Poor Sexual Function Research Articles

Impact of gestational diabetes mellitus on women's sexual function: a systematic review and meta-analysis.

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication with well-established adverse effects on maternal and fetal health. However, research on its impact on sexual health is inconsistent. Currently, there is no comprehensive review on sexual function in pregnant women with GDM. The purpose of this study is to systematically gather and synthesize the available evidence, addressing this important research gap. This systematic review and meta-analysis utilized a comprehensive literature search strategy and incorporated the following databases: the Cochrane Library, Scopus, PubMed, Web of Science, SID, and Google Scholar. The search was conducted until February 21, 2024. The quality of the cross-sectional and case‒control studies included in the current study was evaluated via the modified and standard Newcastle‒Ottawa scale. The certainty of the evidence was evaluated via the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. A meta-regression was conducted to examine the variables that influence total sexual function. Additionally, sequential analysis was performed to determine the required information size for the meta-analysis. The systematic search process yielded a total of 370 studies. The final analysis included six studies. The meta-analysis findings revealed that compared with controls, women with GDM had significantly lower total scores for sexual function (SMD - 1.80, 95% CI -3.44 to -0.15, p = 0.03), sexual desire (SMD - 5.14, 95% CI -8.14 to -2.14, p < 0.001), arousal (SMD - 0.58, 95% CI -0.95 to -0.21, p = 0.002), lubrication (MD -0.41, 95% CI -0.59 to -0.22, p < 0.001) and satisfaction (SMD - 3.82, 95% CI -6.08 to -1.57, p < 0.001). However, the analysis did not reveal statistically significant differences in sexual pain, or orgasm between the GDM and control groups. The meta-regression analysis revealed that older age in the control group was associated with poorer sexual function. Compared with control women, pregnant women diagnosed with GDM have lower sexual function. Further research with larger sample sizes is necessary to enhance the robustness of the evidence, given the low level of certainty. Healthcare providers should focus on the sexual well-being of women with GDM and create tailored interventions to address their specific needs.

Adverse outcomes (AOs) in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) treated with intensified androgen deprivation therapy (ADT+).

113 Background: mCSPC pts experience adverse outcomes (AOs) with intensified androgen deprivation, resulting in treatment discontinuation; however, there is limited data to identify those at risk. The IRONMAN registry is a global initiative to enroll advanced prostate cancer patients worldwide, and survey data on AOs, patient-reported outcomes (PROs), and clinico-epidemiologic (demographic, cancer, and treatment) details. We report the prevalence and predictors of AOs from baseline demographic, clinical, and PRO information with the onset of AOs and present a risk prediction model for clinical use. Methods: We analyzed data from 553 mCSPC patients in the IRONMAN registry from inception to March 2023 who received ADT+ alone (Abiraterone 47.6%, Enzalutamide 26.9%, Apalutamide 22.6%, Darolutamide 2.9%) and had completed baseline PROs. We defined AOs, reported by 60 global sites, as non-progression-related clinically significant serious adverse events (csSAE), treatment discontinuation, and dose reductions (DR/DC), delineated as a composite outcome based on first event. We processed baseline variable groups: Demographics (race, ethnicity, marital status, study site), Clinical Factors (age, ECOG score, metastatic sites, ADT+, concurrent medications, labs [ALP, Hb, LDH, and PSA]), Concurrent therapies (steroid use within 30 days [d] &amp; steroid dose, radiation/surgery prior or planned in 6months) and PROs (EORTC QLQ-C30 and EPIC-23). We developed a multifactorial logistic regression model to predict adverse outcomes (AOs) within two years of initiating ADT+ therapy. All variables with less than 25-30% missing data were included. Variable selection was conducted in two layers: intra-group stepwise selection followed by an inter-group selection of variables retained from the first layer. The model's discriminatory ability was evaluated using the area under curve (AUC). Results: 553 pts met inclusion (51.6% North America, 72% White, mean age: 71 years [range, 40 to 96 years], and 62.9% confirmed bone-metastatic mCSPC). 119 pts (21.5%) developed AOs (61 csSAEs [18 dead; Median: 140 d; IQR 81-360 d], 58 DR/DC [Median: 122 d; IQR 43-262 d]). &lt;5% went off study. The multifactorial model (n=314 pts) performed well at predicting AOs (AUC 0.77 [0.70-0.84]), with significant factors being more self-reported pain, greater urinary frequency, prednisone&gt;5mg within 30d, more self-reported weakness and poor sexual function within 3 months of ADT+ initiation. Conclusions: 1 in 5 mCSPC patients on ADT+ experienced non-progression-related AOs at 2 years. Significant, easily assessed predictive factors are identified and may be utilized in their clinical management. A novel multifactorial model is presented to predict AOs at 2 years. Further validation, assessment of missingness bias, and imputation are planned.

