Predictors Of Sexual Dysfunction Research Articles

Characteristics and predictors of sexual dysfunction in men with multiple sclerosis

PurposeTo validate and culturally adapt the Sexual Health Inventory for Men (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT), to compare the frequency and severity of erectile dysfunction (ED) and premature ejaculation (PE) in male individuals with MS (mwMS) in comparison with healthy controls (HC) and to investigate predictors of the severity of ED and PE in mwMS. Methods216 consecutive mwMS and 37 HC completed IIEF-5 and PEDT. Additionally, 114 mwMS completed the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-2), Composite Autonomic System Score-31 (COMPASS-31), and the 5-level EQ-5D questionnaire. ResultsThe test-retest reliability was satisfactory for both questionnaires, with acceptable reliability for both questionnaires. mwMS scored less on IIEF-5 compared to HC (23, IQR 18.25–25 vs 24, IQR 20.25–25, p = 0.028). ED was present in 39.4 % of mwMS and 27.8 % of HC (p = 0.198). Definite PE was present in 12.1 %, and possible PE in 7.8 % of mwMS; and 5.6 % and 11.1 % of HC respectively (p = 0.496). An increase in EDSS was a positive predictor (Exp(B) 1.455, 95 %CI 1.135–1.886, p = 0.003) and the presence of cremasteric reflex was a negative predictor (Exp(B) 0.381, 95 %CI 0.183–0.790, p = 0.010) for the presence of ED. For the PE, disease duration was the only positive predictor in a univariable logistic regression (Exp(B) 1.084, 95 %CI 1.019–1.153, p = 0.070). ConclusionSD is frequent in mwMS with EDSS being a positive and the presence of cremasteric reflex a negative predictor of ED and disease duration a positive predictor of PE symptoms.

Patterns and predictors of female sexual dysfunction in diabetes mellitus.

Background Sexual complications of people with diabetes mellitus (DM) are often neglected by the patients as well as clinicians. The neglect is more in women due to the associated stigma and taboo. Indian studies are scanty, varied and inconsistent, regarding the impact of DM on sexual functioning in women. We studied the patterns and predictors of sexual dysfunction in women with DM. Methods We did a cross-sectional questionnaire-based study comprising 50 participants in both the study (women with DM1 and DM2) and control groups (relatives/caregivers of patients and the hospital staff), selected randomly from the medicine outpatient department from May to August 2016. Approval from the institutional ethics committee was obtained. Clinical anxiety and depression were screened using the hospital anxiety and depression scale. Sexual dysfunction was assessed through female sexual function index scale (FSFI), and predictors were assessed by correlating FSFI scores with sociodemographic and clinical parameters. Results We found that 44% of women with DM had sexual dysfunction compared with 20% in the control group (p<0.01). The pattern of sexual dysfunction was seen across the domains of desire, arousal, lubrication and orgasm. High body mass index, higher age, duration of DM, treatment with insulin and complications of DM predicted a greater degree of sexual dysfunction among women. Conclusion Sexual dysfunction is common in women with DM, irrespective of the type of DM and coexisting psychological factors such as depression and anxiety.

Predictors of Sexual Dysfunction in Women Seeking Treatment for Opioid Use Disorder: A Comparative Cross-Sectional Study from a Tertiary Center

Predictors of Sexual Dysfunction in Women Seeking Treatment for Opioid Use Disorder: A Comparative Cross-Sectional Study from a Tertiary Center

The Frequency and Predictors of Sexual Dysfunction Among People Living with HIV/AIDS.

The frequency of sexual dysfunctions reported by HIV/AIDS patients is significantly higher than that of their peers. Sexual dysfunction and its predictors may result in increased viral loads, worsening HIV infection, and infectivity. To mitigate its consequences, appropriate evaluation and intervention are required. A cross-sectional study design was conducted among 336 HIV/AIDS-positive individuals at one hospital in southwest Ethiopia. To assess sexual dysfunctions, a tool called the Changes in Sexual Functioning Questionnaire (CSFQ-14) was used. Data analysis was done with SPSS version 20. Bivariate and multivariable logistic regressions were used to identify independent predictor variables, and statistical significance was declared at a p-value of <0.05. 98.53% of the sample completed the questionnaire accordingly. The frequency of SD was 72.0% (95% CI = 67.4-77.0). The frequency of SD was reported to be more prevalent among males (76.8% (95% CI = 70.6-81.6)) than that of females (66.2% (95% CI = 59.5-73.5)). Among the domains of sexual dysfunction, sexual pleasure problems (96.70%, (95% CI: 94.60-98.50)) were the higher figure of SD, and sexual desire problems (82.40%, (95% CI: 78.60-86.60)); were the least prevalent sexual dysfunctions. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication. The frequency of SD was 72.0%. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication.

