Risk Factors For Sexual Dysfunction Research Articles

An estimation of patients at potential risk for drug-induced sexual dysfunction using pharmacy dispensing data.

Background and ObjectivesAdverse drug reactions on sexual functioning (sADRs) may seriously decrease a person’s quality of life. A multitude of diseases and drugs are known risk factors for sexual dysfunction. To inform patients better about these potential effects, more insight is needed on the estimated number of patients at high risk for sADRs and their characteristics.MethodsThis cross-sectional study estimated the number of patients in the Netherlands who were dispensed drugs with a potential very high risk (>10%) or high risk (1–10%) for sADRs as registered in the Summary of Product Characteristics, the official drug information text in Europe.ResultsIn April 2019, 2.06% of the inhabitants of the Netherlands received drugs with >10% risk for sADRs and 7.76% with 1–10% risk. The majority of these patients had at least one additional risk factor for decreased sexual function such as high age or depression. Almost half of the patients were identified with two or more morbidities influencing sexual functioning. Paroxetine, sertraline and spironolactone were the most dispensed drugs with a potential >10% risk for sADRs. One-third of their first dispenses were not followed by a second dispense, with a higher risk of discontinuation for a decreasing number of morbidities.ConclusionAbout 1 in 11 inhabitants of the Netherlands was dispensed a drug with a potential high risk for sADRs, often with other risk factors for sexual complaints. Further research is needed whether these users actually experience sADRs, to understand its impact on multimorbid patients and to provide alternatives if needed.

Risk factors for sexual dysfunction in Romanian women with type 1 diabetes mellitus and chronic autoimmune thyroiditis: a comparative cross-sectional study

BackgroundFemale sexual dysfunction (FSD) is one of the chronic complications of diabetes as is male sexual dysfunction, but the former is less studied. Therefore, the aim of this study was to assess of the prevalence and risk factors associated with FSD in Romanian women with type 1 diabetes mellitus (T1DM) and chronic autoimmune thyroiditis (CAT).MethodsThe study sample included 104 Romanian women with both T1DM and CAT, and 101 Romanian matched controls with only T1DM. The presence of FSD was established using two validated tests: The Female Sexual Function Index and the Female Sexual Distress Scale-revised. The presence of depression was assessed using Beck’s Depression Inventory-II.ResultsWe found that almost half of the women in the group with T1DM and CAT presented with sexual dysfunction (49 vs. 33.7% in the control group; p = 0.025): 27.9 vs. 8.9 (p < 0.001)—desire, 23.1 vs. 7.9% (p = 0.003)—orgasm, 21.2 vs. 5.9% (p = 0.002)—lubrication, 17.3 vs. 6.9% (p = 0.023)—arousal, 9.6 vs. 1% (p = 0.006)—pain, and 20.2 vs. 9.9% (p = 0.040)—satisfaction problems. Multivariate regression analysis revealed that age was a significant risk factor for FSD, along with DM and body mass index. Coexisting CAT, polyneuropathy, depression, and the use of insulin pumps were significant risk factors for FSD.ConclusionsWomen with T1DM and CAT are more likely to present with FSD than those without. It is important for patients to address depression, if present, and exercise caution while using insulin pumps. Moreover, DM complications such as polyneuropathy are significant risk factors for FSD; thus, it is crucial to ensure satisfactory glycemic control and optimal DM management.

Sexual Dysfunction Among Young Adults in Sweden-A Population-Based Observational Study.

IntroductionThere is a lack of studies using validated instruments to investigate prevalence and predictors of sexual dysfunction among young adults.AimThis population-based observational study aimed to determine the prevalence and predictors of sexual dysfunction in young adults in Sweden and to compare sexual function in women and men.MethodsA random sample of the general population aged 19-40 years, identified via the Swedish population registry, was approached with a postal survey. A total of 819 individuals participated, 493 women (51% response) and 326 men (34% response). Predictors of sexual dysfunction were identified by multivariable logistic binary regression analyses.Main outcome measureSexual function and satisfaction were assessed using the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction measure, version 2.0.ResultsAmong the women, 53% reported at least one sexual dysfunction; the corresponding figure for men was 31%. The most common sexual dysfunction in women was low sexual interest (reported by 32%), whereas low satisfaction with sex life was the most common dysfunction in men (reported by 17%). Men reported a higher level of sexual interest and orgasm ability than women, whereas women reported a higher level of orgasm pleasure than men. Regression models showed that in both women and men, having a partner was related to lower risk of dysfunction in the domains satisfaction with sex life and orgasm pleasure. Having children was related to low interest in sex in women, whereas it was related to dissatisfaction with sex life in men. Being born outside of Sweden predicted sexual dysfunction in both women and men, as did experiencing symptoms of anxiety and depression.ConclusionSexual dysfunction is common in young adults, particularly in women. Risk factors of sexual dysfunction include not having a partner, having children, being an immigrant, and reporting symptoms of anxiety and depression.Ljungman L, Lampic C, Wettergren L, et al. Sexual Dysfunction Among Young Adults in Sweden—A Population-Based Observational Study. Sex Med 2020;8:631–642.