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.

Why people face difficulties in attracting mates: An investigation of 17 probable predictors of involuntary singlehood

People living in contemporary post-industrial societies frequently find themselves being single without wanting so, and the current research aimed to understand the reasons why. In particular, we aimed to examine the effects of 17 probable predictors of involuntary singlehood on a sample of 1432 Greek-speaking participants. For women, we found that poor flirting capacity, poor sexual functioning, high choosiness, and low agreeableness were associated with higher probability to be involuntarily single than in a relationship or married. Moreover, shyness, agreeableness, sexual functioning, and choosiness had indirect effects. In addition, high choosiness was associated with more years being single. For men, poor flirting capacity, higher neuroticism, lower self-perceived mate value, lower self-esteem, and not having children from previous relationships were associated with higher probability to be involuntarily single than in an intimate relationship or married. Furthermore, conscientiousness, sexual functioning, self-perceived looks, and BMI had indirect effects. Additionally, lower mating effort, low self-perceived mate value, and poor flirting capacity were associated with more years being single.

(007) Physical activity and female sexual dysfunction: too much of a good thing?

Abstract Introduction Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. Objectives To investigate the clinical, psychological, and sexual correlates of PA in women with FSD. Methods A non-selected series of n=322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (&amp;lt;1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, &amp;gt;6 hours/week: extremely active) were investigated with a specific question. FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), Body Uneasiness Test (BUT), and Middlesex Hospital Questionnaire (MHQ). Results At multivariate analysis, women engaging in PA (67.4%, n=217) scored significantly higher in several FSFI domains - including desire, arousal and lubrication - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (BUT Global severity index), psychopathological symptoms (MHQ total score) and sexual distress (FSDS-R score). These latter two factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i.e. sexual satisfaction and histrionic/hysterical symptoms), even compared to a sedentary lifestyle. Conclusions In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Disclosure No.

Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men.

Prior research suggests that better mental health and higher relationship quality are associated with better sexual function and satisfaction. Such insights can inform intervention development for mental, relationship, and sexual health concerns. This study examined the interactions among these variables in a racially and ethnically diverse group of young men who have sex with men (YMSM) in serious relationships (N = 348). Data were drawn from wave 5 of a longitudinal cohort study. We examined cross-sectional associations between depression and stress (predictors) and sexual function, sexual satisfaction, and anal discomfort (outcomes) and to what extent these associations were moderated by relationship quality. Higher endorsement of depression and stress was associated with worse sexual functioning, lower sexual satisfaction, and more anal discomfort. We also found that fewer negative interactions, stronger commitment, and higher relationship satisfaction were associated with better sexual functioning and higher sexual satisfaction. Higher relationship satisfaction and commitment were found to attenuate the association between stress and sexual satisfaction. Contrary to expectations, higher relationship satisfaction also showed a trend toward exacerbating the association between depression and sexual functioning. These results suggest that, for YMSM, high relationship satisfaction and commitment may protect sexual satisfaction from being negatively impacted by high stress. However, YMSM in highly satisfying relationships may experience poor sexual functioning associated with depression as particularly distressing. This study addressed a major gap in the literature by focusing on mental, relationship, and sexual health in a diverse sample. Future research should examine a wider range of sexual functioning outcomes and include minority stress in study design.

