Sexual Dysfunction In Female Patients Research Articles

Current investigation of the high prevalence of sexual dysfunction in female patients with systemic lupus erythematosus: a cross-sectional study.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = -0.069, t = -2.302, p = 0.022), and depression score (b = -0.117, t = -2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients.

Impact of Genital and Non-Genital Psoriasis on Genital Self-Image, Quality of Life, and Sexual Dysfunction in Female Patients.

Psoriasis is a chronic systemic inflammatory disease that affects millions of people worldwide. While its physical manifestations are well-documented, the psychosocial impact of psoriasis, particularly on female patients, is an area of growing concern. Feelings of shame, inferiority, and stigma are common among individuals with psoriasis, and these emotional burdens can be especially pronounced in females, particularly when the genital area is affected. We aimed to shed light on the significance of genital psoriasis on the overall well-being of female patients. This cross-sectional, descriptive comparative study comprised 50 female participants diagnosed with psoriasis: 25 with genital psoriasis, 25 without genital psoriasis, and 25 healthy women matched for age and sex who served as the control group. All participants underwent an assessment of disease severity using the Psoriasis Area and Severity Index in the psoriasis group and completed questionnaires for the assessment of the Female Sexual Function Index (FSFI). Additionally, quality of life was evaluated using the Dermatology Life Quality Index, and the Female Genital Self-Image Scale (FGSIS) was used to assess genital self-image. We found that females with genital lesions, experience a notable decline in sexual health with higher levels of sexual distress compared to healthy individuals. In terms of the six FSFI domains, the psoriatic group scored lower than the control group in all areas, except for pain, which showed a significant increase. Psoriatic females also exhibited a significantly more negative FGSIS compared to the control group, and there was a highly significant difference in FGSIS between females with and without genital psoriasis. Understanding the impact of genital psoriasis on female sexual health and overall quality of life is essential for comprehensive patient care. This research is instrumental in addressing the psychosocial aspects of psoriasis and enhancing patient well-being.

Nonalcoholic fatty liver disease and female sexual dysfunction in Egyptian premenopausal women: is there a link between metabolic syndrome and sexual function?

Nonalcoholic fatty liver disease (NAFLD) is a major health problem with a paucity of available information about its impact on female sexual dysfunction (FSD). We aimed to study the association between NAFLD and FSD in Egyptian premenopausal women. Sexually active married premenopausal women who visited our NAFLD outpatient screening clinic (2019 to 2022) were divided into NAFLD and non-NAFLD (control) groups based on liver ultrasound and fatty liver index data. All participants completed the Arabic Female Sexual Function Index (ArFSFI) questionnaire. The resulting data were used to calculate the domains and total scores. FSD is then graded as follows: no FSD (≥28.2), minimal (21.7-28.1), mild (14.5-21.6), moderate (7.3-14.4), and severe (≤7.2). We determined the proportions of patients and controls for whom ArFSFI scores indicated dissatisfaction with their sexual lives. Of 995 women participants whose FSFI scores were available, NAFLD was detected in 487 (48.9%) and absent in 508 (51.1%). The two groups were comparable in age, socioeconomic level, residence, and history of female genital cutting. The NAFLD patients had significantly much lower mean scores for the sexual arousal, lubrication, orgasm, satisfaction, and pain domains of the FSFI (P< .001 for all), while no statistical difference was noticed in the desire domain for NAFLD patients compared with the controls. NAFLD women had significantly lower mean total FSFI scores than the controls (mean [SD] 16.7[6.8] vs 21.7[5.1], respectively; P< .001) with higher rates of FSD (98.5% vs 82.1%; P< .001, respectively). Most NAFLD women had higher FSD grades than controls (%): no FSD (1.5, 17.9), minimal (20.6, 51.8), mild (42.5, 38.8), moderate (26.2, 9.4), and severe (10.7, none), respectively. Given the high prevalence of FSD in patients with NAFLD, greater attention to FSF could improve the quality of life in patients with NAFLD. This study was limited by the lack of testing of sex hormones and some other important factors that were not tested (eg, age, socioeconomic level, residence, and female genital cutting), as these characteristics were previously matched. Strengths of the study include the large study size, to our knowledge the largest to date to investigate the possible link between FSD and NAFLD in premenopausal women, together with the inclusion of the detailed version of the validated ArFSFI. In Egyptian premenopausal women, NAFLD could harm their sexual function.

