Self-reported Sexual Problems Research Articles

Psychometric Properties of the Diagnostic Interview for Sexual Dysfunctions in Women in a Symptom-Reporting Sample.

While structured clinical interviews are considered the gold standard for diagnosing mental disorders, respective instruments are still lacking in the field of sexual dysfunctions. The study evaluates the psychometric properties of the new Diagnostic Interview for Sexual Dysfunctions in Women (DISEX-F), which is based on the eleventh edition of the International Statistical Classification of Diseases (ICD-11) and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in a sample of 100 women with self-reported sexual problems. Participants were interviewed twice by trained diagnosticians with the DISEX-F. A third diagnostician evaluated the audio records of the initial interview. Participants also completed self-report measures of sexual functioning/distress and interview acceptance. The DISEX-F demonstrates excellent inter-rater reliability, good test-retest reliability, and strong convergent and discriminant evidence of validity. Furthermore, it achieves high acceptance among participants. Discordant diagnostic outcomes were especially linked to false differential diagnostic decisions and information variance in participants reporting. The results strongly support using the DISEX-F for women presenting with self-reported sexual problems in practice and research.

Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial.

Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177.

P–497 Anxiety, depression and sexual dysfunction among women with genital diseases

Abstract Study question How is the prevalence of anxiety, depression and sexual dysfunction among Chinese women who is suffering from genital diseases? What is the relationship among their anxiety, depression and sexual dysfunction? Summary answer Anxiety, depression and sexual dysfunction symptoms were self-reported by the participants. Besides, their anxiety, depression and sexual dysfunction were inter-correlated. What is known already Reduced sexual activity and dysfunctional problems are highly prevalent in females. Approximately 43% of American women reported experiencing sexual problems. Women who are facing pressure on childbirth, may be more likely to have mental health problems. Some studies have shown that having gynecological disease can lead to anxiety, depression and sexual dysfunction. However, the mental health of females who are suffering from genital diseases has been little studied. Study design, size, duration The investigation was carried out from March to November, 2020. Participants were recruited in the Hong Kong University-Shenzhen Hospital, located in Shenzhen, China. 135 patients were approached while 116 agreed to join the survey. Participants/materials, setting, methods 116 women (35.42±8.19 years old) with a diagnosis of fallopian tube disease, ovarian benign disease or uterine disease voluntarily filled a questionnaire which contains the Female Sexual Function Index–6 Items (FSFI–6) and the Hospital Anxiety and Depression Scale (HADS). Descriptive analysis and stepwise regression were used to present participants’ self-reported anxiety, depression, and sexual dysfunction problems, as well as the relationship among their anxiety, depression, and sexual dysfunction. Main results and the role of chance 25% of the participants reported anxiety symptoms; 9.5% of the women reported depressive symptoms; while 37.3% reported sexual dysfunction problems. Anxiety (p &amp;lt; 0.001) was significantly associated with depression. Depressive symptom can significantly predict sexual dysfunction (p &amp;lt; 0.05) while anxiety was not associated with sexual dysfunction (p &amp;gt; 0.05). Targeted interventions are needed to improve the mental health status of women with genital diseases in China. Limitations, reasons for caution This study can only present mental health status of this population. To better show the odds ratio of mental health problems, a case-control study design is needed. Besides, future qualitative or longitudinal studies are needed to detect the risk factors for the poor mental health of women with genital diseases. Wider implications of the findings: Reduced sexual activity and dysfunctional problems are highly prevalent in females with genital diseases. Sexuality is an important element in patients’ quality of life. For female patients with genital diseases, we should not only treat their physical symptoms, but also guide and treat patients in mental ways. Trial registration number ChiCTR2000031343

Prevalence of sexual dysfunction among prenatal women attending the Greater Accra Regional Hospital, Ghana.

