Orgasmic Disorder Research Articles

Virtual reality exposure therapy for sexual aversion: a proof-of-concept study on acceptability, adequacy, and clinical effects.

Sexual dysfunctions impair theintimate relationships of up to one-third of the population. Virtual reality (VR) offers innovative treatment options for both mental and sexual disorders, such as female orgasmic disorder and erectile disorder. Sexual aversion disorder (SAD)-the anxiety, disgust, and avoidance of sexual contexts-is a chronic condition commonly treated with anxiety-reducing strategies, such as exposure-based therapy. Despite exposure's efficacy in reducing SAD symptoms, VR exposure therapy's (VRET) effectiveness remains unexplored for this condition. This proof-of-concept study examines the acceptability, adequacy, and clinical effects of a VRET's simulation protocol for SAD. In the laboratory, 15 adults suffering from SAD (Mage = 35.00; SD = 11.36) viewed 15 virtual sexual scenarios of increasing intensity (eg, flirting, nudity, genital stimulation) adjusted to their sexual preferences and gender identities. Levels of anxiety, disgust, and catastrophizing beliefs were measured throughout the scenarios using standard self-report measures. Participants also completed validated questionnaires on sexual presence and simulation realism, as well as open-ended questions on scenarios' representativeness and adequacy immediately after immersion. Six months after the laboratory visit, participants completed a negative effects questionnaire and were screened for SAD symptoms again. Repeated-measures ANOVAs and descriptive analyses were performed. Levels of anxiety and disgust significantly increased with the intensity of sexual scenarios. Catastrophizing levels were high and tended to augment with increasing exposure levels. A significant reduction in symptoms of SAD was found from pre-simulation to the 6-month follow-up assessment. Sexual presence and realism scores were moderate. Qualitative assessment revealed that all participants reported the sexual scenarios were representative of real-life situations that tend to elicit SAD symptoms for them. Reported negative effects were generally mild. This proof-of-concept study suggests that VRET may have the potential to elicit self-reported emotional and cognitive manifestations of SAD (sex-related anxiety, disgust, and catastrophizing), while also hinting at its acceptability, adequacy, and benefits in alleviating SAD symptoms. While this study marks the first exploration of the clinical relevance of gender-inclusive virtual sexual scenarios for SAD, its design and sample composition may impact observed effects and the generalizability of findings. This study invites future clinical trials to assess VRET efficacy for SAD.

The comparison of efficacy of Escitalopram and Bupropion in treatment of depression symptoms in patients with heart failure: randomized clinical trial.

This study aims to compare the effects of two medicines, Escitalopram and Bupropion, on HF patients who have depression symptoms. This double-blind randomized clinical trial study was conducted on HF patients with depression symptoms at the Heart Failure Clinics affiliated with Babol University of Medical Sciences. In this study, 80 participants were examined for depression based on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS). They were randomly allocated into two groups of 40 participants treated with Bupropion 75mg and Escitalopram 5mg. Following the intervention, the individuals were assessed in terms of their depression score at 4, 8, and 12-week intervals. Finally, the data were analyzed using SPSS version 22.0. In the examination of Beck and Hamilton scores in the two research groups during different follow-ups, a significant decrease was found over time (P<0.001 for both medicines). While the effectiveness of the two medicines was the same at different times (P>0.05 in all cases). Comparing the side effects between the two intervention groups, the orgasm disorder (P=0.018) and sexual dysfunction (P<0.001) were reported significantly more in the Escitalopram group than in the Bupropion group. The findings of this study showed that Escitalopram has the same efficacy as Bupropion in the treatment of depression symptoms in HF patients.

Correlates of Sexual Dysfunction in Male Patients with Alcohol Dependence Syndrome: A Cross-Sectional Study