Sexual dysfunction and health condition in Chinese doctor: prevalence and risk factors

To our knowledge, little attention has been paid to the sexual function of health workers. The aim of the present study was to assess the frequency of sexual dysfunction among Chinese doctors. In addition, the risk factors for sexual dysfunction were analyzed. This was a questionnaire-based multicenter cross-sectional survey performed in five large academic medical centers in China. A total of 539 male doctors, 547 female doctors were evaluated. We analyzed doctors' demographic characteristics, quality of life, sexual function and attitudes towards sexual problems. Chinese doctors are at high risk of sexual dysfunction and poor health. The prevalence of sexual dysfunction appears to increase with age, and is associated with various social and demographic factors including monthly income, physical exercise, working hours, night shift and health-related quality. The quality of life and sexual health of doctors deserves special attention as a significant public health concern. Alleviating work pressure, increasing income, improving quality of life and therapeutic sexual problems should be considered comprehensively.

Psychosexual Functioning of Female Childhood Cancer Survivors: A Report From the St. Jude Lifetime Cohort Study

IntroductionThere is a growing population of childhood cancer survivors at risk for adverse outcomes, including sexual dysfunction. AimTo estimate the prevalence of and risk factors for sexual dysfunction among adult female survivors of childhood cancer and evaluate associations between dysfunction and psychological symptoms/quality of life (QOL). MethodsFemale survivors (N = 936, mean 7.8 ± 5.6 years at diagnosis; 31 ± 7.8 years at evaluation) and noncancer controls (N = 122) participating in the St. Jude Lifetime Cohort Study completed clinical evaluations, Sexual Functioning Questionnaires (SFQ), and Medical Outcomes Survey Short Forms 36 (SF-36). Linear models compared SFQ scores between sexually active survivors (N = 712) and controls; survivors with scores <10th percentile of controls were classified with sexual dysfunction. Logistic regression evaluated associations between survivor characteristics and sexual dysfunction, and between sexual dysfunction and QOL. OutcomesSexual dysfunction was defined by scores <10th percentile of noncancer controls on the SFQ overall, as well as the domains of arousal, interest, orgasm, and physical problems, while QOL was measured by scores on the SF-36 with both physical and mental summary scales. ResultsSexual dysfunction was prevalent among 19.9% (95% CI 17.1, 23.1) of survivors. Those diagnosed with germ cell tumors (OR = 8.82, 95% CI 3.17, 24.50), renal tumors (OR = 4.49, 95% CI 1.89, 10.67), or leukemia (OR = 3.09, 95% CI 1.50, 6.38) were at greater risk compared to controls. Age at follow-up (45–54 vs 18–24 years; OR = 5.72, 95% CI 1.87, 17.49), pelvic surgery (OR = 2.03, 95% CI 1.18, 3.50), and depression (OR = 1.96, 95% CI 1.10, 3.51) were associated with sexual dysfunction. Hypogonadism receiving hormone replacement (vs nonmenopausal/nonhypogonadal; OR = 3.31, 95% CI 1.53, 7.15) represented an additional risk factor in the physical problems (eg, vaginal pain and dryness) subscale. Survivors with sexual dysfunction, compared to those without sexual dysfunction, were more likely to score <40 on the physical (21.1% vs 12.7%, P = .01) and mental health (36.5% vs 18.2%, P < .01) summary scales of the SF-36. Only 2.9% of survivors with sexual dysfunction reported receiving intervention. Clinical ImplicationsHealth care providers should be aware of the increased risk of sexual dysfunction in this growing population, inquire about symptomology, and refer for appropriate intervention. Strengths & LimitationsStrengths of this study include the use of a validated tool for evaluating sexual function in a large population of clinically assessed female childhood cancer survivors. Limitations include potential for selection bias, and lack of clinically confirmed dysfunction. ConclusionSexual dysfunction is prevalent among female childhood cancer survivors and few survivors receive intervention; further research is needed to determine if those with sexual dysfunction would benefit from targeted interventions.Bjornard KL, Howell CR, Klosky JL, et al. Psychosexual Functioning of Female Childhood Cancer Survivors: A Report From the St. Jude Lifetime Cohort Study. J Sex Med 2020;17:1981–1994.

Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men?

BackgroundTo our knowledge, there is no study in the literature that has investigated a cutoff value of the visceral adiposity index (VAI) for erectile dysfunction (ED) in men. AimTo show a possible relationship between ED and VAI levels representing adipose tissue dysfunction and to identify a cutoff value of the VAI for ED. MethodsThis prospective cross-sectional study included 276 participants in 5 groups: non-ED, mild ED, mild-moderate ED, moderate ED, and severe ED. The VAI was calculated. Fasting glucose, triglyceride, high-density lipoprotein, testosterone (T), prolactin, and estradiol were measured. Erectile function, sexual satisfaction, orgasm, desire, and general satisfaction scores were recorded using the International Index of Erectile Dysfunction 1–15 questionnaire. The participants were divided into BMI1 (<25.0), BMI2 (25–29.9), and BMI3 (>30.0) categories based on body mass index (BMI) and WC1 (<94 cm), WC2 (94–102 cm), and WC3 (>102 cm) categories based on waist circumference (WC). OutcomesThe VAI was investigated as an independent risk factor for ED, compared with BMI and WC. ResultsThe median VAI progressively increased, but a marked increase was recorded in groups 4 and 5 (P = .001). A significant increase in ED was observed for a VAI score higher than 4.33 (P = .001). Each integer increase of the VAI was associated with a 1.3-fold increased risk of ED. The odds ratio of ED for the VAI = 4.33 was 4.4 (P < .001). The WC and BMI significantly increased as the degree of ED increased (P = .001), but statistical analysis showed a significant decrease only in moderate and severe ED groups (P < .05). Starting from non-ED patients, serum triglyceride increased and high-density lipoprotein decreased progressively in all ED groups (P = .001). T/E2 slightly reduced as the severity of ED increased (P > .05). T decreased in ED groups (P = .022). Regardless of the ED level, other sexual subdomains decreased in ED patients (P = .001). The ED rates in 3 increasing BMI and WC categories were similar (P > .05). For VAI = 4.33, BMI ≥ 30.0 kg/m2, and WC > 102 cm, sensitivity and specificity were 61.2% and 73.8%, 31.6% and 90.5%, and 54.3% and 69.0%, respectively. Clinical ImplicationsThe VAI should be considered as a reliable independent risk factor for ED as a predictor of visceral adipose dysfunction. Strengths & LimitationsThe main strength is that this is the first study to investigate the association between the VAI and sexual dysfunction in men. The low number of participants is the limiting factor. ConclusionThe findings suggest that the VAI can be used as a reliable independent risk factor marker for ED as a predictor of visceral adipose dysfunction.Bolat MS, Kocamanoglu F, Ozbek ML, et al. Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men? J Sex Med 2020;17:1926–1933.

Perceived cognitive impairment is associated with sexual dysfunction in people with multiple sclerosis: A 2.5-year follow-up study of a large international cohort

BackgroundThe potential relationship between perceived cognitive impairment (PCI) and sexual dysfunction in multiple sclerosis (MS) has not been studied. ObjectivesTo explore the relationship between cognitive impairment and sexual dysfunction over 2.5 years in people with MS. MethodsData were derived from the Health Outcomes and Lifestyle In a Sample of people with Multiple sclerosis (HOLISM) international cohort over 2.5 years' follow-up. Cognitive function and sexual function were assessed by sub-scores of the MS Quality of Life-54. The impact of perceived cognitive impairment on sexual dysfunction was assessed by calculating prevalence ratios (PR) and relative risks (RR) with 95% confidence intervals (CI) using log-binomial regression models. Results1958 participants were included at baseline, of whom 555 without perceived cognitive impairment at baseline comprised the longitudinal cohort. The prevalence of perceived cognitive impairment at baseline was 45.6%. At baseline, cognitive impairment was associated with increased frequency of self-reported sexual dysfunction (aPR=1.32, 95% CI: 1.17–1.48). Among the sample without sexual dysfunction at baseline, incident sexual dysfunction was more common among participants with persistent (aRR=1.61, 95% CI: 1.06–3.18) and newly reported cognitive impairment (aRR=1.89, 95% CI: 1.14–3.14). ConclusionResults suggest PCI may be an independent risk factor for sexual dysfunction in PwMS, which may represent an additional dimension whereby MS may adversely affect quality of life.

