Psychosexual Effects Research Articles

Psychosexual Implications of Tubal Ligation in a Sample of Iraqi Women

Background: Tubal ligation, recognized as a surgical intervention that ensures permanent contraception, has established itself as an option for women seeking a definitive solution for family planning. Objective: To assess the psychosexual implications of tubal ligation in a sample of women in Baghdad, Iraq. Methods: A prospective cohort study was conducted in a teaching hospital for 2 years, from the first of January 2022 to the end of December 2023, in which 203 women who underwent tubal ligation were included. Results: In the present study, we found that 158 (77.8%) had no depression, mild depression presented in 27 (13.3%), and moderate depression in only 15 (7.4%). While 163 (80.3%) of women did not suffer from anxiety, 32 (15.8%) had mild to moderate anxiety, and only 8 (3.9%) were presented with severe anxiety. 27 (13.3%) have changed in coital frequency this this week. 49 (24.2%) have a change in sexual desire, a change in pleasure, and 37 (18.2%) suffer from a change in orgasm. Conclusions: The current study concluded that there are noticeable psychosexual effects of tubal ligation in women.

Diagnosis and Treatment Approaches in Vaginal Agenesis

The development of the female genital system is a complex process that depends on a series of events involving cellular differentiation, migration, fusion, and recanalization. Failure of any of these processes results in congenital anomalies. Developmental anomalies can occur at various stages, resulting in conditions that impact both the urinary and reproductive systems. In younger patients, such malformations can significantly affect their overall health and quality of life, including aspects such as fertility, sexual function, and psychological well-being. The psychosexual effects of vaginal agenesis should not be overlooked, and clinical care primarily involves comprehensive counseling and support through open communication with the patient. For adult patients, treatment for vaginal agenesis typically starts with therapeutic counseling and education, with non-invasive vaginal dilation being recommended as the first-line approach, or surgery if necessary. Consequently, managing these issues often requires a multidisciplinary approach, engaging specialists such as urologists, gynecologists, endocrinologists, and geneticists, among others. Early detection and timely intervention can greatly enhance the outlook for individuals with these conditions. Besides considering the patient's expectations, the surgeon's experience plays a crucial role in selecting the appropriate surgical technique. This is because the success of the initial surgery is critical to the effectiveness of any subsequent procedures if required. In this review, the evaluation and treatment of vaginal agenesis, which constitutes an important part of congenital anomalies of the vagina, were discussed.

Is the level of varicella-zoster virus IgG associated with symptomatic status of genital herpes simplex virus infection? A case-control study.

Herpes simplex virus (HSV) is a common infection, affecting the majority of the population by age of 50. Recurrent symptomatic outbreaks, experienced by a minority, have significant psychological and psychosexual effects. The varicella zoster virus (VZV), resembling HSV, shows potential for a functional cure via vaccination. This study seeks to investigate if there is an association between low VZV antibody levels and recurrent HSV outbreaks. A total of 110 patients with symptomatic and asymptomatic HSV were recruited during their sexual health screen. Serum samples were collected between Aug 2019 - July 2022; breaks in the study occurred due to COVID. The primary outcome measure was the serological status of HSV and VZV IgG titre level. The average age was 37.3years (range 21-65years). For people with asymptomatic genital HSV2 the average VZV IgG titre was 2373.9IU/mL (n = 17); and 1219.0IU/mL for the symptomatic group (n = 67); p ≤ 0.00001), with similar results for HSV1. There is a strong association between average higher varicella-zoster virus (VZV) IgG level and being an asymptomatic carrier of herpes simplex sirus (HSV)1&2. A feasibility study to assess the use of the VZV vaccine as a treatment of HSV is planned.