(009) Comparing the Sexual Lives of Adolescents and Young Adults (AYA) With and Without a History of Cancer

Abstract Introduction Studies have consistently described poor sexual outcomes for AYA cancer survivors – nearly half of which report some level of negative subjective impact of cancer on their sexual lives (Wettergren et al., 2016, Geue et al., 2015). Available data typically comes from long-term survivors, indicating a chronicity of sexual problems that persist long after treatment and recovery. Among AYA survivors, there remains a major unmet need for sexuality-based supportive care, which will likely have to be tailored to the social/developmental needs of a younger population. Objective 1) Compare a sample of AYA survivors to age- and partner-matched peers across a wide variety of sexual outcomes, including behavior, function, affect, and cognition. 2) Explore variables associated with maintenance of sexual problems within the AYA survivor population, i.e., potential intervention targets. Methods Women ages 18-39 with a history of cancer (31% hematologic, 18% breast, 16% gynecologic, 14% thyroid, 20% other) were matched with healthy controls based on age (within 5 years) and partner status (single vs. partnered) (total N=272). Survivors were diagnosed at age 26 (SD=7.88, range 2 to 39 years). 71% of survivors who reported knowing stage at diagnosis (stage 0-2, 54%). At the time of survey, 79% were partnered. We conducted independent samples t-tests to compare scores on sexual behavior (PROMIS), function (PROMIS), distress (Female Sexual Distress Scale [FSDS]), self-efficacy (Sexual Self-Efficacy Scale for Females), and sexual self schema (SSS), hypothesizing that survivors would have poorer sexual outcomes. Results Age at first intercourse and number of partners were comparable across groups. Survivors were more likely to report having children than controls [X2 (1, N = 192) = 5.63, p =.02]. Survivors evidenced a less varied behavioral repertoire (past 30 days) [t(262)=-2.64, p=.01] and engaged in vaginal intercourse significantly less often [t(205)=-1.97, p=.05]; this effect was more pronounced among partnered survivors. Despite lower frequency of intercourse, survivors reported using lubricant more often than the controls [t(211)=2.04, p=.04]. Survivors reported poorer sexual interest [t(281)=-4.89, p&amp;lt;.01], lubrication [t(281)=-4.12, p&amp;lt;.001], orgasm [t(279)=-2.65, p=.01], and satisfaction [t(278)=-3.07, p&amp;lt;.01]. Sexual affect and cognition were also poorer for survivors; they tended to have higher sexual distress [t(269)=5.05, p&amp;lt;.01], more embarrassed/conservative sexual self schema [t(268)=2.22, p=.03], and lower sexual self-efficacy [t(286)=-4.94, p&amp;lt;.01]. Conclusions Young adult survivors of cancer experience more sexual problems than peers, including a more restricted sexual repertoire, less frequent sexual behaviors, poorer sexual function, as well as more negative emotion and cognition regarding their sexuality. There has been insufficient attention to the unique needs and experiences of younger survivors. Disclosure No

(110) Characterizing Sexuality and Assessing Predictors of Sexual Satisfaction in Patients with Multiple Myeloma

Abstract Introduction There is a paucity of literature documenting cancer-related sexual concerns among patients with multiple myeloma (MM). Despite profound sexual changes being reported in other types of hematological cancer (i.e., lymphoma, leukemia), all types of hematological cancer patients tend to be grouped together, potentially overlooking the unique concerns of patients with MM. Objective This study is the first to characterize sexuality uniquely in the MM population, and to examine predictors of sexual satisfaction for MM, comparatively with participants with other hematological cancer types. Methods We performed a mixed modality self-report survey of patients with hematological cancer, recruiting both in-person and online. Men and women with MM (N=89) and other hematological cancers (N=84) participated in our survey. The survey included demographics and health information, as well as several quantitative sexuality measures including sexual distress, sexual function, sexual flexibility, sexual interest, sexual communication, and sexual satisfaction. Results MM survivors exhibited poor sexual function but low sexual distress, and endorsed mid-high scores on measures of sexual interest, sexual flexibility, sexual communication, and sexual satisfaction. Results indicate that for MM and other hematological cancer survivors, lower sexual distress and higher sexual communication were associated with higher sexual satisfaction (b = .428, p &amp;lt; .001; b = -.299, p = .001) while sexual flexibility, sexual interest, and sexual function did not explain significant variance in sexual satisfaction. Thematic analysis on open-ended questions indicates that potentially unique to MM, consequences of bone disease (i.e., bone pain, bone fracture, and spinal cord compression) affected sexual expression and resulted in reduced mobility impacting sexual activity, as well as painful sexual experiences, or anxiety relating to sex. Conclusions This study supported the need for sexual health interventions for those diagnosed with MM. Further, it demonstrated that sexual interventions that are used for other hematological cancer patients may be similarly effective for those with MM. Special consideration regarding the impact of bone disease on sexual expression in MM patients should be taken. Disclosure No

