Lack Of Partner Research Articles

638: Elevated rates of persistent and recurrent chlamydia infection in pregnancy

Universal screening for chlamydia infection in pregnancy is recommended by ACOG to prevent adverse birth outcomes. Chlamydia trachomatis (CT) is an intracellular bacteria that can lead to persistent or recurrent infection despite therapy in 7-15% of non-pregnant women. Since data in pregnancy is minimal, we sought to determine rates of persistent/recurrent CT infection in this group. We performed a retrospective cohort analysis of women with deliveries at our center between 11/2012 – 12/2017. Testing was performed with highly sensitive nucleic acid amplification (Roche and Aptima Hologic) on samples from genital swabs or urine samples collected during pregnancy. Therapy was not directly observed. An early test of cure period was defined as the first test 3-6 weeks after the initial positive test. The late CT testing period was defined as >6 weeks after the initial positive test and “any positive” was compared to “never positive” for women with >1 CT test. Descriptive characteristics with 95% confidence intervals were used to compute rates of persistent/recurrent CT infection. At our center, 77% (16,138/20946) of deliveries among 13,692 women had CT testing performed during pregnancy. Among these 16,138 deliveries, 1526 (9.5%; 95% CI 9.0-9.9%) had CT detected. Compared to women without CT, women with CT were significantly younger, more likely to be Black and to have public insurance. (Table 1) Early repeat CT testing was performed in 57% of CT cases and 11.6% (95% CI 9.4-13.7%) (99/857) were persistently positive. (Fig 1) Incident chamydia (reinfection was detected in 14% (75/525) of those with a negative early test of cure. Among pregnancies with follow up CT testing only later in pregnancy, 27% (119/446) had a subsequent positive CT test. Chlamydia infection was common among pregnant women screened at our urban center with a disproportionate impact on young women and Black women. Persistent/recurrent and incident CT rates were elevated at early and late time periods at rates that surpass those in non-pregnant women. Potential reasons for CT persistence/reinfection in this cohort include poor adherence or non-response to standard antibiotic therapy, altered host immunity in pregnancy or lack of partner therapy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Utilization of \u201cprevention of mother-to-child transmission\u201d of HIV services by adolescent and young mothers in Mulago Hospital, Uganda

BackgroundPrevention of mother to child transmission (PMTCT) has lowered the incidence of paediatric HIV globally. The risk of mother-to-child transmission of HIV (MTCT) remains high in Africa, where there is a high prevalence of pregnancy and poor health-seeking behaviour among young girls and women.MethodsIn this cross-sectional, mixed-methods study, we evaluated the utilization of PMTCT services and associated factors among adolescent and young postpartum mothers aged 15 to 24 years at a public urban referral hospital in Uganda. Both HIV-positive and HIV-negative participants were recruited. Utilization of PMTCT services was defined as use of the PMTCT cascade of services including ever testing for HIV, receiving HIV test results; If tested negative, subsequent retesting up to 14 weeks; If tested positive, Antiretroviral drugs (ARVs) for the mother, ARVs and septrin prophylaxis for infant, safe delivery, safer infant feeding, early infant diagnosis within 6 weeks, and linkage to treatment and care. Optimal utilization of PMTCT was defined as being up to date with utilization of PMTCT services for reported HIV status at the time of being interviewed. The overall proportion of participants who optimally utilized PMTCT services was determined using descriptive statistics. Qualitative data was analyzed manually using the content thematic approach.ResultsOf the 418 participants, 65 (15.5%) were HIV positive. Overall, only 126 of 418 participants (30.1%) had optimally utilized PMTCT services. However, utilization of PMTCT services was better among HIV positive mothers, with 83% (54/65) having utilized the services optimally, compared to only 20% (72/353) of the HIV negative mothers (OR 18.2 (95% CI; 9.0–36.7)). The benefits of knowing ones HIV status, health of the unborn child, and counseling and support from health workers and peers, were the major factors motivating adolescent and young mothers to utilize PMTCT services, while stigma, financial constraints, non-disclosure, and lack of partner and family support were key demotivating factors.ConclusionUtilization of PMTCT services by these adolescent and young mothers was suboptimal. Special consideration should be given to adolescents and young women in the design of elimination of mother to child transmission (EMTCT) programs, to improve the utilization of PMTCT services.

Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale

BackgroundThe Sexual Modes Questionnaire (SMQ) is a validated and widespread used tool to assess the association among negative automatic thoughts, emotions, and sexual response during sexual activity in men and women. AimTo test the psychometric characteristics of the Italian version of the SMQ focusing on the Automatic Thoughts subscale (SMQ-AT). MethodsAfter linguistic translation, the psychometric properties (internal consistency, construct, and discriminant validity) were evaluated. 1,051 participants (425 men and 626 women, 776 healthy and 275 clinical groups complaining about sexual problems) participated in the present study. Outcomes2 confirmatory factor analyses were conducted to test the fit of the original factor structures of the SMQ versions. In addition, 2 principal component analyses were performed to highlight 2 new factorial structures that were further validated with confirmatory factor analyses. Cronbach α and composite reliability were used as internal consistency measures and differences between clinical and control groups were run to test the discriminant validity for the male and female versions. The associations with emotions and sexual functioning measures also are reported. ResultsPrincipal component analyses identified 5 factors in the male version: erection concerns thoughts, lack of erotic thoughts, age- and body-related thoughts, negative thoughts toward sex, and worries about partner's evaluation and failure anticipation thoughts. In the female version 6 factors were found: sexual abuse thoughts, lack of erotic thoughts, low self-body image thoughts, failure and disengagement thoughts, sexual passivity and control, and partner's lack of affection. Confirmatory factor analysis supported the adequacy of the factor structure for men and women. Moreover, the SMQ showed a strong association with emotional response and sexual functioning, differentiating between clinical and control groups. Clinical TranslationThis measure is useful to evaluate patients and design interventions focused on negative automatic thoughts during sexual activity and to develop multicultural research. Strengths and LimitationsThis study reports on the translation and validation of the Italian version of a clinically useful and widely used measure (assessing automatic thoughts during sexual activity). Limits regarding sampling technique and use of the Automatic Thoughts subscale are discussed in the article. ConclusionThe present findings support the validity and the internal consistency of the Italian version of the SMQ-AT and allow the assessment of negative automatic thoughts during sexual activity for clinical and research purposes.Nimbi FM, Tripodi F, Simonelli C, Nobre P. Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale. J Sex Med 2018;15:396–409.

Sex of children and family structure in Brazil: father & grandmother bias?

Brazil has a high rate of mothers living without a partner as well as a high intergenerational co-residence rate, including parents and grandparents. These family types may influence a child’s well-being. Even though there is no evidence of sex-selective abortion in Brazil, sex preference could still be subtly present. This paper tests the composition of family structure (father co-residence, grandmother co-residence, and birth of siblings) in Brazil associated with the sex of the child by using a nationally representative household survey, treating sex of the first and second child as exogenous variables in OLS regressions. I found women with lower birth-order daughters are less likely to live with a partner. I also found suggestive evidence that maternal grandmothers are more likely to live with granddaughters than with grandsons. Women with lower birth-order daughters are more likely to have additional children. Evidence suggests that in Brazil, fathers show a preference for sons over daughters, while grandmothers show a preference for granddaughters over grandsons. Additionally, mothers of girls, without co-residing partners may compensate for the economic loss caused by their lack of partner by living with their own mother. This contributes to the literature on child sex preferences, which has mostly focused on males (fathers); I have analyzed data on grandmothers to include females.

Psychometric properties of the Iranian version of the Sexual Modes Questionnaire (SMQ): to assess the association between automatic thoughts, emotions and sexual response

