Predictors Of Sexual Function Research Articles

Sexual Excitation and Sexual Inhibition as Predictors of Sexual Function in Women: A Cross-Sectional and Longitudinal Study

To date, no longitudinal studies have evaluated the predictive value of the two factors of the dual control model—sexual excitation (SE) and sexual inhibition (SI)—for future sexual function. The aims of the present study were to investigate the associations between SE/SI and sexual function and estimate their predictive value for future sexual function in a sample of women. Overall, 2,214 women participated in a web-based survey that assessed SE, SI, and sexual function as well as symptoms of depression. The one- and two-year follow-up surveys included 396 and 382 participants, respectively. Correlational analyses and hierarchical regression analyses were conducted to analyze the relationships between predictor and outcome variables. Four factors of SE (Arousability, Partner Characteristics, Sexual Power Dynamics, and Setting) and two factors of SI (Concerns about Sexual Function and Arousal Contingency), as well as symptoms of depression and partnership status, were significant predictors of concurrent and future sexual function. Several subscales of SE and SI contributed to the prediction of future sexual function above and beyond prior sexual function levels. Our study provides the first supportive evidence for the assumptions of the dual control model that propensities for low SE and high SI influence future sexual function.

Sexual Functioning in Young Women and Men: Role of Attachment Orientation

Prior research has documented various ways in which adult attachment styles are characteristic of differential behavioral and cognitive patterns within romantic relationships and sexuality. However, few studies have examined the direct influence of anxious or avoidant attachment orientation on sexual function. The aim of the present study was to assess the impact of insecure attachment on sexual function. Undergraduate students completed questionnaires measuring attachment style and sexual functioning. Among women, attachment avoidance tended to be associated with impairments in all aspects of sexual function, whereas anxious attachment tended to be associated with declines in arousal, satisfaction, and ability to achieve orgasm. A different trend was seen in men: Anxious attachment tended to be associated with multiple facets of sexual dysfunction, while avoidant attachment did not correlate with any sexual function deficits and was associated with superior physiological competence. These results suggest that both anxious and avoidant attachment styles are important yet differential predictors of sexual function in men and women.

Patterns and predictors of sexual function after liver donation: The Adult-to-Adult Living Donor Liver Transplantation Cohort study.

Although sexual functioning is an important facet of a living donor's quality of life, it has not received an extensive evaluation in this population. Using data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we examined donor sexual functioning across the donation process from the predonation evaluation to 3 months and 1 year after donation. Donors (n = 208) and a comparison group of nondonors (n = 155) completed self-reported surveys with specific questions on sexual desire, satisfaction, orgasm, and (for men) erectile function. Across the 3 time points, donor sexual functioning was lower at the evaluation phase and 3 months after donation versus 1 year after donation. In the early recovery period, abdominal pain was associated with difficulty reaching orgasm [odds ratio (OR), 3.98; 95% confidence interval (CI), 1.30-12.16], concerns over appearance were associated with lower sexual desire (OR, 4.14; 95% CI, 1.02-16.79), and not feeling back to normal was associated with dissatisfaction with sexual life (OR, 3.58; 95% CI, 1.43-8.99). Efforts to educate donors before the surgery and prepare them for the early recovery phase may improve recovery and reduce distress regarding sexual functioning.

