Risk Factors For Sexual Dysfunction Research Articles

Assessment of sexual function in postmenopausal breast cancer survivors.

Breast cancer (BC) is considered a risk factor for sexual dysfunction, which may be associated with the diagnosis itself or with oncological treatments. However, sexual dysfunction often remains underdiagnosed and unaddressed among BC survivors. The study sought to evaluate the sexual function of postmenopausal BC survivors compared with postmenopausal women without BC. This case-control study included 178 postmenopausal BC survivors (stages I-III), 45 to 70years of age, with amenorrhea for ≥12months and sexually active. They were compared with 178 women without BC, matched (±2years) for age and time since menopause in a 1:1 ratio. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of 6 domains (desire, arousal, lubrication, orgasm, satisfaction, and pain), with a total score ≤26.5 indicating risk of sexual dysfunction. Statistical analysis included Student's t test, chi-square test, and logistic regression (odds ratio [OR]). Evaluation of sexual function in postmenopausal women treated for BC. Postmenopausal BC survivors showed poorer sexual function in the desire domain (P = .002). No significant differences were observed between groups in the other FSFI domains and total score (P >.05). Postmenopausal BC survivors had a higher prevalence of risk of sexual dysfunction (64.6% with a total score ≤26.5) compared with the control group (51.6%) (P = .010). Adjusted risk analysis for age and time since menopause revealed a higher risk of sexual dysfunction in BC survivors compared with women without cancer (OR, 1.98; 95% confidence interval, 1.29-2.96; P = .007). Among BC survivors, the use of hormone therapy was associated with a higher risk of sexual dysfunction (OR, 3.46; 95% confidence interval, 1.59-7.51; P = .002). Postmenopausal BC survivors should be regularly assessed before and throughout treatment to enable the early detection and diagnosis of sexual dysfunction. The main strength is that this study might contribute to a better understanding of sexual function in postmenopausal BC survivors compared with women without BC. The main limitation is that while the FSFI is a valid and reliable tool for the evaluation of female sexual function, it does not allow a comprehensive diagnosis of sexual dysfunction, as it is not applicable to partners. Compared with postmenopausal women without BC, postmenopausal BC survivors face a higher risk of sexual dysfunction, especially when treated with adjuvant hormone therapy.

The Prevalence and Risk Factors of Sexual Dysfunction in the Elderly in Southern China.

This study aims to evaluate the epidemiological features of sexual dysfunction in people aged more than 65 years in parts of China, and to investigate the independent significant risk factors. According to the population distribution of five communities in Xiamen and Chongqing, we have randomly enrolled 2403 people more than 65 years-of-age. We collected data information through a questionnaire survey. Then demonstrated the current condition of sexual dysfunction in the samples by statistical analysis, and multivariable logistic regression was used to disclose the risk factors of sexual dysfunction in the older adults. According to this study, about 10.48% of the elderly had sexual dysfunctions of different degrees and duration. The proportion of men was about twice that of women (14.5% of males and 7.3% of females). During the course of the disease, 3.19% (43/1344) of women and 3.31% (35/1059) of men had more than 15 years duration of sexual dysfunction. In severity, 5.7% (77/1344) of women and 7.0% (74/1059) of men had very severe sexual dysfunction. There were statistically significant differences in BMI, smoking, drinking history, hypertension, depression incidence or median (p<0.05). Alcohol consumption history [OR = 1.711, 95% CI: 1.124-2.604, p = 0.012] and depression [OR = 2.107, 95% CI: 1.109-4.356, p =0.044] were independent risk factors for sexual dysfunction. The prevalence of sexual dysfunction was low among elderly in the southern part of China. But the course of the disease is long and the degree of the disease is very severe. Elderly with a history of drinking and depression are more prone to sexual dysfunction.

Sexual dysfunction among Nigerian women living with HIV infection.