Effects of pole dance on mental wellbeing and the sexual self-concept—a pilot randomized-controlled trial

BackgroundPrior studies on beneficial effects of dance have primarily focused on traditional and expressionistic dance forms, neglecting newer dance styles like pole dance, which employ distinct techniques. The present pilot randomized controlled trial examined psychological and psychosexual effects of pole dancing.MethodsFifty women were randomized to an eight-weeks pole dancing program or waitlist. The primary outcome was global mental wellbeing. Secondary outcomes included several dimensions of the sexual self-concept, as well as body appreciation and global self-esteem.ResultsCompared to waitlist, the pole dance group showed an increase in mental wellbeing and improvements in sexual self-efficacy, sexual anxiety, sexual self-esteem, and body appreciation.ConclusionsPole dancing may have broad psychological effects on both overall mental wellbeing and important domains of the sexual self-concept.

Knowledge on human papilloma virus and experience of getting positive results: a qualitative study among women in Kilimanjaro, Tanzania

BackgroundHuman papilloma virus (HPV) is a sexually transmitted infection causing more than 80% of cervical cancers. WHO recommends using of sensitive screening methods like HPV-testing to timely prevent future morbidity and mortality from cervical cancer. Pilot studies have shown that HPV-testing is feasible and can be scaled in developing country like Tanzania. However, there is limited information on women understanding, reactions and psychological challenges following diagnosis of high risk HPV (HR-HPV). This study explored the knowledge of women on HPV and their experience after HPV positive results in Kilimanjaro, Tanzania.MethodsThe study was part of a larger study that assessed incidence and persistence of HR-HPV among women aged 18 years and above in Kilimanjaro. This was a cross sectional study conducted in Moshi municipal council among women who had HR-HPV positive results at enrollment. In-depth interviews were conducted with 13 randomly selected women who were attending for follow-up after enrollment. Interviews were conducted at the health facility and Atlas.ti.8 was used to analyze the data using thematic framework analysis.ResultsWomen had knowledge on HPV infection but they had different reactions following receiving positive HPV results. Reaction toward the positive HPV results had two extremes; some women had psychological effect (hopeless, death sentence, having cancer, being shocked, failure to disclose and psychosexual effects) while others women explained positive results is good as they are identified earlier, will be followed up and it has made them plan to continue with cervical cancer screening in future.ConclusionWomen had knowledge on HPV, but positive results lead to negative and positive experiences by women. Clinicians and programs need to develop interventions and good strategies to minimize the psychological and social burden of testing positive for HPV.

Social and psychological effects of circumcision: A narrative review

Descriptions of penile circumcision have focused primarily on disease, dysfunction, or sensation, with relatively little consideration of the psychological and psychosocial implications of the procedure. It is also reported to be of interest regarding potential qualitative changes in the subjective experience of sexual activity following changes in penile anatomy (removal of the foreskin) or related sexual biomechanics. Circumcision indeed has psychological, psychosocial, and psychosexual effects. The differences in circumcisions performed during infancy, childhood, and adulthood are remarkable. There are also potential psychosocial effects on parents who may or may not choose circumcision for their children. We argue that additional attention should be paid to the potential for long-term effects of the procedure, which may not be appropriately considered when the patient is an infant or child.

Sexual dysfunction in women with genital warts: a systematic review

PurposeTo provide an understanding of the changes in sexual function in women with genital warts.MethodsIn this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included.Results19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts.ConclusionThis study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future.Systematic review registration: (PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584).

The Relationship Between Sexual Satisfaction and Marital Satisfaction in Women With Ovarian Cancer and Their Spouses.