PD5-12 SEXUAL FUNCTION CHANGES FOLLOWING DIFFERENT TRANSURETHRAL PROSTATE SURGERIES: PROSPECTIVE SHAM CONTROLLED STUDY

INTRODUCTION AND OBJECTIVES: To prospectively assess the change and predictors of sexual function after different transurethral surgery for Benign Prostate Hyperplasia (BPH). METHODS: Patients presented for BPH surgery in a tertiary referral center between August 2012 and May 2014 were consented and prospectively enrolled in this trial. Inclusion criteria were sexually interested patients with interested partner. Exclusion criteria were patients with indwelling catheter for more than 1 month, patients who required re-intervention and patients with unreliable answers. Eligible patients were asked to fill the International Index of Erectile Function15 (IIEF-15) and ejaculatory subdomain of male sexual health (MSHQ) questionnaires preoperatively, 3 months and 6 months postoperatively. Studied interventions were Holmium laser enucleation of the prostate (HoLEP), Monopolar, Bipolar transurethral resection of the prostate (TURP) and diagnostic (OPC) outpatient cystoscopy (Sham procedure) ClinicalTrials.gov ID: NCT01810068 RESULTS: Out of 444 BPH patients, 245 were included. HoLEP, monopolar TURP and bipolar TURP were performed in 81, 112 and 52 procedures respectively. Sham group includes 35 sexually active men with free OPC who filled the questionnaire before and after OPC at the scheduled intervals. There were no significant changes in mean erectile function/IIEF (EF) score between baseline and 6-months visit in any of the study groups. Normal EF 26, has been reported in 48.6, 29.6, 29.5 and 23.1% of Sham, HoLEP, Monopolar and Bipolar groups respectively (P1⁄40.079). Regardless the study group lower morbidity score, BMI and higher baseline EF score are the only predictors of postoperative normal EF. There were no significant changes in mean orgasm/IIEF score between baseline and 6-months visit in Sham and HoLEP groups with statistically significant score reduction Monopolar and bipolar groups. However when compared to the Sham, changes were not statistically different from changes in Sham group. There were no significant changes in mean desire/IIEF, intercourse satisfaction/IIEF nor overall satisfaction score between baseline and 6-months visit in any of the study groups. There were significant reduction of mean ejaculatory/MSHQ score between baseline and 6-months visit in all study groups in comparison to Sham CONCLUSIONS: Sham controlled short term assessment of different BPH treating procedures denied the their impact on erectile function. However, all procedures significantly affect ejaculatory function with subsequent minimal effect on orgasm perception

Predictors of Sexual Functioning Following Traumatic Brain Injury

Introduction According to the World Health Organization, the incidence of traumatic brain injury (TBI) is increasing every year. Sexuality is compromised following traumatic brain injury. It is important to know the background of sexual dysfunction after TBI. Objectives To investigate predictors of sexual functioning following TBI. Aims The aim of the current study was to examine sexuality in men with traumatic brain injury, as well as factors affecting sexuality. The current study aims to characterize those who reported a decrease in sexuality after TBI. Methods A total of 104 participants with predominantly moderate to severe TBI completed the Sexual Men's Scale, The Symptom Checklist-90-R (SCL-90-R), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI). Men underwent Magnetic resonance (MR) imaging and electroencephalography (EEG). Results weak sexual constitution, depression, anxiety, and location of the pathological focus in the right hemisphere significantly differentiated participants with TBI who reported decreased sexuality from those who reported increased sexuality. Conclusions study of predictors of sexual dysfunction contribute to improving the diagnosis and treatment of sexual dysfunctions.

Predictors of sexual function during pregnancy

The aim of the study was to evaluate sexual functions of pregnant women and to determine the factors affecting their sexual function. The cross-sectional study recruited 286 pregnant women from a hospital. To collect data, ‘Patient Information Form’, ‘State Anxiety Inventory’ and ‘Female Sexual Function Index’ were used. The mean age of women was 29.15 ± 4.85 and 77.6% of them presented with sexual dysfunction. Having partner at advanced age, a history of miscarriage, a history of health problem during previous pregnancy and a high level of anxiety were found to be factors negatively affecting sexual function. Health professionals should be aware of a number of risk factors that may contribute to sexual dysfunction in pregnant women.

Funcionamiento sexual en personas mayores: influencia de la edad y de factores psicosexuales

ObjectiveTo examine the prevalence of changes in sexual functioning in both men and women older than 55 years. In addition, we analysed the effect of age, sexual assertiveness, sexual attitudes and partner violence on sexual functioning. Material and methodThere were 405 individuals (48.4% men and 51.6% women) with ages ranging from 55 to 80 years old, selected by a non-probabilistic sampling, who answered the validated Spanish versions of the MGH-SFQ, HISA, SOS, HISF and ISA assessment tools. ResultsSome difficulties in sexual functioning were reported by 39% of men and 58% of women. In men, age negatively predicted sexual functioning (β=−.29), while initiation sexual assertiveness (β=.26) and no shyness/refusal (β=.17) positively predicted it. In women, age was also negatively associated with sexual functioning (β=−.41). In addition, no shyness/refusal (β=.17), positive attitude towards sexual fantasies (β=.26), no physical partner violence (β=−.20) and the interaction between age and positive attitudes towards sexual fantasies (β=.21) were predictors of sexual functioning. ConclusionsWomen show a greater prevalence of sexual dysfunction; however, such problems are not necessarily linked to sexual dissatisfaction. Age, sexual assertiveness and sexual attitudes, along with psychological abuse in the case of women, are predictors of sexual functioning in elderly people.

Physiological stress responses predict sexual functioning and satisfaction differently in women who have and have not been sexually abused in childhood.

