Risk Of Female Sexual Dysfunction Research Articles

(184) The Prevalence of Sexual Dysfunction in Women Seeking Infertility Treatment in Vietnam

Abstract Introduction Sexual function plays a crucial role in women's psychosocial and overall well-being, significantly impacting their quality of life. Any decline in sexual function can have detrimental effects on the affected individuals' quality of life Objective (i) To describe the prevalence of sexual dysfunction in women seeking infertility treatment at the Andrology and Fertility Hospital of Hanoi, Viet Nam, and (ii) to analyze the factors associated with sexual dysfunction in the study population. Methods This was a cross-sectional descriptive study. All women (1.039) seeking infertility treatment at the Andrology and Fertility Hospital from December 30, 2022, to March 30, 2023 participate in the study. They were invited to scan a QR code and complete the research questionnaire. Female sexual dysfunction is assessed based on the FSFI scale included six domains: sexual desire, arousal, lubrication, orgasm, satisfaction, and pain (comprising 19 questions). The data were extracted into Excel, cleaned, and analyzed using STATA 17.0 software. The analysis of factors associated with female sexual dysfunction was conducted using logistic regression models. Results Among the 1039 participants in the study, the mean age was 30.9±5.3 years. The overall score for female sexual dysfunction was 25.09 ± 6.20, with individual component scores. The prevalence of female sexual dysfunction was 49.7%. There is a positive correlation among the six components of female sexual dysfunction, p<0.01. In the multivariate regression model, the risk of female sexual dysfunction is higher among individuals who work away from home, have an underweight body mass index, have a poor relationship with their partner, have had no sexual intercourse in the past 4 weeks, experience fear of pain, anxiety, and body image concerns during sexual activity, have infrequent or no discussions with their partner regarding sexual desires, preferred positions, and stimulation, and are dissatisfied with their sexual life. Conclusions Half of the women seeking infertility in late-stage medical care experience sexual dysfunction. Factors that increase the risk of sexual dysfunction include having a job far from home, being underweight based on body mass index, having a poor overall relationship with a partner, not engaging in sexual activity in the past four weeks, fear of pain, anxiety, body image concerns during sexual intercourse, and limited or lack of communication with a partner about sexual issues such as desires, preferred positions, and stimulation. Additionally, dissatisfaction with one's sexual life contributes to the occurrence of sexual dysfunction. Therefore, early screening and timely intervention are necessary for this group of individuals. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Andrology and Fertility Hospital of Hanoi.

Effect of COVID-19 on sexual function and activities among reproductive-age women in Ibadan, South-West Nigeria.

Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health. To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria. This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05. Respondents were aged 20 to 50years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers. An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores. Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction. Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results. A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown.

Association between cardiovascular disease and risk of female sexual dysfunction: a systematic review and meta-analysis.

Female sexual dysfunction (FSD) is a considerably underestimated condition. It has been repeatedly reported that patients with cardiovascular diseases (CVD) may suffer from an increased risk of FSD. However, there is still a lack of comprehensive and systematic evaluation of various CVD and FSD. We aimed to elucidate the association between CVD and FSD through a comprehensive literature review and meta-analysis. The PubMed, Scopus, Embase, and Cochrane Library databases were systematically searched from inception to 28 February 2023. We identified all relevant studies reporting the risk of FSD in subjects with or without CVD. The associations between CVD and the risk of FSD were assessed by calculating pooled odds ratios (ORs) (cross-sectional studies) and risk ratios (RRs) (longitudinal studies) with 95% CIs. We employed random-effects models to account for potential heterogeneity, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale. Fifty-four articles with 148 946 individuals were included in our meta-analysis. Compared with control subjects, subjects with CVD had a 1.51-fold increased risk of FSD (OR 1.51 95% CI, 1.34-1.69, P < 0.001, heterogeneity I2 = 91.4%, P < 0.001). Subgroup analyses indicated that the association between CVD and FSD remained significant in longitudinal studies (RR 1.50 95% CI, 1.21-1.86, P < 0.001, heterogeneity I2 = 86.7%, P < 0.001). Particularly, hypertension (OR 1.41 95% CI, 1.23-1.62, P < 0.001, heterogeneity I2 = 82.7%, P < 0.001), stroke (OR 1.81 95% CI, 1.54-2.12, P < 0.001, heterogeneity I2 = 0%, P < 0.423), and myocardial infarction (OR 2.07 95% CI, 1.60-2.67, P < 0.001 heterogeneity I2 = 82.4%, P < 0.001) were significantly associated with FSD. Meta-regression revealed that the primary sources of heterogeneity in FSD are attributable to adjustments for covariates, study design, and study population. Our meta-analysis indicated that patients with CVD suffer from a greater risk of developing FSD. Meanwhile, we validated these findings in longitudinal queues. Notably, conditions such as hypertension, stroke, and myocardial infarction demonstrated a significant association with the incidence of FSD.