Ovarian cancer can have long-term physical and psychosexual effects on survivors. The post-ovarian cancer sexuality concerns of women can cause sadness and anxiety and negatively impact sexual and marital satisfaction in these women and their spouses. The aim of this study was to investigate the relationship between sexual satisfaction and marital satisfaction of women with ovarian cancer and their spouses. This study was designed retrospectively. This study was conducted with 172 participants: 86 women with ovarian cancer and 86 spouses. Data were collected over 6 months from July 2019 to December 2019. Sexual satisfaction levels were assessed using the Golombok Rust Inventory of Sexual Satisfaction. Marital satisfaction levels were assessed using the Golombok Rust Inventory of Marital State. Spouses' sexual satisfaction (mean, 8.10) was worse than that of the women (mean, 5.60). The women's marital satisfaction (mean, 47.39) was worse than that of their spouses (mean, 40.75). As the sexual satisfaction of the women increased, the marital satisfaction of the women (r = 0.346, P = .001) and spouses (r = 0.308, P = .001) increased. As the sexual satisfaction of the spouses increased, the marital satisfaction of the women (r = 0.512, P = .001) and spouses (r = 0.409, P = .001) increased. Nurses and healthcare teams need to be aware of post-ovarian cancer sexual and marital satisfaction problems of women and their spouses and organize activities at education and couple counseling on these problems.

Immunotherapeutic Approaches for the Treatment of HPV-Associated (Pre-)Cancer of the Cervix, Vulva and Penis.

Human papillomavirus (HPV) infection drives tumorigenesis in almost all cervical cancers and a fraction of vulvar and penile cancers. Due to increasing incidence and low vaccination rates, many will still have to face HPV-related morbidity and mortality in the upcoming years. Current treatment options (i.e., surgery and/or chemoradiation) for urogenital (pre-)malignancies can have profound psychosocial and psychosexual effects on patients. Moreover, in the setting of advanced disease, responses to current therapies remain poor and nondurable, highlighting the unmet need for novel therapies that prevent recurrent disease and improve clinical outcome. Immunotherapy can be a useful addition to the current therapeutic strategies in various settings of disease, offering relatively fewer adverse effects and potential improvement in survival. This review discusses immune evasion mechanisms accompanying HPV infection and HPV-related tumorigenesis and summarizes current immunotherapeutic approaches for the treatment of HPV-related (pre-)malignant lesions of the uterine cervix, vulva, and penis.

Penile cancer.

Penile squamous cell carcinoma (PSCC) is a rare cancer with orphan disease designation and a prevalence of 0.1-1 per 100,000 men in high-income countries, but it constitutes up to 10% of malignancies in men in some African, Asian and South American regions. Risk factors for PSCC include the absence of childhood circumcision, phimosis, chronic inflammation, poor penile hygiene, smoking, immunosuppression and infection with human papillomavirus (HPV). Several different subtypes of HPV-related and non-HPV-related penile cancers have been described, which also have different prognostic profiles. Localized disease can be effectively managed by topical therapy, surgery or radiotherapy. As PSCC is characterized by early lymphatic spread and imaging is inadequate for the detection of micrometastatic disease, correct and upfront surgical staging of the inguinal lymph nodes is crucial in disease management. Advanced stages of disease require multimodal management. Optimal sequencing of treatments and patient selection are still being investigated. Cisplatin-based chemotherapy regimens are the mainstay of systemic therapy for advanced PSCC, but they have poor and non-durable responses and high rates of toxic effects, indicating a need for the development of more effective and less toxic therapeutic options. Localized and advanced penile cancers and their treatment have profound physical and psychosexual effects on the quality of life of patients and survivors by altering sexual and urinary function and causing lymphoedema.

The psychosexual effects of risk reducing bilateral salpingo-oophorectomy in female BRCA1/2 mutation carriers: A systematic review of qualitative studies.

Background: For women with BRCA1/2 mutations risk-reducing bilateral salpingo-oophorectomy (RRBSO) to reduce the risk of primary ovarian cancer is often performed, however the surgery results in immediate onset of surgical menopause. The aim of this research was to explore the psychosexual impacts of risk reducing bilateral salpingo oophorectomy in the published qualitative literature.