Sexual impairment in patients with hidradenitis suppurativa: a systematic review.

Hidradenitis suppurativa (HS) can cause considerable impact on several aspects of quality of life. Sexuality is a central aspect of quality of life. In recent years, there has been an increase in the number of articles on HS and sexuality. To achieve our aim of synthesizing the available scientific evidence on HS and sexual health, we conducted a systematic review in February 2020. The clinical databases used included Medline and Embase. All types of epidemiological articles were included; reviews, guidelines, protocols, conference abstracts and case report articles were excluded. Eleven studies were included for review, representing 42729 patients with HS. The most common study design was cross-sectional with or without comparison group(s), conducted in an outpatient setting or through surveys. Prevalence of sexual dysfunction ranged between 51-62%, and in the case of erectile dysfunction, a specific kind of sexual dysfunction affecting penile erection, it ranged from between 52% and 60% of patients studied using validated questionnaires. Potential risk factors for sexual dysfunction among men and women were identified, mainly related to disease activity, symptoms and partners. Mood disorders like depression and anxiety appear to be associated with sexual dysfunction. Women were more affected by sexual distress. HS patients with sexual dysfunction had a decreased overall quality of life. With respect to treatment, surgery did not improve sexual function and there is no scientific evidence regarding medical treatments. Patients stated that they would like to treat their sexual problems with healthcare professionals. In conclusion, sexual and erectile dysfunction are common in HS patients, and negatively affect their quality of life. There are clinical factors potentially associated with this which should be identified and treated by dermatologists in the comprehensive care of HS patients. Prospective studies are needed to provide more scientific evidence on this unmet need.

Male and Female Sexual Dysfunction in Pediatric Cancer Survivors

BackgroundPediatric cancer survivors suffer indirect long-term effects of their disease; however, there is a paucity of data regarding the effect of pediatric cancer survivorship on sexual function. AimTo assess the prevalence and risk factors associated with sexual dysfunction among pediatric cancer survivors. MethodsPediatric cancer survivors were recruited to complete an online survey using the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF-5), both validated questionnaires to assess female sexual dysfunction (FSD) and erectile dysfunction (ED). Patient demographics, oncologic history, prior treatment, and sexual habits were also queried. Logistic regression was used to evaluate risk factors for sexual dysfunction, and Mann-Whitney U test was used to identify factors associated with individual domains of the FSFI. OutcomesThe main outcome measures were FSFI and IIEF-5 score, which are used to diagnose FSD (FSFI<26.55) and ED (IIEF-5<22). ResultsA total of 21 (72.4%) female respondents and 20 (71.4%) male respondents were sexually active and completed the survey and FSFI or IIEF-5 questionnaire, respectively. Mean (±SD) age was 23.7 (4.1) years, and average age at diagnosis was 9.1 (5.0), with no difference between genders. Overall, 25.0% (5/20) of male and 52.4% (11/21) of female pediatric cancer survivors reported sexual dysfunction (P = .11). Oncologic history and prior treatment were not associated with sexual function. Females who reported difficulty relaxing during intercourse in the last 6 months had higher odds of reporting sexual dysfunction (odds ratio: 13.6, 95% confidence interval: 1.2–151.2, P = .03). Subgroup analysis of FSFI domains found that previous radiation therapy was correlated with decreased lubrication and satisfaction during intercourse, whereas previous treatment to the pelvic region significantly reduced satisfaction and increased pain during intercourse. Clinical ImplicationsFemale pediatric cancer survivors have higher odds of reporting sexual dysfunction after treatment and should be screened appropriately to provide early intervention and to mitigate risk. Strength & LimitationsOur study includes validated questionnaires to assess FSD and ED and queries specific characteristics to assess their association with sexual dysfunction. However, the study is limited by sample size and its cross-sectional survey design. ConclusionsThe prevalence of female sexual dysfunction in this cohort is higher than that in the general population of equivalent-aged individuals, and clinicians should be aware of these potential long-term sequelae.Greenberg DR, Khandwala YS, Bhambhvani HP, et-al. Male and Female Sexual Dysfunction in Pediatric Cancer Survivors. J Sex Med 2020;17:1715–1722.