Sexual dysfunction in women with HIV is a necessary but understudied aspect of HIV complications in women living with HIV. This study reports the prevalence, pattern, and risk factors for sexual dysfunction in women living with HIV in southwest Nigeria. A validated Female Sexual Function Index was used to determine sexual dysfunction in a cross-sectional study design involving 2926 adult women living with HIV in a large, publicly funded tertiary HIV treatment centre in Lagos, Nigeria. A score of less than 26.5 indicated sexual dysfunction. Multivariate logistic regression analysis was performed to identify risk factors for sexual dysfunction. P<0.05 was considered statistically significant at a 95% confidence interval (CI). The prevalence of sexual dysfunction was 71.4%. The types of dysfunctions detected included disorder of desire (76.8%), sexual arousal (66.0%), orgasm (50.0%), pain (47.2%), lubrication (47.2%), and satisfaction (38.8%). Multivariate analysis showed that menopause (aOR: 2.0; 1.4-4.1), PHQ score of 10 and above (aOR: 2.3; 1.7-3.2), co-morbid medical conditions (aOR: 1.8; 1.4-2.7), use of protease inhibitor-based antiretroviral therapy (aOR: 1.3; 1.2-2.1) and non-disclosure of HIV status (aOR: 0.7; 0.6-0.8) were factors associated with sexual dysfunction. Sexual dysfunction is common among Nigerian women living with HIV. Menopause, use of protease inhibitor-based regimens, PHQ score of at least 10, co-morbid medical condition, and non-disclosure of HIV status were associated with sexual dysfunction. National HIV programmes, in addition to incorporating screening and management of sexual dysfunction in the guidelines, should sensitise and train health workers on the detection and treatment of sexual dysfunction.

Predictors of sexual satisfaction among patients with chronic pain.

Sexual satisfaction is an important aspect of quality of life. Chronic pain, depression and anxiety, and relational problems correspond with higher risk for sexual difficulties. Less is known about how risk factors for sexual dysfunction and other problems-such as medical conditions, pain severity, and medication side effects-affect the sexual satisfaction of people with chronic pain. Using a biopsychosocial framework, this study explored factors related to sexual satisfaction among patients presenting for evaluation of chronic pain. Researchers used a hierarchical multiple regression analysis to model potential predictors of sexual satisfaction. Variables analyzed were demographic features, medical history, average pain severity, depressed mood, anxiety, and perceived significant other support. Data collection involved administration of retrospective questionnaires and chart review. The sample included male and female participants (N = 134) presenting for evaluation at a multidisciplinary pain rehabilitation clinic. Medical history (i.e., medical conditions, surgical history, and medications) and clinical self-report variables (i.e., pain severity, depressed mood, anxiety, and perceived significant other support) were associated with sexual satisfaction. In this sample, antidepressant use and higher pain severity were unique predictors of lower sexual satisfaction. Married marital status and higher levels of perceived significant other support were predictive of greater sexual satisfaction. Findings highlight the importance of understanding the unique impact of biopsychosocial variables on the sexual satisfaction of patients presenting for evaluation at a multidisciplinary pain rehabilitation clinic. Further exploration of protective factors that account for sexual satisfaction among individuals with chronic pain may help inform screening, referrals, and treatment.

The risk of sexual dysfunction in Chinese women with recurrent pregnancy loss and the associated factors: a multicenter cross-sectional study.