ABSTRACTThe role of cognitive-affective factors on male and female sexual functioning has been studied in North America and European countries and there is a lack of validated measures available for use elsewhere. The aim of this study was to translate and validate the Sexual Modes Questionnaire (SMQ) to the Iranian context. The SMQ is a validated measure aimed at assessing the association between thoughts, emotions and sexual response during sexual activity. A total of 388 participants (224 women and 164 men) completed the SMQ. A principal component analysis with varimax rotation and subsequent confirmatory factor analysis (CFA) were performed. Three factors were identified in the male version: Failure Anticipation Thoughts, Erection Concern Thoughts, and Lack of Erotic Thoughts. In the female version, six factors were identified: Failure and Disengagement Thoughts, Low Self-Body Image Thoughts, Sexual Abuse Thoughts, Sexual Passivity and Control, Lack of Erotic Thoughts, and Partner's Lack of Affection. Also, a consistent pattern of correlations was found between the three subscales of the SMQ (thoughts, emotions, and sexual response) supporting the interactional character of the measure. This study has provided some preliminary evidence of the reliability and validity of the SMQ for use in Iranian populations.

Why all women should freeze their eggs.

The use of oocyte cryopreservation via vitrification has increased lately, becoming a common strategy in many IVF centers. This review summarizes the current state of oocyte vitrification, by analyzing the most recent reports on its use in IVF as part of infertile treatment and its contribution to elective fertility preservation (EFP). Oocyte vitrification has become helpful for managing different clinical situations currently providing similar results to fresh oocytes. Owing to satisfactory results, oocyte vitrification is being offered to healthy women to extend their reproductive options (EFP). Although little is known about outcomes in this specific population, new evidence is starting to emerge. Currently, most women are motivated by age and lack of partner. Age is strongly related to the probability of having a child with better chances when they do EFP younger than 35. In contrast to the biological efficiency, the majority of studies show that EFP is more cost-effective at 37-38 years. Oocyte vitrification is an efficient tool which can be helpful in managing the IVF cycle. Fertility preservation providers should inform women about their specific probabilities according to their age at vitrification, making emphasis in the fact that egg freezing does not guarantee success, but increases the possibilities of having a biological child in the future.

Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature.

Objectives:To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute.Materials and Methods:From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event.Results:Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7–50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients.Conclusions:Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems.

Determinants and Use of Family Planning Among Young Women (18-28 Years) Attending Health Facilities in Garu-Tempane District of Ghana

Determinants and Use of Family Planning Among Young Women (18-28 Years) Attending Health Facilities in Garu-Tempane District of Ghana Martin Amogre Ayanore, Paul Armah Aryee Abstract Background: Improving family planning use across Sub-Saharan Africa is critical for improving women’s health outcomes. Aim: We aim to provide new perspectives of family planning use in a rural setting of Ghana. Method: Applying a descriptive cross-sectional design, a total of 720 young women attending health facilities were interviewed with a questionnaire whiles 40 other participants were engaged in focus group discussions. Six in-depth interviews with midwives were conducted. Quantitative data was analysed using SPSS to generate frequencies and associations whiles qualitative data was analysed using content analysis. Results: Ever use was higher (54.8%) than current use (33.9%). Statistically significant relationships were found between marital status and family union type for current users. Lack of partner (p<0.001) and family support (p<0.001), lack of access on demand (p<0.001), ever educated on use (p<0.001), ever experience of side effects (p=0.018), poor knowledge (p<0.001), unsatisfactory services (p<0.001) and negative attitude of providers (p<0.001) were significant self-reported factors influencing family planning use. Ever use (p<0.001, a OR=49.4) and access on demand (p<0.001, a OR=2.5) significantly predicted family planning use. Conclusions: Addressing current user’s myths and misconceptions whiles addressing institutional barriers have positive effects on family planning use for young women. Full Text: PDF DOI: 10.15640/ijhs.v3n4a5

Climacteric symptoms in Quechua and Mestizo women from the Andean region of Cusco, Peru: Effects of altitude and ethnicity