2274-PUB: Prevalence and Risk Factors of Sexual Dysfunction in Romanian Women with Type 2 Diabetes Mellitus and Chronic Autoimmune Thyroiditis

Background: Female sexual dysfunction (FSD) represents one of the chronic complications of diabetes, as the male sexual dysfunction, but less studied. Objective: Assessment of the prevalence and risk factors associated with sexual dysfunction in Romanian women with type 2 diabetes mellitus (T2DM) and chronic autoimmune thyroiditis (CAT). Material and Methods: The study sample included 132 Romanian women with T2DM and CAT. The presence of sexual disfunction was established using two validated questionnaires: Female Sexual Function Index, and Female Sexual Distress Scale-revised. CAT diagnosis was confirmed by the presence of antithyroid antibodies (antiperoxidase and antithyroglobulin antibodies). Results: We found that 47% of women presented sexual dysfunctions: 25.8% loss of libido, 21.2% orgasm, 17.4% lubrication, 18.9% arousal, 8.3% pain, and 17.4% satisfaction problems. The analysis revealed that age was a significant risk factor for FSD, along with DM duration and CAT duration. The presence of dyslipidemia as well as a ponderal status of overweight or obese, and also the glycemic control parameters such as average glycemic level and HbA1c were significant risk factors for FSD. Conclusions: Women with T2DM and CAT are more likely to present FSD and should be aware of additional risk factors. Disclosure A. Gherbon: None. M. Frandes: None. R. Timar: None.

Trajectories of sexual dysfunction and its risk factors in women with gynecologic cancer across radiation therapy and healthy controls.

e24097 Background: Women with gynecological cancer (GynCa) reported an increased risk for acute and long-term sexual dysfunction across cancer treatments, especially radiation therapy (RT). However, limited data exist on the course of sexual dysfunction across RT and its risk factors are unknown. This study sought to characterize women’s sexual dysfunction trajectories and identified risk factors of persistent sexual dysfunction. Methods: Using a longitudinal study design, patient-reported sexual dysfunction, demographic and clinical data were collected. Women receiving RT for GynCa older than 18 years or age, race, and BMI matched healthy controls were enrolled. Female Sexual Function Index (FSFI) was used to assess women’s sexual dysfunction. Patients completed all the questionnaires pre-RT, at the end of RT, 6- and 12-month post-RT. Group-based trajectory modeling was used to identify trajectories of sexual dysfunction and risk factors of persistent sexual dysfunction. Results: Eighty-two patients were analyzed, including 36 GynCa patients receiving RT and 46 healthy post-menopausal women, comprising of 33 Blacks, 44 Whites, and 5 others. Three trajectory groups of sexual dysfunction (total FSFI score) were identified: low risk (17.4%), moderate risk (12.3%), and high risk (70.4%). All three trajectory groups were significantly different from each other (p&lt;0.01). Similarly, three trajectories were identified for each of six FSFI domains: desire (low [6.3%], moderate [62.5%], high [31.2%], p&lt;0.01); arousal (low [38.1%], moderate [46.4%], high [15.4%], p&lt;0.01); lubrication (low [49.7%], moderate [44.6%], high [5.7%], p&lt;0.01); orgasm (low [43.8%], moderate [31.3%], high [24.9%], p&lt;0.01); pain (low [25.5%], moderate [64.2%], high [10.3%], p&lt;0.01); and satisfaction (low [8.3%], moderate [61.4%], high [30.3%], p&lt;0.01). Risk factors of sexual dysfunction were high pH (p=0.007) and without chemotherapy (p=0.019). Young women had more arousal (p=0.011); high education level was associated with high arousal (p=0.039); low pH was associated with high arousal (p=0.018) and orgasm (p=0.036). No risk factors were found for desire and satisfaction domains. BMI, surgery, and study cohort (cancer vs healthy) were not predictors of sexual dysfunction trajectories. Conclusions: This study identified three trajectories of sexual dysfunction. Low education, high pH, no chemotherapy, and elder women were risk factors of severe sexual dysfunction. Sexual dysfunction interventions should address these risk factors.