Introduction: Sexual dysfunction and alcohol dependence syndrome are complex issues that significantly impact the overall well-being and quality of life of affected individuals. Sexual dysfunction, encompassing various issues such as erectile dysfunction, reduced libido, and orgasmic disorders, is a prevalent concern affecting a substantial proportion of the male population worldwide. Aim: To estimate prevalence of sexual dysfunction in patients admitted for Alcohol dependence and to identify various Clinical and Socio demographic correlates for sexual dysfunction in this population. Materials and Methods: The study involved fifty-eight male participants who had sought deaddiction treatment at the Psychiatry Outpatient Department of Tertiary Care Centre, Maduranthakam for alcohol dependence syndrome, diagnosed according to the ICD‑10. Information on sociodemographic, alcohol-related, and sexual dysfunction-related variables was gathered. Sexual dysfunction was assessed for the past year, ignoring temporary and situational complaints. The relationship between sexual dysfunction and various study variables was explored using relevant statistical tools. Results: Out of the total sample size evaluated using SAD-Q score, 71% are moderately dependent and 29 % are severely dependent. Sexual Dysfunction was present for 64% of patients in the study. For the 58 patients in the study, the most common sexual dysfunction reported was an absence of sexual desire in 19 patients, followed by erectile dysfunction which was present in 18 patients. The ability to reach orgasm was difficult for 6 patients. Satisfaction from orgasm was absent for 4 patients. Conclusion: This research seeks to advance our understanding of sexual dysfunction in male patients with alcohol dependence syndrome by unravelling the intricate web of factors influencing their sexual health.

Report of climacturia and orgasmic disorders after radical prostatectomy in a Brazilian tertiary hospital: shedding light on a neglected condition.

After radical prostatectomy (RP), it is rarely acknowledged that several sexual dysfunctions can arise. These include issues in the orgasmic domain (e.g., decreased orgasm intensity, dysorgasmia), problems with ejaculation (e.g., absence of ejaculation), the development of penile deformities, and low sexual desire. This article aims to report the occurrence of orgasmic and ejaculatory dysfunction when actively investigated, documenting those rates and characterizing specific features of these conditions following RP. This study has analyzed retrospective data from men who underwent RP and were experiencing erectile dysfunction. During a structured visit, patients were systematically questioned about dysorgasmia, altered orgasmic sensation, climacturia, and arousal incontinence. Continuous variables were analyzed using the Student T or ANOVA tests, while categorical variables were analyzed using Chi-squared or Fisher's exact tests. The associations were described as odds ratios with precise confidence intervals. All tests were two sided; a p value < 0.05 was considered statistically significant. Sixty patients were included, out of which 3 (5%) reported dysorgasmia, while 33.3% presented a decrease in orgasm intensity. Climacturia was reported as the most common orgasmic disorder in 40 (66.6%) patients. However, only 14 patients (35%) reported that it frequently occurs, i.e., more than half of the time. Among the patients who reported climacturia, 72.5% classified it as mild losses. Additionally, arousal incontinence (AI) was noted in the study by 19 (26.3%) patients. Our study highlights the importance of discussing orgasmic dysfunctions after RP, which can be frequent and bothersome but are often overlooked in preoperative counseling.

Body, emotions, and sexuality in the metaverse: A randomized control trial exploring the use of second life for an avatar-based intervention to support women with female orgasmic disorder

Body, emotions, and sexuality in the metaverse: A randomized control trial exploring the use of second life for an avatar-based intervention to support women with female orgasmic disorder

New management approaches for female sexual dysfunction.

The goal of this paper is to review the most recent studies evaluating treatments for female sexual dysfunction (FSD), including distressing symptoms of desire, arousal, and orgasm disorder. We divide the sections into psychological and pharmacological. There is excellent evidence in favour of mindfulness, cognitive behavioural therapy, and psychoeducation for improving low sexual desire in women, and less evidence in support of these approaches to address other sexual dysfunctions in women. There are two US Food and Drug Administration (FDA) approved pharmacological treatments for low desire in premenopausal women that have modest benefits above placebo, and a significant proportion of users will experience side effects. Evidence also supports the use of transdermal testosterone for low desire in postmenopausal women. Sexual dysfunction in women is common and distressing, and there are a variety of psychological and pharmacological treatments. More research is needed to better understand the predictors of a positive treatment response in order to deliver more personalized care.

Comparing the Effects of Lavender Aromatherapy and Mindfulness-Based Cognitive Therapy on Sexual Function in Women in Iran

ObjectiveTo compare the effects of aromatherapy with lavender and mindfulness-based cognitive therapy for sexuality (MBCT-S) on female sexual function. DesignRandomized controlled trial. SettingHealth centers in Roudan city, Iran. ParticipantsSixty married women, ages 18 to 45 years, were recruited using the Female Sexual Function Index (FSFI). Participants were selected from health centers in 2022 via convenience sampling. Intervention and MeasurementsUpon their completion of a demographic checklist and the FSFI as a pretest, participants were divided into three groups, including lavender aromatherapy (n = 20), MBCT-S (n = 20), and control (n = 20) through random selection with permutation blocks. All groups completed FSFI as a posttest. Data were analyzed by SPSS 26 using chi-square, Wilcoxon, Kruskal–Wallis, and Mann–Whitney statistical tests. ResultsThere was no statistically significant difference among the three groups before the intervention (p = .652), but there was a significant difference among them after the intervention (p = .001). There was a significantly positive difference between the intervention groups and the control group (p < .001). A significant relationship was observed among the three groups in sexual desire, pain, satisfaction, lubrication, and arousal. The mean scores of the posttest in sexual desire, pain, satisfaction, and lubrication were positively higher in the MBCT-S group than in the aromatherapy group, and both intervention groups showed the same effect for sexual arousal. Aromatherapy and counseling had no significant effect on improving sexual orgasm. ConclusionMBCT-S can be used to improve many aspects of female sexual function, except for orgasm disorders; aromatherapy may improve sexual arousal.

