and interpersonal difficulties.ObjectiveFew studies are reported from Sub-Saharan African Countries (SSA) regarding female sexual dysfunction (FSD) in (HD) patients. The study aims to explore the prevalence and associated factors of FSD in female HD at a sole dialysis centre in Somalia.MethodOver a one-month period, a cross-sectional study was conducted among women with end-stage renal disease aged 18–50 years who were undergoing a dialysis program for at least three months at the dialysis center of our hospital. The participants were married, and they were living with their partners. Data regarding the sociodemographic features, clinical characteristics, frequency of sexual intercourse per week, and the Female Sexual Function Index (FSFI) scores were collected using a standard face-to-face interview questionnaire.ResultsDuring the study period, a total of 115 participants were eligible for the study’s inclusion criteria. The mean patient age was 38.5 ± 9.3 years. The most common cause of ESRD was diabetes, which accounted for 53%, followed by hypertension (26.1%) and glomerulonephritis (9.6%). The mean duration of dialysis was 2.9 ± 1.4 years, and approximately two-thirds of the participants (62.5%) were in the program for more than three years. Regarding the frequency of sexual intercourse, 61.7% of female participants performed sexual intercourse less than once time/a week. The prevalence of FSD was 92.2% (n = 106) of all participants. The mean FSFI score of the participants was 16.05 ± 4.48. Longer duration of dialysis program (i.e., more than four years), increasing age (i.e., > 35 years), those with diabetes had scored lower overall FSFI scores.ConclusionThe prevalence of female sexual dysfunction among Somali female hemodialysis patients was very high, representing a significant problem in end-stage renal disease (ESRD). Our study findings revealed that increasing age, diabetes, and duration of dialysis negatively impact female sexual function and are significantly associated with FSD.

Adapted Counseling Care Model for Management of Female Sexual Dysfunction Among Women Living With and Without HIV.

Sexual health research among women living with human immunodeficiency virus (HIV) has focused mainly on sexual practices and risk behaviors, with little consideration for treating sexual dysfunction and improving sexual satisfaction. The aim of this pilot study was to assess the effectiveness of an adaptive counseling care model in the management of female sexual dysfunction (FSD) among women living with HIV and without HIV in northern Nigeria. This was a prospective cohort study of 200 women with HIV and a matched comparison arm of 200 women without HIV. Sexual function was assessed using the Female Sexual Function Index (FSFI), with a score ≤ 26.55 indicating FSD. We counseled women with FSD using the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model and evaluated the effectiveness of the model by comparing mean differences in baseline and six weeks post-intervention FSFI scores. The overall prevalence of FSD was 96.8%, with no difference between HIV-positive and HIV-negative participants (p = 0.398). Based on the six domains of the FSFI, the most common reported dysfunctions were sexual pain (21.7%), sexual desire disorder (17.6%), orgasm disorder (17.6%), lubrication disorder (17.2%), sexual arousal (16.9%), and poor sexual satisfaction (9.0%). The overall mean FSFI score (±standard deviation, SD) for those with FSD, in both groups (n = 387) prior to the counseling intervention was 16.05±10.65 (HIV-positive: 18.58±8.46; HIV-negative: 13.98±10.85). At the end of the intervention, the overall mean FSFI score in both groups increased to 23.58±16.53 (HIV-positive: 21.37±11.24; HIV-negative: 16.72±13.81) (p < 0.05 in all cases). FSD is very common among women in Northern Nigeria, irrespective of HIV status. An adapted counseling care model improved sexual function in both HIV-positive and HIV-negative women. The PLISSIT model can guide healthcare providers to initiate and navigate sexual health discussions with women in this setting.

Pelvic floor and sexual function 3 years after hysterectomy - A prospective cohort study.

Long term effects after hysterectomy, such as a worsening of pelvic floor and sexual function, have been studied with diverse results. Therefore, we investigated the long-term effects of hysterectomy for benign indication on pelvic floor and sexual function as well as differences in outcome depending on mode of hysterectomy. In a prospective clinical cohort study, we included 260 women scheduled for hysterectomy who answered validated questionnaires; pelvic floor impact questionnaire (PFIQ-7), pelvic floor distress inventory (PFDI-20) and female sexual function index (FSFI). Participants were followed up to 3 years after surgery. Nonparametric statistics and mixed effect models were used in analyses of the data. After exclusions, 242 women remained in the study, with a response rate at the 3-year follow-up of 154/242 (63.6%) for all questionnaires. There was an improvement of pelvic floor function with a mean score of PFIQ-7 at baseline of 42.5 (SD 51.7) and at 3 years 22.7 (SD 49.4), (p < 0.001) and mean score of PFDI-20 at baseline was 69.6 (SD 51.1) and at 3 years 56.2 (SD 54.6), (p = 0.001). A deterioration of sexual function was seen among the sexually active women after 3 years with a mean score of FSFI at baseline 25.2 (SD 6.6) and after 3 years 21.6 (SD 10.1), (p < 0.001). However, this was not consistent with the unaltered sexual function for the whole cohort. No difference in pelvic floor or sexual function was detected when comparing robotic assisted laparoscopic hysterectomy, laparoscopic hysterectomy and abdominal hysterectomy. Three years after surgery robotic assisted laparoscopic hysterectomy, total laparoscopic hysterectomy and abdominal hysterectomy improve pelvic floor function to the same extent. Among the sexually active women, a decline of sexual function was seen after 3 years, not consistent with the entire cohort and independent of surgical methods. Whether this is a trend associated with aging or menopausal transition remains to be studied.

