Risk Of Female Sexual Dysfunction Research Articles

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 >1 year; ii) not knowing of any condition that can prevent pregnancy; iii) being actively TTC; iv) female age >22<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 <12 months, 22.8% >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 <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>.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 >1 year; ii) not knowing of any condition that can prevent pregnancy; iii) being actively TTC; iv) female age >22<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 <12 months, 22.8% >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 <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>.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.

Thyroid Autoimmune Disease-Impact on Sexual Function in Young Women.

The important prevalence of autoimmune thyroid disease (AITD) in the general population was the main motivation for conducting the present study. The present paper aims to estimate the possible comorbidities related to female sexual dysfunction (FSD) and depression related to AITD. The study group consisted of 320 patients: 250 cases known with untreated AITD, divided into subgroups (euthyroid subgroup, subclinical hypothyroidism subgroup and clinical hypothyroidism subgroup); respectively 70 healthy females in the control group. Patients underwent thyroid evaluation, ovarian evaluation and laboratory assays. At the time of the diagnosis of autoimmune thyroid disease, psychometric scales were filled in by the patients: the Female Sexual Function Index 6 (FSFI-6) and the Beck’s Depression Inventory-II (BDI-II). It was observed that healthy patients had significantly higher FSFI scores than patients with AITD (28 vs. 27; p = 0.006). In the AITD group, the risk of FSD increases with the severity of thyroid disease. The most affected areas were: sexual desire (p < 0.001), lubrication (p = 0.001) and orgasm (p = 0.008), followed by excitability and sexual satisfaction. The severity of hypothyroidism influences the degree of decrease in libido, central and peripheral excitability. Sexual satisfaction and orgasm were less influenced. The field related to pain seems uninfluenced by the presence of thyroid disease. The concomitant presence of depression and the value of thyroid-stimulating hormone (TSH) are risk factors in the development of FSD. Higher TSH value and BDI-II score increase the risk of female sexual dysfunction by 1.083 and 1.295 times, respectively. Our findings are significant and promising; they may help professionals dealing with sexual and reproductive health. Despite the importance of female sexual dysfunction and its prevalence, clinicians and patients often ignore it. In fact, only a small percentage of patients consult their doctors about sexual health, and their doctors do not often ask them questions related to this aspect.

Sexual behaviors and function during menopausal transition-does menopausal hormonal therapy play a role?

The menopausal transition is a biological adaptation to the variety of life changes (body, comorbidities, relationship), but that biology is not an "end all" in the context of sexual function and overall sexual health. The aim of this study is to evaluate determinants altering the risk of female sexual dysfunction (FSD) and other sexual problems and to establish whether menopausal hormonal therapy (MHT) decreases that risk and modifies sexual behaviors. A cross-sectional observational study was conducted in 210 women between the ages of 45 and 55. Two groups were identified: MHT users (n = 107) and controls-MHT non-users (n = 103). Diagnostic and Statistical Manual of Mental Disorders -five criteria were used to assess sexual dysfunction. Sexual problems were evaluated by the Changes in Sexual Function Questionnaire (CSFQ), body image by Body Exposure during Sexual Activity Questionnaire, and quality of relationship by the Well-Match Relationship Questionnaire. Logistic regression was used to determine the risk factors for FSD and sexual problems. Women using MHT had higher body esteem during sexual activities, better sexual function (CSFQ) in all domains except desire/interest, better quality of relationship, and lower prevalence of FSD and sexual complaints (CSFQ) except arousal/excitement problems. However, self-rated effects of MHT on sexual behaviors showed that MHT did not play a major role. Women with secondary and higher education (OR = 0.09, CI: 0.02-0.4; P < 0.01 and OR = 0.2, CI: 0.05-1.0; P < 0.05, respectively) and with a higher number of lifetime sexual partners (OR = 0.6, CI: 0.4-0.9; P < 0.01) were less likely to have FSD. In contrast, individuals with more anxious behaviors during sexual activity (OR = 3.2, CI: 1.3-7.3; P < 0.01) and with more severe menopausal symptoms (OR = 1.1, CI: 1.0-1.2; P < 0.001) were more likely to have FSD. Using MHT was not associated with that risk nor with sexual function. In women during menopausal transition, sexual behaviors were different in MHT users compared with non-users. However, in this cross-sectional observational study conducted in 210 women between the ages of 45 to 55 years, using MHT was not associated with modification of sexual function, decreasing the risk of sexual dysfunction, nor sexual problems.