Sexual functional outcomes of vaginal dilation therapy for MRKH syndrome: a prospective study

Objectives: To report the sexual functional outcomes of vaginal dilation therapy in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients. Methods: From March 2020 to February 2023, 97 MRKH syndrome patients performed vaginal dilation therapy with guidance from Peking Union Medical College Hospital, and 45 of them engaged in penetrative intercourse and were included in this prospective cohort study. The Chinese version of female sexual function index (FSFI) was used to assess sexual function. Functional success was defined as FSFI>23.45. Forty age-matched healthy women were selected as controls. Kaplan-Meier survival analysis was used to calculate the median time to success. Pearson correlation analysis was used to explore the relationship between neovagina length and sexual function. Complications were collected using follow-up questionnaires. Results: The functional success rate of vaginal dilation therapy was 89% (40/45) with a median time to success of 4.3 months (95%CI: 3.0-6.1 months). Compared to controls, MRKH syndrome patients had significantly lower scores in the orgasm domain (4.72±1.01 vs 4.09±1.20; P=0.013) and pain domain (5.03±0.96 vs 4.26±0.83; P<0.001). However, there were no significant differences in the FSFI total score (26.77±2.70 vs 26.70±2.33; P=0.912), arousal domain (4.43±0.77 vs 4.56±0.63; P=0.422) and satisfaction domain (4.88±0.98 vs 4.65±0.86; P=0.269) between MRKH syndrome patients and controls. MRKH syndrome patients had significantly higher scores in the desire domain (3.33±0.85 vs 3.95±0.73; P<0.001) and lubrication domain (4.37±0.56 vs 5.20±0.67; P<0.001). The prevalence of sexual dysfunction in MRKH patients was non-inferior to controls: low desire [3% (1/40) vs 23% (9/40); P=0.007], arousal disorder [3% (1/40) vs 3% (1/40); P>0.999], lubrication disorder [5% (2/40) vs 25% (10/40); P=0.012], orgasm disorder [40% (16/40) vs 20% (8/40); P=0.051], sexual pain [30% (12/40) vs 15% (6/40); P=0.108]. Conclusions: MRKH syndrome patients undergoing non-invasive vaginal dilation therapy could achieve satisfactory sexual life. Given its high functional success rate and slight complication, vaginal dilation therapy should be recommended as the first-line option, reducing the need for unnecessary surgeries.

Efficacy of Online Coital Alignment Technique in Female Orgasmic Disorder

Efficacy of Online Coital Alignment Technique in Female Orgasmic Disorder

(078) ASSESSMENT OF RESIDENT EDUCATION IN THE DIAGNOSIS AND TREATMENT OF COMMON CONDITIONS OF FEMALE SEXUAL DYSFUNCTION

Abstract Introduction Female sexual dysfunction (FSD) affects 30-50% of women. Despite the fact that doctors from all specialties are likely to encounter patients with sexual health difficulties, just half of U.S. medical schools currently offer formal teaching in sexuality. Due to insufficient training in the female pelvic physical exam and minimal training on sexual health, FSD has been substantially underdiagnosed and undertreated. Objective The aim of our study was to assess the knowledge and confidence of residents on how to conduct a comprehensive vulvar examination, as well as to assess the comfortability with diagnosing and managing conditions of FSD. Methods This cross-sectional analytical survey study used Qualtrics to administer the survey. The target audience included urology residents, obstetrics and gynecology residents, dermatology residents, internal medicine residents, family medicine residents, and emergency medicine residents. The survey link and a brief description of the project were emailed to all residency program directors in these specialties who had valid email addresses provided in the FREIDA American Medical Association Residency Database. Program directors were requested to share the link to the anonymous online survey with their current resident cohorts. Results In total, n=141 residents completed the survey (n=19 OBGYN, n=18 urology, n=5 dermatology, n=37 family medicine, n=27 internal medicine, n=35 emergency medicine). Less than half of all respondents indicated they had received prior formal training in physical examination of the clitoris (23%), vulvar vestibule (45%), and pelvic floor (36%). Regarding FSD, the following percentage of respondents indicated they had received prior training in these conditions: 78% genito-pelvic pain/penetration disorder, 36% hypoactive sexual desire disorder, 24% female orgasmic disorder, 33% female sexual arousal disorder. The majority of respondents reported feeling uncomfortable with the diagnosis and management of these conditions. Conclusions Residents are uncomfortable with diagnosing and managing common female sexual dysfunctions, owing to a lack of training in both vulvar examination and these conditions of FSD. This educational shortcoming persists across several specialties. Awareness of this knowledge and comfortability gap is critical for implementing the appropriate changes to resident education. Improving residents’ ability to diagnose and treat FSD is important for preparing the next generation of physicians to appropriately attend to the needs of female patients. Disclosure No.