To estimate the prevalence and types of sexual dysfunction in pregnancy. A cross-sectional facility-based descriptive study among pregnant women attending the prenatal clinic of the Greater Accra Regional Hospital, a large tertiary health facility in Accra, Ghana, from May to June 2018. The inclusion criteria were 18 years or older, singleton pregnancy of 8 gestational weeks or more, and residing with their partner for at least 4 weeks before the study. Face-to-face interviews were conducted among consecutively enrolled women by using the Female Sexual Function Index (FSFI) tool. Overall, 425 women were enrolled. The mean age was 30.8 ± 4.8years. The mean gestational age was 32.3 ± 7.1weeks (range 9.7-42.0 weeks). The prevalence of sexual dysfunction in pregnancy was 64.9% (95% confidence interval [CI], 60.3%-69.4%) but only 32 (7.5%) women self-reported sexual problems. The predominant types of sexual disorder were desire disorder (377 [88.7%; 95% CI, 85.3%-91.4%] women) and arousal disorder (320 [75.3%; 95% CI, 71.0%-79.2%]). Sexual dysfunction in pregnancy was found to be common, but most pregnant women were not aware that they had it.

Self-Reported Sexual Function in Sexually Active Male Hodgkin Lymphoma Survivors.

IntroductionUnambiguous data on sexual dysfunction after Hodgkin lymphoma (HL) treatment are scarce.AimsTo form a baseline in this area, we compared patient-reported sexual function in sexually active male HL survivors in complete remission with a sexually active, age-matched, male Dutch sample population. Furthermore, we explored whether sociodemographic and clinical factors were associated with sexual dysfunction in HL survivors and investigated whether reporting to perceive sexual problems was indicative for sexual dysfunction.MethodsThis cross-sectional study included male patients with HL who were treated with chemotherapy and age-matched sexually active males.Main outcome measuresOutcome measures included the internationally validated International Index of Erectile Function (IIEF) and self-reported sexual problems by adding 3 items to the study-specific questionnaire.ResultsErectile dysfunction (ED) occurred in 23.3% of the HL survivors vs in 23.0% of controls: respectively 13.3% and 12.3% had moderate to severe ED. However, more HL survivors positively answered the question whether they did perceive sexual problems than controls (20.0% vs 7.0%; P = .087). More patients treated with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procabazine, and prednisone (BEACOPP) had sexual problems 33.3% vs 8.3% who were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (P = .057). Importantly, we found that the mean IIEF score for erectile function was 15.7 in HL survivors who reported to perceive sexual problems (moderate ED) vs 28.3 (normal) in those without perceiving sexual problems.ConclusionIn general, sexual function of male HL survivors is comparable to that of matched normal controls. Perceiving sexual problems was associated with lower sexual function measured by the IIEF. None of the HL survivors who were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine perceived sexual problems. However, one-third of HL survivors who were treated with BEACOPP did, including ED in one-third of the cases. This is an important consideration for daily clinical practice as BEACOPP is increasingly used as standard therapy in advanced-stage HL.Eeltink CM, Lissenberg-Witte BI, Incrocci L, et al. Self-Reported Sexual Function in Sexually Active Male Hodgkin Lymphoma Survivors. Sex Med 2020;8:428–435.

342 Self-Reported Sexual Problems Predicts Higher Levels of Distress, Fatigue and Insomnia in Patients with Cancer

342 Self-Reported Sexual Problems Predicts Higher Levels of Distress, Fatigue and Insomnia in Patients with Cancer

068 Female Patients with Cancer who Endorse Sexual Problems do not have Higher Suicide Ideation

Our previous studies have shown that women with cancer who endorse suicide ideation have higher levels of anxiety and depression. There has been very little, if any, research on self-reported sexual problems and suicide thoughts in women with cancer. The current study was designed to evaluate the extent to which self-reported sexual problems accompanied suicidal thoughts. Adult female patients seen in the MDACC outpatient psychiatry oncology clinic (June 2014-June 2017) who provided informed consent were included (N=1,443). Sexual problems was evaluated as a binomial variable (Yes/No answer) from the NCCN Distress Thermometer checklist, and suicidal thoughts was assessed as a categorical variable using question 9 of the PHQ-9 (“Over the last 2 weeks, how often have you experienced thoughts that you would be better off dead or hurting yourself in some way”?). Demographic variables included age, race/ethnicity, and marital status. Data are presented as percentages. In this cohort, female patients were predominantly White (73%), ∼52 years of age, and most were in a committed relationship (59%). Patients who endorsed (Yes) sexual problems represented 25% of the full sample, and the vast majority of patients (83%) specified “not at all” to the suicide question. As compared to patients who reported no sexual problems, those who reported sexual problems were significantly less likely to answer the suicide question as “none at all” (73% vs. 86%), and more likely to answer it as “several days” (19% vs 9%) and “more than half the days” (7% vs 4%)(χ2=34.2, p<.0001).