Endometriosis and sexual disorders: the effect of surgical and medical treatment, a multicentre cross-sectional study

Background Sexual health is a major concern in women with endometriosis, however only a few controlled studies have examined this with validated instruments. The effect of hormonal treatments on sexual function in endometriosis is also an underrated topic. The aim of this study was to investigate sexual function of patients with endometriosis by a specific tool to better evaluate their sexual function (including different domains), and the influence of hormonal treatment or surgery on these parameters. Methods An observational, cross-sectional, multicentre study was conducted in a group (n=194) of sexually active, women aged 25–45 years old, with surgical or ultrasonographic diagnosis of endometriosis, referred to the Endometriosis Center of Careggi University Hospital or Negrar di Valpolicella. Sexual function was assessed by administering the Female Sexual Function Index (FSFI), which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction and pain. FSFI scores were compared to those of a control group (n=58) and according to the treatment received by patients with endometriosis. Results Ovarian endometriosis was present in 50 patients (25.8%), deep infiltrating endometriosis in 65 patients (33.5%) and both in 79 patients (40.7%). Adenomyosis coexisted in 102 patients (52.6%). Women with endometriosis reported a mean total FSFI score of 18.3 [4.2-25.8] (&lt; 26.55), indicating female sexual dysfunction (FSD) in all patients. At multivariate analysis, after adjusting for confounders (BMI and hormonal therapy), women with endometriosis presented significantly lower scores than controls in all the FSFI (p&lt;0.001). Patients with endometriosis under hormonal treatments (n=124; 64%), regardless of the type, had significantly lower scores in all FSFI subscales and total score, even after adjusting for confounders—age, BMI and history of surgery. Conclusions Patients with endometriosis are at risk for FSD, encompassing not only dyspareunia, but all domains of sexual function. Hormonal treatments do not result in improvement in sexual symptoms.

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

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

Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome

Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18–45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction.

Prevalence and factors associated with sexual dysfunction in brazilian women: a cross-sectional study.

Changes in the mechanisms that modulate sexual response can contribute to the development of female sexual dysfunction (FSD). Although the prevalence of FSD in Brazil has been established, its associated risk factors have not been thoroughly examined. This study aimed to determine the prevalence of FSD in Brazilian women and identify any factors that may be associated with its presence. This study used a cross-sectional design and included women aged 18 years or older who had engaged in sexual activity within the past four weeks. Participants completed the Female Sexual Function Index (FSFI) and a sociodemographic and health questionnaire. Two groups were created based on FSFI scores: those with risk for FSD (score >26.55) and those without. The study used t-tests for independent samples to compare quantitative variables between the groups, and the chi-squared test, to compare categorical variables. Binomial logistic regression was used to test the association between sociodemographic and health variables and FSD. FSD had a prevalence of 31.7% (95% CI: 28.2%-35.5%). The results indicated that practice of physical activity was inversely associated with FSD (OR: 0.64, 95% CI: 0.45-0.92), whereas urinary incontinence (OR: 2.55, 95% CI: 1.68-3.87) and post-menopause (OR: 4.69, 95% CI: 1.66-13.3) were directly associated with FSD. A high prevalence of FSD was observed among Brazilian women in this study. Physically active women are less likely to have FSD. Menopause and the presence of urinary incontinence can negatively impact female sexual function.