(062) IMPLEMENTING A VALIDATED SEXUAL DYSFUNCTION SCREENING TOOL AT AN INNER-CITY WOMEN’S HEALTH CLINIC

Abstract Introduction The American College of Obstetricians and Gynecologists (ACOG) reports 43% of American women experience sexual health problems, including Female Sexual Interest and Arousal Disorder, Female Orgasmic Disorder, Genito–Pelvic Pain and Penetration Disorder, and Substance or Medication-Induced Sexual Dysfunction. Objective At Women’s Ambulatory Health Services (WAHS), an inner-city clinic associated with Hartford HealthCare, at which UConn Health ObGyn residents work, there is no routine screening in place for sexual dysfunction. This project aimed to implement the Female Sexual Function Index (FSFI) for screening for sexual dysfunction at this clinic to identify patients who may benefit from treatment. Methods We implemented the FSFI-short version, a six-question screening tool for sexual dysfunction that has been validated in English and Spanish and utilized in many countries on July 1st, 2022. Patients presenting for a new gynecologic visit or an annual gynecologic exam were asked to complete the screening tool. Patients who scored equal to or less than 18 on the FSFI-short version were identified as at risk for female sexual dysfunction and were offered referral to a health psychologist specializing in sexual dysfunction. We utilized the RE-AIM framework for implementation science to guide the implementation evaluation. We collected data on patients from July 1 through December 1, 2022. We collected patient demographics and implementation outcomes, including rate of survey completion, candidacy for referral and referral completion. Results 196 surveys were reviewed between July 1st and December 1st of 2022. 44 surveys were excluded for various reasons, including not meeting study inclusion criteria or invalid responses. 152 screening forms were included and 45 patients screened positive. Subjective patient barriers were gathered from comments written directly onto the paper survey as well as quotes documented by their providers in the visit note. These subjective barriers included hesitancy to discuss sexual health and lacking knowledge that the gynecologist provider offers assessment and management for these disorders. Conclusions The introduction of the FSFI-sv at WAHS has both expanded the resources offered to patients, enhanced the environment surrounding topics of women’s health both between staff members as well as within the patient-provider relationship, and has unearthed multiple opportunities for improving the screening process, referral selection and work flow for sexual dysfunction amongst the patient population. Disclosure No.

Exploring adverse events of Vilazodone: evidence from the FAERS database

ObjectiveThis study aims to conduct an exhaustive evaluation of Vilazodone's safety in clinical application and to unearth the potential adverse event (AE) risks associated with its utilization based on FDA Adverse Event Reporting System (FAERS) database.MethodsThis research employed data spanning from the first quarter of 2011 to the third quarter of 2023 from the FAERS database. Various signal detection methodologies, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), were utilized to ascertain the correlation between Vilazodone and specific AEs.ResultsThe study compiled a total of 17,439,268 reports of drug AEs, out of which 5,375 were related to Vilazodone. Through signal mining, 125 Preferred Terms (PTs) encompassing 27 System Organ Classes (SOCs) were identified. The findings indicated a higher prevalence among females and patients within the 45 to 65 age bracket. The principal categories of AEs included Psychiatric disorders, Nervous system disorders, and Gastrointestinal disorders, with prevalent incidents of Diarrhoea, Nausea, and Insomnia. Moreover, the study identified robust signals of novel potential AEs, notably in areas such as sleep disturbances (Sleep paralysis, Hypnagogic hallucination, Rapid eye movements sleep abnormal, Sleep terror, Terminal insomnia, Tachyphrenia), sexual dysfunctions (Female orgasmic disorder, Orgasm abnormal, Disturbance in sexual arousal, Spontaneous penile erection, Anorgasmia, Sexual dysfunction, Ejaculation delayed), and other symptoms and injuries (Electric shock sensation, Violence-related symptom, Gun shot wound).ConclusionAlthough Vilazodone presents a positive prospect in the management of MDD, the discovery of AEs linked to its use, particularly the newly identified potential risks such as sleep and sexual dysfunctions, necessitates heightened vigilance among clinicians.