Physiological responses to sexual stimuli may contribute to the increased rate of sexual problems seen in women with childhood sexual abuse (CSA) histories. We compared two physiological stress responses as predictors of sexual function and satisfaction, sympathetic nervous system (SNS) activation and cortisol in women with (CSA, N = 136) and without CSA histories (NSA, N = 102). In CSA survivors, cortisol response to sexual stimuli did not significantly predict sexual functioning; however, in NSA women, cortisol increases were associated with poorer sexual functioning, and decreases with higher functioning. For women with CSA histories, lower SNS activity was associated with poorer sexual functioning. For CSA survivors with low lifetime trauma, lower SNS activity was associated with higher sexual satisfaction; for women with high lifetime trauma, the reverse was true. Decreased SNS activity during sexual stimuli predicted higher sexual functioning in NSA women with low lifetime exposure to traumatic events, but lower sexual functioning in those with high exposure. Differences between women with and without CSA histories in the association between cortisol and SNS response and sexual functioning and satisfaction suggests that CSA causes disruptions in both short and long-term stress responses to sexual stimuli that perpetuate into adulthood.

Depressive Symptoms as a Predictor of Sexual Function during Pregnancy

Biopsychological and sociocultural factors have been reported to be associated with sexual function in pregnancy. To date, very few studies have focused on the relationship between sexual function and depression during pregnancy. To determine whether depressive symptoms predict overall sexual function, desire, arousal, lubrication, orgasm, satisfaction, and pain during pregnancy by using the Female Sexual Function Index (FSFI). Pregnant women undergoing prenatal examinations were randomly selected for this cross-sectional investigation. The study included 555 pregnant women who completed the Taiwanese versions of the Center for Epidemiologic Studies Depression Scale (CES-D), FSFI, and a demographic questionnaire during pregnancy. CES-D scores for depressive symptoms, scores for overall sexual function on the FSFI, and the FSFI domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. After adjusting for demographic factors, CES-D scores during the first trimester negatively predicted overall sexual function (P=0.0004), arousal (P=0.0104), lubrication (P=0.0016), orgasm (P=0.0022), and pain (P<0.0001). Moreover, CES-D scores during the third trimester negatively predicted sexual desire (P=0.0005) and satisfaction (P<0.0001). Furthermore, gestational age negatively predicted overall sexual function, arousal, lubrication, orgasm, and pain (all P<0.0001). Parity was a positive predictor of overall sexual function, arousal, lubrication, and orgasm (all P<0.0005). Medical conditions were positive predictors of sexual desire (P=0.0023). The present study revealed that depressive symptom scores during early and late pregnancy were significant negative predictors of sexual function during pregnancy.

Perceived Prevalence and Definitions of Sexual Dysfunction as Predictors of Sexual Function and Satisfaction

Evidence for the influence of sexual beliefs on sexual functioning and satisfaction has mainly emanated from clinical lore. Empirical investigations on this topic remain sparse. This study investigated whether beliefs regarding prevalence and definitions of male and female sexual dysfunctions predicted sexual function and satisfaction in a sample of 131 undergraduate students. Results indicated that higher perceived prevalence of male and female sexual dysfunctions was predictive of lower sexual functioning and poorer sexual satisfaction in women. For the male participants, none of the examined sexual beliefs emerged as significant predictors of their sexual functioning or satisfaction. Surprisingly, it was also found that participants estimated the prevalence of female sexual dysfunctions to be higher than male sexual dysfunctions, while defining male sexual dysfunctions more broadly than female sexual dysfunctions. Possible mechanisms for the findings are provided.

Predictors of Sexual Functioning in a Sample of U.S. Marines: An 11-Year Follow-Up Study

ABSTRACT We examined predictors of sexual functioning in male and female U.S. Marines (n = 589) assessed longitudinally for approximately 11 years. Multiple domains of sexual functioning (dysfunctional sexual behaviors, sexual frequency, sexual problems, and sexual satisfaction) were assessed at the 11-year follow-up assessment (T5). T5 depressive symptoms emerged as the most robust predictor of all domains of sexual functioning. Different patterns of correlates were associated with the different domains of sexual functioning—a finding that highlights the importance of considering the multidimensional nature of human sexuality. In addition, several significant gender × predictor interactions indicated differential relationships between predictors and sexual functioning outcomes for men and women. In particular, concurrent physical health and mental health were more strongly related to sexual functioning for women compared with men. We discuss how findings of the current study can contribute to the development of theories that can better capture the complexity of human sexuality, and we suggest ways that the current findings can inform mental health practitioners working with veterans and military personnel.