529 Poster - The psychosexual effects of risk reducing bilateral salpingooophorectomy in female BRCA1/2 mutation carriers: A systematic review

Introduction: Breast and ovarian cancer account for approximately 15000 deaths per year in the United Kingdom. It is estimated that up to 20% of these cases have an inherited genetic aetiology. The most common genetic mutation occurs in the BRCA1 or 2 genes. For women with mutations in these genes, or a high incidence of breast and/or ovarian cancer in their family, riskreducing bilateral salpingo-oophorectomy (RRBSO) may be offered to eliminate the risk of primary ovarian cancer. In pre-menopausal women this results in immediate onset of surgical menopause. Women experience menopausal symptoms including hot flushes, vaginal dryness, loss of libido and dyspareunia. This article sought to explore the psychosexual impacts of risk reducing bilateral salpingo-oophorectomy in the published qualitative literature.

Let’s talk about sex: A review of expectations, body image and sexual function in exstrophy

Background: The bladder exstrophy epispadias complex (BEEC) is a rare disorder characterised by a number of genito-urinary abnormalities. The condition and subsequent treatment may result in lasting effects on continence, renal function and fertility. There are equally important psychosocial and psychosexual effects as part of overall long-term quality of life. The literature consists largely of small studies with variable methodology; this study aims to consolidate these data. Methods: This study reviews the available literature sourced from the Medline database using the keywords listed below. Results: Patients appear to be high achievers with good overall health-related quality of life. Most form close personal friendships although express anxiety related to revelation of their condition. Data suggest the majority of patients are able to engage in and be satisfied with sexual intercourse. Fertility may be adversely affected, but this can usually be overcome with assisted reproductive techniques and specialist input during pregnancy and delivery. Conclusions: Psychosocial and psychosexual outcomes in patients with BEEC may be excellent. Therefore careful transition and psychological support combined with long-term follow-up is important to allow these patients to maximise their quality of life. Level of evidence: Not applicable.

Psychological Aspects of Congenital Hypogonadotropic Hypogonadism.

Congenital hypogonadotropic hypogonadism/Kallmann syndrome (CHH/KS) is a rare, treatable form of infertility. Like other rare disease patients, individuals with CHH/KS frequently experience feelings of isolation, shame, and alienation. Unlike many rare diseases, CHH/KS is not life threatening and effective treatments are available. Nevertheless, it remains a profoundly life-altering condition with psychosocial distress on a par with untreatable or life-limiting disease. Patients with CHH/KS frequently express lasting adverse psychological, emotional, social, and psychosexual effects resulting from disrupted puberty. They also frequently experience a “diagnostic odyssey,” characterized by distressing and convoluted medical referral pathways, lack-of-information, misinformation, and sometimes-incorrect diagnoses. Unnecessary delays in diagnosis and treatment-initiation can significantly contribute to poor body image and self-esteem. Such experiences can erode confidence and trust in medical professionals as well as undermine long-term adherence to treatment–with negative sequelae on health and wellbeing. This review provides a summary of the psychological aspects of CHH/KS and outlines an approach to comprehensive care that spans medical management as well as appropriate attention, care and referrals to peer-to-peer support and mental health services to ameliorate the psychological aspects of CHH/KS.

Surgical treatment for primary premature ejaculation with an inner condom technique.

To explore a novel surgical treatment for primary premature ejaculation using an inner condom technique.A total of 20 males with premature ejaculation, who admitted our andrology clinic from June 2016 to July 2017, were enrolled. By surgery, an inner condom made of acellular dermal matrix (ADM) was transferred to the subcutaneous pocket of the penis. The prolongation of intravaginal ejaculatory latency time (IELT) after the surgery was examined. The perioperative complications were also studied.The surgical intervention significantly increased the average IELT in patients, from 0.67 to 2.37 min (P = .009). No serious perioperative complications and adverse psychosexual effects were seen. Patients could resume sexual activity 6 weeks after the surgery.The novel inner condom using ADM is an effective and safe surgical treatment for males with premature ejaculation. The efficacy of this new treatment modality warrants further investigation in independent cohorts.