Exploring the association between isotretinoin and sexual dysfunction: a comprehensive scoping review.

A potential link between isotretinoin and sexual dysfunction has been reported in various studies. However, such an association has not been explored within the context of a literature review until now. To evaluate the methodology and quality of studies investigating this association, and to examine the definitions of sexual dysfunction used. A scoping review approach was used to identify peer-reviewed research articles. The search terms used were 'isotretinoin', 'sexual dysfunction', 'erectile dysfunction', 'ejaculatory disorders', 'decreased libido', 'female sexual interest', 'female arousal disorder', 'libido', 'pelvic pain', 'dyspareunia', 'orgasmic disorder', 'impotence', 'ovaries', 'fertility' and 'menstrual irregularity'. In total, 55 peer-reviewed manuscripts were included, consisting of 8 animal studies and 46 human studies with 2420 patients. Of the studies in humans, there were 18 case reports or case series, 2 case-control studies, 4 cross-sectional studies, 6 longitudinal studies, 3 pharmacovigilance reports and 13 cohort studies. The most frequently observed dose range of isotretinoin was 0.5-1.0 mg kg-1 per day, usually for a duration of 1-6 months. More than half of the studies (54%, n = 25) reported a beneficial or neutral effect of isotretinoin on sexual function. The majority of studies (89%, n = 41) were categorized as Oxford Evidenced-Based Medicine level 4. This scoping review revealed very weak evidence supporting a link between isotretinoin and sexual dysfunction. Notably, the diverse definitions of sexual dysfunction pose a significant challenge for comparative analysis. The authors advocate for a standardized definition of sexual dysfunction and a framework for determining causality in order to contribute to a more comprehensive understanding of the relationship between isotretinoin and sexual dysfunction.

The relationship between female orgasmic disorder, attention-deficit/hyperactivity disorder, and depression in Dominican women

Abstract Background Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. Aim The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. Methods A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. Outcomes The diagnosis of ADHD was obtained from the participants’ medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. Results There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P &amp;lt; .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). Clinical Implications These findings may have important implications for the prevention and treatment of sexual disorders in women. Strengths and Limitations This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. Conclusion There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.

Review of Delusional Jealousy and Its Association with Sexual Dysfunctions

IntroductionMental state changes can affect one’s sexual life, while sexual dysfunction can lead to relationship challenges. Delusional jealousy, also called Othello syndrome, involves a paranoid belief in a partner’s infidelity, leading to controlling and violent behaviors. It can manifest as a paranoid disorder, as a delusional symptom of psychiatric, neurological or other medical conditions, or as side effect of dopaminergic medication. Although its exact prevalence remains uncertain, it has been identified in 0.5-1.4% of psychiatry inpatients.ObjectivesTo describe sexual dysfunctions associated with delusional jealousy and to explore strategies for addressing these dysfunction.MethodsA non-systematic review of the literature available at PubMed was conducted using the keywords “Sexual Dysfunction” AND “Delusional Jealousy OR Othello Syndrome”.ResultsA number of factors, including sexual dysfunction, can trigger or exacerbate delusional jealousy. This is especially true for middle-aged men who have a history of alcohol consumption, neurological or personality disorders. Individuals with sexual dysfunction experience feelings of insecurity, projecting these concerns onto their partners and suspecting extramarital relationships. On the other hand, sexual dysfunctions such as Hypoactive Sexual Desire Disorder, Female Sexual Arousal and Orgasmic Disorders, Erectile Dysfunction and Ejaculation Disturbance may occur as consequence of Othello Syndrome. Multiple factors contribute to these dysfunctions, including increased testosterone and cortisol levels, chronic alcohol use, comorbid psychiatric conditions and antipsychotics. There are reports of increased sexual desire, especially in cases of dementia.ConclusionsAlthough the evidence is limited and dated, it points to a bidirectional association between delusional jealousy and sexual dysfunction. Further studies are essential to determine the prevalence and types of sexual dysfunctions in Othello syndrome, and the causal relationship between them. Additionally, investigating gender differences is crucial, given the male-centric focus of existing studies. This research can contribute to clinical care by promoting the screening for sexual issues and their integration into delusional jealousy management.Disclosure of InterestNone Declared