Effects of Hormonal Profile, Weight, and Body Image on Sexual Function in Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a hyperandrogenic endocrinological disorder associated with chronic oligo-anovulation and polycystic ovarian morphology. Compared to women without PCOS, women with PCOS have a risk of sexual dysfunction that is more than 30% higher. Although alterations in sex hormones and psychosocial wellbeing have been proposed, the precise mechanisms of FSD in PCOS remain unclear. The aim of our study was to analyze how the hormonal, clinical and psychometric parameters of PCOS patients are involved in the development of sexual dysfunction. The study group consisted of 54 women, aged between 21 and 32 years, diagnosed with PCOS. We collected the following parameters: age, body mass index (BMI), the Ferriman-Gallwey score (FG), maximum duration of oligomenorrhea, abdominal circumference (AC), free testosterone value (FT), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio value, serum cortisol value and ovarian ultrasound appearance. At the time of the examination, patients were asked to fill in the Female Sexual Function Index (FSFI) and the Body Exposure during Sexual Activities Questionnaire (BESAQ). Statistically significant differences were observed between normal weight and overweight women regarding BESAQ (p-value = 0.02) and FSFI total (p-value <0.001). Elevated BMI, AC or BESAQ scores correlated with a lower FSFI score. The most involved domains of the scale were orgasm, arousal, and desire. Elevated BESAQ scores increase the risk of female sexual dysfunction (FSD) by 4.24 times. FT, BESAQ score, BMI, and LH/FSH ratio were found to independently predict FSD. The cutoff point for the BESAQ score in detecting FSD was found to be 1.97. Weight, body image and anxiety related to sexual activities seem to be significant components in the development of sexual dysfunction in PCOS patients, beyond the effect due to hyperandrogenism. FT value has a U-shape effect in sexual dysfunction, because both in the case of deficit and in the case of excess, sexual function is impaired. BESAQ is a strong predictor for sexual dysfunction in women with PCOS, along with FT value, LH/FSH ratio and BMI.

Impact of the COVID-19 Pandemic on the Female Sexual Function Index and Female Behavioral Changes: A Cross-Sectional Survey Study in Thailand

Sexual health alterations are associated with disasters. Consequently, the COVID-19 pandemic may affect female sexual function. This study aimed to determine the COVID-19 pandemic effect on female sexual function and to know the risk of female sexual dysfunction. This online, cross-sectional, observational research was conducted during the pandemic period. A logistic regression model was used to investigate the associations between outcomes and potential risk factors. In total, 432 sexually active women participating in the region affected by the COVID-19 pandemic were analyzed. The overall findings of our study are that 60 percent of females were at risk for female sexual dysfunction. The average FSFI score was 21.27 ± 7.17. Comparing female sexual behavior before and during the COVID-19 pandemic reveals a significant decrease in the frequency of having sex per week, foreplay duration, and coital duration. In the multivariate analysis, the factors associated with the development of RFSD are age greater than 45 years (adjusted odds ratios (AOR) 15.09, 95% confidence interval (CI) 3.67-62.07), body mass index (BMI) greater than 25 (AOR 3.26, 95%CI 1.23-8.67), jobs as a healthcare provider (AOR 8.45, 95%CI 3.66-19.53), previous COVID-19 infection within the previous three months (AOR 36.81, 95%CI 10.93-123.98), and screened-positive anxiety (AOR 13.07, 95%CI 4.75-35.94). COVID-19 influences female sexual behavior and may increase the risk of sexual dysfunction in women. Concern for the effects of female sexual quality of life in high-risk individuals is essential.

A new part of life covid: female sexual dysfunction

<h3>Objectives</h3> The purpose of this review study for of the summarizes the effect of COVID-19 on sexual dysfunction in women. <h3>Methods</h3> The articles used for this review were collected based on research results from relevant articles from NCBI, Google Scholar, Web of Science, Scopus. The search terms used; covid, pandemic, sex, sexuality, female sexual dysfunction The results were reviewed for the purposes of the present study. <h3>Results</h3> Social isolation may have significantly contributed to higher rates of sexual dysfunction. Depression, anxiety, and stress are well-established risk factors for sexual dysfunction, and it follows that rates of sexual dysfunction may be increasing given a more distressed. Culture is effective on sexuality during the pandemic; studies show that Turkey and Italy have demonstrated an increase in FSD and decrease in the frequency of intercourse with the onset of the pandemic, however, India, Nepal showed no effect from pandemics to sexuality. <h3>Conclusions</h3> COVID-19 has had a significant impact on the quality of life and sex life of the population. The development of risk for female sexual dysfunction was associated with higher pandemic anxiety and depression. <h3>Conflicts of Interest</h3> There are no conflicts of interest.