(144) Clitoral Anatomy and its Relation to Sexual Function after Apical Prolapse Repair using Pelvic MRI

Abstract Introduction The clitoris is the primary sexual organ involved in the physiological changes that occur during the female sexual response. Sparse research and contradictory evidence concerning clitoral anatomy and its role in female sexual function exist, especially in the context of pelvic floor disorders and their surgical correction. Comprehensive description of clitoral anatomy and how it relates to postoperative sexual function in women surgically treated for pelvic floor disorders is necessary to better understand the pathophysiological mechanisms of female sexual dysfunction following gynecologic surgery. Objective To identify characteristics of clitoral anatomy (size, location, shape) associated with female sexual function in women after vaginal hysterectomy with uterosacral ligament suspension (native tissue repair, NTR) or transvaginal mesh (VM) hysteropexy for uterovaginal prolapse. We hypothesized that a smaller clitoris and clitoral components would correlate with poorer sexual function. Methods In this ancillary study of women enrolled in a randomized clinical trial, 30–42-month postoperative axial MRIs of 82 women surgically treated (41 NTR, 41 VM) were obtained at rest. The clitoral components (glans, body, crura) and vestibular bulbs were segmented to create 3D models of the “clitoral complex” (Figure 1). Using these models and computational morphometry, clitoral dimensions and position were computed with respect to a 3D pelvic coordinate system (Figure 2). After aligning, normalizing (scaling), and establishing corresponding points between models, statistical shape modeling was performed via Principal Component Analysis (PCA) to identify/quantify significant modes of anatomic variation of the clitoris. Participant data included demographics, medical history, sexual activity status, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). The relationships between clitoral measurements/shape and sexual function were evaluated using Spearman rank correlation. Results For this group of mostly postmenopausal women (80/82 [97.6%]), median (min-max) age was 65.3 (47-79), 15/82 (18.3%) were sexually active (SA), and 21/82 (25.6%) were not sexually active (NSA) postoperatively (46/82 [56.1%] did not respond). Among SA women, a smaller glans width correlated with overall poorer sexual function (lower PISQ-IR mean score) (r=0.74, p=0.002), frequent feelings of shame/fear with leakage of urine/stool during sex (r=0.69, p=0.004), and low sexual arousal (r=0.61, p=0.02). A smaller glans height correlated with dyspareunia (r=-0.64, p=0.02) and less intense orgasms postoperatively (r=0.64, p=0.01). A smaller glans volume correlated with low sexual arousal (r=0.60, p=0.02) and a clitoral complex farther away from participants’ midline (midsagittal plane) correlated with greater negative impact of incontinence/prolapse on sex life (r=-0.66, p=0.007). Among NSA women, a clitoris farther away from participants’ midline was associated with dyspareunia as a strong reason for sexual inactivity (r=0.49, p=0.03). From the PCA, 11 significant modes of shape variation were found. For SA women, Modes 5 and 8 correlated with leakage of urine/stool during sex (r=-0.65, p=0.009) and dyspareunia (r=-0.59, p=0.04), respectively (Figure 3). For NSA women, Mode 4 correlated with dyspareunia as a strong reason for sexual inactivity (r=0.46, p=0.04) (Figure 3). Conclusions Poorer sexual function was associated with a smaller clitoral glans (width, height, volume) among SA women and a clitoral complex positioned farther away from participants’ midline in SA and NSA women following prolapse surgery. Disclosure Yes, this is sponsored by industry/sponsor: Boston Scientific Clarification Industry funding only - investigator initiated and executed study

(125) Factors Associated with Erectile Dysfunction in Copper and Cobalt Miners: A Cross-sectional Study in the Katanga Province, DR Congo