Prevalence of Female Sexual Dysfunction in Patients with Thyroid Disorders

Prevalence of Female Sexual Dysfunction in Patients with Thyroid Disorders

(220) Sexual Dysfunction in Krabbe Disease Patients - A Scoping Review

Abstract Introduction Krabbe Disease (KD) or globoid cell leukodystrophy is a rare autosomal recessive lysosomal storage disorder affecting approximately 1 in 100,000 people worldwide. GALC gene mutations associated with KD involve a galactosylceramidase deficiency, which damages the oligodendrocytes and Schwann cells. Therefore, nervous system demyelination is a hallmark of KD. While only a few infants survive beyond two years in early-onset Krabbe disease, patients with late-onset Krabbe Disease exhibit a milder phenotype and longer life expectancy. Late-onset KD symptoms include progressive muscle weakness and stiffness, developmental regression, behavioral changes, dementia, hearing loss, vision problems, and seizures. Only a few cases of sexual dysfunction associated with KD have been reported in literature but they highlight the wide-ranging impact of this condition on young adults and adults. Objective This review aims to examine sexual dysfunction in KD, as reported in literature. We employ a broad definition of sexual dysfunction (erectile dysfunction, dyspareunia, orgasmic disorder, muscle weakness, etc.) and its incidence in both sexes with KD. A comprehensive review of this topic has not yet been conducted, and we offer here preliminary information for healthcare providers when addressing sexual concerns in patients with lysosomal storage disorders. Methods A literature search was conducted by two separate investigators who independently screened studies and abstracted data. Data sources included peer reviewed publications from the following databases: PubMed, Scopus, Web of Science, EMBASE, Cochrane, Google Scholar and Clinical trials.gov. There were no restrictions on language nor date of publication. The search algorithm utilized to generate the review list was: (Globoid cell leukodystrophy OR Galactosylcerebrosidase deficiency OR Galactosylceramidase deficiency OR Krabbe disease OR Late-onset Krabbe disease OR GALC mutation). Results were further filtered by article type, restricting articles to Case Reports, Clinical Trials, Reviews, and Systematic Reviews. Results were then screened for reports containing data on sexual dysfunction in patients with KD. Results A total of four case reports and one review paper contained reports of sexual dysfunction in KD patients. All cases involved late-onset Krabbe disease, characterized by a milder and more insidious presentation. Genitourinary symptoms reported included urinary incontinence (N=3) and erectile dysfunction (N=2), however, there were no reports (N=0) of symptoms related to female sexual dysfunction. Other symptoms commonly reported in late-onset KD that might be linked to sexual function were ataxia, spasticity and weakness of lower limbs (N=3), and sensory dysfunction due to peripheral neuropathy (N=4). Conclusions This pioneering review reveals that patients with KD experience symptoms of sexual dysfunction. While the rarity of KD makes it challenging to study it clinically, sexual dysfunction may be consistent with the known pathophysiology of late-onset KD. This review also highlights that sexual dysfunction in female patients with KD is an under-investigated component of the disease presentation. Future clinical research into this important comorbidity, especially in female patients where the literature is lacking, may improve the care of patients with KD. Disclosure No.

(027) The Prevalence of Female Sexual Dysfunction in Patients with Irritable Bowel Syndrome (IBS)

Abstract Introduction Irritable bowel syndrome is a functional disorder in the digestive system that is defined by specific intestinal-gastric symptoms. A combination of psychological and organic causes are involved in its creation and continuation. A wide range of psychological disorders and personality traits have been reported in patients with irritable bowel syndrome; But one of the consequences and complications of this syndrome can be the effect on sexual performance. Objective In this study, the frequency of each of women's sexual dysfunction, including hypo active sexual desire and arousal disorder, orgasm dysfunction and pain during sex, and the level of satisfaction in sex were compared with the control group. The relationship between the severity of each of these sexual disorders and the severity of symptoms of irritable bowel syndrome has been investigated. Methods In this study 300 patients with irritable bowel syndrome presentation has compared with control group by using FSFI (Female Sexual Function-Index) standard questionnaire which its validity and reliability were assessed and demographic questionnaire. Results Examining the dimensions of sexual desire in two groups showed that the frequency and intensity of sexual stimulation and satisfaction with it in women with irritable bowel syndrome is significantly lower than the control group. The number of orgasms and intensity of orgasm experienced and satisfaction with it in women with irritable bowel syndrome is significantly lower than in the control group. Examining the dimensions of sexual satisfaction in two groups showed that the level of closeness with a sexual partner in women with irritable bowel syndrome is significantly lower than in the control group. Based on the results, there is a significant relationship between the score of sexual pleasure and sexual satisfaction and the severity of irritable bowel syndrome symptoms. Conclusions The results of this research showed that symptoms of irritable bowel syndrome can have significant effects on sexual performance and relationship satisfaction in women. Since women are exposed to more psychological stressors compared to men, and on the other hand, psychological factors can aggravate the symptoms of irritable bowel syndrome, the doctor's attention to sexual problems in women can improve the health and quality of life of affected patients. Disclosure No.

Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant

Type 2 diabetes mellitus (T2DM) is a multisystemic disease with a high global burden and chronic complications. Sexual dysfunction (SD) in patients with T2DM is an often-overlooked complication, despite its high impact on quality of life (QoL). Female sexual disorders can affect women of reproductive age as well as menopausal women. Proposed mechanisms are intertwining a variety of physiological, neurological, vascular, hormonal, and psychological variables. The impairment of sexual function has been linked to hyperglycemia, insulin resistance, chronic low-grade inflammation, endothelial dysfunction, neuropathy, and hormonal abnormalities. There are many different manifestations of female sexual dysfunction, such as insufficient sexual desire, diminished arousal, difficulty in eliciting orgasm, and pain during sexual engagement. Numerous studies have shown that the QoL of patients living with diabetes mellitus (DM) is lower than that of those without DM. SD in women with T2DM leads to deteriorated QoL. Treatment must be individualized based on the diagnosis and the sexual dysfunction as well as underlying medical, psychological, and interpersonal issues. The goal of modern medical care for patients living with diabetes is not to delay death but to improve their health and QoL. The present review article aimed to raise awareness about female sexual dysfunction in patients with T2DM and to provide an overview of its impact on QoL.

(112) Treatment Options for Female Sexual Dysfunction in Patients with Epilepsy: A Systematic Review

Abstract Introduction Epilepsy is one of the most common neurologic conditions worldwide, affecting approximately 5 million people globally every year. Many with this diagnosis rely on lifelong medications for seizure prophylaxis, which involve complex mechanisms of action with various hormones. The myriad of therapeutic side effects and the debilitating nature of this disease process make sexual dysfunction a common occurrence, with low libido, arousal, and orgasm being the primary complaints for 30-67% of female patients with epilepsy. Prioritizing quality of life from a biopsychosocial perspective is imperative – the need for investigating diverse treatment options for sexual dysfunction in these female patients becomes increasingly evident. Objective This study aims to discuss the available treatment options for sexual dysfunction in females with diagnosed epilepsy. Methods A systematic review in the PubMed database that spanned between January 2015 and November 2022 was executed. Six authors independently and thoroughly screened titles, abstracts, and full-text articles. They assessed the relevant medical literature that acknowledged the presence of female sexual dysfunction and explicitly stated treatment options for patients who have epilepsy. MeSH advanced key terms used to refine the search include: [“epilepsy”], [“female sexual dysfunction”], AND [“treatment”]. Results The published articles (n = 26) that fit the inclusion criteria were reviewed. The pathophysiology behind sexual dysfunction in patients with epilepsy is multifactorial. Seizure activity preferentially occurring in the temporal and frontal lobes alters several fundamental functions of the brain and nervous system, including the HPA axis and the release of gonadal hormones. Furthermore, anti-epileptic drugs target complex substrates that influence the limbic system, hypothalamus, pituitary, endocrine glands, as well as steroid and protein synthesis and metabolism in the liver and adipose tissue. Specifically, drugs documented to correlate with sexual dysfunction negatively are valproate, topiramate, and gabapentin. Agents such as lamotrigine, oxcarbazepine, and levetiracetam are reported to result in fewer sexual side effects and may even have a protective role against sexual dysfunction. Non-pharmacological approaches such as treating underlying comorbidities, addressing psychosocial variables, and mindfulness-based cognitive therapy have also proven significantly beneficial in treating and preventing adverse sexual outcomes. Conclusions Sexual dysfunction, secondary to epilepsy-induced seizures or anti-epileptic drug management, is not adequately explored and treated. The body of literature supports treating sexual dysfunction in females with epilepsy from a multidimensional standpoint; however, there remains a lack of thorough discussion on treatment options tailored to female pelvic anatomy. Going forward, continued research on how the pathologic consequences of epilepsy affect sexual function, unrelated to the use of anti-epileptic drugs, could enhance the prevention and comprehensive management of female sexual dysfunction in this population. Additionally, evaluating the effectiveness of topical estrogens, 5-HT1a agonists/5HT2a antagonist like Flibanserin, and melanocortin receptor agonists like Bremelanotide in female patients with epilepsy and other neurologic disorders may aid in the understanding of this relationship and spark further discussion. Sexual dysfunction and related symptoms have a devastating impact, indicating the need for this research, standardized guidelines, and a wide array of biopsychosocial treatment options. Disclosure No