BackgroundLatin-American women present a greater severity of climacteric symptoms than women from other parts of the world. Previous studies suggest that this could be due to either its Amerindian crossbreeding or the altitude in which a huge proportion of the Latin-American population lives. ObjectiveTo answer this question, climacteric symptoms between Peruvian women (“Hispanic-Mestizas” and “Quechuas”) living in similar altitude (around 3000 MASL) were compared. MethodThis is a cross sectional descriptive study of healthy women of 40–59 years of age living in Departamento de El Cusco, Peru. Using the MRS questionnaire climacteric symptoms were assessed in 395 “Hispanic-Mestizas” (Quechua-Spaniard breeding) and 376 pure “Quechuas”. ResultsThe “Quechuas” compared with “Hispanic-Mestizas” have comparable similar age, but less: obesity, schooling years, cigarette smoking, use of hormonal therapy, diabetes and hypertension; and a greater: proportion of postmenopausal women and number of children. “Quechuas” showed a greater prevalence in ten of the eleven symptoms evaluated by the MRS scale, except for insomnia. The total MRS score was 14.54±7.51 vs. 9.87±6.26 (p<0.0001), respectively. As a consequence of this, 46.5% of the “Quechuas” had a deteriorated quality of life due to severe climacteric symptomatology, compared to only 14.2% of “Hispanic-Mestizas” women (p<0.0001). After adjusting for confounding variables menopause was associated with increased risk of severe menopausal symptoms (OR: 5.86, 95% CI: 3.93–8.75), followed by lack of partner (OR: 3.52, 95% CI: 1.91–6.48), arterial hypertension (OR: 2.62, 95% CI: 1.28–5.39) and Quechua being (OR: 2.38, 95% CI: 1.27–4.45). ConclusionsPeruvian “Quechuas” women have severer climacteric symptoms than the Peruvian “Hispanic-Mestizas” who live in a comparable altitude. This could suggest that the ethnicity could be one of the factors that could explain the augmented symptoms in Latin-American climacteric woman.

Lean on me: The importance of one's own and partner's intercultural personality for expatriate's and expatriate spouse's successful adjustment abroad

This research explores the role of three intercultural personality traits—emotional stability, social initiative, and open-mindedness—as coping resources for expatriate couples’ adjustment. First, we examined the direct relationships of expatriates’ and expatriate spouses’ personality trait levels with psychological and sociocultural adjustment. Psychological adjustment refers to internal psychological outcomes such as mental health and personal satisfaction, whereas sociocultural adjustment refers to more externally oriented psychological outcomes that link the individual to the new environment. Second, we examined the association of expatriates’ personality trait levels with professional adjustment, which was defined in terms of job performance and organizational commitment. Cross-sectional analyses among 196 expatriates and expatriate spouses (i.e., 98 expatriate couples) revealed that the three dimensions are each associated with specific facets of adjustment. A longitudinal analysis among a subsample (45 couples) partially confirmed these findings. Furthermore, we obtained evidence for a resource compensation effect, that is, the compensatory process whereby one partner's lack of sufficiently high levels of a certain personality trait is compensated for by the other partner's high(er) levels of this traits. Through this resource compensation effect, the negative consequences of a lack of sufficient levels of a personality trait on adjustment can be diminished. Apparently, in the absence of sufficiently high trait levels, individuals can benefit from personality resources in their partners.

Sexual function, satisfaction with life and menopausal symptoms in middle-aged women

PurposeTo assess sexual function, satisfaction with life (SWL), and menopause-related symptoms among mid-aged Spanish women. Materials and methodsCross-sectional study of 260 women, aged 40–59, attending the public gynecology consultations completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), the SWL Scale (SWLS), the Menopause Rating Scale (MRS), and a socio-demographic questionnaire. ResultsMedian [inter quartile range] age was 47 [8.0] years, 87.7% had a stable partner, 27.0% were postmenopausal, and 53.9% had increased body mass index (BMI). The prevalence of sexual dysfunction was 46.5% (CSFQ-14 score≤41). Postmenopausal status was associated with lower CSFQ-14 scores (worse sexual function) and severe menopausal symptoms whereas there were not significant differences in SWLS scores. CSFQ-14 scores correlated with SWLS (p<0.04), and inversely correlated with menopausal symptoms (p<0.02). Multiple linear regression analysis model predicted 26.6% of the total CSFQ-14 score variance, and higher scores (better sexual function) were correlated with better SWL, and inversely correlated to female age and worse menopausal symptoms. A second model predicted 38.4% of the SWLS score variance. The SWLS score correlated with the total CSFQ-14 score and BMI, and inversely correlated with economical problems, female tobacco use, lack of healthiness, menopausal symptoms, not having a partner, and partner's lack of healthiness. ConclusionsLower sexual function was related to low SWL, age and menopausal symptoms while low SWLS score was related with economical problems, smoking, menopausal symptoms, and partner factors.

Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance

BackgroundActive surveillance (AS) is emerging as an alternative approach to limit the risk of overtreatment and impairment of quality of life (QoL) in patients with low-risk localised prostate cancer. Although most patients report high levels of QoL, some men may be distressed by the idea of living with untreated cancer. ObjectiveTo identify factors associated with poor QoL during AS. Design, setting, and participantsBetween September 2007 and March 2012, 103 patients participated in the Prostate Cancer Research International Active Surveillance (PRIAS) QoL study. Mental health (Symptom Checklist-90), demographic, clinical, and decisional data were assessed at entrance in AS. Health-related QoL (HRQoL) Functional Assessment of Cancer Therapy-Prostate version and Mini-Mental Adjustment to Cancer outcomes were assessed after 10 mo of AS. Outcome measurements and statistical analysisMultivariate logistic regression models were used to identify predictors of low (<25th percentile) HRQoL, adjustment to cancer, and a global QoL index at 10 mo after enrolment. Results and limitationsThe mean age of the study patients was 67 yr (standard deviation: ±7 yr). Lack of partner (odds ratio [OR]: 0.08; p=0.009) and impaired mental health (OR: 1.2, p=0.1) were associated with low HRQoL (p=0.006; area under the curve [AUC]: 0.72). The maladaptive adjustment to cancer (p=0.047; AUC: 0.60) could be predicted by recent diagnosis (OR: 3.3; p=0.072). Poor global QoL (overall p=0.02; AUC: 0.85) was predicted by impaired mental health (OR: 1.16; p=0.070) and time from diagnosis to enrolment in AS <5 mo (OR: 5.52; p=0.009). Influence of different physicians on the choice of AS (OR: 0.17; p=0.044), presence of a partner (OR: 0.22; p=0.065), and diagnostic biopsy with >18 core specimens (OR: 0.89; p=0.029) were predictors of better QoL. Limitations of this study were the small sample size and the lack of a control group. ConclusionsFactors predicting poor QoL were lack of a partner, impaired mental health, recent diagnosis, influence of clinicians and lower number of core samples taken at diagnostic biopsy. Educational support from physicians and emotional/social support should be promoted in some cases to prevent poor QoL.

Parenthood in Long-Term Survivors After CHOEP Treatment for Aggressive Lymphoma Is Not Significantly Impaired in Comparison to the General Population. Results From the Mabthera International Trial (MInT) and the DSHNHL NHLB1 Study