Abstract Introduction The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Based on a preliminary case-control study of erectile dysfunction among mineworkers in the former Katanga province of the Democratic Republic of Congo (Musa et al. Occupational and Environmental Medicine 2020), Objective We further investigated possible factors associated with erectile dysfunction in copper and cobalt miners in the Katanga province. Methods In a cross-sectional study of 138 miners and 140 controls (bakers), we administered questionnaires face-to-face in French or Swahili to obtain socio-demographic and occupational data, and to assess male sexual function [International Index of Erectile Function (IIEF-15)] and marital relation quality [Revised Dyadic Adjustment Scale (DAS)]. We measured trace metals in blood and urine and testosterone and thyroid hormones in serum. Results Miners and bakers had similar median (IQR) age [35.6 y (30.6–40.0)]. Miners had significantly lower scores than bakers for IIEF-15 [66 (49–73) vs 73 (66–74)] and for the three DAS domains (Consensus; Satisfaction; Cohesion). Miners had significantly lower free testosterone (8.1 ng/dL) and thyroxin (13.45 pmol/L) than bakers (9.3 and 14.75, respectively). Factors associated with IIEF- EF scores ≤ 22 were: mining-related job (aOR 2.09, 95% CI 1.14–3.81; p=0.016), work seniority in mining (aOR 1.07, 95% CI 1.02–1.13; p=0.005) and regular use of aphrodisiacs (aOR 2.80, 95% CI 1.56–5.02; p=0.001). Mediation analysis showed that consensus mediated by 50% the relation between work seniority in mining and erectile function. Conclusions Compared to controls, miners had poorer sexual function and marital relation, and lower free testosterone and thyroxin. This may be due to their high exposure to trace metals (especially Pb). Erectile dysfunction is found to be increased by lower consensus in couples possibly due to longer time spent working away from home. Disclosure No

(029) Frequent Pornography Consumption is Linked to Poor Body Satisfaction and Consequently to Poor Sexual Functioning in Heterosexually-identified Men Who Endorse Masculinity Ideologies

Abstract Introduction In Western societies, men may frequently receive messages about ideals of an often unattainable male body through visual media, including pornography. Additionally, men may hold traditional masculinity beliefs that idealize slender and muscular male bodies. Objective The current study analyzed whether pornography consumption was associated with men’s body satisfaction. Additionally, it was analyzed whether the endorsement of masculinity ideologies was a vulnerability factor that makes men more or less susceptible to pornography’s influence on body satisfaction. The study further analyzed whether body satisfaction in turn predicted men’s experiences of distressing sexual problems. Methods An online questionnaire study was conducted among 261 self-identified heterosexual young men (Mage = 24.4, SD = 3.5) at an Austrian medical university. The questionnaire contained questions about frequency of pornography consumption, body satisfaction, and distressing sexual problems. Endorsement of masculinity ideologies was assessed with the Male Role Norms Inventory–Short Form. A structural equation model was calculated to test whether the frequency of pornography consumption predicted body satisfaction, and whether body satisfaction in turn predicted distressing sexual problems. Men’s endorsement of masculinity ideologies was considered as a moderator for the effect of pornography consumption on body satisfaction. Results A structural equation model (χ2(30) = 39.3, p = .119; χ2/df = 1.3; RMSEA = .035, 90%CI = .000 – .062; CFI = .941; SRMR = .029) revealed that for most men pornography consumption was not associated with body satisfaction. However, there was a negative association between pornography consumption and body satisfaction for men who strongly endorsed the masculinity ideology of men needing to always be the dominant. Poor body satisfaction in turn was significantly associated with the experience of distressing erectile difficulties, ejaculation sooner than desired, or diminished intensity of orgasmic sensations. Conclusions This study reveals the importance of body satisfaction for sexual functioning in young heterosexual-identified men. Thus, clinicians who treat sexual problems in young men should address their clients’ or patients’ body satisfaction. Empowering men who endorse masculinity ideologies to challenge norms for an “ideal” male body, as depicted in most pornography, may be an important component of such interventions. Disclosure No

Bidimensional self-esteem and sexual functioning among young adults: A systematic review