Wpływ aktywności fizycznej na jakość życia seksualnego — badanie pilotażowe

Introduction: We decided to run a research on how level of physical activity affects the quality of sex life. Material and methods: The form consisted of original demographic questionnaire, short form of International Physical Activity Questionnaire (IPAQ-SF) to asses physical activity level, Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) for rating satisfaction of sexual life, adequately for women and men. For statistical analysis we used program “Statistica 13.3”. Results: We received answers from 255 women and 138 men. Among respondents 27 (10.59%) women had insufficient, 137 (53.72%) sufficient and 91 (35.69%) high level of physical activity and among men 22 (15.94%) presented insufficient, 53 (38.41%) sufficient and 63 (45.65%) high level of physical activity. Sexual dysfunction has been noted by 69 women (27.06%). Among men 26 (18.84%) manifested erectile dysfunction. The results of presented research showed no statistically significant relation between level of physical activity and sex life satisfaction (p > 0.05). Conclusions: Physical Activity do not impact on sex life satisfaction among young people. The presence of a permanent sexual partner reduces the risk of female sexual dysfunction.

The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis

Aim To systematically compare sexual function between non-treated women with and without endometriosis.Methods A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis.Results In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = −2.15; 95% CI −4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = −0.43; 95% CI −0.57, −0.19); arousal (MD = −0.66; 95% CI −1.15, −0.17); lubrication (MD = −0.41; 95% CI −0.79, −0.02); orgasm (MD = −0.40; 95% CI −0.73, −0.06); satisfaction (MD = −0.45; 95% CI −0.72, −0.18); and pain (MD = −1.03; 95% CI −1.34, −0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea.Conclusion Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.

Sexual dysfunctions in female university students and the correlation with body image: a cross-sectional study

Purpose This study aims to correlate female sexual dysfunctions and dissatisfaction with female university students' body image. Methods 276 female university students completed an online questionnaire, including sociodemographic data, the Female Sexual Function Index, and the Body Shape Questionnaire. Results 31.1% reported some degree of dissatisfaction with body image, and 39.5% had a risk of female sexual dysfunction. The majority of women with a risk of female sexual dysfunctions (69.4%) had no concerns with shape, and the majority of women without sexual problems (67.7%) had no concerns with shape. Pearson’s coefficient underlined no correlation between Body Shape Questionnaire and Female Sexual Function Index domains. Conclusion The body image perception did not seem to affect the sexual function of female university students in our sample. However, it is important to further investigate these variables to improve women’s quality of life.

Female Orgasm and Overall Sexual Function and Habits: A Descriptive Study of a Cohort of U.S. Women