(212) Do Women with Remittent-Recurrent Multiple Sclerosis (RRMS) have Higher Prevalence of Sexual Dysfunction? A Transversal Analytic Study of Brazilian Patients

Abstract Introduction Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) which is characterized by inflammation, demyelination, axon loss and gliosis. More than 2.8 million people worldwide are affected by MS, mainly young people at reproductive age with significant lifelong repercussions. Among several MS symptoms, sexual dysfunction (SD) is one of the most neglected during routine clinical care. Objective We aimed to evaluate the prevalence of SD in female patients diagnosed with Remitting-Recurrent MS (RRMS), compared with a control group of women without comorbidity and to stratify the different causes and factors that can lead to SD. Methods This transversal analytic study was carried out by Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo/SP, Brazil, between November 2020 and November 2021. Our sample included 80 patients diagnosed with RRMS and 106 control group. We have collected demographic data and all participants underwent neurological examination. Questionnaires about sexual dysfunction (Multiple Sclerosis Intimacy and Sexuality Questionnaire - MSISQ-19- and Female Sexual Function Index - FSFI) and about depression and anxiety (Hospital Anxiety and Depression Scale – HADS, Beck's Depression Inventory – BDI- and Beck anxiety inventory-BAI) were applied. Baseline characteristics were reported as proportions and mean ± SD or median ± IQR as appropriate according to data distribution. The presence of SD was described according to the evaluated qualitative parameters and the association with the use of Chi-square tests or exact tests was verified and the quantitative characteristics were compared according to the presence of dysfunction with the use of t-Student tests or Mann-Whitney tests. Statistical analyses were performed using IBM-SPSS for Windows versão 20.0 Results We observed high prevalence of SD in both groups (43.4% and 38.8%, respectively, patients with RRMS and control group) according to FSFI analysis. A higher statistically prevalence (56.3%) of sexual dysfunction in patients with RRMS was observed when using the MSISQ-19 as a tool for assessing sexuality in this population, in comparison with FSFI scale (p = 0.016). The presence of anxious (53.2% to RRMS and 47.2% to control group by BAI) and depressive symptoms (37.2% to RRMS and 38.8% control group, by BDI) were statistically similar between the groups (p &amp;gt; 0.05). Both groups revealed high rates of anxious and depressive symptoms. There were no other statistically significant factors associated with RRMS on the prevalence of SD. Conclusions We did not find a higher prevalence of SD in MS patients when compared to the control group. Nevertheless we found a higher prevalence in both groups and the specific tool (MSISQ-19) was able to reveal that MS patients did have higher prevalence of SD. Besides that, anxious and depressive symptoms were also statistically significant in MS patients and are related to SD, so we strongly suggest that healthcare providers assess and treat these comorbidities in all RRMS patients in paralel with sexual dysfunction approach and we also suggest the use of the specific questionnaire to deal with their sexual function. Disclosure No

Sexual Dysfunctions in Females with Parkinson's Disease: A Cross-Sectional Study with a Psycho-Endocrinological Perspective.