Social Meaning and Consequences of Infertility in Ogbomoso, Nigeria

<p><strong>Background:</strong> This study examined the meaning of infertility from layman's perspective, and experiences of women suffering from infertility among reproductive age women seeking care at the gynaecology unit of the Bowen University Teaching Hospital, Ogbomoso, Nigeria.</p><p><strong>Materials and Methods:</strong> It was a cross-sectional study. Quantitative and qualitative data collection methods were employed. Quantitative data collection was by the aid of a structured interviewer-administered questionnaire among 200 women seeking care for infertility at the hospital. Qualitative data collection was by Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs).</p><p><strong>Result:</strong> Approximately 40% and 60% of the respondents seeking care for infertility were suffering from primary and secondary infertility respectively. Perceived meaning and etiologies of childlessness were multidimensional, but 33% of the respondents not sure of the causal factor. Seventy-nine percent were under pressure to become pregnant. The high premium placed on fertility within marriage has placed a larger proportion of them under pressure from their husbands (25%), their mother-in-laws (40%), and the community (14%).</p><p><strong>Conclusion:</strong> This study concluded that women regard infertility to be caused by multiplicity of factors. Most of these etiologies were unscientific and unverifiable. Fruitful expectations also put enormous burden on those women suffering from infertility including adverse psychosexual effects. The unceasing pressure due to infertility in this group of patients calls for urgent intervention as most of these women become susceptible to high risk sexual behavior, depression and other severe consequences.</p>

Psychosexual Complications of Female Genital Mutilation for Couples: A Comparative Study

Introduction: Female genital mutilation (FGM) comprises of various procedures that damage female genitalia for non-therapeutic intentions, and it offers multidimensional and interdependent effects. Objectives: The aim of this study was to determine whether FGM versus non-FGM couples in Kermanshah in Iran vary in relationship characteristics, such as relationship satisfaction, sexual satisfaction, and mental health. Methods: To achieve this goal of research, a sample of 414 couples (206 FGM couples and 208 normal couples) of Uramanat area in Kermanshah Province, were selected by non-randomized sampling. Enrich Marital Inventory, 25-SCL Mental Health Inventory and the Arizona Sexual Experience Scale were used for data collection. Data were analyzed between the two groups by utilizing independent t-test. The significance level was P < 0.05. Results: The findings indicated that there was a significant difference between FGM couples and normal couples. Besides, the results revealed that the two groups of participants had significant differences in mental health, marital satisfaction, and sexual function. Overall, FGM couples compared with normal couples had lower levels of mental health, marital satisfaction, and sexual function. Conclusion: FGM is associated with frequent psychosexual difficulties in Uramanat couples; notably orgasm difficulties, sense of incomplete sexual-needs fulfillment, and neurotic symptoms. Awareness of the psychosexual effects of this operation could help women cope with psychological and psychosexual problems, and could prevent the performing of this inhuman action on others.

Female Genital Cutting

Female genital cutting (FGC) is a practice that affects millions of girls and women worldwide. This deeply rooted practice has cultural, religious, and psychosexual meaning to its practitioners, but it also carries long-term physical and mental complications. Decried as a human rights violation, nonetheless this practice is still carried out today. Nurses are in a unique position to contact and educate women who have been cut or are at risk for mutilation. To advocate for these women, a thorough understanding of the practice of FGC, its cultural overtones, religious implications, and psychosexual effects is needed.