Endometriosis and sexual disorders: the effect of surgical and medical treatment, a multicentre cross-sectional study.

Sexual health is a major concern in women with endometriosis, however only a few controlled studies have examined this with validated instruments. The effect of hormonal treatments on sexual function in endometriosis is also an underrated topic. The aim of this study was to investigate sexual function of patients with endometriosis by a specific tool to better evaluate their sexual function (including different domains), and the influence of hormonal treatment or surgery on these parameters. An observational, cross-sectional, multicentre study was conducted in a group (n=194) of sexually active, women aged 25-45 years old, with surgical or ultrasonographic diagnosis of endometriosis, referred to the Endometriosis Center of Careggi University Hospital or Negrar di Valpolicella. Sexual function was assessed by administering the Female Sexual Function Index (FSFI), which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction and pain. FSFI scores were compared to those of a control group (n=58) and according to the treatment received by patients with endometriosis. Ovarian endometriosis was present in 50 patients (25.8%), deep infiltrating endometriosis in 65 patients (33.5%) and both in 79 patients (40.7%). Adenomyosis coexisted in 102 patients (52.6%). Women with endometriosis reported a mean total FSFI score of 18.3 [4.2-25.8] (< 26.55), indicating female sexual dysfunction (FSD) in all patients. At multivariate analysis, after adjusting for confounders (BMI and hormonal therapy), women with endometriosis presented significantly lower scores than controls in all the FSFI (p<0.001). Patients with endometriosis under hormonal treatments (n=124; 64%), regardless of the type, had significantly lower scores in all FSFI subscales and total score, even after adjusting for confounders-age, BMI and history of surgery. Patients with endometriosis are at risk for FSD, encompassing not only dyspareunia, but all domains of sexual function. Hormonal treatments do not result in improvement in sexual symptoms.

Comparing long-term sexual dysfunction across different uterine cancer treatment modalities

The objective of this study was to assess differences in long-term sexual and menopausal side effects after uterine cancer treatment among treatment modalities. This is a cross-sectional study that examined women treated for uterine cancer from 2006-2018. Eligible women included those who underwent a hysterectomy/bilateral salpino-oophorectemy alone (HS), with brachytherapy (BT), or with external beam radiation therapy (EBRT). A noncancer cohort of women who underwent a hysterectomy/BSO for benign indications were also identified (non-CA). To compare outcomes, we utilized a shortened form of the female sexual function index (FSFI) and the menopause survey, which consists of 3 subscales: hot flashes, vaginal symptoms, and urinary symptoms. Demographic, comorbidity, and other treatment variables were collected. Survey totals were compared across cohorts using ANOVA tests and logistic regression. A total of 284 women completed the Menopause Survey (Non-CA 64, HS 60, BT 69, EBRT 91); 116 women reported sexual activity in the last 4 weeks and completed the FSFI (NC 32, HS 21, BT 31, EBRT 32). The mean FSFI score for the entire cohort was 11.4 (SD 4.16), which indicates poor sexual function. There was no significant difference between any cohort in the overall FSFI score (p = 0.708) or in any of the FSFI subscales (all p > 0.05). On univariate analysis, BT was associated with fewer menopausal hot flashes and vaginal symptoms compared to the non-CA cohort (p < 0.05), which did not persist on multivariable analysis. There was no significant difference in sexual dysfunction or menopausal symptoms in those treated for uterine cancer with or without adjuvant radiation. Most patients reported poor sexual function.

Determination of Sexual Functioning and Factors Affecting Sexual Functions of Women Following Abdominal and Vaginal Hysterectomy

Objective: The study was designed as an analytic and descriptive study to determine sexual functioning and the factors affecting sexual functions in women undergoing abdominal and vaginal hysterectomy. Materials and Methods: Based on the power calculation, 120 women (Abdominal hysterectomy=60; Vaginal hysterectomy=60) were included in the study. The study data were collected using “Demographic and Individual Information Form”, “Female Sexual Function Index (FSFI)”, and “Beck Depression Inventory (BDI)”. Results: The mean FSFI scores were similar in women who underwent abdominal hysterectomy (22.73±6.94) and vaginal hysterectomy (20.84±8.22) (p&gt;0.05). There was a significant relationship between the mean FSFI score and age, menopausal status, and changes in sexual life after hysterectomy in women in both groups (p

Long term sexual outcomes of Mayer Rokitansky Küster Hauser Syndrome patients after Uncu-modified Davydov procedure.