Prevalence and Predictors of Sexual Dysfunction (SD) after Treatment of Localized Rectal and Anal Cancer (LRAC)

SD is possible after treatment of LRAC and is associated with distress and impaired quality of life. We report the prevalence of SD in our LRAC patients treated with curative intent. We also evaluate patient/treatment-related factors associated with SD. LRAC patients from 2010-2022 were identified. Consented patients were surveyed and patient/treatment factors were collated from medical records. Sexual function (SF) was measured using the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). The impact of disease/treatment on SF since treatment was measured using the SF Questionnaire Medical Impact Scale (SFQ-MIS). FSFI ≤ 19.2 and IIEF ≤ 32.2 were considered SD based on the mean scores of SD patients in the primary literature. SFQ-MIS ≥ 15.5 was used to dichotomize responses into "at least some impact" versus "at least no impact." Spearman rank correlations examined correlations between FSFI/IIEF and factors. Comparisons involving componential domains and factors were based on a two-sided Mann-Whitney test. RT dose, surgery, the extent of lymphadenectomy, T stage, and time since treatment were factors assessed in all patients. In females, dilator use during RT, tumor distance (TD) from the anterior vaginal wall and whole vagina, and V25Gy, V45Gy, and mean dose to the anterior vaginal wall and whole vagina were other factors assessed. In males, TD from the neurovascular bundle (NVB), V25Gy, V45Gy, and mean dose to NVB was used. Forty-five patients (13.5% response rate) completed study surveys (62% males; 80% white; 71% rectal cancer patients). The median age and time since treatment were 63 and 4 yrs. respectively. RT doses ranged from 25 - 54Gy. The overall prevalence of SD was 58% (71% in females; 50% in males). The proportion of patients who reported at least some SF impact was 56% (53% in females; 57% in males). There was a marginal association between higher total IIEF and receipt of surgery (p = 0.059). A correlation of 0.44 was seen between total IIEF and TD from upper NVB-the strongest among all comparisons. In the domains of IIEF, statistically significant associations were found between intercourse satisfaction (ISAT) and TD from upper NVB (p = 0.004), overall satisfaction (OSAT) and TD from lower NVB (p = 0.040), and ISAT and T stage (p = 0.047). There were marginal associations between TD from upper NVB and OSAT (p = 0.052), orgasm (p = 0.063), and erectile dysfunction (p = 0.097). There was a marginal association between V25Gy to the anterior vaginal wall and pain during penetrative sex (p = 0.095). No other association with FSFI or its domains was significant. SD is prevalent in a large majority of patients studied (58%). In males, higher TD from NVB was associated with better overall SF, better intercourse, and overall satisfaction. While a higher proportion of females had SD, no significant associations were found in females likely due to their small sample size.

Patterns and predictors of sexual dysfunction in women with epilepsy

ObjectivesAvailable data about sexual-related problems among Egyptian women with epilepsy (WWE) are scarce. Hence, this work aimed to study the pattern and predictors of sexual dysfunction in a sample of Egyptian WWE. MethodsIn this cross-sectional study, sexually active WWE and age and years of marriage-matched healthy controls were included. The Female Sexual Function Index questionnaire (FSFI) was used to assess sexual function in both groups. ResultsIn the patient group (n = 142), the median age was 33 (28–39), whereas the median age of the control group (n = 142) was 33.5 (28–36). Women with epilepsy had significantly lower desire, arousal, pain, and FSFI-total scores than the control group (P = 0.001, 0.001, 0.023, 0.008, respectively). There was a significant difference between the FSFI-total score of women on polytherapy and those on monotherapy (P = 0.042), as well as between those on enzyme-inducing ASMs and those on ASMs that did not affect P450 (P = 0.032). Seizure frequency in the last three months was negatively correlated with scores of desire, arousal, lubrication, orgasm, and satisfaction (P 0.047, 0.02, 0.009, 0.013, 0.046, respectively). By multiple backward linear regression models, age, and seizure frequency were the significant predictors of the FSFI-total score (B −0.219, −0.33, respectively). ConclusionThe pattern of sexual dysfunction among Egyptian WWE is characterized by reduced sexual desire, arousal deficits, and sexual-related pain. Seizure frequency, epilepsy duration, enzyme-inducing medications, and multiple anti-seizure medications (ASMs) may adversely affect WWE's sexual health. The only factor that could predict higher sexual dysfunction in WWE was higher seizure frequency.