Background and Objectives: Normal human sexual functioning is a complex integration of an intact neuroanatomic substrate, vascular supply, a balanced hormonal profile, and a predominance of excitatory over inhibitory psychological mechanisms. However, sexual functioning in Parkinson's disease (PD) is often overlooked in clinical practice, especially in female patients. Materials and Methods: In this cross-sectional study, we have investigated the frequency of sexual dysfunction and the possible correlation with psycho-endocrinological factors in a sample of women with idiopathic PD. Patients were assessed using a semi-structured sexual interview, in addition to psychometric tools, including the Hamilton Rating Scale for Anxiety and for Depression and the Coping Orientation to the Problems Experiences-New Italian Version. Specific blood tests, including testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen E2, prolactin (PRL), and vitamin D3 were also evaluated. Results: Our results reported a statistical difference in sexual intercourse frequency before and after the onset of PD (p < 0.001). The percentage of women who complained about reduced sexual desire increased after diagnosis (52.7%) compared to the period before the onset of the illness (36.8%). The endocrinological profile in females with PD revealed statistically significant differences regarding testosterone (p < 0.0006), estradiol (p < 0.00), vitamin D3 (p < 0.006), and calcium (0.002). Depression (44% characterized by perceived feelings of anger and frustration during sexual intercourse) and anxiety symptoms (29.5% reported feelings of fear and anxiety for not satisfying the partner) with abnormal coping strategies (48.14% experienced feelings of anger and intolerance) were also found to be statistically significant. This study showed a high frequency of sexual dysfunction in female patients with PD, which correlated with sexual hormone abnormalities, mood/anxiety, and coping strategies alterations. This supports the idea that there is a need to better investigate the sexual function of female patients with PD to provide them with an adequate therapeutic approach and potentially improve quality of life.

Sexual Dysfunction and Associated Factors in Women with Psoriasis.

Psoriasis, a chronic inflammatory skin disease, may negatively affect sexual function; however, data on the sexual health of female patients with psoriasis in Vietnam are lacking. To assess the risk of sexual dysfunction (SD) and its associated factors in female patients with psoriasis who visited the Ho Chi Minh City Hospital of Dermato-Venereology from April 2020 to October 2020. Cross-sectional study. A total of 302 female patients with psoriasis aged 18 to 49 years were recruited. The Female Sexual Function Index (FSFI) was used to assess the risk of SD (cut-off value at 26). The risk of SD accounted for 79.1% of the study population and was not associated with age, comorbidities, weight, or trigger factors. Urban dwellers had greater odds of SD risk than non-urban dwellers (OR = 2.63). Similar trends were observed in terms of higher education than grade 12, less than once a week of physical activities, and psychological stress as a trigger factor (OR = 1.89, 2.65, and 3.41, respectively). Female psoriasis patients with SD risk had a lower age of onset and higher weight, BMI, waist circumference, and PASI than patients who did not (P < 0.05). Psychological stress and high PASI were independent risk factors of SD risk in female patients with psoriasis (P < 0.05). Factors with negative impacts on psoriasis may also increase the risk of SD in female patients; among these factors, psychological stress and high PASI were the strongest predictors of SD in female patients with psoriasis.

Sexual dysfunction in female patients with chronic kidney disease

AimTo evaluate sexual function in female patients with CKD and patients with end-stage renal disease who are on regular dialysis.BackgroundChronic kidney disease (CKD) affects both sexual function (SF) and quality of life.MethodA total of 100 individuals were included in this case-control study. Participants were divided into two groups. The first group included 50 female patients with chronic kidney disease (CKD-V) and the second group included 50 healthy females (control group). All subjects were subjected to a clinical evaluation, were the Female Sexual Function Index (FSFI) was administered.ResultsIn the CKD group, most of patients reported sexual dysfunction, and there was a statistically significant difference between this group and the control group. In the CKD group, all domains of sexual function were affected with variable percentages. There was no statistically significant correlation between any of the FSFI score domains and age or duration of disease in the patient group.ConclusionsSexual dysfunction is common in female patients with CKD, Therefore, we emphasize the need for routine assessment and early treatment of female sexual dysfunction in CKD patient.

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

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

The effects of bupropion on sexual dysfunction in female patients with multiple sclerosis: A double-blind randomized clinical trial