AbstractAbstract 3649 Background:A growing number of patients with aggressive lymphoma experience long term survival after front-line treatment and survivorship issues have been increasingly addressed in recent years. Within treatment-induced sequelae, gonadal failure represents a major late-effect of chemotherapy. With respect to hematologic malignancies the majority of data on fertility effects pertains to Hodgkin Lymphoma treatment regimens whereas information on gonadal toxicity of non-Hodgkin Lymphoma treatments is limited. While CHOP as the standard treatment for aggressive lymphoma is supposed to be associated with only temporary side-effects on fertility in both sexes, nothing is known about the fertility effect of a moderate intensification of CHOP by adding etoposide in frequently used regimens such as CHOEP or dose-adjusted EPOCH. Methods:Our study assessed fertility aspects in young patients with aggressive lymphoma who enjoy ongoing first remission after treatment in the Mabthera International Trial or the German DSHNHL NHLB1 study between 1995 and 2003. Long term survivors of both prospective studies were contacted and invited to answer a questionnaire. Patients who received radiotherapy to the gonadal area as part of their primary treatment as well as those who received chemotherapy for secondary neoplasia were excluded from the analysis. Data on parenthood obtained in the subgroup of patients who received 6 complete cycles (R)-CHOEP (total cyclophosphamide and etoposide dose 4,500 mg/m2 and 1,800 mg/m2, respectively) is reported here. Results:Altogether 66 (31 female, 35 male) patients agreed to participate in the survey. Median age at treatment was 32.5 years (range: 18 – 40) and at time of data collection 44 years (range: 28 – 55), respectively, with a median follow-up after treatment completion of 11 years (range: 7 – 17). While 31 (46.9%) patients already had children before treatment (18 female – 58.1%, 13 male – 37.1%), 35 (53.0%) expressed a clear desire for children after treatment (14 female – 45.2%, 21 male – 60.0%). Ten of these 35 patients did not try to achieve pregnancy, with lack of partner being the main reason. Of the remaining 25 patients (12 female, 13 male) who tried to achieve pregnancy, 18 (9 female – 75%, 9 male – 69%) were finally successful. Apart from 2 deliberate abortions all pregnancies were uncomplicated and resulted in 25 live births. No major health problems were reported in the children. The interval between completion of treatment and birth of first child after treatment ranged from 21 to 146 months (median 58 months) in female patients and from 25 months to 106 months (median 60.5 months) in male patients. Patients not achieving pregnancy tended to be older then patients who successfully achieved pregnancy (median age 30 versus 25 in female patients and 34.5 versus 28 years in male patients). Not achieving parenthood after treatment was associated with emotional stress in 3 of 3 female patients but only in 1 of 4 male patients. Fourteen patients chose cryopreservation of sperm before treatment but none of them utilized preserved sperm for reproductive purposes. Cryopreservation techniques were not used in female patients. Only one female patient received a GnRH analogue in parallel to chemotherapy and gave birth to two children after treatment.Comparison of the presented patient data with the German general population (The German Socio-Economic Panel, 2011) revealed only non-significant differences in the overall percentage of childless women (16.1% in the study population versus 26.0% in the general population, p=0.15) and men (45.7% versus 33.8%, p=0.07). Total fertility rate in female study patients (1.45) paralleled that in the general population (around 1.4 between 1980 and 2010). Conclusions:Parenthood after treatment with CHOP plus etoposide seems not to be significantly impaired in comparison to the general population. Most patients who had attempted post-treatment parenthood were successful. The small percentage of patients not achieving pregnancy despite a clear desire for parenthood after treatment is in line with previous reports on the fertility effects of CHOP. However, all patients of reproductive age should be offered counselling with regard to the impact of planned therapy on their fertility. Disclosures:No relevant conflicts of interest to declare.

Impact of Breast Cancer Treatment on Female Sexual Function: A Systematic Review

INTRODUCTION: Breast cancer (BC) is the most common cancer in women worldwide and, nowadays, advances in BC screening and treatments have led to increasing rates of survival. This factor leads to a special concern about this women’s quality of life and among them, the sexuality. Sexual changes can become the most problematic aspect of a woman’s life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The aim of this study was to identify the most common type of female sexual dysfunction (FSD) after the treatment for BC. METHODS: It was performed a systematic review of studies published in the literature until July 2012 in the following database: MEDLINE, Pubmed, SciELO e Lilacs. It was used as used the descriptor: “breast cancer” associated with the following: “sexual dysfunction”, “sexual function” and “sexuality”. It were included studies which evaluated quantitatively the sexual dysfunction presence after BC treatment. It was considered sexual dysfunctions: disorders of desire, lubrication, arousal, orgasm and the presence of pain during the sexual intercourse. The exclusion criteria were narrative review, editorials, case studies and qualitative researches, because there is no objective data, making its compilation impossible. One researcher performed the studies search and two researchers, independently, evaluated the articles to be analyzed by means of structured guide with the following items: 1) sample characterizes, 2) type of treatment for BC and 3) method used to evaluate female sexual function. RESULTS: By reading the title, were chosen for inclusion in 97 articles, of which 85 were excluded after reading the abstract and another 2 were excluded after reading the entire article. It was included 10 studies which evaluated a total of 8. 465 women. The most frequent treatment for BC were: chemotherapy (100%), surgeries for BC (100%) and radiotherapy (83%). The most frequent sexual dysfunction were: decrease of desire/sexual interest (66%), difficulty in lubrication (50%), lack of arousal (33%) and pain during the sexual intercourse (11%). Other associated symptoms were described as fatigue, insomnia, physical problems, lack of satisfaction, shortness of intercourse, feeling less attractive, partner lack of understanding about their feelings and concern about partner desire/interest. DISCUSSION: in a recent study it was questioned the assessment of sexual function during a routine visits. The evidence showed that this theme approach increases the FSD diagnostic capability and improves access to treatment. Due to the high prevalence of these disorders in women who underwent treatment of BC and the various non-hormonal treatment options, it is important to underscore the tackling of this issue by Breast Cancer Specialist and/or Oncologist during consultation and forward for treatment when necessary. CONCLUSION: The FSD were identified as hypoactive sexual desire, lubrication difficult and lack of arousal. The studies demonstrated that the various treatment of BC negatively impact female sexual function.