Recurrent pregnancy loss (RPL) is a severe traumatic event for women of childbearing age. However, the association between RPL and female sexual dysfunction was unknown. The study sought to investigate the association between RPL and sexual dysfunction, and to explore the risk factors of sexual dysfunction for RPL patients. A multicenter cross-sectional study involving both RPL patients and healthy women was performed in 3 different hospitals in West China from May 2021 to January 2023. Baseline information including sociodemographic data and disease histories were collected. The Female Sexual Function Index (FSFI) was used to assess the sexual function of participants. The main outcome was the proportion of women at increased risk of sexual dysfunction (total FSFI scores <26.55), and the secondary outcome was risk factors of sexual dysfunction in RPL patients. A total of 233 RPL patients and 185 healthy women were included in this study. RPL patients had significantly lower total FSFI scores (median 31.7 [interquartile range, 26.6-33.5] vs 33.0 [interquartile range, 31.2-34.1]; P < .001) and a significantly higher risk of sexual dysfunction than healthy women (24.9% vs 8.6%; P < .001). Body mass index >24 kg/m2 (adjusted odds ratio [OR], 4.132; 95% confidence interval [CI], 1.902-8.976, P < .001), working >8 h/d (adjusted OR, 2.111; 95% CI, 1.020-4.369, P = .044), and unexplained RPL (adjusted OR, 3.785; 95% CI, 1.967-7.280, P < .001) were independent risk factors of sexual dysfunction for RPL patients. RPL patients, especially those patients with the previously mentioned risk factors, should be focused on the risk of sexual dysfunction, and appropriate preventions could be applied. We explored the association between RPL and sexual dysfunction and explored the risk factors of sexual dysfunction among RPL patients for the first time, and the multicenter data increased the generalizability of results. However, the cross-sectional design did not provide an exact causal relationship between RPL and sexual dysfunction, and potential risk factors related to mental health were not investigated. RPL patients were at an increased risk of sexual dysfunction. Overweight, fatigue caused by work, and unexplained RPL were risk factors of sexual dysfunction for RPL patients.

Correlates of sexual function in women with acute lumbar disc herniation in Iran: a cross-sectional study

Evidence suggests that lumbar disc herniation (LDH) influences sexual function to a great deal. However, most existing studies have been conducted on men. Thus, the current study aimed to assess sexual function and its correlates in women with acute LDH. This descriptive cross-sectional study was conducted on 350 women of reproductive age with acute LDH in Fasa, Iran in 2023. The mean score of female sexual function was 21.33 (3.38). Almost 80% of women had sexual dysfunction. Women scored lower on sexual desire and the higher on lubrication. As the severity of LDH increased, arousal, lubrication and sexual pain score decreased and low back pain (LBP) score increased (p < 0.05). The number of sexual activities after disc herniation was significantly lower in the women with sexual dysfunction (p < 0.001). Regression analysis showed a significant association between sexual dysfunction and LBP intensity (OR = 1.13, CI 1.02–1.26, p = 0.01) and lumbar disc herniation intensity (OR = 2.22, CI 1.07–4.62, p = 0.03). Lumbar disc herniation (LDH) may significantly affect women's sexual function. Severity of low back pain and severity of lumbar disc herniation were found to be risk factors for sexual dysfunction in this population.

Influence of surgically inducted weight loss on sexual function of obese male patients - literature overview

Introduction: &#x0D; Obesity is one of the most challenging and popular problem in nowadays society. Overweight and obesity are connected with chronic complications, such as arterial hypertension, atherosclerotic cardiovascular disease and type 2 diabetes. Nonsurgical methods of weight loss were not positively conducted in significant part of obese population. It has given a chance to develop part of medicine known as bariatric surgery. Obesity is identified as an risk factor for sexual dysfunction. &#x0D; The aim of this article is to summarize the main findings of studies about the influence of bariatric surgery on sexual functions of obese male patients. &#x0D; &#x0D; Materials and methods: &#x0D; The study is based on medical articles gathered from PubMed database spanning the years 2016-2023 and article from National Institutes of Health and from Nutritionhospitalaria. The research was conducted through the analysis of keywords such as ”Obesity”, „Bariatric Surgery”, Sexual Dysfunction”, „Men”. &#x0D; &#x0D; Results:&#x0D; This review indicated that surgically inducted weight loss could improve sexual function in obese men. It is connected with important increase in IIEF score and serum testosteron level. It is a need for further clinical studies to explore association of sexual function after bariatric surgery.

Commentary on: The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis.

Commentary on: The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis.