Validity and Reliability of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in Patients With Type 2 Diabetes

Despite the wide use of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in several populations, the instrument has yet to be validated among patients with type 2 diabetes. The aim of this study was to evaluate the validity and reliability of the GRISS for the estimation of clinically relevant sexual dysfunction among type 2 diabetes patients under clinical management. This cross-sectional study was conducted among a total of 136 and 126 type 2 diabetic males and females, respectively, using GRISS for male and female. Internal consistency, test-retest reliability, and scores of discriminant validity were calculated. Cronbach’s alpha coefficient ranged from 0.71 to 0.90 in total samples of males and females. The values obtained were similar between the chronic diabetic patients with self-reported sexual problems and normal samples. Test-retest reliability gave fair scaling results of 0.94 overall for males and 0.97 for females using Pearson’s correlation coefficient. GRISS subscales differentiated multivariately between men (F7,122 = 19.308; p = 0.000; eta2 = 0.721; power = 0.993) and women (F7,118 = 18.705; p = 0.000; eta2 = 0.526; power = 0.928) with and without sexual problems. GRISS appears to be valuable and reliable for use among the Ghanaian population. Regular use of the GRISS for the screening of sexual problems among diabetic patients appears warranted.

Patient-clinician communication about sexual health in breast cancer: A mixed-methods analysis of clinic dialogue

ObjectivesBreast cancer patients’ sexual health needs are frequently unmet. We examined the prevalence and content of communication about sexual health between breast cancer patients and clinicians. MethodsFemale breast cancer patients being seen in oncology clinic follow-up had a clinic visit audio recorded and self-reported sexual problems after the visit. Transcripts were coded for sexual health communication; data were analyzed descriptively or using Chi-square tests. ResultsWe recorded 67 patients (81% participation rate) interacting with one of 7 cancer clinicians (5 physicians; 2 advanced practice clinicians). Approximately 1/3 of women (n = 22) reported sexual problems; sexual health communication occurred with 10/22 of those women (45%). Across all 67 patients, 27 (40%) visits contained communication about sexual health. Seventy-percent of sexual health communication was clinician-initiated. When in-depth sexual health discussions occurred, the most common topics discussed were sexual inactivity (6), body image (5), vaginal dryness (4), and safety of sexual activity (2). ConclusionCommunication about sexual health was uncommon even for women reporting sexual problems and was largely initiated by clinicians. Practice implicationsBecause women with breast cancer often do not raise sexual concerns during clinic visits, breast cancer clinicians should raise the topic of sexual health for all patients.

698 Genital responses to sexual imagery in women with and without sexual problems: preliminary findings

Problems with sexual function are highly prevalent in women (∼11% of women in Czech Republic). However, the results of psychophysiological studies have shown that genital responsiveness does not differ between women with or without problems with sexual functioning. The two groups are commonly compared in response to visual erotic stimuli but not to other types of stimuli, e.g. sexual imagery. The aim of our study was to compare genital response of women with and without sexual difficulties to two types of erotic stimulus: erotic video and sexual imagery combined with mindfulness instructions. Genital responses were assessed using vaginal photoplethysmography. So far, a group of 9 women with self-reported sexual problems (low sexual desire/low sexual arousal; mean age=31.6) has participated. Matching on age, we included (from a larger sample of 52 women) a control group of 9 sexually healthy women (mean age=32.1). Women were presented six 3-minute erotic videos without sound, in random order. Two videos depicted non genital interactions (courtship behaviour) between a man and a woman, two videos depicted solitary masturbation of woman, and two videos depicted a man and a woman engaging in sexual intercourse. Each video was followed by a return-to-baseline period combined with a distracting cognitive task. In addition, audiotape of directed imagery focused on body sensation with mindfulness instructions (inspired by Brotto & Heiman, 2003) were used, including solitary sexual arousal sensation instructions as well as the imagery of sexual interaction with desired partner. Mean VPA per category of stimuli was counted in both groups.

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

Prevalence and correlates of sexual health disorders among adult men in a rural area of North India: An observational study.