Quality of life and sexual function of women with urinary incontinence

The aim of this study was to examine the urinary incontinence (UI) types on the sexual function and quality of life (QOL) of women with UI and the correlation between sexual function and QOL. The sample for this descriptive study was comprised of 122 women who presented to obstetrics and gynecology and urology outpatient clinics at university hospitals in Denizli and Izmir, Turkey, who had UI, who were sexually active, who volunteered to participate in the study, and who were chosen by a convenience sampling method. A sociodemographic data collection form, the Female Sexual Function Index (FSFI), and the Incontinence Quality of Life (I-QOL) questionnaire were used for data collection in the study. The mixed type of incontinence had an effect on the women's quality of life, mixed and stress incontinence affected the FSFI's pain subscale, and the total sexual functioning score was lower for the women with mixed incontinence. Even though the correlation values were low, it was clear that there was a positive correlation between sexual function and quality of life. Among the incontinence types, a significant difference was determined by the FSFI and I-QOL. Urinary incontinence seems to be the predictor of sexual function and quality of life. As a result, a comprehensive assessment of patients with UI is recommended because this condition has a negative influence on their sexual function and quality of life.

The Relationship between Testosterone and Sexual Function in Depressed and Healthy Men

Men with Major Depressive Disorder (MDD) report high rates of sexual dysfunction, as do healthy males with low levels of testosterone. The objective of this study is to evaluate the effects of depression and low testosterone across various domains of sexual function. Untreated depressed males (N = 44) and age-matched healthy controls (N = 50) had blood samples drawn to determine morning levels of total testosterone (TT) and bioavailable testosterone (BT). In addition, questionnaires regarding depressive symptoms as well as sexual function were administered. Sexual function outcomes were measured using the Sex Effects (SexFX) Scale and depression severity was assessed with the Hamilton Rating Scale for Depression-17 item (HAMD-17). Using TT criteria, 27.9% of men were categorically defined as hypogonadal compared to 19.3% using BT criteria. Within both TT and BT hypogonadal groups, men with MDD had lower scores on all domains of sexual function compared to healthy controls with hypogonadism. Testosterone levels interacted with MDD status to affect orgasm and desire, although not arousal. Multiple linear regression analyses revealed that depression status was the main factor influencing sexual function. Hypogonadal status was not a predictor of sexual function in this sample, although age did play a minor role in the domain of arousal. While testosterone levels appear to influence sexual function, specifically orgasm, the presence of MDD appears to be a stronger factor and has high predictive value for sexual outcomes.

Vascular Risk Factors as Predictors of Sexual Function Following Coronary Artery Bypass Graft

A strong association between cardiovascular risk factors and erectile dysfunction (ED) was suggested. Coronary artery bypass grafting (CABG) is the gold standard for surgical myocardial revascularization. We herein evaluate the impact of vascular risk factors on postoperative sexual functions in patients undergo CABG. ED severity by the International Index of Erectile Function (IIEF-5) and penile duplex study. The present study included 100 patients who underwent CABG. The patients were evaluated by an abridged form of the IIEF-5 questionnaire, followed by CABG. Six months after surgery the erectile function of all patients was re-evaluated utilizing the IIEF-5. Number of risk factors was significantly associated with postoperative change in IIEF-5 score (P = 0.02). A post hoc analysis of the association revealed that patients with one risk factor were significantly more likely to have increased IIEF-5 scores (N = 18), whereas those with two or more risk factors were significantly more likely to have decreased IIEF-5 scores (N = 21, P < 0.05). Furthermore, those with no risk factors were significantly more likely to be stable (N = 8) compared with those with more than two risk factors, who were more likely to have decreased scores (P < 0.05). The hierarchical logistic regression results showed that when examining all risk factors simultaneously, because of multicollinearity, only hyperlipidemia was significantly associated with postoperative ED (odds ratio [OR] = 11.33, confidence interval [CI] = 1.25, 102.82). Frequency of intercourse was also significantly associated with postoperative ED after controlling for risk factors (OR = 0.71, CI = 0.52, 0.97). This data clearly shows that the number of cardiovascular risk factors is an essential predictive factor for sexual function following surgery. Only hyperlipidemia may play a predictive role for the future sexual function of patients undergo CABG.