Breaking the Taboo: Unveiling the Prevalence and Predictors of Female Sexual Dysfunction in Tunisia

Introduction Female sexuality is a complex and multifactorial domain that can be influenced by a variety of psychological, biological, relational, and sociocultural factors. However, sexual dysfunctions in women remain a taboo subject in many cultures and are often underestimated, underdiagnosed, and undertreated. In Tunisia, few studies have been conducted to assess the prevalence of sexual dysfunctions in women and their predictive factors.Objectivesto determine the prevalence of sexual dysfunctions in a group of Tunisian women and to identify the predictive factors of these dysfunctions.Methods This is a cross-sectional, descriptive, and analytical study, over a period of three months, from September to December 2022, conducted online via a pre-established questionnaire to collect various sociodemographic data, personal history, psychoactive substance consumption, weight, and height. We used the Female Sexual Function Index (FSFI) scale to evaluate sexual functioning in participants. We recruited sexually active Tunisian women over 18 years of age who agreed to anonymously respond to the questionnaire. The form was disseminated on social networks, in groups that focus on women, with a rate of three publications per week.ResultsWe collected data from 90 women with a mean age of 35 ± 12.84 years.More than half of our population (60%, n=54) had at least one sexual dysfunction.The most common sexual dysfunctions reported were arousal disorders (31.3%), followed by desire disorders (26.8%) orgasm disorders (12.4%).We found that several factors were significantly associated with sexual dysfunctions : Women over 45 years of âge (p&lt;10-3), who are divorced (p=0,02), have a low socioeconomic status (p=0,04), and report having experienced traumatic romantic/sexual expériences (p&lt;10-3) were found to have a higher prevalence of sexual dysfunctions. According to our results, cannabis consumption had a negative impact on lubrication (p&lt;10-3) and orgasm (p=0.003) among our study respondents. Personal psychiatric history also had a negative influence on arousal (p=0.02) and sexual satisfaction (p=0.01).ConclusionsBy identifying sexual dysfunctions early and treating them effectively, we can improve the quality of life of those affected and avoid serious consequences on their physical and mental health. It is therefore crucial to promote a proactive approach to sexual health and encourage healthcare professionals to approach sexuality openly and comprehensively.Disclosure of InterestNone Declared

(147) Analysis of Sexual Dysfunction Development among Male and Female Living Kidney Donors

Abstract Introduction The need for kidney donations in patients with end-stage kidney disease has continued to exceed the number of deceased donor transplants, signifying the need for the continued growth, sustainability, and success of living kidney donation. Following donation, living kidney donors have excellent survival rates with mixed data regarding long-term outcomes of renal failure, hypertension, and proteinuria. However, no studies to our knowledge have looked at differences in the development of long-term sexual dysfunction following living kidney donation, a potentially serious quality of life issue. Objective To analyze differences in five-year sexual dysfunction outcomes among male and female living kidney donors using the US Collaborative Network within the TriNetX database, a federated network of EMR data from multiple healthcare organizations across the United States. Methods We used the TriNetX database to perform a propensity score-matched cohort study comparing five-year outcomes of sexual dysfunction development among adult (≥18) male living kidney donors (Male) and female living kidney donors (Female) from December 2013 to December 2022. Living kidney donors were defined as the presence of one diagnostic code and one procedural code. Patients were excluded from the study if they had any instance of diagnosed transplant status (by ICD-10) or transplantation procedures (by CPT) prior to the kidney donor status. Patients were matched on age, sex, race, ethnicity, marital status, diabetes mellitus, cardiovascular disease, personal history of genitourinary disease, presence of urogenital implants, mood disorders, BMI, tobacco and alcohol use, and problems related to lifestyle and socioeconomic circumstances. Primary outcomes analysis included 5-year hazard ratio of diagnosed decreased libido, sexual dysfunction (composite of new diagnosed male ED, vaginismus/dyspareunia, infertility, orgasmic disorders, arousal/desire disorders, or unspecified), UTI, and STDs. Secondary outcomes included sex counseling or problems in relationship with spouse or partner. Results There were 2,821 patients in each cohort after matching (Male, Female). Mean age of the cohort was 42.7 ± 12.7, 73.3% were White, and 10.8% were Hispanic/Latino (p &amp;gt;0.05). At 5-years, Kaplan-Meier analysis revealed that the Male donor cohort had a significantly higher hazard ratio (HR) than Female donors for sexual dysfunction (HR: 3.006, 95% Confidence Interval [CI]: 1.761,5.131). Between the cohorts, 39 (1%) Male patients developed ED and ~10 (&amp;lt;1%) Female patients developed vaginismus/dyspareunia within 5 years. No significant difference was found for the development of sexual arousal disorders/desire disorders (0.17% vs 0.06%, p = 0.052), orgasmic disorders (0.03% vs 0.03%, p = 0.99), decreased libido (0.48% vs 0.85%, p =0.94) and STD’s (0.72% vs 0.89%, p = 0.70). For secondary outcomes, no significant difference was found for the 5-year hazard of need for sex counseling or interpersonal relationship issues. Conclusions In our analysis of this large, real-world database, we found that male living kidney donors had higher rates of sexual dysfunction development 5-years post-living kidney donation. While living kidney donation is a safe, viable, and excellent alternative to deceased kidney donation, clinicians and living donors should both be aware about the potential association of developing sexual dysfunction post-donation. Disclosure No.