ARTISTIC: a randomised trial of human papillomavirus (HPV) testing in primary cervical screening

Primary cervical screening uses cytology to detect cancer precursor lesions [cervical intraepithelial neoplasia stage 3 or beyond (CIN3+)]. Human papillomavirus (HPV) testing could add sensitivity as an adjunct to cytology or as a first test, reserving cytology for HPV-positive women. This study addresses the questions: Does the combination of cytology and HPV testing achieve a reduction in incident CIN3+?; Is HPV testing cost-effective in primary cervical screening?; Is its use associated with adverse psychosocial or psychosexual effects?; and How would it perform as an initial screening test followed by cytology for HPV positivity? ARTISTIC was a randomised trial of cervical cytology versus cervical cytology plus HPV testing, evaluated over two screening rounds, 3 years apart. Round 1 would detect prevalent disease and round 2 a combination of incident and undetected disease from round 1. Women undergoing routine cervical screening in the NHS programme in Greater Manchester. In total 24,510 women aged 20-64 years were enrolled between July 2001 and September 2003. HPV testing was performed on the liquid-based cytology (LBC) sample obtained at screening. Women were randomised in a ratio of 3:1 to have the HPV test result revealed and acted upon if persistently positive in cytology-negative cases or concealed. A detailed health economic evaluation and a psychosocial and psychosexual assessment were also performed. The primary outcome was CIN3+ in round 2. Secondary outcomes included an economic assessment and psychosocial effects. A large HPV genotyping study was also conducted. In round 1 there were 313 CIN3+ lesions, representing a prevalence in the revealed and concealed arms of 1.27% and 1.31% respectively (p = 0.81). Round 2 (30-48 months) involved 14,230 (58.1%) of the women screened in round 1 and only 31 CIN3+ were detected; the CIN3 rate was not significantly different between the revealed and concealed arms. A less restrictive definition of round 2 (26-54 months) increased CIN3+ to 45 and CIN3+ incidence in the arms was significantly different (p = 0.05). There was no difference in CIN3+ between the arms when rounds 1 and 2 were combined. Prevalence of high-risk HPV types was age-dependent. Overall prevalence of HPV16/18 increased with severity of dyskaryosis. Mean costs per woman in round 1 were 72 pounds and 56 pounds for the revealed and concealed arms (p < 0.001); an age-adjustment reduced these mean costs to 65 pounds and 52 pounds. Incremental cost-effectiveness ratio for detecting additional CIN3+ by adding HPV testing to LBC screening in round 1 was 38,771 pounds. Age-adjusted mean cost for LBC primary screening with HPV triage was 39 pounds compared with 48 pounds for HPV primary screening with LBC triage. HPV testing did not appear to cause significant psychosocial distress. Routine HPV testing did not add significantly to the effectiveness of LBC in this study. No significant adverse psychosocial effects were detected. It would not be cost-effective to screen with cytology and HPV combined but HPV testing, as either triage or initial test triaged by cytology, would be cheaper than cytology without HPV testing. LBC would not benefit from combination with HPV; it is highly effective as primary screening but HPV testing has twin advantages of high negative predictive value and automated platforms enabling high throughput. HPV primary screening would require major contraction and reconfiguration of laboratory services. Follow-up continues in ARTISTIC while maintaining concealment for a further 3-year round of screening, which will help in screening protocol development for the post-vaccination era.

Hysterectomy’s Psychosexual Effects in Turkish Women

Although many current studies have been conducted about sexual functioning after hysterectomy, the number of studies evaluating both sexual functioning and psychological wellness together is very limited. This study was planned for the purpose of investigating hysterectomy’s psychosexual effects. Ninety-three women were interviewed by the researcher face-to-face. The Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI) were administered 1–3 days before and repeated 3 months after the hysterectomy. Additionally, semi-structured interviews were done to explore women’s attitudes about sexuality. In the third month after hysterectomy 49.5% of the women had begun to have sexual intercourse again, 34.3% of those were determined to have a decrease in sexual functions. It was also found that level of depression was less in the postoperative period compared to the preoperative period. Three months after hysterectomy, sexual functioning had significantly decreased. A clear resolution in symptoms of depression was seen after hysterectomy. It was determined that sexual functioning after hysterectomy was affected by advanced age, a women’s attitude about sexuality, and the type of hysterectomy. In addition, sexual functioning was negatively affected by symptoms of depression.