Prevalence and predictors of sexual dysfunction in females with type 1 diabetes: a systematic review and meta-analysis.

Several observational studies have explored the prevalence and predictors of female sexual dysfunction (FSD) among females with type 1 diabetes. However, no systematic review and meta-analysis of pooled data provide reliable estimates of FSD prevalence among females with type 1 diabetes. To investigate the global prevalence of FSD, analyze the association between FSD risk and type 1 diabetes, and evaluate the predictors of FSD among females with type 1 diabetes. The study search of the present systematic review was conducted through the Wanfang Database, China National Knowledge Infrastructure, PubMed, and Embase from the inception date to February 28, 2023. Heterogeneity among the studies was analyzed with the Q and I2 tests. The sources of heterogeneity were detected through subgroup analyses and meta-regression. Outcomes included the pooled prevalence of FSD among females with type 1 diabetes, the association between FSD risk and type 1 diabetes, and the predictors of FSD among females with type 1 diabetes. The pooled prevalence of FSD among females with type 1 diabetes was 38.5% (95% CI, 32.1%-45.0%). The risk of FSD was higher in patients with type 1 diabetes than in healthy controls (odds ratio [OR],3.77; 95% CI, 2.24-6.35). The significant predictors of FSD among females with type 1 diabetes were depression status (OR,2.77; 95% CI, 1.29-5.93) and longer diabetes duration (OR,1.19; 95% CI, 1.06-1.34). Females with type 1 diabetes had a significantly increased prevalence of FSD, indicating that clinicians should be concerned about FSD among females with type 1 diabetes. The strength of the present study is that it is the first systematic review and meta-analysis to investigate the global prevalence and predictors of FSD among females with type 1 diabetes. The limitation is that the results revealed significant heterogeneity after pooling the articles. The present systematic review and meta-analysis revealed that the overall prevalence of FSD among females with type 1 diabetes was 38.5%, demonstrating a significant association between FSD risk and type 1 diabetes among females. Furthermore, we found that the significant predictors for FSD among females with type 1 diabetes were depression and a longer duration of diabetes.

Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study

Purpose This study was conducted to determine the dyadic adjustment between individuals with SCI and their spouses and the relationship between their sexual self-consciousness and sexual life and to evaluate it according to the objectification theory. Method This descriptive and cross-sectional study was conducted with 131 married individuals with SCI registered in the physical therapy and rehabilitation outpatient clinic of a university hospital between February 2020 and April 2021. The data of the study were collected using a Descriptive Information Form, the American Spinal Injury Association Impairment Scale (ASIA), the Dyadic Adjustment Scale (DAS), the Sexual Self-Consciousness Scale (SSCS), and the Arizona Sexual Experiences Scale (ASEX). In the study, the predictors of the sexual life of individuals with SCI were evaluated with the Stepwise Multiple Linear Regression analysis. In addition, predictors of sexual dysfunction in individuals with SCI were evaluated by the logistic regression analysis. The results were discussed within the framework of objectification theory. Results According to the results of the study, .67.2% of the individuals with spinal cord injuries experienced sexual functionality problems; increased age, falling injuries, and being in ASIA grade A increased sexual self-awareness and sexual dysfunction; and being a male with SCI increased sexual focus. It was found that the adjustment between individuals with SCI and their spouses was a predictor that significantly reduced sexual embarrassment, sexual self-consciousness, and sexual dysfunction and that the strong adjustment between couples was an important factor for the prevention of sexual dysfunction development. Conclusion It was found that most individuals with spinal cord injuries experienced sexual dysfunction. The importance of dyadic adjustment and sexual self-consciousness has come to the fore in the sexual life of these individuals.

Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study

IntroductionPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale.Materials and methodsThe present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12.ResultsIn the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05).ConclusionThe results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.