Background and Objectives:Sexual health disorders are an important but less researched public health issue in India. We aimed to estimate the prevalence of sexual health disorders and their associated factors among adult men in a rural community of Haryana, India.Materials and Methods:A community-based cross-sectional study was conducted among adult men aged 18–60 years using a multistage stratified random sampling. Information pertaining to sociodemographic characteristics, lifestyle and sexual practices, and self-reported sexual problems were collected. Sexual health disorders were defined based on International Statistical Classification of Diseases-10 classification of mental and behavioral disorders. Step-wise logistic regression was carried out to identify factors independently associated with sexual disorders.Results:At least one sexual health disorder was reported by 81% of the men. The most commonly reported disorder was self-perceived defect in semen (64.4%), followed by loss of libido (21%), masturbation guilt (20.8%), erectile dysfunction (5%), and premature ejaculation (4.6%). Factors significantly associated with sexual health disorders among all men were being never married (odds ratio = 2.04; 95% confidence interval: 1.51, 2.77), smoking (1.57; 1.16, 2.14), cannabis use (4.20; 1.68, 10.48), diabetes (2.40; 1.22, 4.73), and hypertension (3.17; 1.12, 8.92).Interpretation and Conclusions:A high burden of sexual health disorders was identified among the rural men. Wider recognition of this issue is needed among the health-care providers and policymakers.

040 Self-Reported Sexual Problems are Higher in Breast Cancer vs. Non Breast Cancer Patients

040 Self-Reported Sexual Problems are Higher in Breast Cancer vs. Non Breast Cancer Patients

041 Self-Reported Sexual Problems Predicts Higher Levels of Depression, Anxiety and Distress in Female Cancer Patients

The current study was designed to evaluate the prevalence of sexual problems and the extent to which this impacted mood symptoms in cancer patients. Only adult female patients seen from July 2014-September 2015 in the MDACC outpatient psychiatry oncology clinic who provided informed consent were included (N=733). Assessment tools include the Patient Health Questionnaire-9 (PHQ-9) to measure depression, the Generalized Anxiety Disorder scale (GAD-7) to measure anxiety, and the NCCN Distress Management Thermometer (DT) and Checklist to measure distress. Demographic variables included age, race/ethnicity, and marital status. Additional categorical variables included cancer diagnosis and psychiatric diagnosis. Data are presented as percentages or Mean ± S.E.M. In this cohort, 25.3% (186/733) female patients endorsed (Yes vs No) “sexual problems” on the DT checklist. Patients who endorsed sexual problems were significantly younger (48.9 ± .8 vs 53.2 ± .5, F1,730=17.7, p <. 0001), but there were no differences according to race/ethnicity (χ2 = 1.4, p = .51). Patients in a committed relationship (married or life partner) were more likely to endorse sexual problems as compared to those who were single, separated, divorced or widowed (31.6% vs 21.9%; χ2 = 12.1, p = .0005). Of interest, there were no differences in prevalence of sexual problems according to psychiatric diagnosis (χ2 = 1.4, p = .51). Importantly, patients who endorsed sexual problems had significantly higher levels of depression (13.1 ± .4 vs 10.3 ± .2, F1,730 = 33.1, p < .0001), anxiety (11.6 ± .4 vs 9.0 ± .2, F1,730 = 29.3, p<.0001) and distress (6.5 ± .2 vs 5.5 ± .1, F1,730 = 17.0, p < .0001).

P04.25 Sexual health problems among adult males of north india: a community based study

Introduction Sexual health problem, though less studied, is an important public health problem. The magnitude of sexual health problems in Indian population, due to various myths and cultural taboos, may be alarming. However, there has never been a community based study to document the magnitude of sexual health problems. Objective To estimate the prevalence of different types of sexual health problems in adult males aged 18 or more in rural Haryana and identify various factors associated with reported sexual health problems. Methodology The study was conducted in a sample of 900 adult males of Faridabad district of Haryana. Socio-demographic characteristics, lifestyle practices, sexual habits and practices and self-reported sexual problems were captured. Sexual health problems studied were erectile dysfunction (ED), premature ejaculation (PME), nocturnal emission, loss of libido, defect in semen and genitalia and culture bound sexual neurosis. Bi-variate analysis was done to find out the factors associated with presence of sexual health problems. Results Nearly 50% of the participants reported having any of the sexual health problems. Common sexual health problems reported were ED (20%), PME (14.6%), nocturnal emission (13.6%), defect in semen (33%), loss of libido (20%), and culture bound sexual neurosis (5%). Adults males of more than 30 years of age and who were current alcoholic and smoker with duration of intake more than 10 years, cannabis users, having history of snoring and chronic illness were at significantly higher risk of having a sexual health problem. Conclusion The prevalence of sexual health problems was high in the study population. High prevalence of sexual health problems warrants a community level intervention as most of the factors associated were modifiable. A holistic care and support mechanism to deal with sexual health problems is required.