COVID-19'lu Kadınların İyileşme Sonrası Cinsel İşlevleri ve İlişkili Faktörler

This study was conducted to investigate the sexual function status and related factors in women after contracting COVID-19. The study comprised 261 women who had been infected with COVID-19. Data were collected using the Personal Information Form, the Female Sexual Function Scale, and the State-Trait Anxiety Inventory. Sub-dimension scores for desire (3.80 ± 1.16, 3.66 ± 1.17), arousal (4.25 ± 1.40, 4.11 ± 1.41), orgasm (4.36 ± 1.25, 4.29 ± 1.26), and sexual satisfaction (4.50 ± 1.49, 4.40 ± 1.49) in women, as well as the Female Sexual Function Scale total score (26.50 ± 6.79, 26.00 ± 6.93), decreased following COVID-19 infection. Moreover, the frequency of weekly intercourse decreased (2.78 ± 0.90; 2.60 ± 0.92) compared to the pre-infection levels, and the frequency of sexual dysfunction increased (FSFI &lt; 26 = 38.7%, 46.0%). In this study, advanced age, high body mass index (BMI) value, low education, income level, unemployment, smoking, lack of physical activity, anxiety, decreased coital frequency, and COVID-19 infection were identified as risk factors for sexual dysfunction. There was no significant relationship between the time elapsed after recovery from COVID-19 and sexual function. In conclusion, this research suggests that COVID-19 infection may lead to sexual dysfunction in women. Based on these research findings, health practitioners should assess the sexual health of female patients who have had COVID-19 infections, ensuring that women feel comfortable discussing their sexual health issues and referring them to appropriate treatment and counseling services when needed.

The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients

BackgroundMigraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning. ObjectiveTo determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities. MethodThis is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction. ResultsWe included 306 patients (85.6% women, mean age 42.3±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17–5.00]; p<0.001), being older than 46.5 years (4.04 [2.48–6.59]; p<0.001), having chronic migraine (2.31 [1.41–3.77]; p=0.001), using preventive medication (2.45 [1.35–4.45]; p=0.004), analgesic overusing (3.51 [2.03–6.07]; p<0.001), menopause (4.18 [2.43–7.17]; p<0.001) and anxiety (2.90 [1.80–4.67]; p<0.001) and depression (6.14 [3.18–11.83]; p<0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62–0.85), Kappa: 0.48, p=0.005). ConclusionsSexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.

The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis.

In recent years, numerous epidemiological studies have investigated the prevalence of female sexual dysfunction (FSD) in females with inflammatory bowel disease (IBD). However, a comprehensive systematic review with meta-analysis pooling their findings is lacking. This study aimed to determine the pooled prevalence estimates of FSD and its risk factors among females with IBD based on extensive research in electronic databases (PubMed, Embase, and Web of Science) from inception until April 1, 2023. The overall prevalence of FSD among females with IBD, along with its 95% confidence interval (CI), and subgroup-specific prevalence rates, were summarized. Sources of heterogeneity were identified through subgroup analyses and meta-regression. A total of 13 studies were included in this systematic review and meta-analysis. The pooled global prevalence of FSD among females with IBD was 61.4% (95% CI: 52.8-70.1%). Sensitivity analysis, which involved excluding individual studies, indicated no significant variation in the pooled prevalence, confirming the robustness of our results. Additionally, a significant risk factor for FSD among females with IBD was the quality of life (OR = 0.39, 95% CI: 0.19-0.79). In conclusion, our systematic review and meta-analysis revealed a high prevalence of FSD among females with IBD, which warrants attention from health organizations and clinical practitioners. Importantly, the quality of life was identified as a potential risk factor for FSD in this population. Nonetheless, future prospective cohort studies with a large sample size are warranted to confirm these findings.

The Impact of Systemic Sclerosis on Sexual Health: An Italian Survey.