A Structural Equation Model on Sexual Function in Women with Gynecologic Cancer

This study was designed to construct and test a structural equation model on sexual function in women with gynecologic cancer. The model was constructed and tested under the hypotheses that women's physical changes in sexual function after gynecologic cancer treatment did not automatically lead to sexual dysfunctions. Women's psychosocial factors were considered to be mediating variables. Two hundred twelve women with cervical, ovarian, and endometrial cancer were recruited and asked to complete a survey on their physical factors, psychosocial factors and sexual function. Data was analyzed using SPSS WIN 12.0 and Amos WIN 5.0. Predictors of sexual function in the final model were sexual attitude affected by physical distress and couple's age, sexual information affected by physical distress and couple's age, depression affected by physical distress, and marital intimacy affected by physical distress. Tumor stage and time since last treatment directly affected women's sexual function without any mediating psychosocial variables. However, body image did not affect women's sexual function. Nursing professionals should develop a tailored educational program integrating both physical and psychosocial aspects, and apply it to women and their spouses in order to promote sexual function in women with gynecologic cancer.

Sexual function after treatment for gynecological malignancy.

This review summarizes current knowledge about the nature of sexual dysfunction in gynecological cancers, highlighting recent publications on disease effects, treatment effects, and communication issues. Recent studies have shown the impact of radiotherapy on sexual function in cervical cancer and have highlighted differences in the levels and duration of sexual problems in women with early stage compared with advanced, recurrent, or persistent disease. Qualitative studies in cervical and endometrial cancer have highlighted women's concerns in relation to femininity, fears of sexual relations, and the importance of communication with the woman's partner. Similar findings have been obtained in studies of ovarian cancer. Predictors of sexual function in ovarian cancer have been suggested by a recent study, with risk factors for poorer sexual functioning being age, treatment, time since treatment, poor self esteem/body image, physical symptoms, poor performance status, depression, and anxiety. Similar risk factors have been highlighted in vulval cancer. Communication issues have been discussed, with some preliminary exploration of the benefits of group therapy and psychosexual counseling. Recent research is helping us to understand more about the impact of the different types of gynecological cancer and its treatment on sexual functioning, with information being provided about key risk factors and predictors of sexual dysfunction that can be used to guide appropriate advice and support. The assessment and treatment of sexual functioning must become part of the standard care of women diagnosed with gynecological cancer.

MHB5 Changes in Sexual Function And Bother in Men Treated for Prostate Cancer: Results from the Capsure™ Database

OBJECTIVE: To determine the effect of treatment choice radical prostatectomy (RP) with or without nerve sparing or pelvic irradiation (XRT) on sexual function and sexual bother after controlling for sociodemographic and clinical factors. METHODS: We studied 131 men (mean age 64 ± 6.7 yrs) from the CaPSURE™ database, a longitudinal prostate cancer registry. Patients had undergone either RP or XRT and had a minimum of one year of follow-up with health-related quality of life (HRQOL) information. Covariates and sexual bother are measured with the UCLA Prostate Cancer Index on 0–100 scales (higher scores representing better outcomes), then regressed against selected independent variables. RESULTS: Multivariable regression analysis showed that sexual function scores were significantly lower in the RP groups than in the XRT group (p < 0.001) three months after treatment. Improvement in sexual function over time was better in those undergoing RP with nerve sparing, compared to non-nerve sparing group showed a trend toward greater improvement in sexual function compared to XRT (p=0.12) Younger age was a significant predictor of sexual function and post-treatment improvement, but disease stage was not. No significant differences were found in sexual bother scores among the three treatments. CONCLUSIONS: Significant differences in sexual function are found between patients undergoing RP versus XRT for prostate cancer. Men undergoing nerve sparing RP showed greater improvements in sexual function than either XRT or non-nerve sparing RP patients. Sexual bother from dysfunction may be explained by non-treatment-related variables.

The natural history of sexual dysfunction in diabetic women. A 6-year follow-up study.

The natural history of sexual dysfunction in diabetic women was evaluated in a 6-year prospective study. Fifty type I, insulin-treated diabetic women, aged 26-45 years, were assessed and re-evaluated 6 years later. Measures included psychological, physiological and social parameters. The frequency of sexual dysfunction was similar in 1977 and 1983. Diabetic women did not differ in sexual function from their healthy controls. None of the physiologic measures studied were predictive of sexual function. Six out of 14 women who were sexually dysfunctional in 1977 recovered normal function, some of them in spite of objective evidence of neuropathy. None of the women had been on psychotherapy for their sexual problem. The most important factor in the spontaneous remission rate seemed to be improvement in the overall marital and social situation. The women's acceptance of illness, as judged by the interviewer, and data from the questionnaires concerning psychological distress, were strong predictors of sexual function. Sexual dysfunction in diabetic women is thus an index of psychological adjustment to chronic illness. Family and marital counseling should be routinely offered as part of the medical care of the diabetic patient.