Relationship Between Dyslipidemia and Sexual Dysfunction Among Type 2 Diabetics in Tema Metropolis of Ghana

Background: The prevalence of diabetes is high and still rising worldwide. This study sought to investigate the influence of dyslipidemia on the risk of sexual dysfunction among type 2 diabetics in Tema Metropolis of Ghana. Methods: An analytical cross-sectional study design was employed and involved 246 type 2 diabetics selected through consecutive sampling from Tema General Hospital. Sexual dysfunction was evaluated using the Golombok Rust Inventory of Sexual Satisfaction questionnaire. Lipid profile of subjects was determined and dyslipidemia diagnosed according to the National Cholesterol Education Program-Adult Treatment Panel III criteria. Regression analysis was performed to determine the association between dyslipidemia and sexual dysfunction. Results: About 64.9% and 66.4% of male and female diabetics had sexual dysfunction respectively. The prevalence of combined/Mixed dyslipidemia were 46.2% and 48.3% among male and female diabetics respectively. In male diabetics, hypercholesterolemia was significantly associated with sexual dysfunction. Male diabetics that had hypercholesterolemia were 3.2 times more likely to suffer from sexual dysfunction as compared to those without hypercholesterolemia (Adjusted Odds Ratio = 3.18; 95% Confidence Interval: 1.30-7.79; P=0.011). In female diabetics, dyslipidemia was not found to be associated with sexual dysfunction. Conclusion: Study concluded that dyslipidemia (Hypercholesterolemia) is an independent predictor of sexual dysfunction in male but not in female type 2 diabetics.

SEXUAL DYSFUNCTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract INTRODUCTION Inflammatory bowel disease (IBD) is likely to have an impact on sexual function because of its symptoms like diarrhea, fatigue and abdominal pain. The impact of the disease on sexuality and intimacy is one of the main concerns of IBD patients but there is still limited data on sexual (SD) and erectile dysfunction (ED) and its determinants in IBD. AIM OF THE STUDY This study aimed to evaluate sexual function and search for predictors of sexual dysfunction among patients with IBD during biological treatment. METHODS This was a prospective, one center study enrolled a cohort of 135 patients with Crohn’s disease (CD) and ulcerative colitis (UC) treated with biological treatment on the basis of the same inclusion criteria (CDAI&amp;gt;300 for CD, Total Mayo score&amp;gt;6 for CU). All IBD patients were invited to fill an anonymous validated questionnaire on their sexual function: Female Sexual Function Index (FSFI) or International Index of Erectile Function-5 (IIEF-5) and one question about how bowel problem limited sexual activity during the last 2 weeks from Inflammatory Bowel Disease Questionnaire (IBDQ). RESULTS Both groups of patients (CD and CU) considered for sexual function were treated with anti -TNF alfa agents. GKS were more frequent among females (24/68, 35%) than males (12/67, 18%), p = 0.037. Comorbidities index was also higher in females (31/68, 46% vs. 17/67, 25%), p = 0.023. In the entire study group SD occurred in 43,7% of patients, in comparable value of men and women (p =0,536). We didn’t demonstrate a relationship between the duration of IBD, taken drugs (GKS, immunosuppressants) and calprotectin levels and the results of the FSFI and IIEF-5 questionnaires. Self-assessment of limitation by disease (IBDQ) was significantly worse for females, than for men p &amp;lt; 0.001. There was a significant correlation between self-assessment of limitation by disease and IIEF-5 (p&amp;lt;0.001) and FSFI (p&amp;lt;0.001) scores in CU and CD patients. CONCLUSIONS According to our study SD and ED were mainly associated with psychological factors, the severity of the disease had no effect on them. The type of medication used to treat the underlying disease has no impact on the development of sexual dysfunction.

Prediktori seksualne disfunkcije kod muškaraca zaraženih HIV-om

Aims: The prevalence of sexual dysfunction in people infected with human immunodeficiency virus (HIV) is higher than in those without this infection. Sexual dysfunction in HIV-infected people is associated with adverse outcomes. This study aimed to investigate the predictors of sexual function in people infected with HIV. Material and Methods: This cross-sectional study was done at Behavioral disease counseling centers. Samples were taken from 186 HIV-infected men. Demographic variables were recorded. Sexual function and psychological status were assessed by the International Index of Erectile Function Questionnaire, the DASS-21 (Depression, Anxiety, Stress Scales), and the Domestic Violence Questionnaire. To examine the CD4 cells and hormonal profiles, blood samples were taken from each patient. The data were analyzed using the SPSS18 software. Results: A multivariate analysis showed that hepatitis B infection (P = 0.034, OR = 9.6), smoking (P = 0.026, OR = 2.5), severe stress (P = 0.04, OR = 0.32) and severe depression (P = 0.042, OR = 6.9) were the predictors of sexual dysfunction in HIV-infected men. Conclusion: This study showed that smoking, hepatitis B infection, severe depression, and severe stress could be predictors of sexual dysfunction in those men.