IntroductionFew studies have investigated women's experiences with orgasm and the factors that they cite as important for their orgasmic function and sexual behavior related to foreplay and sexual stimulation. AimTo investigate and describe overall sexual function in a cohort of North American women, with a special focus on orgasmic function, satisfaction, triggers, risk factors, and sexual behavior. MethodsA total of 303 women aged 18–75 years completed a 100-questionnaire survey, which included the Female Sexual Function Index (FSFI) questionnaire and questions on orgasmic function, duration of sexual activity, sexual behaviors and relationship, and the partner’s sexual function. Statistical analysis was performed using SPSS to illuminate factors affecting sexual function. OutcomesThe main outcome measures are FSFI score, satisfaction with sexual life, ability to reach orgasm, orgasm frequency, preferred sexual stimulation, and sexual habits. ResultsFSFI scores, which were calculated for the 230 women who reported having had a steady male sex partner in the preceding 6 months, showed that 41% of the 230 women were at risk for female sexual dysfunction (a cutoff less than 26.55) and 21% were dissatisfied with their overall sexual life. Almost 90% of the overall cohort reported good emotional contact with their partner, that their partner was willing to have sex, satisfaction with the partner’s penis size (wherever applicable), and good erectile function and ejaculatory control of their partner (wherever applicable). 81% of the overall cohort claimed to be sexually active. Around 70% (70–72) did reach orgasm frequently, but around 10% never did so. Vaginal intercourse was reported by 62% of the overall cohort as the best trigger of orgasm, followed by external stimulation from the partner (48%) or themselves (37%). External stimulation was reported to be the fastest trigger to orgasm. Clinical ImplicationsThe knowledge on how women reach orgasm and how it is related to the partners' willingness to have sex and other factors can be incorporated in the clinical work. Strengths & LimitationsThe use of a validated questionnaire and the relative large number of participants are strengths of the study. Limitations are the cross-sectional design, the lack of a sexual distress measure, and a possible selection bias. ConclusionMost women in the overall cohort were satisfied overall with their sexual life and partner-related factors, even though 41% (of those who cited a steady sex male partner) were at risk for female sexual dysfunction. Most women did reach orgasm through different kinds of stimulation. Correlation was good between preferred and performed sexual activities and positions.Shaeer O, Skakke D, Giraldi A, et al. Female Orgasm and Overall Sexual Function and Habits: A Descriptive Study of a Cohort of U.S. Women. J Sex Med 2020;17:1133–1143.

Sexual Functioning, Sexual Distress, and Well-being of Sexually Active Adult Women Living with HIV: an HIV Program-Based Cross-sectional Study

Chronic diseases, including HIV, are associated with psychosocial factors known to influence sexual functioning. This study aimed to assess the sexual functioning and well-being of sexually active HIV-positive women. In this HIV program-based cross-sectional study (October 2018 to March 2019), 458 sexually active women in Ogun State, Nigeria, completed the Female Sexual Function Index, the Revised Female Sexual Distress Scale, and the World Health Organization-5 Well-Being Scale to assess different domains of sexual functioning and well-being. The mean age was 41.82 (± 10.27) years. Forty-four (9.6%) of the women had symptoms of depression while 77.29% had scores suggestive of a high risk of female sexual dysfunction. The prevalence of female sexual dysfunction subtypes was as follows: (1) 92.36% for difficulties in the interest domain, (2) 74.67% for symptoms suggestive of Candace syndrome, (3) 60.04% for difficulties in the orgasmic domain, and (4) 76.69% for dyspareunia. The prevalence of female sexual distress and poor well-being was 6.55% and 6.99% respectively. The correlation between dyadic adjustment scores and the participants’ sexuality (− 0.122, 95% CI − 0.211 to − 0.030) and well-being (− 0.420, 95% CI − 0.492 to − 0.341) was statistically significant (p < 0.05). There was significant correlation between depression and female sexual dysfunction (0.108, 95% CI 0.017 to 0.198, p = 0.022), and between depression and poor well-being (0.282, 95% CI 0.185 to 0.364, p < 0.001). There was a borderline correlation between poor well-being and sexual distress (− 0.087, 95% CI − 0.176 to 0.004, p = 0.062). Although the prevalence of female sexual distress is low among HIV-positive women accessing care in Nigeria, female sexual dysfunction is a significant problem. Sexual health interventions in HIV setting should be holistic and must address HIV stigmatization, criminalization of sex, and partner relationship, among other things. Couple-based interventions, as well as those that boost mood and reduce depression, are also recommended. The study highlights the need for policies that address HIV stigmatization, decriminalize sex, and promote healthy partner relationships as a means to mitigate sexual dysfunction and boost the well-being of women living with HIV.

Interactions between inflammation and female sexual desire and arousal function.