Somalian women with female genital mutilation had increased risk of female sexual dysfunction: a cross-sectional observational study

Studies regarding the impact of female genital mutilation/cutting (FGM/C) on sexual function are scarce. This study is the first to explore the rate of female sexual dysfunction (FSD) among Somalian women who underwent FGM and its association with different FGM types. This study was carried out among women with a history of FGM who visited our clinic for a medical check-up. It relied on data including socio-demographic features, type of FGM determined by an examination, and the Female Sexual Function Index (FSFI) scores. Overall, 255 women were included. While 43.9% (n = 112) of the respondents had a history of Type 3 FGM, 32.2% had Type 2 (n = 82), and 23.9% had Type 1 (n = 61) FGM. Among all patients, 223 had FSD (87.6%). There was a significant association between the FGM type and FSD (p < 0.001). The mean total FSFI score for the patients with Type 1, 2, and 3 FGM was 22.5, 19.7, and 17.3, respectively, all indicating FSD. The FSD is prevalent among mutilated Somalian women. Patients with Type 3 FGM had the lowest mean total FSFI scores indicating that the impact on sexual function was correlated with the extent of tissue damage during FGM.

The effects of COVID-19 pandemic and its related lockdown on female sexual function and reproductive health: An observational study in Egypt.

This retrospective observational online study was carried out to evaluate the effect of the COVID-19 pandemic and its related lockdown on female sexual functions and reproductive health. It included 409 sexually active females. The sexual function was assessed using the Female Sexual Function Index (FSFI). The reproductive life was assessed by a structured self-administered questionnaire modified from Egypt Demographic and Health Survey. The study revealed a significant decrease in the overall FSFI score during the pandemic lockdown compared to the pre-pandemic score (19.3 ± 6 vs. 21.3 ± 6.4, P<0.001). Below half (41.6 %) of women were using contraception methods during the pandemic, while 27.9% had stopped taking contraception during the pandemic, 30.6% (57/186) of the pregnant women only tended to get pregnant. So, the COVID-19 pandemic and its related lockdown were associated with an elevated risk for female sexual dysfunction and altered women's reproductive health quality. Heath system should therefore develop new methods to provide basic reproductive health service, family planning services, and to ameliorate the female sexual function during COVID-19 pandemic including consults with physicians, counsellors, and psychologists, as well as health education programs, either in person or virtually via telemedicine.

Evaluating the Link Between Self-Reported Endometriosis and Female Sexual Dysfunction