Female Sexual Dysfunction before and after Diagnosis of Infertility

This study determined the prevalence, domain, and predictors of sexual dysfunction among 222 infertile women before and after Diagnosis of infertility in Ife East Senatorial district, Nigeria. They were interviewed using interviewer-administered questionnaire and Female Sexual Function Index assessment tool. Information about their sexual functions after marriage and before the couple started having difficulty in getting pregnant were obtained and compared with sexual functions after Diagnosis of infertility. Data management was done using SPSS Version22 and STATA 12. The Chi-square test was used to test associations. P-value of was set &lt;0.05. Before infertility diagnosis, the prevalence of sexual dysfunction was 23.9%. After infertility diagnosis, this increased to 57.2%, P&lt;0.001. The mean scores of female sexual function index for infertile patients were 29.57 ±5.10 before the infertility diagnosis but reduced to 24.42 ± 5.86 after infertility diagnosis P &lt;0.001. The domain scores reduced after Diagnosis of infertility, and it shows statistical significance at P&lt;0.001. Significant predictors at multivariate analysis include increasing maternal age, increasing duration of infertility, Hausa /Fulani tribe, and female genital mutilation. Infertility increases the prevalence of female sexual dysfunction and reduces the domain scores of sexual functions.

Evaluation of sexual dysfunction and its predictive factors in female and male patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a common disabling joint disease affecting both males and females. Sexual dysfunction (SD) is a common association with RA. The aim of this work was to study the prevalence and predictors of sexual dysfunction in male and female patients with rheumatoid arthritis.ResultsThe mean age of female patients was 32.1 years and 39.7 years for males. The prevalence of sexual dysfunction was higher in RA female patients than controls, 62.1% versus 41.2% respectively (P ≤ 0.05). The prevalence of global sexual dysfunction was higher in RA male patients than controls, 63.8% versus 47.5% respectively (P ≤ 0.05). Predictors of sexual dysfunction in female RA patients were the number of children, BMI, disease duration, DAS score, HADs-D score, HAQ score, VAS score, joint deformity, and the number of drugs. Predictors of sexual dysfunction in male RA patients were age, disease duration, DAS score, HAQ score, VAS score, and the number of drugs.ConclusionSD is prevalent in RA patients. Disease activity, pain, depression, and disturbed quality of life affect nearly all domains of sexual functions in female and male patients.

P-473 Should couples be educated on how to try to conceive (TTC) before an infertility diagnosis? A comparative study of fertile, subfertile and infertile couples