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome has an incidence of 1 in 4000. The absence of the vagina and uterus results in sexual dysfunction and infertility. The first-line treatment is vaginal dilatation. There exists a number of second-line surgical options including the Uncu-modified Davydov procedure. To determine the complication rate, anatomical outcomes, and long-term sexual outcomes of MRKH syndrome patients after Uncu-modified Davydov procedure. Patients with MRKH syndrome who underwent paramesonephric remnant-supported laparoscopic double-layer peritoneal pull-down vaginoplasty (aka Uncu-modified Davydov procedure) between January 2008 and December 2021. The procedure involves laparoscopic circular dissection of the pelvic peritoneum followed by pulling down, through the opened vaginal orifice, and suturing the vaginal cuff with the support of uterine remnants. The long-term complication rate, anatomical outcomes, and sexual function outcomes (as measured by Female Sexual Function Index (FSFI)) were ascertained. Main Outcome Measures: The long-term complication rate, anatomical outcomes and FSFI survey results. A total of 50 patients with MRKH syndrome underwent the Uncu-modified Davydov procedure between Jan 2008- Dec 2021. There were four perioperative complications: three bladder injuries (6%) and one rectal serosa injury (2%). Four long-term postoperative complications were identified: one vesicovaginal fistula (2%), one recto-vaginal fistula (2%), and two vaginal stenoses (4%). All patients were physically examined at least one year after surgery. The mean vaginal length was 8.4 + 1.9 cm. The mean FSFI score was 31.5 + 3.9 (minimum score of 24, maximum score of 36). Conclusion: The Uncu-modified Davydov procedure has been demonstrated to be a safe and effective treatment option with high female sexual function index scores for patients with MRKH syndrome. The long-term complication rate, anatomical and sexual outcomes of Uncu-modified laparoscopic peritoneal pull-down vaginoplasty were reported in this study. The results indicated that the surgical approach could be used in selective MRKH patients who failed first-line self-dilatation therapy.

The relationship between sleep problems and sexual dysfunction among pregnant women in Turkey.

Sexual dysfunction and sleep problems are common in women. Nevertheless, the relationship between sleep problems and sexual dysfunction during pregnancy has yet to be fully clarified. The aim of this study was to evaluate the relationship between sleep problems and sexual dysfunction in pregnant women. The study had a cross-sectional design and the sample was determined by employing the G*Power program on the basis of the findings of a related study. Taking the correlation value between the Female Sexual Function Index (FSFI) and the Insomnia Severity Index (ISI) into account, it was found that the minimum sample size was 219 pregnant women. Healthy pregnant women who were literate, did not have a diagnosed psychiatric disease, did not have a mental disability or communication problems, were in the gestation period, were not restricted by their doctors in terms of engaging in sexual activity, and who were willing to participate were included. The study included those pregnant women who consecutively attended the NST polyclinic in a maternity hospital in a province in the Black Sea region of Turkey between January 2022 and August 2022. The Sociodemographic Information Form, the Pittsburgh Sleep Quality Index (PSQI), the ISI, and the FSFI were used to collect data. A total of 220 pregnant women took part. The women had a mean age of 27.4 ± 6.3. Of the pregnant women, all had poor sleep quality: 61% had insomnia problems; 30% had sexual dysfunction. When the relationships between the PSQI, ISI and FSFI were examined, there was a statistically significant positive correlation between the mean PSQI and ISI scores (p = 0.000). A statistically significant negative correlation was determined between the mean ISI and FSFI scores (p = 0.044). According to the multiple regression analysis, age did not significantly predict sexual function (β = -0.112; t = -1.639; p = 0.103); insomnia severity predicted sexual function negatively (β = -0.146; t = -2.136; p = 0.034). The explained variance was 2.6%. The findings suggest that sleep quality as measured by the PSQIdoes not correlate with female sexual dysfunctionin pregnant women. However, severity of insomnia does correlate with sexual dysfunction.

A Comparative Study on Sexual Function and Sexual Distress of Women With and Without Breast Cancer in Zanjan, Iran

Background &amp; Aims Breast cancer (BC) is one of the important challenges of the health system due to its impact on marital relationships. This study aims to compare sexual function and sexual distress of women with and without BC. Materials &amp; Methods In this case-control study, 75 women with BC and 75 healthy women from Zanjan, Iran participated. Data were collected using a demographic form, the female sexual distress scale-revised (FSDS-R), and the female sexual function index (FSFI). Data analysis was done in SPSS software, version 20 using the Mann-Whitney test and multivariate analysis of covariance. Results The mean age of patients was 36.49±6.53 years and the mean age of controls was 36±0.72 years. There was no statistically significant difference between the two groups in terms of some demographic variables such as age, educational level of women and their husbands, occupation of women and their husbands, place of residence, and number of children (P&gt;0.05). The mean score of FSFI in all subscales in the patient group was lower than in the control group. This difference was statistically significant only in the dimension of desire (P=0.003). regarding the sexual distress variable, the mean FSDS-R score of healthy women was lower than that of women with breast cancer, but this difference was not statistically significant (P&gt;0.05). Conclusion The difference between women with and without breast cancer is significant only in the desire domain of sexual function. There is no statistically significant difference between the two groups in sexual distress and in other domains of sexual function. The sexual problems of women with BC require consideration and support, and provding counseling in terms of sexual function.