(225) Female Sexual Function During the Last Trimester of Pregnancy

Abstract Introduction Since antiquity and until today, sexuality remains a taboo and complex subject, often little discussed either in private circles or with healthcare professionals. Although advertising and the media sometimes use it to attract attention, sexuality is still synonymous with the unknown, raising several interrogations. These concerns are accentuated during the onset of pregnancy and all the physical, psychological, and environmental upheavals associated with this physiological state. Objective This study aims to assess the changes in female sexual function during the third trimester of pregnancy Methods It is a cross-sectional online study that took place over 5 weeks starting March 1st, 2023. All low-risk singleton third-trimester pregnant and newly delivered women enrolled in the public and private prenatal care centers of the region were contacted through the institutions’ social media groups to be recruited. The online questionnaire was a 4-item Google form elaborated in concertation with the literature and included the validated translated version of the Female Sexual Function Index (FSFI). Results The study included 81 married participants (8% response rate). The median age of the participants was 30,4± 6,9 years and 65,4% of them were employed when pregnant. The mean pregnancy rate per participant was 2,7± 1,9 and 90% of the pregnancies were spontaneous. When questioned about their sexual life during the 3rd trimester of pregnancy, 68% of the participants report being uncomfortable when the subject of sexuality is on the table. Most of the respondents (78%) were unsatisfied with their couple's sexuality during pregnancy. A low sexual desire was reported in 84,0%, dyspareunia in 55,6% with a decrease in lubrification in 16,0%, and orgasm disorders in 17,3%. Secondary vaginismus was described by 12,3%. Partners initiated sexual intercourse according to 72,8% of the respondent. Sexual intercourses were mutually initiated in 27,2%. Pregnant women reported a change in their sexual life during the 3rd trimester in 96,3%: the 7th month of pregnancy is associated with less frequent (70,5%) and shorter (69,2%) penetrative intercourses with lower female sexual desire (48,7%). The 8th and 9th months are associated with lower sexual desire (80,8%; 94,9%), lower sexual pleasure (75,6%; 92,3%), and less frequent orgasms (67,9%; 82,1%) and penetrative intercourses (85,9%; 93,6%). Conclusions Our results suggest that the third trimester in singleton low-risk pregnancies is associated with severe impairment of the female sexual function in relation to less frequent and shorter penetrative intercourses, lower desire, and pleasure associated with a general sexual unsatisfaction. Disclosure No.