Abstract Study question What sexual strategies do individuals TTC with different fertility status use?; What are the predictors of sexual dysfunction(SD) and frequency of intercourse(IF) when TTC? Summary answer TTC strategies with no evidence of effectiveness are the most used. Poor marital quality predicted SD, and female SD was a significant predictor of IF. What is known already It is well known that couples TTC have low fecundity knowledge. Previous evidence showed that after 12 months the frequency of intercourse decreases. After seeing a fertility specialist couples report a feeling of waiting time by attempting natural conception, which can be associated to evidence of an overestimation and excessive confidence in the success of fertility treatments. Existing guidelines recommend intercourse every other day, but no comparative studies exist up to date on what sexual strategies are used in different fertility status and what are the predictors of sexual frequency and sexual dysfunction when trying to conceive. Study design, size, duration This study is part of a randomized controlled trial on the effects of timed intercourse in psychosocial outcomes. Data was collected between July 2016 and November 2019 via an advertising strategy and obstetrics/gynecology centers. Inclusion criteria were: i) adult in a marital/cohabitation heterosexual relationship &amp;gt;1 year; ii) not knowing of any condition that can prevent pregnancy; iii) being actively TTC; iv) female age &amp;gt;22&amp;lt;42 years old; v) no previous children. Measurements were carried out online. Participants/materials, setting, methods Our final sample had 399 subjects (252 women). Participants rated the use of the following strategies: intercourse every other day (EOD), fertile week (FW), basal temperature, cervical mucus monitoring (CMM), ovulation predictor kits (OPK), and keeping legs elevated afterwards (EL). We also accessed psychological adjustment, relationship quality, SD and IF. Comparisons between groups were made by analysis of variance (ANOVA) and Chi-square tests, and logistic regression was used to determine predictors of SD and IF. Main results and the role of chance Participants were highly educated (72,8%), in the relationship for 9 years (±5.2), cohabitating for 5 (±3.6), and TTC for 2,5 years (range 0-16). Women were 33 years old (±4.4) and men 36 (±5.5). Regarding fertility status, 22.6% of participants were TTC &amp;lt;12 months, 22.8% &amp;gt;12 months but not diagnosed, 23.6% had a diagnosis but no treatment, and 31.1% had ART. The most reported female strategy in all groups was EL, and the most never used was OPK. Differences were found in EOD, with significantly more women TTC &amp;lt;12 months that never used it, and more women with previous ART using it. Women who had ART are the ones who more frequently use FW and CMM comparing to other women (P&amp;gt;.05). In all groups, the majority reported IF once or twice/week. SD was found in 17.5% of women and 10,9% of men. Age (OR 0.91, 95%CI 0.85-0.97) and SD (OR 2.47, 95%CI 1.02-6.02) were the only predictors of low IF for women, with no significant findings for men. Poor relationship quality increased the risk of SD for both men (OR 0.11, 95%CI 0.03-0.40) and women (OR 0.46, 95%CI 0.03-0.40), and depression increased the risk of female SD (OR 1.24, 95%CI 1.06-0.46). Limitations, reasons for caution The cross-sectional nature of this study does not allow causal relationships to be determined. Further cohort studies allowing to assess differences as couples cross different fertility status are warranted. There are important predictors of SD that were not considered, specifically the comorbidity of diseases and pain. Wider implications of the findings Findings indicate that individuals TTC are misinformed, and that those using evidence-based sexual strategies are fertility patients. SD should be screened in patients TTC given that it might be an important predictor of IF. Couples might benefit from counselling to improve marital quality and consequently sexual functioning. Trial registration number NCT028140069

P–473 Should couples be educated on how to try to conceive (TTC) before an infertility diagnosis? A comparative study of fertile, subfertile and infertile couples

Abstract Study question What sexual strategies do individuals TTC with different fertility status use?; What are the predictors of sexual dysfunction(SD) and frequency of intercourse(IF) when TTC? Summary answer: TTC strategies with no evidence of effectiveness are the most used. Poor marital quality predicted SD, and female SD was a significant predictor of IF. What is known already It is well known that couples TTC have low fecundity knowledge. Previous evidence showed that after 12 months the frequency of intercourse decreases. After seeing a fertility specialist couples report a feeling of waiting time by attempting natural conception, which can be associated to evidence of an overestimation and excessive confidence in the success of fertility treatments. Existing guidelines recommend intercourse every other day, but no comparative studies exist up to date on what sexual strategies are used in different fertility status and what are the predictors of sexual frequency and sexual dysfunction when trying to conceive. Study design, size, duration This study is part of a randomized controlled trial on the effects of timed intercourse in psychosocial outcomes. Data was collected between July 2016 and November 2019 via an advertising strategy and obstetrics/gynecology centers. Inclusion criteria were: i) adult in a marital/cohabitation heterosexual relationship &amp;gt;1 year; ii) not knowing of any condition that can prevent pregnancy; iii) being actively TTC; iv) female age &amp;gt;22&amp;lt;42 years old; v) no previous children. Measurements were carried out online. Participants/materials, setting, methods Our final sample had 399 subjects (252 women). Participants rated the use of the following strategies: intercourse every other day (EOD), fertile week (FW), basal temperature, cervical mucus monitoring (CMM), ovulation predictor kits (OPK), and keeping legs elevated afterwards (EL). We also accessed psychological adjustment, relationship quality, SD and IF. Comparisons between groups were made by analysis of variance (ANOVA) and Chi-square tests, and logistic regression was used to determine predictors of SD and IF. Main results and the role of chance Participants were highly educated (72,8%), in the relationship for 9 years (±5.2), cohabitating for 5 (±3.6), and TTC for 2,5 years (range 0–16). Women were 33 years old (±4.4) and men 36 (±5.5). Regarding fertility status, 22.6% of participants were TTC &amp;lt;12 months, 22.8% &amp;gt;12 months but not diagnosed, 23.6% had a diagnosis but no treatment, and 31.1% had ART. The most reported female strategy in all groups was EL, and the most never used was OPK. Differences were found in EOD, with significantly more women TTC &amp;lt;12 months that never used it, and more women with previous ART using it. Women who had ART are the ones who more frequently use FW and CMM comparing to other women (P&amp;gt;.05). In all groups, the majority reported IF once or twice/week. SD was found in 17.5% of women and 10,9% of men. Age (OR 0.91, 95%CI 0.85–0.97) and SD (OR 2.47, 95%CI 1.02–6.02) were the only predictors of low IF for women, with no significant findings for men. Poor relationship quality increased the risk of SD for both men (OR 0.11, 95%CI 0.03–0.40) and women (OR 0.46, 95%CI 0.03–0.40), and depression increased the risk of female SD (OR 1.24, 95%CI 1.06–0.46). Limitations, reasons for caution The cross-sectional nature of this study does not allow causal relationships to be determined. Further cohort studies allowing to assess differences as couples cross different fertility status are warranted. There are important predictors of SD that were not considered, specifically the comorbidity of diseases and pain. Wider implications of the findings: Findings indicate that individuals TTC are misinformed, and that those using evidence-based sexual strategies are fertility patients. SD should be screened in patients TTC given that it might be an important predictor of IF. Couples might benefit from counselling to improve marital quality and consequently sexual functioning. Trial registration number NCT028140069