To describe the current state of research on interactions between inflammation and female sexual function. Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of inflammation on sexual function, arising from different evolutionary selection pressures on regulation of reproduction. A variety of inflammation-related conditions are associated with risk of female sexual dysfunction, including cardiovascular disease, metabolic syndrome, and chronic pain. Clinical implications include the need for routine assessment for sexual dysfunction in patients with inflammation-related conditions, the potential for anti-inflammatory diets to improve sexual desire and arousal function, and consideration of chronic inflammation as moderator of sexual effects of hormonal treatments. Although the evidence points to a role for inflammation in the development and maintenance of female sexual dysfunction, the precise nature of these associations remains unclear.

Risk of female sexual dysfunction following concussion in women of reproductive age

ABSTRACTObjectives: Traumatic Brain Injury (TBI) has frequently been associated with changes in sexual functioning. The TBI and sexuality literature, however, has limited generalizability to concussed females, who often use the emergency department (ED) as their first line of care after head injury.Primary Objective: The primary objective of this study was to evaluate the impact of concussions on female sexual functioning.Secondary Objective: Secondarily, we evaluated if concussed women with sexual dysfunction also report more post-concussion symptoms (PCS) and/or mood changes.Research Design: This was a prospective cohort, with outcomes assessed at 6–10 weeks after ED enrollment.Methods and Procedures: Sexual dysfunction was defined as ≤ 45 on the Brain Injury Questionnaire on Sexuality (BIQS). The Rivermead Post-concussion Symptoms Questionnaire (RPQ) and the Hospital Anxiety and Depression Scale (HADS) assessed PCS and post-injury mood, respectively.Main Outcomes & Results: Eighty-nine eumenorrheic females (8–14 menstrual cycles/year) completed the study; 31(36%) had concussions, and 55(64%) were extremity injured. Concussed women had 70% increased risk of sexual dysfunction (adj.RR:1.70, 95% CI: 1.04,2.76; p = .03) versus extremity injured. Of clinical relevance, concussed women with sexual dysfunction also reported more PCS symptoms (adj.β = 5.5, 95% CI: −6.7,18.2; p = .37) and mood scores (adj.β = 8.0; 95% CI: −0.4, 16.4; p = .06).Conclusions: This study highlights the need for more research and interventions for one of the fastest growing subgroups within the TBI population.

Is polycystic ovary syndrome associated with risk of female sexual dysfunction? A systematic review and meta-analysis.

The aim of this study was to evaluate whether polycystic ovary syndrome (PCOS) is a risk factor for female sexual dysfunction (FSD) by conducting a systematic review and meta-analysis. The databases PubMed, EMBASE and the Cochrane Library were searched for relevant studies. The association between PCOS and risk of FSD was assessed by relative risk or standard mean differences with 95% confidence interval. The protocol for this meta-analysis is available from PROSPERO (CRD42018102247). Overall, 2626 participants (mean age 25-36 years) were included from 10 studies (five cross-sectional and five case-control studies), 1163 of whom were women with PCOS. The pooled results from eight included studies providing the number of cases revealed no significant association between PCOS and increased risk of FSD (RR = 1.09, 95% CI 0.9 to 1.32; heterogeneity: I2 = 11.0%). The combined overall standard mean difference from five studies reporting Female Sexual Function Index (FSFI) scores showed that patients with PCOS had similar values in total FSFI scores compared with healthy controls (standard mean difference = -0.03, 95% CI -0.12 to 0.05; heterogeneity: I2 = 0.0%). Sensitivity analyses yielded similar results. This meta-analysis suggests no direct association between PCOS and risk of FSD. Well-controlled trials with large sample sizes, however, are needed to validate this evidence.