AbstractSexual difficulties marked by poor sexual functioning is often reported by young adults, where young adulthood is an important period for the formation of intimacy in relationships. There has been increasing research showing the relationship between global self-esteem and sexual functioning, but this association is seldom examined through the bidimensional framework of self-esteem that includes domains of self-liking and self-competence. Thus, the purpose of this systematic review was to examine the empirical evidence on self-esteem domains and sexual functioning among young adults. Six databases (PsycINFO, Ovid MEDLINE, Scopus, PubMed, Web of Science, and CINAHL Plus) were searched for peer-reviewed journal articles published from inception to June 2022. Articles were included in this review if they measured at least one domain of self-esteem, one domain of sexual functioning, reported the association between self-esteem and sexual functioning, and involved young adults from 18–30 years old. Of the 6020 records retrieved, 17 articles were included in this review. Data were extracted and synthesised, and a quality assessment tool for observational cohort and cross-sectional studies was used to appraise the quality of articles ranging from poor to good. Most studies found positive associations between self-esteem elements and sexual functioning, particularly for global self-esteem and sexual self-esteem. However, these findings cannot be generalised due to the heterogeneity in measures of self-esteem constructs. This review reveals a gap in the literature as self-liking and self-competence have not been studied together in relation to sexual functioning, where most studies have focused on sexual satisfaction.

Prevalence of sexual dysfunction in HTLV-1 patients without spastic paraparesis and the association with psychiatric symptoms.

The findings of previous studies are inconclusive in terms of psychological abnormalities and sexual function in asymptomatic human lymphotropic virus type 1 (HTLV-1) carriers. This study aimed to evaluate the prevalence of sexual dysfunction and its relationship with psychological abnormalities in asymptomatic HTLV-1 carriers. This cross-sectional study was conducted on asymptomatic HTLV-1 patients who were referred to the Neurology Clinic of a tertiary hospital in Mashhad, Iran. Patients with spastic paraparesis, leukemia, and uveitis, and those with an expanded disability status scale (EDSS) score higher than 2 were excluded. Sexual function in male and female subjects was evaluated using the brief male sexual function inventory (BMSFI) and female sexual dysfunction index (FSFI) questionnaires, respectively. The severity of psychological symptoms was evaluated in all patients using the symptom checklist-90-revised (SCL-90-R) questionnaire. A total of 117 patients (61 males and 56 females) with a mean age of 35.3 ± 6.3 years were evaluated. Overall, 50.9% of males had a high and 39.3% of females had a good sexual function. Both male and female patients with poor sexual function were older and had more children compared to those with good sexual function (P < 0.05). There was no significant difference in the distribution pattern of SCL-90 domains between patients with high and low to moderate sexual function among male patients (P > 0.05). Depression, hostility, interpersonal sensitivity, paranoid ideation, and psychological abnormality were significantly more prevalent in female patients with poor sexual function compared to those with good sexual function (P < 0.05). The prevalence of psychological abnormalities was high in female with sexual dysfunction and these disorders might have a negative effect on various dimensions of sexual function.

Sexual self-concept, functioning, and practices of women with binge eating episodes

PurposePositive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population.MethodsIn total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants’ sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions.ResultsParticipants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating.ConclusionsSexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind–body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes.Level of evidence: Level II: The experimental study is a non-randomized controlled trial.

Effects of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress.

Few studies have investigated psychogenic sexual dysfunction including psychogenic erectile dysfunction (pED); the effect of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress (CUMS) remains unclear. The aim was to explore the influence of CUMS on sexual behavior of male rats and the effects of tadalafil on that. Adult male rats were divided into 3 groups, including the normal group without CUMS, the model group with 6weeks' CUMS, and the tadalafil group with treatment of tadalafil during CUMS. CUMS consists of water deprivation, food deprivation, stroboscopic lightning, white noise, cage tilting, weeding packing, and housing 2 unfamiliar rats. The apomorphine test and vaginal smear test were conducted with the aim to screen out male rats with good erectile function and make preparation for the sexual behavior test, respectively. At the end of the study period, the level of anhedonia and sexual function were evaluated by the sucrose preference test, sexual behavior test, and measurement of serum testosterone, dopamine, and 5-HT. Sucrose preference showed significant decrease in rats after CUMS. The intromission ratio and total intromission frequency decreased significantly, while the mount latency and ejaculation latency prolonged significantly in CUMS-induced rats when compared with normal rats. Meanwhile, the treatment of tadalafil reversed the level of anhedonia and sexual function in CUMS-induced rats. However, there were no statistical differences in the levels of serum testosterone, dopamine, and 5-HT among groups. The study constructed an animal model that can provide clinical insights into the mechanism of psychogenic sexual dysfunction and supports the application of tadalafil in pED therapy. We found that CUMS-induced rats exhibited anhedonia and poor sexual function that could be prevented by tadalafil administration. Future research needs to construct the standard of pED model and explore the mechanism of tadalafil on central nervous system. Tadalafil could prevent the changes of depression and poor sexual function in rats induced by CUMS, and the method of CUMS and the sexual behavior test should be used in the future for pED modeling.