Concordance of sexual dysfunction and dissatisfaction by self-report and those by partner's perception in young adult couples.

We evaluated concordance levels of young adult spouses (N=107 couples, total N=214) with regards to sexual satisfaction by using Golombock-Rust Inventory of Sexual Satisfaction (GRISS). Each spouse of the couples filled out both female and male forms of the GRISS. Self- and spouse-reported scores were analyzed in terms of inter-rater correlation and agreement. The prevalence of overall sexual dissatisfaction was 10.3% and 26.2% in wives and husbands, respectively. The correlation coefficient (r) between the self-reported overall sexual satisfaction scores and those assessed by the spouses was 0.25 (P=0.014) and 0.04 (P=0.680) for wives and husbands, respectively. The sensitivity for perception of partner's sexual problems ranged 11% to 47%, and the specificity was around 64% to 100%, except for vaginismus, which had a sensitivity of 83% and a specificity of 25%. The prevalance-adjusted and bias-adjusted kappa (PABAK) value for overall sexual dissatisfaction reported by themselves and that assessed by their spouses was 0.68 and 0.16 for the wives and husbands, respectively. For specific female sexual problems, the PABAK value was the highest in female dissatisfaction (0.81) followed by anorgasmia (0.78), female avoidance (0.44), vaginismus (0.44), infrequency (0.33), non-communication (0.14) and female nonsensuality (0.14). For specific male sexual problems, the PABAK value was the highest in male nonsensuality (1.00), followed by male dissatisfaction (0.78), infrequency (0.46), non-communication (0.42), male avoidance (0.36), impotence (0.27) and premature ejaculation (-0.04). Our findings suggested that in this clinical sample the partner's perception of sexual dysfunction and dissatisfaction did not correlate well with the subject's self-reported sexual problems, and generally male sexual problems were less correctly perceived by the partners than were female sexual problems. This result may provide helpful information for clinicians who take care of patients' sexual problems.

Problems in sexual functioning among male OEF/OIF veterans seeking treatment for posttraumatic stress

ObjectiveFew studies have examined sexual dysfunction among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with posttraumatic stress disorder (PTSD). The present study investigated predictors of erectile dysfunction [ED] and self-reported sexual problems among 150 male combat veterans seeking outpatient treatment for PTSD within the Veterans Affairs healthcare system. MethodParticipants completed clinical interviews and several questionnaires including measures of sexual arousal and sexual desire. A medical records review was also conducted to document evidence of an ED diagnosis or associated medication use. ResultsAn ED diagnosis was present for 12% of the sample, and 10% were taking associated medications. Sexual arousal problems were reported by sixty-two percent of partnered veterans. Sexual desire problems were endorsed by 63% of the total sample, and by 72% of partnered veterans. Age was the only significant predictor of ED diagnosis or medication use. Age, race, PTSD diagnosis (versus subclinical symptoms), depression, and social support predicted self-reported sexual arousal problems; while race, combat exposure, social support, and avoidance/numbing symptoms of PTSD predicted self-reported sexual desire problems. ConclusionsSexual problems are common among male OEF/OIF combat veterans seeking treatment for PTSD. Moreover, avoidance/numbing symptoms robustly predicted sexual desire problems. These findings highlight the importance of expanding assessment of sexual dysfunction and support the need for additional research in this area.