Prevalence of female sexual dysfunction among women attending college presenting for gynecological care at a university student health center

Objective: To estimate the prevalence of female sexual dysfunction (FSD) among women attending college (18–29 years of age) presenting for routine gynecological care at a university-based student health center. Participants: Location: University affiliated women’s health care clinic. Methods: Study design: Descriptive, cross sectional study. Primary endpoint: Estimated prevalence of FSD in the 18–29-year- old population. A subanalysis between those with and without recent sexual activity was performed. Logistic Regression was performed to identify potential predictors of FSD among those affected. Results: Of 310 women, FSFI was estimated as ranging from 35.5% (not sexually active) to 42.3% (sexually active). Those of younger age (18–21), with prior mental health diagnosis, and self-reported problems with arousal were at increased risk for FSD. Conclusion: Screening for FSD in the 18–29-year-old population is justified and recommended.

A Population-Based Epidemiologic Study of Female Sexual Dysfunction Risk in Mainland China: Prevalence and Predictors

BackgroundEpidemiologic data on female sexual dysfunction in China are sparse. AimTo assess the prevalence of risk of female sexual dysfunction in mainland China and its regional and sociodemographic variations and physiologic, pathologic, and behavioral risk factors. MethodsA survey of the general female population was conducted in mainland China from February 2014 through January 2016. Women were randomly selected using multistage, stratified, cluster sampling. The prevalence rate of sexual dysfunction, as measured by the Female Sexual Function Index and a score lower than 23.45 as the cutoff threshold, was determined. Multivariate logistical regression models were used to examine the effects of sociodemographic, physiologic, pathologic, and behavioral factors on women’s risk of experiencing sexual dysfunction and domain-specific sexual problems. OutcomesThe questionnaire on sexual dysfunction was completed by 25,446 women 20 to 70 years old. ResultsThe prevalence of sexual dysfunction in women 20 to 70 years old in mainland China was estimated at 29.7% (99% CI = 28.9–30.4), with large regional variations. The prevalence rates of potential domain-specific sexual problems were 21.6% (99% CI = 20.9–22.2) for low desire, 21.5 (99% CI = 20.8–22.2) for arousal disorder, 18.9% (99% CI = 18.3–19.6) for lubrication disorder, 27.9% (99% CI = 27.2–28.7) for orgasm disorder, and 14.1% (99% CI = 13.6–14.7) for sexual pain. Higher educational attainment and urban residency were associated with a decreased risk of sexual dysfunction. Women of ethnic minorities (or non-Han ethnicity) had fewer reports of sexual dysfunction than women of Han ethnicity (odds ratio = 0.67, 99% CI = 0.47–0.97). Diabetes, cancers, pelvic inflammatory disease, and pelvic organ prolapse significantly increased the reports of sexual dysfunction. Clinical TranslationThis survey provided the prevalence and risk factors of female sexual dysfunction in China, information that could be useful for potential prevention and clinical treatment. Strengths and LimitationsThis is the first large-scale, nationally based epidemiologic study of female sexual dysfunction in mainland China. The limitations of the study design included an overpowered study caused by the large sample, the under-representation of younger and unmarried women, and no information on the women’s partners, their values and knowledge, and detailed medical conditions. ConclusionsThe prevalence rate of female sexual dysfunction in mainland China was modest overall, although variations existed across regions and social groups.Zhang C, Tong J, Zhu L, et al. A Population-Based Epidemiologic Study of Female Sexual Dysfunction Risk in Mainland China: Prevalence and Predictors. J Sex Med 2017;14:1348–1356.

Does the Severity of Overactive Bladder Symptoms Correlate With Risk for Female Sexual Dysfunction?