Tick tock: can the clock be stopped? the use of elective oocyte cryopreservation (EOC) as a means to preserve fertility (PF)

Tick tock: can the clock be stopped? the use of elective oocyte cryopreservation (EOC) as a means to preserve fertility (PF)

The Importance of Sexual Self‐Disclosure to Sexual Satisfaction and Functioning in Committed Relationships

Past research indicates that sexual self-disclosure, or the degree to which an individual is open with his or her partner about sexual preferences, is a key aspect of sexual satisfaction and that partner's lack of knowledge about one's sexual preferences is associated with persistent sexual dysfunction. To replicate and extend past research by examining (i) how one's own levels of sexual self-disclosure are related to one's own sexual health (after controlling for partner's levels of sexual self-disclosure); (ii) how one's partner's levels of sexual self-disclosure are associated with one's own sexual health (after controlling for one's own levels of sexual self-disclosure); and (iii) whether gender moderates the associations between sexual self-disclosure and sexual health. Scores from the Golombok Rust Inventory of Sexual Satisfaction and the Sexual Communication Satisfaction Scale. A cross-sectional dyadic study using a convenience sample of 91 heterosexual couples in long-term committed relationships. Data were analyzed using the Actor-Partner Interdependence Model. One's own level of sexual self-disclosure is positively associated with one's own sexual satisfaction, β = -0.24, t(172.85) = -3.50, P < 0.001. Furthermore, partner's level of sexual self-disclosure is associated with men's sexual satisfaction but not with women's sexual satisfaction, β = -0.45, t(86.81) = -4.06, P < 0.001 and β = 0.02, t(87.00) = 0.20, ns, respectively. The association between own self-disclosure and sexual problems is stronger for women as compared with men, β = -0.72, t(87.00) = -6.31, P < 0.001 and β = -0.24, t(86.27) = -3.04, P < 0.01, respectively. Our results demonstrate that sexual self-disclosure is significantly associated with sexual satisfaction and functioning for both men and women, albeit in different ways. Our findings underscore the importance of sexual self-disclosure and highlight the importance of the interpersonal level of analysis in understanding human sexuality.

The role of cognitive distraction on female orgasm

Summary Distraction or interference in the cognitive processing of erotic stimulus plays an important role in the development of sexual dysfunctions or difficulties ( Geer and Fuhr, 1976 ). The aim of this study was to evaluate negative automatic thoughts presented during sexual activity. A total of 191 women from the general population answered to a set of questionnaires assessing orgasm function, automatic thoughts during sexual activity and cognitive distraction. The orgasm function was measured by the Female Sexual Function Index (IIEF, Rosen et al., 2000 ), automatic thoughts were measured by the Sexual Modes Questionnaire ( Nobre and Pinto-Gouveia, 2008 ), and cognitive distraction by the Cognitive Distraction Scale ( Dove and Wiederman, 2000 ). Findings indicated that lack of erotic thoughts during sexual activity was the best predictor of women's sexual difficulties. Sexual abuse thoughts, failure and disengagement thoughts, partner's lack of affection, sexual passivity and control, and lack of erotic thoughts were significantly higher in women with orgasm difficulties compared to sexually healthy women. The results are supported by the literature indicating that cognitive distraction from the erotic thoughts is strongly associated with orgasmic dysfunction.