To evaluate the impact of systemic sclerosis (SSc) on vulvovaginal atrophy (VVA) and sexual health in an Italian population. An Italian survey about the prevalence and severity of VVA (on a 0 to 10 scale) and sexual dysfunction (using the Female Sexual Function Index-FSFI) through an anonymous online questionnaire. We investigated couple relationships and intimacy with partners, the predisposition of patients to talk about their sexual problems, physicians' receptivity, and treatment scenarios. Risk factors for VVA symptoms and sexual dysfunction were assessed. A total of 107 women affected by SSc were enrolled. Of these, 83.2% of women (89/107) complained about VVA symptoms and 89.7% (among sexually active women; 87/97) about sexual dysfunction. Menopausal status did not affect VVA symptoms, while age was the only independent risk factor for sexual dysfunction. About 70% (74/107) of women reported a negative impact of disturbances on intimacy with their partner. A total of 63 women (58.9%) had never discussed their sexual problems and VVA condition with a physician. Lubricants were the only treatment prescribed, and 75% of women would welcome new therapies, even if experimental (62.9%). In women with SSc, VVA symptoms and sexual dysfunction are highly prevalent, independently from menopause. In more than half of the investigated women with SSc, we found reluctance to talk about their sexual problems, despite being symptomatic. This should encourage physicians to investigate vulvovaginal and sexual health. SSc patients would welcome the advent of new treatment possibilities for their VVA and sexual complaints.

Prevalence of sexual dysfunction after breast cancer compared to controls, a study from CONSTANCES cohort.

Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history. The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction. Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n = 911), 34% had pain during SI (n = 901) and 30% were not satisfied with their sex life (n = 803). Sexual dysfunction was significantly more frequent in women who had a history of BC: they had less sexual interest (OR 1.79 [1.65;1.94], p < 0.001), experienced more pain during SI (OR 1.10 [1.02;1.19], p < 0.001) and were more dissatisfied with their sex life (OR 1.58 [1.47;1.71], p < 0.001). This stayed true after adjustment on multiple demographic factors such as age, menopausal status, body mass index and depression. Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders. Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued.

(079) Evaluating Sexual Self-schema Scales for Use Among Women Who Experienced Sexual Trauma: A Systematic Review of Measurement Properties and Practice Implications

Abstract Introduction “Sexual self-schema" refers to a psychological construct describing the organization of cognitive, affective, and behavioral dimensions of our understanding of ourselves as sexual beings. Sexual self-schema have been shown to mediate a variety of women’s sexual wellbeing outcomes. It is unclear the extent to which existing measurements of sexual self-schema capture aspects relevant to a sexual trauma history, such as unique patterns of dysregulated sexual excitation and inhibition. Objective This systematic review describes existing validated sexual self-schema measurements, and critically discusses each instrument in the context of assessing women who experienced sexual trauma. Methods We conducted the review according to PRISMA guidelines. We searched Academic Search Premier, Web of Science, and PsycINFO for reports focused on development and validation of assessment tools for women’s sexual self-schema. The search used pre-specified keywords (“sexual self-schema,” “sexual self-concept,” “sexual self-perception,” or “sexual self-view”). To ensure literature saturation, authors conducted reference branching on studies identified from the search via Google Scholar. Authors then screened titles, abstracts, and methods of all potentially eligible studies. Results Searches identified 576 articles, of which 455 unique articles were considered. Of these, 287 and 63 were excluded based on information in the title and abstract, respectively. Of 43 full-text articles retrieved, 20 were removed upon methods inspection. Reference list branching identified 65 additional potential articles, of which two were included. Across methods, 21 total papers were included in the final review. This presentation will present data on each measurement tool, including scope of use, sample description, measurement validation properties, and application considerations. Qualitative synthesis across papers revealed that the Sexual Self Schema Scale for Women (Andersen &amp; Cyranowski, 1994) is the most widely cited and is clearly the field standard, from which further emic versions have been developed across languages and nationalities. Further, available measures vary widely in content specificity/comprehensiveness, face validity, and response valence dimensionality. Only two papers explicitly considered elements of sexual trauma at the measurement development or validation phase. Conclusions Existing scales have limited utility in capturing unique social-relational patterns that are common among women who have experienced trauma. Further, few validated scales incorporate nuanced elements of co-occurring, conflicting approach-avoidance orientations toward sex, which suggests that measures may be limited in their ability to assess risk factors for sexual dysfunction among sexual trauma survivors. We list measurement development and validation details and relevant strengths and limitations of 21 unique, varied sexual self-schema measurement instruments for researchers and clinicians who seek to understand cognitive risk and resilience factors among women who have experienced sexual trauma. Disclosure No

Sexual Function in Pregnancy in a Nigerian Population: A Prospective Longitudinal Study.