Gestational Diabetes as a Predictor of Sexual Dysfunction in Pregnant Women

Introduction: Pregnancy is associated with changes in sexual function and perhaps many more sexual problems when accompanied by particular disorders such as gestational diabetes. Objective: The present study was conducted to investigate factors associated with sexual functions in women with gestational diabetes. Materials and Methods: The present analytical, cross-sectional study was conducted on 300 women with gestational diabetes (150) and low-risk pregnant women (150) attending clinics affiliated to Mazandaran University of Medical Sciences in the north of Iran in 2019. A multistage cluster random sampling method was used, and samples were selected by convenience sampling method. The study data were collected using a demographic and obstetrics questionnaire, female sexual distress scale-revised, prenatal distress questionnaire, world health organization quality of life questionnaire, depression, anxiety, stress questionnaire, and a female sexual function index. Data analysis was done by descriptive statistics indicators, the Chi-square test, t-test, and multivariate linear regression. Results: The frequency of sexual dysfunction was 87.3% in women with gestational diabetes and 34.67% in low-risk pregnant women. Compared to women with low-risk-pregnancy, women with gestational diabetes reported lower sexual function scores (P=0.001). Women with gestational diabetes experience lower quality of life (P&lt;0.05) than low-risk pregnant women. Besides, women with gestational diabetes experience higher levels of stress (P=0.001), more prenatal concerns (P=0.014), and higher sexual distress (P&lt;0.05). The linear regression test showed that gestational diabetes in pregnant women predicts a significant reduction in sexual desire (β=-0.599; P= 0.001). Conclusion: Gestational diabetes predicts a significant reduction in sexual function during pregnancy due to the physical and psychological effects of gestational diabetes. Thus, it is recommended that pregnant women with gestational diabetes should be trained and counseled about gestational diabetes control and sexual function.

Prediktori seksualne disfunkcije kod žena zaraženih HIV-om

Sexual dysfunction is more common among the people with human immunodeficiency virus (HIV) infection than in those without it. The sexual dysfunction in HIV-infected people is associated with adverse outcomes such as reduced quality of life, unprotected sexual activities, and reduced adherence to highly active antiretroviral therapy. Therefore, the present study was designed to investigate a potential predictor role of some variables such as socioeconomic status, hormonal and HIV disease profile, type of treatment, depression, anxiety, stress, domestic violence, and status of partner infection for sexual function in people with HIV infection. This descriptive cross-sectional study was conducted on 40 HIV-infected women with medical records in behavioral disease counseling centers of Shiraz University of Medical Sciences. The required data were collected using the Female Sexual Function Index (FSFI), Depression‚ Anxiety‚ Stress Scale (DASS-21), and Domestic Violence Questionnaire. To examine the CD4 cell levels and hormonal profiles, 5cc blood was taken from the patients simultaneously on days 3 - 5 of their menstrual cycles. The data were analyzed using the SPSS18 software. The mean age of the participants was 38.2 ± 5.2 years, and the frequency of sexual dysfunction was 100%. There was a statistically significant difference in the levels of the elevated variables such as estradiol, stress, anxiety, and depression. The multivariate analysis showed that only the increased estradiol level (P = 0.005, B = 0.06) was a predictor factor of sexual dysfunction. All the HIV-infected women had sexual dysfunction. The results of this study showed that in those women the increased levels of estradiol could be a predictor of sexual dysfunction.