Sexual Dysfunction as a Marker of Cardiovascular Disease in Males With 50 or More Years of Type 1 Diabetes

OBJECTIVEVascular dysfunction is a major contributor to diabetes complications. It is also the primary physiologic cause of erectile dysfunction and considered an independent predictor of cardiovascular disease (CVD) in males over age 40 years. A cohort of individuals with 50 or more years of type 1 diabetes, Joslin Medalists, have low rates of small but not large vessel complications. This study aims to identify the prevalence and longitudinal association of sexual dysfunction (SD) with CVD in Joslin Medalists.RESEARCH DESIGN AND METHODSDescription and association of self-assessment of SD in males of the Medalist cohort by self-reported sexual problems with CVD. SD is validated through the use of the abbreviated International Index of Erectile Dysfunction (IIEF).RESULTSOf 301 males in the Medalist Study, 69.8% reported a history of SD. Unadjusted risk factors included elevated glycated hemoglobin (HbA1c) (P = 0.02), elevated BMI (P = 0.03), higher total cholesterol (P = 0.02), lower HDL (P < 0.01), and increased levels of interleukin-6 (P = 0.03). SD was independently associated with CVD (age-, HbA1c-, and BMI-adjusted OR 1.9 [95% CI 1.0–3.5]). In adjusted analyses, retinal, neural, and renal complications were not associated (P > 0.05) with SD. Current report of SD (IIEF score ≤17) in a subset of Medalists was significantly correlated with self-reported longitudinal SD.CONCLUSIONSSD in those with extreme-duration type 1 diabetes is independently associated with CVD, representing a large-vessel pattern. The findings suggest that SD may predict CVD in those with type 1 diabetes of long duration. These individuals have also been found to be relatively free of microvascular complications.

Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age

To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors. Young female Hodgkin lymphoma survivors are at risk of infertility and impaired sexual function. However, little is known about their awareness of infertility and its association with sexual functioning. A descriptive questionnaire survey. In this cross-sectional study, a survey was completed by female Hodgkin lymphoma survivors (< 40 years). Outcome measures included self-reported fertility status and sexual problems and the internationally validated Female Sexual Function Index. In total, 36 survivors were included (mean age 32 years, SD 4). Eighteen women (50%) thought themselves fertile. Eight survivors (22%) who perceived themselves as being infertile were more often treated with alkylator-based chemotherapy, and 63% reported sexual dysfunction. Ten survivors (28%) were not aware as to whether they were fertile or not; seven of these would like to have children. The reported fertility status was related to age and chemotherapy regimen. Regarding sexuality, 14 (39%) of the female Hodgkin lymphoma survivors reported one or more sexual problem and none reported recovery. Female sexual dysfunction according to the Female Sexual Function Index was reported by 11 (31%) survivors. Almost 30% of Hodgkin lymphoma survivors do not know whether they are fertile or not. Overall sexual dysfunction is common in Hodgkin lymphoma survivors and comparable to the general population. However, a lack of desire was significantly more often reported in female Hodgkin lymphoma survivors. To prevent assumed infertility and unintended childlessness by postponing parenthood in young female survivors, awareness of fertility status is needed. There is also a need to routinely assess sexual function and provide adequate interventions to improve arousal and lubrication problems.

Sexual dissatisfaction and associated factors in a sample of patients on antiretroviral treatment in KwaZulu-Natal, South Africa

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Sexual expression affects physical, mental and social well-being. There is a lack of understanding on sexual problems among patients on antiretroviral treatment in Africa. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using systematic sampling, HIV-positive patients were selected prior to commencing on ART from outpatient departments from three hospitals and followed-up for 20 months (n=495) and interviewed with a questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Rates of self-reported sexual problems were high (34.3%, among men: 30.3% and women 36.0%) but significantly reduced from prior to ART (57.7%) to 20 months on ART (34.3%) (P=0.006). In multivariate analysis not being formally employed (odds ratio: 0.4, 0.2-0.9), having had sexual intercourse in the past 3 months (OR: 5.8, 1.7-19.8), taking medications for HIV-related opportunistic infections (OR: 2.5, 1.1-5.7), internalized stigma (OR: 1.4, 1.2-1.6), lack of social support (OR: 0.4, 0.3-0.6), and low depressive symptoms (OR: 0.9, 0.8-1.0) were found to be associated with sexual problems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This prospective study with a large sample of persons on ART showed evidence of reduction of sexual problems over time and a number of factors influencing sexual problems which should be addressed in health care provider interventions.&lt;/p&gt;