Studies are abound from low- and middle-income countries (LMICs) on postpartum sexual dysfunction but very limited in pregnancy. The data will help clinicians in providing women with evidence-based information and counseling in these regards. To determine the effects of different trimesters of pregnancy on sexual functions and the possible risk factors for sexual dysfunction in pregnancy. The study was longitudinal in design, and study population consisted of 270 pregnant women attending antenatal care at the two largest tertiary hospitals in Enugu, Nigeria. The recruitment was in the first trimester, and each recruited participant served as her own control. Interviews were conducted at specific times in the three trimesters, and data regarding sexual functions were obtained using validated questionnaires. Analysis of variance (ANOVA) was performed to compare the mean total and domain female sexual function index (FSFI) scores between the three trimesters, and Bonferroni's test for significant association between any two trimesters as may be applicable. The risk factors were determined via multivariate logistic regression analysis. A P value ≤0.05 was considered statistically significant. The FSFI means total score decreased as pregnancy advanced. It was significantly lower in second trimester (T2) than in first trimester (T1) (P < 0.001), and significantly lower in third trimester (T3) than T1 (P < 0.001), but no difference between T3 and T2 (P = 0.759). Similarly, the mean frequency of coitus per week declined across the trimesters; lower in T2 than T1 (2.2 ± 0.7 vs. 2.4 ± 0.6; P < 0.01), and lower in T3 than T1, but no difference between T3 and T2. The overall rate of sexual dysfunction was 50.7% and the risk factors age ≥35 years (AdjOR: 1.4; 95%CI: 1.1-1.9; P: 0.01), multiparity (AdjOR: 1.7; 95%CI: 1.2-2.5; P: 0.013) and a previous history of cesarean section (AdjOR: 2.1; 95%CI: 1.7-2.6; P: 0.004). Sexual function declines as pregnancy advances and the rate of sexual dysfunction is high in Enugu, Nigeria. Obstetricians are encouraged to discuss sexual health issues during antenatal care services and make more efforts towards reducing the modifying obstetric risk factors.

Association between body mass index, body image and self-esteem with sexual function: A survey of young women in Singapore.

Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women. A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55). BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78). Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.

P426 Sex and sexuality in IBD - the pediatric gastroenterologists’ point of view

Abstract Background Although sexual dysfunction (SD) and sexually transmitted infections (STI) are occasionally encountered in patients with inflammatory bowel disease (IBD), physicians may be embarrassed to discuss these issues. This is especially true in adolescent patients, where parents are active participants in clinic visits. In addition, data in the literature about SD in this age group is limited. Our aims were to assess pediatric gastroenterologists (PedGI) knowledge and common practice regarding sexual advice and STI in pediatric patients with IBD. Methods A questionnaire was sent to all registered PedGI in Israel, and included 24 questions addressing knowledge of adolescent sexual behavior, SD, receptive anal intercourse (RAI) and STI in pediatric patients with IBD. Results Overall, 52 physicians completed the questionnaire (27 males, 52%). Only 50% provided the correct answer regarding the mean age at which Israeli youth start practicing sexual activity, whereas none were correct regarding the mean age when RAI is practiced. Fifty eight percent rightfully stated that SD is equally distributed among males and females and 38% responded that it is equally prevalent among patients with Crohn’s and those with Ulcerative Colitis. The most quoted, incorrectly, risk factor for SD was perianal disease. Seventy five percent thought that providers should talk about sex with their patients, but only 19% actually do so, most often in response to a patient’s query. Ninety six percent felt they do not have enough knowledge about SD in IBD. Finally, only 2% routinely obtain bacterial swabs for STI in patients with refractory proctitis, although 15% encountered such as a problem in clinic. Conclusion Sexuality and SD are not discussed routinely in the pediatric IBD clinics by the majority of PedGI. Providers should obtain more knowledge in the field, and proactively discuss these issues with teenagers with IBD.