Genital self-image as predictor of sexual dysfunction in women with pelvic organ prolapse in Indonesia.

Background:The incidence of sexual dysfunction increases in women with pelvic organ prolapse. In addition to physical factors, other important components that influence each other in sexual dysfunction are psychological aspects and genital self-image. Sociocultural factors also affect individual sexuality and sexual behavior. Until now, there are no data and the relationship between genital self-image and sexual dysfunction in pelvic organ prolapse is not known in Indonesia.Objective:This study aims to analyze the correlation of genital self-image with sexual dysfunction in women with pelvic organ prolapse.Methods:In this cross-sectional study, 113 consecutive women with pelvic organ prolapse were selected in urogynecology referral centers in Jakarta. Demographic data, physical examination, and guided interviews were filled in to complete the Female Sexual Function Index and Female Genital Self-Image Scale-7 questionnaires. Preliminary research has been carried out in the form of language translation and cultural validation of the Indonesian version of the Female Genital Self-Image Scale-7 questionnaires.Results:There is a significant correlation between genital self-image and sexual dysfunction, where the lower Female Genital Self-Image Scale-7 score significantly predicts the lower Female Sexual Function Index score (p < 0.000; odds ratio: 14.17).Conclusion:Genital self-image is the main variable that affects sexual function in women with pelvic organ prolapse. It is necessary to evaluate and treat genital self-image because sexual function is an integrated component of quality of life.

Limitations of sexual activity in patients with chronic heart failure

Abstract Background Limitation of sexual activity may potentially have a great impact in the quality of life of patients with chronic heart failure (HF), although the burden of sexual limitation and its clinical drivers are not completely understood. We aimed to characterize the impact of sexual limitation and how it relates to different measures of HF severity, in patients with HF. Methods We prospectively selected a cohort of patients followed in our ambulatory HF Clinics, with HF and currently or previously documented left ventricular ejection fraction (LVEF) ≤40%, aged between 18 and 80 years, with NYHA class I-IV. Clinical, laboratorial, imaging and ergometric data was collected. A questionnaire characterizing sexual activity of the patient was filled by her/himself before consultation with the physician, while alone in a private room. Results A total of 65 patients were selected, 75% of which were male, with mean age 61±11 years, 32% were in NYHA I or II, and 21% had a resynchronization system. Mean BNP was 520±850 pg/mL, LVEF was 39±12% and peak oxygen consumption (pVO2) was 17.2±5.3 mL/min/m2. Limitations of sexual activity were reported in 40 (62%) patients, including erectile dysfunction (25%), fatigue (11%), reduction of libidum (8%), fear of HF symptoms during sexual activity (5%), absence of sexual partner (5%), and other reasons (8%). Of these 40 patients, 22 (55%) reported severe or very severe sexual limitation. Only 2 (3%) patients actively searched for clinical aid. Patients with sexual limitations were older (63±12 vs 56±11 years), were in higher NYHA classes (One-Way ANNOVA), had higher levels of BNP (775±1051 vs 181±212 pg/mL) and lower glomerular filtration rates (66±19 vs 86±23 mL/min) (all p&amp;lt;0.05). Other major variables such as ischemic etiology, diabetes, resynchronization therapy, LVEF and pVO2 were not associated with the presence or severity of sexual limitations, although there was a numerical trend for lower pVO2 (16.5±5.8 vs 19.0±4.0 mL/l/min/m2, p=0.20). NYHA class ≥II (β 6.5, 95% CI 0.4–10.5) and BNP levels (β 1.03, 95% CI 1.01–1.06) were independent predictors of sexual dysfunction. Conclusions Sexual limitation was highly prevalent among patients with HF, was often severe and the most frequent reason was erectile dysfunction. Simple and highly accessible parameters, such as age, NYHA class, BNP levels and renal function, are related to the presence of sexual limitation. More attention should be payed to sexual limitation in patients with HF considering the high burden and the large room for improvement. Funding Acknowledgement Type of funding source: None