(220) Sexual Dysfunction in Krabbe Disease Patients - A Scoping Review

Abstract Introduction Krabbe Disease (KD) or globoid cell leukodystrophy is a rare autosomal recessive lysosomal storage disorder affecting approximately 1 in 100,000 people worldwide. GALC gene mutations associated with KD involve a galactosylceramidase deficiency, which damages the oligodendrocytes and Schwann cells. Therefore, nervous system demyelination is a hallmark of KD. While only a few infants survive beyond two years in early-onset Krabbe disease, patients with late-onset Krabbe Disease exhibit a milder phenotype and longer life expectancy. Late-onset KD symptoms include progressive muscle weakness and stiffness, developmental regression, behavioral changes, dementia, hearing loss, vision problems, and seizures. Only a few cases of sexual dysfunction associated with KD have been reported in literature but they highlight the wide-ranging impact of this condition on young adults and adults. Objective This review aims to examine sexual dysfunction in KD, as reported in literature. We employ a broad definition of sexual dysfunction (erectile dysfunction, dyspareunia, orgasmic disorder, muscle weakness, etc.) and its incidence in both sexes with KD. A comprehensive review of this topic has not yet been conducted, and we offer here preliminary information for healthcare providers when addressing sexual concerns in patients with lysosomal storage disorders. Methods A literature search was conducted by two separate investigators who independently screened studies and abstracted data. Data sources included peer reviewed publications from the following databases: PubMed, Scopus, Web of Science, EMBASE, Cochrane, Google Scholar and Clinical trials.gov. There were no restrictions on language nor date of publication. The search algorithm utilized to generate the review list was: (Globoid cell leukodystrophy OR Galactosylcerebrosidase deficiency OR Galactosylceramidase deficiency OR Krabbe disease OR Late-onset Krabbe disease OR GALC mutation). Results were further filtered by article type, restricting articles to Case Reports, Clinical Trials, Reviews, and Systematic Reviews. Results were then screened for reports containing data on sexual dysfunction in patients with KD. Results A total of four case reports and one review paper contained reports of sexual dysfunction in KD patients. All cases involved late-onset Krabbe disease, characterized by a milder and more insidious presentation. Genitourinary symptoms reported included urinary incontinence (N=3) and erectile dysfunction (N=2), however, there were no reports (N=0) of symptoms related to female sexual dysfunction. Other symptoms commonly reported in late-onset KD that might be linked to sexual function were ataxia, spasticity and weakness of lower limbs (N=3), and sensory dysfunction due to peripheral neuropathy (N=4). Conclusions This pioneering review reveals that patients with KD experience symptoms of sexual dysfunction. While the rarity of KD makes it challenging to study it clinically, sexual dysfunction may be consistent with the known pathophysiology of late-onset KD. This review also highlights that sexual dysfunction in female patients with KD is an under-investigated component of the disease presentation. Future clinical research into this important comorbidity, especially in female patients where the literature is lacking, may improve the care of patients with KD. Disclosure No.

(091) Use of a Vibrating Device in the Management of Female Situational Anorgasmia: Prospective Case Series Study in Women from Southeastern Spain

Abstract Introduction Around 40 percent of women in Spain are unable to achieve orgasm during coital relations, although most can do so through other means. Many of these women do not seek treatment, even though this situation may affect their sexual and relational life. Female Orgasm Disorder (FOD) treatment has seen little innovation since the 1980s. The growing acceptance, technological development, and focus on diversity have contributed to the flourishing of the sex toy industry. This sector has enabled the development of therapeutic devices that have already demonstrated usefulness in addressing other female and male sexual dysfunctions, often making treatments more Accessible. However, more scientific studies are needed on this topic. Objective Present the results of the utility and safety of using a vibrating device in the management of situational female orgasm disorder (FOD) in a group of women from Spain. Methods A case report study of an observational, descriptive, prospective nature, involving 19 women undergoing treatment, that meet criteria for lifelong, situational FOD from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was conducted in Murcia, Spain, from January 2022 to July 2023. Patients were 18 years or older, generally healthy as evidenced by medical history, were sexually active, in a current relationship of 3 months or longer, and participation was voluntary. Patients did not meet criteria for PTSD, psychosis or dissociative disorders, depression or bipolar disorders, were not pregnant or in menopause and did not use drugs known to interfere with sexual functioning. Main outcome measures were assessed using the Female Sexual Function Index (FSFI) domain for orgasm at baseline and after 6 and 12 weeks, as well as the success rate of achieving orgasm during coital relations. Treatment consisted of an educational session where a vibrating device called Crescendo II® and its accompanying resource of different positions, Play Book was provided, along with instructions for using the device during coital relations. Results Patients had a mean age of 31.19 years (range 27–53). An improvement was observed in the average scores at six and twelve weeks in FSFI orgasmic domain, (mean pre = 1.62 (SD) = 0.42, mean post six weeks = 3.47 (SD) = 1.26, mean post twelve weeks = 3.43 (SD) = 1.25). The success rate (orgasm achievement during intercourse) at the end of the study was 90.47%. Conclusions This case series suggests that the use of a vibration device could be an effective and safe therapeutic option for female situational anorgasmia in addition to reducing the length and cost of treatment. Future research with experimental designs should confirm the clear potential of the use of these devices in treating FOD and clarify issues related to the most appropriate amplitude and frequency of vibration, as well as the possible long-term effects of using these types of vibration devices in patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Mysteryvibe.