Evaluation Of Morbid Obese Patients In Terms Of Sexual Dysfunctions: A Cross-Sectional Study

Aim: Obesity is a risk factor for sexual dysfunction. The aim of this study was to determine the frequency of sexual dysfunction in patients diagnosed with morbid obesity.Methods: The patient group included in the study consisted of 78 morbidly obese patients with BMI≥40 kg/m2 and 68 healthy individuals with normal BMI. The data were obtained by using the sociodemographic information form filled by the participants, Beck anxiety scale, Beck depression scale and Golombok Rust Sexual Satisfaction Inventory.Results: Obese individuals were found to have sexual dysfunction compared to individuals with normal body BMI (p&amp;lt;0.05). When the Golombok Rust subscale scores of obese men were compared to those of normal-weight individuals, a significant deterioration was found in all subscale scores, including frequency, communication, satisfaction, avoidance, touch, impotence and premature ejaculation. In addition, the anxiety and depression scores of obese individuals were shown to be higher than those of normal-weight individuals (p&amp;lt;0.05).Conclusion: Morbidly obese individuals should be evaluated in terms of sexual functions. We believe that regulating obesity treatment, including possible treatment for sexual dysfunction, will increase the success rate and enhance the quality of life for patients.

Sexual dysfunction among gynecologic cancer survivors in a population-based cohort study.

Treatment for gynecologic cancer is associated with sexual dysfunction, which may present during and/or after treatment. The aim of this study was to investigate the risk of sexual dysfunction among gynecologic cancer survivors compared to cancer-free women in a population-based cohort study. We identified a cohort of 4863 endometrial, ovarian, and cervical cancer survivors diagnosed between 1997 and 2012 in the Utah Cancer Registry. Up to five cancer-free women were matched to cancer survivors (N = 22,693). We used ICD-9 codes to identify sexual dysfunction. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for sexual dysfunction with adjustment for potential confounders. Approximately 6.6% of gynecologic cancer survivors had sexual dysfunction diagnoses 1-5years after cancer diagnosis. Gynecologic cancer survivors had higher risks of overall sexual dysfunction (HR: 2.51, 95% CI: 2.16, 2.93), dyspareunia (HR: 3.27, 95% CI: 2.63, 4.06), and vaginal dryness (HR: 2.63, 95% CI: 2.21, 3.12) compared to a general population of women, 1-5years after cancer diagnosis. Sexual dysfunction was associated with advance cancer stage (HRRegional vs. Localized: 1.61, 95% CI: 1.19, 2.31), radiation therapy (HR: 1.73, 95% CI: 1.29, 2.31), and chemotherapy (HR: 1.80, 95% CI: 1.30, 2.50). This large cohort study confirms that there is an increased risk of sexual dysfunction among gynecologic cancer survivors when compared to the general population. Further investigation is needed to address the risk factors for sexual dysfunction and to improve patient-provider communication, diagnosis, documentation, and treatment of sexual dysfunction among gynecologic cancer survivors.

Sexual Dysfunction in Female Patients with Inflammatory Bowel Disease: An Overview.

Sexual dysfunction is common among females with inflammatory bowel disease and may result in issues involving intimacy, sexual activity, and satisfaction, as well both the formation and preservation of personal relationships. Risk factors for sexual dysfunction include select surgical interventions, medications, mental illnesses, and IBD-related intestinal and extraintestinal comorbidities. In addition, certain demographic factors such as age, disease type and activity may influence the severity of sexual dysfunction. Evaluation of sexual dysfunction may include the use of validated sexual functioning questionnaires, a brief mental health assessment, initial inquiry into vulvovaginal or perineal symptoms, and a gynecologic and GI-focused physical exam. An interdisciplinary care team involving IBD specialists, obstetrician-gynecologists, pelvic floor physical therapists, and primary care physicians may be best suited to provide optimal care and treatment recommendations for patients with sexual dysfunction. Options for management often include pelvic floor physical therapy, biofeedback, and mental health support. Further research is necessary to delineate the impact of IBD activity on sexual dysfunction, to determine if health outcome differences exist depending on surgical approaches utilized during J-pouch operations, and finally to evaluate the care and perceptions of patients with IBD who identify as sexual and gender minorities.