BackgroundStudies have found that women with endometriosis have a higher risk of female sexual dysfunction (FSD). AimTo evaluate the relationship between self-reported endometriosis and FSD utilizing validated surveys. MethodsA cross-sectional analysis was conducted among sexually active women aged 18–90 who presented to 3 Mayo Clinic sites from 2015 to 2021. FSD was determined utilizing a combined endpoint of Female Sexual Function Index score ≤ 26.55 and Female Sexual Distress Scale-Revised score ≥ 11. Associations between history of endometriosis and FSD were evaluated by fitting 3 multivariable logistic models and were stratified by menopause status. In the first model, the association was adjusted for age, BMI, race/ethnicity, marital status, and education. The second model adjusted for the variables in Model 1 and hormone therapy, hormonal contraceptive use, self-reported history of abuse within the last year, and co-morbidities including the history of diabetes, heart disease, hypertension, osteoporosis, and stroke. The third model adjusted for the variables in Model 1, Model 2, and anxiety, depression, relationship satisfaction, and SSRI/SNRI use. OutcomesThe outcomes included self-reported endometriosis and female sexual dysfunction determined utilizing a combined endpoint of Female Sexual Function Index score ≤ 26.55 and Female Sexual Distress Scale-Revised score ≥ 11. ResultsOf 7118 patients (mean age 51.3), 92.2% were white, 78.4% were peri- or postmenopausal, 8.7% reported endometriosis history, and 57.2% met the criteria for FSD. Women with endometriosis were more likely to be overweight or obese, be smokers, have had a history of heart disease and osteoporosis, have had anxiety and depressed mood, have had a hysterectomy and bilateral salpingo-oophorectomy, and have used hormone therapy. Compared to those without endometriosis, women with endometriosis were significantly more likely to have FSD only among premenopausal women (74.2% vs 57.4%). Similarly, in multivariable analysis the relationship was only seen for premenopausal women in all 3 models (Model 1: OR 2.74 (95% CI 1.43–5.27); Model 2: OR 2.55 (95% CI 1.30–5.04); Model 3: OR 2.30 (95% CI 1.13–4.68)). Clinical ImplicationsThese findings highlight the opportunity for healthcare practitioners to evaluate sexual function in premenopausal women with endometriosis. For peri and postmenopausal women with endometriosis, the risk of FSD was lower than for premenopausal women with endometriosis. Strengths and LimitationsThis study analyzed the association between endometriosis and FSD in women by menopause status using validated tools that included a measure of distress associated with sexual dysfunction. Limitations include its cross-sectional design which does not allow for determination of the direction of this association. ConclusionThe risk for FSD associated with endometriosis depends on menopause status. Endometriosis increased the odds of FSD only in premenopausal women.Kling JM, Ghaith S, Smith T, et al. Evaluating the Link Between Self-Reported Endometriosis and Female Sexual Dysfunction. J Sex Med 2022;19:1533–1561.

Female sexual function before and during the severe acute respiratory syndrome coronavirus-2 pandemic: a systematic review and Meta-analysis of longitudinal studies

Purpose To compare the female sexual function before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Female Sexual Function Index (FSFI). Methods Relevant studies were retrieved by online databases and manual searching reporting FSFI scores before and during the SARS-CoV-2 pandemic. The methodological quality of reviewed articles was evaluated using the Newcastle-Ottawa Scale, and heterogeneity with the I 2 statistic. The standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were calculated by random-effect meta-analyses. Results Four studies met the inclusion criteria reporting 1002 sexually active non-pregnant women comparing results of the 19-item FSFI. The meta-analysis of the overall FSFI score showed an SMD (95% CI) of −1.16 (−1.97 to −0.35), comparing the pandemic with the pre-pandemic scores. In addition, SMD scores for the FSFI domains were also significantly lower during the pandemic for arousal −0.80 (−1.13 to −0.48), orgasm −0.66 (−1.07 to −0.25), satisfaction −0.59 (−0.97 to −0.22), and pain −0.35 (−0.54 to −0.16), whereas there were not significant differences for desire and lubrication domains. There was a low risk of bias and the sensitivity analysis suggests that results are robust. Conclusion The available studies showed a lower overall FSFI score during the pandemic, suggesting an increased risk of female sexual dysfunction compared to prepandemic results. Also, there were increased risks of sexual arousal, orgasm, satisfaction, and pain disorders. However, there were no alterations in the desire and the lubrication domains. Limitations are related to the heterogeneity populations, and pandemic confounding and aggravating factors.

FSFI score and timing of tubal ligation in patients: preliminary results of an online survey

IntroductionTubal ligation is the most common contraceptive method worldwide. Apart from a very low pearl index and anxiety relief, other benefits are not commonly recognised. In young patients, there is the post-operative risk of regretting the decision with the need for In-Vitro-Fertilisation or refertilising surgery. Positive side effects have not been widely published. In our study we investigated the change in the female sexual function index score after tubal ligation.Material and methodIn this survey the FSFI score of participants around the time of the tubal ligation was compared with the FSFI score of intermediate and long-term time distance to the ligation.ResultsThe data indicate an increase in younger women seeking information on permanent contraception and whilst the FSFI score of the early group indicates a risk of female sexual dysfunction, the intermediate and long-term FSFI scores are comparable to published control groups.DiscussionBesides the obvious benefit of a low pearl index, tubal ligation may contribute to reduce the risk of female sexual dysfunction in the mid and long term. Informed consent is essential for the surgeon and patient to weigh up the risks and benefits individually including possible future perspectives on family planning.

Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia.

This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents' ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (0R=16.60, 95% CI=2.54-108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (0R=0.13, 95% CI=0.08-0.24). Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.

Female Sexual Dysfunction in Patients Treated with Antidepressants: A Comparison between Agomelatine and Escitalopram

Aim: This study aims to determine and compare the prevalence of Female Sexual Dysfunction (FSD) between patients on escitalopram and agomelatine, as well as to investigate possible factors associated with their usage.&#x0D; Study Design: Cross-sectional.&#x0D; Place and Duration of Study: Psychiatric Day Care Clinic, Department of Psychological Medicine, University Malaya Medical Centre (UMMC), Malaysia, between November 1, 2020 until February 1, 2021.&#x0D; Methodology: This study is a cross-sectional study involving 66 women with depression from the outpatient psychiatric clinic of a university hospital; 35 of whom were prescribed with escitalopram and 31 with agomelatine. The subjects were in remission and had no significant signs or symptoms of depression for at least 2 months. The prevalence of FSD between the two groups were compared after adjusting for underlying depression severity.&#x0D; Results: This study showed that the overall prevalence rate of FSD was 33.3%, with the prevalence being higher for those on escitalopram (42.9%) than those on agomelatine (22.6%), but did not achieve statistical significance (P=0.081). Out of the six domains of FSD, multivariate analyses revealed that there was a significant reduction of 69% in sexual desire disorder (95% CI:0.110, 0.855), P=0.022 for those on agomelatine compared to escitalopram. Controlling for drug dosage and depression severity (as measured using Montgomery-Asberg Depression Rating Scale), the odds for patients on agomelatine developing sexual desire disorder was 0.267 (95% CI:0.091, 0.783), P=0.016.&#x0D; Conclusion: There was no significant difference in FSD risk between patients on agomelatine and those on escitalopram. Patients on agomelatine were however less likely to develop sexual desire disorder, which demonstrates a slightly better sexual acceptability profile of agomelatine in women in this respect compared to escitalopram.

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

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

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

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

Female Sexual Function During the COVID-19 Pandemic in the United States.

IntroductionInternational studies have demonstrated increasing rates of sexual dysfunction amidst the coronavirus disease 2019 (COVID-19) pandemic; however, the impact of the pandemic on female sexual function in the United States is unknown.AimTo assess the impact of the COVID-19 pandemic on female sexual function and frequency in the United States.MethodsA pre-pandemic survey containing the Female Sexual Function Index (FSFI) and demographic questions was completed by adult women in the United States from October 20, 2019 and March 1, 2020. The same women were sent a follow-up survey also containing the FSFI, as well as the Patient Health Questionnaire for Depression and Anxiety with 4 items (PHQ-4), and questions pertaining to mask wearing habits, job loss, and relationship changes. Risk for female sexual dysfunction (RFSD) was defined as FSFI < 26.55.Main Outcome MeasureDifferences in pre-pandemic and intra-pandemic female sexual function, measured by the FSFI, and sexual frequency.ResultsNinety-one women were included in this study. Overall FSFI significantly decreased during the pandemic (27.2 vs 28.8, P = .002), with domain-specific decreases in arousal (4.41 vs 4.86, P = .0002), lubrication (4.90 vs 5.22, P = .004), and satisfaction (4.40 vs 4.70, P = .04). There was no change in sexual frequency. Contingency table analysis of RFSD prior to and during the pandemic revealed significantly increased RFSD during the pandemic (P = .002). Women who developed RFSD during the pandemic had higher PHQ-4 anxiety subscale scores (3.74 vs 2.53, P = .01) and depression subscale scores (2.74 vs 1.43, P = .001) than those who did not. Development of FSD was not associated with age, home region, relationship status, mask wearing habits, knowing someone who tested positive for COVID-19, relationship change, or job loss and/or reduction during the pandemic.ConclusionIn this population of female cannabis users, risk for sexual dysfunction increased amidst the COVID-19 pandemic and is associated with depression and anxiety symptoms. Bhambhvani HP, Chen T, Wilson-King AM, et al. Female Sexual Function During the COVID-19 Pandemic in the United States. Sex Med 2021;9:100355.