Sexual Function and Depressive Symptoms Among Female North American Medical Students

Depression and sexual dysfunction are often comorbid. We explored the relationship between sexuality, sexual dysfunction, and depressive symptoms in female medical students in North America. Female North American medical students were invited to participate in an internet survey. The CES-D was utilized to screen for depressive symptoms and an abbreviated Spielberger State-Trait Anxiety Index (STAI) was used to quantify anxiety symptoms. Subjects completed an ethnodemographic survey, a sexuality survey, and modified instruments for the quantification of sexual function (the Female Sexual Function Index [FSFI] and the Index of Sexual Life [ISL]). Multivariable logistic regression was used to explore the relationship between sexuality and depressive symptoms. There were 1,241 female subjects with complete data on CES-D and STAI. Mean age was 25.4 years. Depressive symptoms (CES-D>16) were present in 46% of respondents and were more common in subjects with anxiety symptoms. Subjects who were Caucasian, younger than 28, heterosexual, and in a relationship were least likely to report depressive symptoms. High risk of female sexual dysfunction (HRFSD) was significantly associated with greater likelihood of depressive symptoms (odds ratio [OR] 2.25, P<0.001). After adjusting for ethnodemographic and sexual history factors, HRFSD remained significantly positively associated with depressive symptoms (OR 1.85, P<0.001). Analysis of FSFI and ISL domains indicated that depressive symptoms were most directly associated with worse orgasmic function, interference in sex life from stress and lack of partner, and lower general life satisfaction (P<0.05). Interestingly, greater ISL-sexual satisfaction was associated with greater odds of depressive symptoms (OR 1.40, P=0.01). Depressive symptoms are common in female medical students. HRFSD is associated with depressive symptoms, although the relationship is complex when psychosocial factors are included in the multivariate model. Attention to sexuality factors from student health providers may enhance quality-of-life, academic achievement, and patient care.

Prevalence of Sexual Activity and Associated Factors in Men Aged 75 to 95 Years

Knowledge about sexuality in elderly persons is limited, and normative data are lacking. To determine the proportion of older men who are sexually active and to explore factors predictive of sexual activity. Population-based cohort study. Community-dwelling men from Perth, Western Australia, Australia. 3274 men aged 75 to 95 years. Questionnaires from 1996 to 1999, 2001 to 2004, and 2008 to 2009 assessed social and medical factors. Sex hormones were measured from 2001 to 2004. Sexual activity was assessed by questionnaire from 2008 to 2009. A total of 2783 men (85.0%) provided data on sexual activity. Sex was considered at least somewhat important by 48.8% (95% CI, 47.0% to 50.6%), and 30.8% (CI, 29.1% to 32.5%) had had at least 1 sexual encounter in the past 12 months. Of the latter, 56.5% were satisfied with the frequency of activity, whereas 43.0% had sex less often than preferred. In cross-sectional analyses, increasing age, partner's lack of interest, partner's physical limitations, osteoporosis, prostate cancer, diabetes, antidepressant use, and β-blocker use were independently associated with reduced odds of sexual activity. Living with a partner and having a non-English-speaking background were associated with increased odds. In longitudinal analyses, higher testosterone levels were associated with increased odds of being sexually active. Other factors were similar to the cross-sectional model. Response bias may have influenced findings because sexuality can be a sensitive topic. Attrition may have resulted in a healthier-than-average sample of older men. One half of elderly men consider sex important, and one third report being sexually active. Men's health problems were associated with lack of sexual activity. Key modifiable risk factors include diabetes, depression, and medication use. Endogenous testosterone levels predict sexual activity, but the role of testosterone therapy remains uncertain. National Health and Medical Research Council of Australia.

Effects of reciprocity on attraction: The role of a partner's physical attractiveness

Two studies examined whether expectations of reciprocal desire had a greater impact on people's desire for a potential partner the more the partner was physically attractive. Study 1 showed that a reciprocity manipulation had a greater impact on participants' desire for attractive, relative to moderately attractive, and relatively unattractive potential partners. In Study 2, after learning of a potential partner's desire, desire for highly attractive, relative to attractive, potential partners increased to a larger extent. Mediation analyses showed that this effect was due to the participant's initial expectations of reciprocal desire. In contrast, after learning of a potential partner's lack of desire, participant's desire for highly attractive and attractive potential partners decreased to a similar extent.