Sexual functioning beliefs, sexual satisfaction, and sexual functioning in women: a cross-sectional mediation analysis

Sexual dysfunctional beliefs are known to be negative predictors of women's sexual functioning and sexual satisfaction, but little is known about the role that beliefs about sexual functioning play in women's sexual functioning and sexual satisfaction. The purpose of the present study was to examine the mediating role of sexual functioning in the relationship between women's beliefs about sexual functioning and sexual satisfaction. A sample of 301 women was invited to participate in a web survey about female sexuality in May 2020. Participants completed the sociodemographic questionnaire, the Beliefs About Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index. Sexual functioning was a significant mediator in the relationship between beliefs about sexual functioning and sexual satisfaction in women. When the dimensions of sexual functioning were considered as mediators, only sexual desire and absence of sexual pain were significant mediators in the relationship between beliefs about sexual functioning and sexual satisfaction in women. Negative beliefs about sexual functioning in women are associated with poor sexual functioning and lack of sexual satisfaction. Therefore, beliefs about sexual functioning should be assessed during the intervention for women's sexual difficulties and to increase sexual pleasure and satisfaction. In addition, special attention should be paid to women with problems with sexual desire and sexual pain when beliefs about sexual functioning are being assessed. This study is one of the first attempts to explore the role of beliefs about sexual functioning in women's sexual satisfaction and to examine the mediating role of sexual functioning. Limitations include the small sample size, the lack of a clinical sample, and the nonlongitudinal methodological approach. Beliefs about sexual functioning are a negative predictor of sexual functioning and sexual satisfaction in women. In addition, women with sexual pain and lack of sexual desire are more likely to have lower sexual satisfaction if they have more negative beliefs about sexual functioning.

A comparative study of sexual behavior, dysfunction, satisfaction, relationship, and sexual quality of life amongst treatment-naïve and abstinent men (buprenorphine-maintained) with Opioid (heroin) dependence syndrome.

Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking. To compare sexual behavior, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients (GROUP-I) with Opioid (heroin) dependence syndrome (ODS-H) with those maintained on buprenorphine (GROUP-II). Married adult males diagnosed with ODS-H, currently sexually active, and living with their partner were recruited. They were assessed for their sexual practices and high-risk sexual behavior (HRSB) through a semi-structured questionnaire and sexual functioning, relationships, satisfaction, and sQoL through structured questionnaires. A total of 112 individuals (GROUP-I: 63; GROUP-II: 49) were recruited from the outpatient settings. Mean age and employment in GROUP-II were higher (p < 0.05) than in GROUP-I (37 vs 32 years; 94% vs 70%, respectively). Other sociodemographic variables and the age of onset of heroin use were comparable. The current practice of HRSB (e.g., engaging in casual partner sex, sex with commercial sex workers, and sex under intoxication) was higher in GROUP-I while almost no differences were seen in lifetime HRSB. The frequency of erectile dysfunction and premature ejaculation in the two groups were: 78% vs 39% (p < 0.001), and 30% vs 6% (p = 0.001), respectively. GROUP-II had significantly higher scores in all the scales (p < 0.05) as compared to GROUP-I, indicating better sexual satisfaction, quality of life, and sexual relationship. Heroin use is associated with HRSB, poorer sexual functioning, overall satisfaction, and sQoL. Maintenance of Buprenorphine helps with improvement in all these parameters. Comprehensive management for substance use should target sexual problems as well.