Influential factors on sexual function in infertile women with endometriosis: a path analysis

BackgroundEndometriosis have a negative influence on women’s sexual life. The aim of the current study was to test a conceptual model considering the interrelated role of anxiety, depression, sleep quality, physical activity, BMI, stage of endometriosis, the intensity of dyspareunia and pelvic pain on sexual function (SF) in infertile women with endometriosis. Also test the mediating role of sleep quality, anxiety, and depression.MethodIn the present cross-sectional study, 220 infertile women with a laparoscopically confirmed endometriosis were recruited. Data were collected using a socio-demographic checklist, Female Sexual Function Index (FSFI), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Visual Analog Scale (VAS).ResultsWe found that anxiety, depression, sleep quality, BMI, level of education, stage of endometriosis, and dyspareunia have a direct effect on women’s SF. In our study, sleep quality, anxiety, pelvic pain, and depression were the four major mediators that the higher scores lead to a decrease in the SF of endometriosis patients. The intensity of pelvic pain with an effect on sleep quality (SQ) and dyspareunia change women’s SF. The lower level of physical activity, and higher BMI with indirect effect thorough anxiety, and SQ can worsen SF. Also, a higher level of anxiety leads to poor SQ and depression. Anxiety with both direct and indirect effect impress women’s SF.ConclusionIt seems that the main risk factors for sexual dysfunction in women with endometriosis are higher rates of anxiety, depression, poor sleep quality, pelvic pain, and dyspareunia. In the care of women with endometriosis, not only laparoscopy and medical treatment should be performed but also psychotherapeutic and psychosexual help should be offered.

EVALUASI RISIKO TERJADINYA DISFUNGSI SEKSUAL PASIEN KANKER KOLOREKTAL DENGAN STOMA: A SYSTEMATIC REVIEW

Objective: Stoma is a surgical procedure commonly used for the treatment of colorectal cancer patients, this will affect the patient's sexuality problems. This research study with qualitative and quantitative research designs published between 2008 to 2018 in English articles. Methods: PubMed, EBSCO, and Google Scholar, are sought to evaluate the risk of sexual dysfunction in colorectal cancer patients with stoma. Results: Research that has been explored in nine consists of mixed methods case control, case control retrospective study, systematic review, phenomenology study, multiple logistic regression, prospective descriptive study, longitudinal study, cross sectional design, descriptive comparison study. Most of the findings of the study show that sexual dysfunction is a problem of concern. Conclusions: evaluating sexual dysfunction problems in colorectal cancer patients with stoma, are the basic essence of nursing intervention. Health care professionals must be more aware of the problems of risk factors for sexual dysfunction experienced by patients after making stoma, so that services and treatments performed are more optimal.

Effects of Hypothyroidism and Subclinical Hypothyroidism on Sexual Function: A Meta-Analysis of Studies Using the Female Sexual Function Index.

IntroductionHypothyroidism and subclinical hypothyroidism (SCH) are common metabolic diseases with severe psychological and physiological effects, which may be the risk factors of sexual dysfunction.AimThe purpose of this study is to explore the influence of hypothyroidism and SCH on female sexual function through systematic literature review.MethodsUntil February 2020, systematic searches were conducted on Pubmed, Web of Science, EMBASE, and Clinicalkey to obtain eligible studies to report the mean and standard deviation of Female Sexual Function Index (FSFI) in various fields in women with clinical hypothyroidism, SCH, and healthy controls. In accordance with the results of heterogeneity test, a random effect model or fixed effect model was selected to aggregate the scores of each field. The scores of female patients with hypothyroidism and healthy controls were compared using forest plot. Stata (version 15.1) uses meta-analysis.Main Outcome MeasureEvaluation values of various fields of FSFI in clinical hypothyroidism, SCH, and healthy controls.ResultsThis study included 7 studies, including 88 women with clinical hypothyroidism, 337 women with SCH, and 2056 healthy controls. Compared with healthy controls, patients with hypothyroidism scored lower in all FSFI dimensions (desire, arousal, lubrication, orgasm, satisfaction, and pain), especially in lubrication. And, only arousal and orgasm decreased in patients with SCH. Hypothyroidism (odds ratio = 3.912, P = .002) rather than SCH (odds ratio = 1.036, P = .886) was a risk factor for female sexual dysfunction.ConclusionHypothyroidism does impair female sexual function to varying degrees. SCH has little effect on female sexual function. It is essential to measure and evaluate the thyroid function of women with sexual dysfunction regularly, which can help clinicians improve sexual function and sexual quality of life.Wang Y and Wang H. Effects of Hypothyroidism and Subclinical Hypothyroidism on Sexual Function: A Meta-Analysis of Studies Using the Female Sexual Function Index. Sex Med 2020;8:156–167.