BackgroundSeveral studies have associated overactive bladder (OAB) with female sexual dysfunction (FSD); however, there are no reports using a quantitative approach to measure OAB severity and to relate OAB to the risk of FSD. AimTo evaluate women with OAB and to correlate the severity of their urinary symptoms with their sexual function. MethodsThis cross-sectional study included 267 women older than 18 years with untreated OAB. All subjects completed the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and the Female Sexual Function Index (FSFI). OutcomesLinear regression was used to analyze the association between variables and the numeric FSFI score, and categorical FSFI scores were analyzed using logistic regression. Spearman rank correlation coefficient was used to assess the correlation between ICIQ-OAB results and the different FSFI domains. The significance level was 5%. ResultsSubjects’ mean age was 50.2 ± 11.9 years. Most women were married, had at least three children, and were postmenopausal (54.3%). Mean FSFI total score was 19.2 ± 9.8. For menopausal status, 65.6% of premenopausal women had a risk for FSD vs 86.2% of postmenopausal women. Mean ICIQ-OAB score was 10 ± 3.17. Postmenopausal women had the following risk factors statistically associated with sexual dysfunction: age, ICIQ score, and marital status. For these women, greater OAB severity, especially those with urgency and/or urge incontinence, was associated with worse scores in the arousal, lubrication, orgasm, and sexual pain domains. However, there was no statistically significant association for premenopausal women. Clinical ImplicationsHealth professionals have to pay attention to OAB in women because of the greater risk for FSD in these patients. Strengths and LimitationsThe strength was using a quantitative approach to measure OAB severity in a larger population. Limitations include a convenience sample with no power calculation; exclusion of women who did not have sexual intercourse in the past month; unmeasured distress caused by sexual disorders; and the impossibility of establishing causality between OAB and sexual dysfunction. ConclusionWomen with OAB frequently have a risk for sexual dysfunction. In the postmenopausal group, women with scores indicating severe OAB had worse sexual function, mainly in the arousal, lubrication, orgasm, pain, and total domains.Juliato CRT, Melotti IGR, Junior LCS, et al. Does the Severity of Overactive Bladder Symptoms Correlate With Risk for Female Sexual Dysfunction? J Sex Med 2017;14:904–909.

Sexual Function, Contraception, Relationship, and Lifestyle in Female Medical Students.

We undertook to study possible determinants of female sexual dysfunction (FSD) in a large cohort of female medical students from German-speaking countries. We conducted an online questionnaire-based anonymous survey in a cohort of >2600 female medical students enrolled at German-speaking universities. The questionnaire comprised the Female Sexual Function Index (FSFI) plus additional questions regarding contraception, sexual activity, age, height, weight, lifestyle, activity at work, sexuality and emotional interaction with a steady partner, pregnancy history and plans, health problems, and self-acceptance. Data analysis employed descriptive statistics, univariate and multivariate analyses, and standard nonparametric tests. Of the 2612 respondents aged ≤30 years included in the analysis (mean age [standard deviation], 23.5 [2.5] years), 38.7% of the overall cohort and 33.5% of the sexually active subcohort (91.8% of all students) were at risk for FSD (FSFI score <26.55). Multivariate analysis revealed the following significant factors to be associated with the FSFI: alcohol consumption, level of fitness, use of contraception, steady relationship, and self-acceptance (overall cohort and sexually active subcohort); smoking (overall cohort only); and body mass index and activity at work (sexually active subcohort only). Almost 40% of German-speaking female medical students are at risk for FSD. Contraception, smoking, alcohol, steady relationship, physical fitness, and self-acceptance are significantly associated with the FSFI total score. Being in a steady relationship, better physical fitness, higher activity at work, and subjectively positive self-acceptance, in particular, are associated with higher FSFI total scores, that is, with less risk for sexual dysfunction.

HP-03-005 The correlation between a risk of female sexual dysfunction and anxiety, depression, eating disorders symptoms, type D personality, and the 2nd to 4th digit ratio as possible marker of prenatal androgen exposure