Use of Prophylactic Antibiotics in Third and Fourth Degree of Perineal Rupture

Numerous studies have demonstrated how routine episiotomies can cause additional problems like poor postpartum sexual function, ongoing perineal pain, and increased anal sphincter damage resulting in flatus or fecal incontinence. To combat the high frequency of maternal labor morbidity, antibiotic prophylaxis is recognized as a method of intervention that can be applied. . On the other hand, several studies seem to support the use of preventive antibiotics in situations of severe perineal rupture. It is not advised to use antibiotics excessively due to the rising prevalence of their use, which increases the danger of antibiotic resistance. As a result, following a serious perineal tear, the use of prophylactic antibiotics is crucial to preventing infection and determining whether a side effect is present in the mother or infant. Therefore it is necessary to assess the effectiveness of antibiotic prophylaxis to reduce maternal morbidity and side effects of third and fourth-degree perineal rupture during vaginal delivery.

Anxiety Sensitivity in the Sexual Context: Links between Sexual Anxiety Sensitivity and Sexual Well-Being

Anxiety sensitivity, the fear of physiological arousal sensations, has been linked to lower sexual frequency, poorer sexual function, and greater sexual anxiety. The current study assessed whether anxiety sensitivity specific to the sexual context, termed sexual anxiety sensitivity, was linked to a wide range of indicators of sexual well-being over and above associations accounted for by general anxiety sensitivity. As a first step, we developed the Sexual Anxiety Sensitivity Inventory (SASI). Participants were 484 adults aged 19 to 60 years old who completed an on-line survey. To develop the SASI, we constructed parallel items to those on the Anxiety Sensitivity Scale-3 (ASI-3; Taylor et al., 2007). The SASI demonstrated the same three-factor structure as the ASI-3 and showed high internal consistency providing evidence for its reliability. As predicted, sexual anxiety sensitivity was significantly associated with all ten of the markers of the behavioral, cognitive-affective, and functional domains of sexual well-being assessed and six of these associations remained significant after controlling for general anxiety sensitivity. The results provide evidence that sexual anxiety sensitivity is an important construct for understanding individuals’ sexual well-being and provide initial evidence that the specificity of the SASI has value as a reliable and valid measure for assessing sex-related anxiety sensitivity. Implications for clinicians and researchers are discussed.

Identification of Risk Factors for Sexual Dysfunction after Multimodal Therapy of Locally Advanced Rectal Cancer and Their Impact on Quality of Life: A Single-Center Trial.

Sexual function is crucial for the quality of life and can be highly affected by preoperative therapy and surgery. The aim of this study was to identify potential risk factors for poor sexual function and quality of life. Female patients were asked to complete the Female Sexual Function Index (FSFI-6). Male patients were demanded to answer the International Index of Erectile Function (IIEF-5). In total, 79 patients filled in the questionary, yielding a response rate of 41.57%. The proportion of women was represented by 32.91%, and the median age was 76.0 years (66.0-81.0). Sexual dysfunction appeared in 88.46% of female patients. Severe erectile dysfunction occurred in 52.83% of male patients. Univariate analysis showed female patients (OR: 0.17, 95%CI: 0.05-0.64, p = 0.01), older age (OR: 0.34, 95%CI 0.11-1.01, p = 0.05), tumor localization under 6cm from the anal verge (OR: 4.43, 95%CI: 1.44-13.67, p = 0.01) and extension of operation (APR and ISR) (OR: 0.13, 95%CI: 0.03-0.59, p = 0.01) as significant risk factors for poor outcome. Female patients (OR: 0.12, 95%CI: 0.03-0.62, p = 0.01) and tumors below 6 cm from the anal verge (OR: 4.64, 95%CI: 1.18-18.29, p = 0.03) were shown to be independent risk factors for sexual dysfunction after multimodal therapy in the multivariate analysis. Quality of life was only affected in the case of extensive surgery (p = 0.02). Higher Age, female sex, distal tumors and extensive surgery (APR, ISR) are revealed risk factors for SD in this study. Quality of life was only affected in the case of APR or ISR.