The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists

BackgroundBicycle riding's impact on erectile function remains a topic of great interest given cycling's popularity as a mode of transportation and exercise. AimWe evaluated risk factors for sexual dysfunction in male cyclists with the primary intention of determining if genital/pelvic pain and numbness are associated with erectile dysfunction (ED). MethodsWe surveyed male cyclists using an online anonymous questionnaire. Cyclists were queried on their demographics, cycling experience, and sexual function using the Sexual Health Inventory for Men (SHIM). ED was diagnosed when a completed SHIM score was <22. Regression analysis was used to evaluate the risk of ED in men with genital/pelvic pain or numbness after riding. The survey was designed in the United States. OutcomesQuantitative characterization of cycling habits, onset and timing of genital pain and numbness, and SHIM score. ResultsA total of 1635 participants completed the survey. A majority of men were over the age of 50 (58%, 934/1,607), Caucasian (88%, 1,437/1,635), had been active cyclists for over 10 years (63%, 1,025/1,635) and used road bikes (97%, 1,578/1,635). Overall, 22%, 30%, and 57% of men reported ED, genital pain, and genital numbness, respectively. While controlling for cohort demographics, body mass index, cycling intensity and equipment, and medical comorbidities, no saddle characteristics were associated with the risk of developing genital numbness. However, men reporting penile numbness were at higher risk of reporting ED (odds ratio [OR] = 1.453, P = .048). In addition, quicker onset of numbness and resolution of numbness within a day was associated with impaired erectile function. For example, numbness occurring less than 1 hour after cycling had greater odds of leading to ED than numbness after 5 hours (OR = 2.002, P = .032). Similarly, genital pain occurring less than 1 hour (OR = 2.466, P = .031) after cycling was associated with higher ED risk. Strengths & LimitationsStrengths include a large sample size of high-intensity cyclists and validated questionnaire use. Limitations include reliance on anonymous self-reported survey data and minimal inquiry into the riding preferences and terrain traversed by cyclists. ConclusionsPelvic pain and numbness are common complaints among male riders in the United States. Men with such complaints are more likely to also report ED especially if it occurs earlier in the ride. Although direction of causality and temporality are uncertain, alleviation of factors resulting in pelvic discomfort may reduce cycling's impact on sexual function. Such interventions are critical given that cycling for both active travel and aerobic exercise confers numerous health benefits.Balasubramanian A, Yu J, Breyer BN, et al. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists. J Sex Med 2020;17:919–929.

Cutoff score of the traditional Chinese version of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12)

ObjectiveThe short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) is a condition-specific instrument used to evaluate sexual function in women with pelvic floor disorders. The traditional Chinese version of the PISQ-12 (CVPISQ-12) has been validated, however the cutoff score has yet to be determined. The aim of this study is to establish the cutoff score for the CVPISQ-12 and analyze the risk factors for female sexual dysfunction. Material and methodsA sub-analysis of data involving sexually active women who sought consultation for pelvic floor disorders at a medical center in 2016. Based on the known cutoff value of Female Sexual Function Index, the cutoff score of the CVPISQ-12 was analyzed using receiver operating characteristic (ROC) curve analysis. Other assessments included 1-h pad test and incontinence-related questionnaires using the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). ResultsROC curve analysis showed a cutoff score of 32.5, with a sensitivity of 87% and specificity of 88%. The area under the ROC curve was 0.937 (p <0.001; 95% confidence interval: 0.895–0.979). The 1-h pad test (B = −0.266; p = 0.031), IIQ-7 (B = −0.378; p = 0.047) and age (B = −0.415; p = 0.001) were risk factors for sexual dysfunction in women with a score <32.5. However, age was the only significant risk factor for women with a higher score (B = −0.384; p = 0.035). ConclusionsA CVPISQ-12 score ≥32.5 suggested normal sexual function. For this patient group, age may be a more important factor associated with sexual function than pelvic floor disorders.

Men With Inflammatory Bowel Disease: Sexual Function, Fertility, Medication Safety, and Prostate Cancer.