To analyse if anxiety, depression, eating disorders symptoms, type D personality, and the 2d to 4th digit ratio (2D:4D) are related to the risk of female sexual dysfunction. Sample: 84 females (18-40 years old) who were evaluated with: Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Type-D Personality scale (DS14) which consisted of negative affectivity and social inhibition subscales, subscales from Eating Disorder Inventory-3 (EDI-3): Drive for thiness, Bulimia and Body dissatisfaction. 2nd and 4th digits lenghts were measured by using callipers. We found statistically significant correlations between the presence of a risk of sexual dysfunction and: anxiety symptoms (χ2 = 8.750, p < 0.003), negative affectivity (χ2 = 6.860, p < 0.009), type D personality (χ2 = 5.265, p < 0.022) and abnormal body dissatisfaction (χ2 = 9.208, p < 0.002). 18 participants 2D:4D was ≥1 and 59 - 2D:4D was < 1. There was a statistically significant correlation between a risk of sexual dysfunction and 2D:4D < 1 (χ2 = 4.405, p < 0.036). We integrated all the aforesaid factors into binary regression model and found, that the leading factors for the risk of sexual dysfunction were: anxiety simptoms (odds ratio (OR) 3.887 [1.009 -14.965], p < 0.048) and abnormal body dissatisfaction (OR 3.901 [1.074-14.166], p < 0.039).

P-06-010 Sexual function in women with Turner syndrome in Lithuanian population

The aim of the study was to evaluate the sexual function in the women with TS in Lithuanian population. The study was undertaken at the Department of Endocrinology, Lithuanian University of Health Sciences. 32 women with TS aged 18-45 years were enrolled and compared with aged-matched healthy counterparts. The sexual function was investigated by The Female Sexual Function Index (FSFI). Women with total FSFI scores of less than 26.55 were classified as “being at risk” for female sexual dysfunction (FSD). Standard anthropometric measurements (body mass index (BMI), waist-hip ratio) were evaluated. The participants were classified with the BMI cut off value of 25kg/m2 and with a waist-hip ratio as < 0.85 or ≥ 0.85 55% (n = 17) of women with TS did not have a stable relationship, 39% (n = 13) had a partner and 6% (n = 2) were divorced. Mean FSFI score in sexually active females with TS (n = 13) did not differ if compare with controls (p = 0.92), but women with TS reported a lower arousal (p = 0.015) and orgasm (p = 0.041) scores. 66% of TS patients with BMI ≥ 25kg/m2 and 10% of TS patients with BMI < 25kg/m2 were estimated as being at risk for female sexual dysfunction (p = 0.092). TS females with waist-hip ratio < 0.85 had better sexual function if compare with TS women with waist-hip ratio ≥ 0.85 (28.79 ± 2.49 vs 24.66 ± 5.71 (p = 0.058)).

Are hormonal components of oral contraceptives associated with impaired female sexual function? A questionnaire-based online survey of medical students in Germany, Austria, and Switzerland

To investigate in a large cohort of young university women whether different progestins and different ethinyl estradiol (EE) dosages in oral hormonal contraceptives (OHCs) adversely affect sexual function. Female medical students from German, Austrian, and Swiss universities (14/1/1) completed an anonymous online questionnaire comprising the 19 Female Sexual Function Index (FSFI) questions and 17 additional questions concerning demographics, lifestyle, sexual activity, and contraceptive use. OHCs were categorized by EE dose (≤20, <20 to ≤30, and >30µg) and partially androgenic or antiandrogenic progestins. FSFI scores were analyzed by contraceptive method using descriptive statistics and standard nonparametric tests. We analyzed 2612 questionnaires submitted by respondents aged ≤30years [mean age (SD) 23.5 (2.5) years]. Of 2126 contraceptive users, 1535 (72.2%) used OHCs. Median FSFI total scores (ranges) were 28.2 (2.0-36.0) for all respondents. Median FSFI was significantly lower in non-users (24.4) versus users (28.7) of contraception (p<0.001). Stratified analysis showed that 279/486 (57.4%) respondents using no contraceptives, 563/1535 (36.7%) using OHCs, 71/227 (31.3%) using non-oral hormonal contraceptives, and 96/351 (27.4%) using non-hormonal contraceptives were at risk for female sexual dysfunction (FSFI total score <26.55). FSFI scores for the three EE dosage categories and progestin components did not differ significantly. For OHCs, the FSFI score was lower than for other contraceptives but there was no significant association with EE dose or progestins, possibly due to small sample sizes. Further research needs to clarify the role of OHCs in female sexual function.