Half of patients with inflammatory bowel disease (IBD) are men, yet less attention has been focused on their sexual issues despite higher rates of sexual dysfunction and infertility than the general population. Depression and IBD disease activity are the most consistently reported risk factor for sexual dysfunction among men with IBD. Methotrexate and sulfasalazine have been rarely associated with impotence. Sulfasalazine reversibly reduces male fertility. No other medications used in IBD significantly affect fertility in humans. There is no increase in adverse fetal outcomes among offspring of fathers with IBD. Patients with IBD seem to be at a higher risk for prostate cancer; therefore, screening as recommended for high-risk patients should be considered.

Prevalence and Risk Factors of Sexual Dysfunction in Patients with Chronic Heart Failure in Yaoundé, Cameroon

Heart failure is a major public health problem in sub Saharan Africa, associated with high morbidity and mortality. Sexual dysfunction contributes a lot to the burden of the disease. This complication is linked to the side effects of drugs, physical and psychological factors, and the coexistence of shared risk factors between heart failure and sexual dysfunction. Although patients with heart failure frequently report sexual disorders, few data are available in our context. This research seeks to determine the prevalence and risk factors of sexual dysfunction in patients with chronic heart failure in three reference hospitals of Cameroon. We carried out an analytical cross-sectional study over a period of four months (January to April 2018). All consenting patient with chronic heart failure aged 18 years and above were selected. Baseline socio-demographical and clinical characteristics were collected. The assessment of sexual function was made using a self-administered questionnaire. Data analysis was done using the software IBM SPSS 23.0; the level of statistical significance was set at p 60 years (p=0.001), hypertension (p=0.0017), use of beta blockers (p=0.0081) and fear of heart attack (p<0,001). Sexual dysfunction is common in patients with chronic heart failure in our context. Indeed, it affects more than half of our study population (57.7%) and is influenced by many factors.

Prevalence and risk factors of sexual dysfunction in patients with chronic heart failure in Yaoundé, Cameroon

Heart failure is a major public health problem in sub Saharan Africa, associated with high morbidity and mortality. Sexual dysfunction (SD) contributes a lot to the burden of the disease. This complication is linked to the side effects of drugs, physical and psychological factors, and the coexistence of shared risk factors between heart failure and sexual dysfunction. Few data are available in our context. This research seeks to determine the prevalence and risk factors of SD in patients with chronic heart failure in three reference hospitals of Cameroon. We carried out an analytical cross-sectional study over a period of four months (January to April 2018). All consenting patient with chronic heart failure aged 18 years and above were selected. Baseline socio-demographical and clinical characteristics were collected. The assessment of SD was made using a self-administered, the Arizona Sexual Experience Scale. Data analysis was done using the software IBM SPSS 23.0; the level of statistical significance was set at P < 5%. A total of 170 patients with chronic heart failure were recruited, the mean age was 60.46 ± 10.66 years old, with a female predominance (sex-ratio = 0.78). The prevalence of sexual dysfunction was 57.7%. The main sexual disorders were: Sexual desire disorders (21.65%), vaginal lubrication disorders (20%) in women, erectile disorders in men (17.3%), orgasmic dysfunction (7.22%), arousal disorders (4.44%) and sexual satisfaction disorders (1%). The independent risks factors of SD were: Female gender ( P = 0.008), age > 60 years ( P = 0.001), hypertension ( P = 0.0017), use of beta blockers ( P = 0.0081) and fear of heart attack ( P < 0,001). Sexual dysfunction is common in patients with chronic heart failure in our context. Indeed, it affects more than half of our study population (57.7%) and is influenced by many factors.

High Prevalence of Male Sexual Dysfunction in a Prospective Multicenter VA Inflammatory Bowel Disease Population.

Aims of this study were to assess the prevalence of and risk factors for sexual dysfunction (SD) in male veterans with inflammatory bowel disease (IBD). We collected IBD history, quality of life (QOL), and sexual function surveys. One hundred seventy-one men enrolled, mean age 50 years, 85% had SD, 92% had erectile dysfunction (ED). More severe ED (P = 0.0001), decreased sexual desire (P = 0.004), and decreased satisfaction (P = 0.001) were associated with poorer QOL. Biologic use was associated with increased SD; hypertension with a decrease in sexual desire. SD and ED are highly prevalent and associated with poorer QOL.