Background: Sexual dysfunction (SD) is one of the most common complications of multiple sclerosis (MS). The aim of this study was to evaluate the effects of bupropion on SD among female patients with MS. Methods: This double-blind placebo-control randomized clinical trial was conducted on MS patients with SD complaint. Diagnosis was based on the secondary SD subscale scores of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19). Accordingly, individuals scoring above 27 based on this scale were diagnosed with SD. The subjects were randomly assigned to the bupropion and placebo groups. Bupropion was administered 75 mg twice daily for twelve weeks. As for the study outcomes, besides MSISQ-19, quality of life (Multiple Sclerosis Quality Of Life-54 (MSQOL-54)), fatigue (Multidimensional Fatigue Inventory (MFI)), depression and anxiety (Hospital Anxiety and Depression Scale), and bupropion tolerability were assessed at baseline as well as at weeks 6 and 12. Results: From 84 patients who met the inclusion criteria, 64 patients completed the trial and were analyzed. Demographics and baseline clinical characteristics were not significantly differed between the two groups. The results showed the mean score of MSISQ-19 from baseline to the end of the study period significantly improved in the bupropion group compared with the placebo (week 6: P: 0.03; week 12: P: 0.03). Similarly, MFI scores showed significant improvement in the bupropion group compared with the placebo group (P: 0.001). Both anxiety and depression scores showed significant alterations at study interval between the two groups (Anxiety: weeks 6 and 12: P:0.04; depression: week 6: 0.01, week 12: 0.02). However, there was no significant change in the MSQOL-54 score between the two groups. Conclusion: The results of the study substantiated that bupropion can be an effective agent for SD improvement in female patients with MS. Further clinical trials with larger sample sizes can more accurately evaluate the observed findings.

Sexual Dysfunction in Female Patients Undergoing Hemodialysis and Its Relationship With Anxiety and Depression.

Introduction Hemodialysis is renal replacement therapy. However, it is associated with various complications. Sexual dysfunction is one of them. It is estimated that 25%-64% of female patients on hemodialysis have sexual dysfunction worldwide. This impaired quality of life further leads to anxiety and depression. Around 22.8%-39.3% of patients on hemodialysis are depressedwhile 27% have a major anxiety disorder. In Pakistan, the incidence of end-stage renal disease (ESRD) is 100 per million people. As far as we know, this is the first study conducted in Multan to assess sexual dysfunction in female patients undergoing hemodialysis. The objective of this study was to find out the prevalence of sexual dysfunction in female patients on hemodialysis and its relationship with anxiety and depression. Material and methods A cross-sectional study was conducted in Nishtar Medical University Hospital, Multan, Pakistan, from February 2021 to May 2021.Data were collected from 55 female patients in the form of an interview after having met inclusion and exclusioncriteria.The questionnaire had some sociodemographic questions. The female sexual function index (FSFI) was used to evaluate sexual dysfunction in hemodialysis patientswhile anxiety and depression were assessed using the hospital anxiety and depression (HADS) scale. SPSS version 25.0 (IBM Corp., Armonk, NY) was used for data analysis. Pearson's correlation was used to find the association of sexual dysfunction with anxiety and depression. A p-value of <0.05 was considered statistically significant. Results Hypertension (56.4%) was the leading cause of chronic kidney disease (CKD). The most serious problem of the patients was sexual arousal suggested by the low mean score (1.77 ± 2.27) as compared to other sexual domains. Anxiety and depression were found in 20% and 30.9% of patients, respectively.There was a significant negative correlation between age ((arousal: r=-0.297, p=0.028), (lubrication: r= -0.274, p=0.043), (orgasm: r=-0.298, p=0.027), and (pain: r=-0.271, p=0.045)) and depression ((desire: r=-0.465, p=<0.001), (satisfaction: r=-0.366, p=0.006)) with sexual function. While anxiety was not significantly associated with sexual function ((desire: r=-0.347, p=0.069), (arousal: r=0.053, p=0.700), (lubrication: r=0.061, p=0.658), (orgasm: r= 0.047, p= 0.736), (satisfaction: r=-0.113, p=0.410) and (pain: r=0.045, p=0.746)). Conclusion Sexual dysfunction is not uncommon in female hemodialysis patients.There was a significant negative correlation of different sexual domains with age and depression, respectively. The correlation of anxiety with sexual dysfunction was found to be statistically insignificant.

Sexual dysfunction in female patients of reproductive age group with recurrent urinary tract infection—a cross-sectional study

Sexually active female patients often present with urinary tract infection. Recurrent urinary tract infections negatively affect a patient's social and sexual life, leading to deterioration of overall life quality. This study aimed to determine the prevalence of sexual dysfunction in recurrent urinary tract infection patients of reproductive age, and the association between recurrent urinary tract infections and sexual dysfunction. A total of 697 women of reproductive age with urinary tract infection attending a urology outdoor patient department in a tertiary-care center in eastern India were evaluated with a comprehensive history (including a validated questionnaire), physical examination, and relevant investigations. To assess sexual dysfunction and sexual distress profiles, the Female Sexual Function Index scale and the revised Female Sexual Distress Scale were used. Recurrent urinary tract infection was found in 143 of 697 (20.5%) patients. Women with recurrent urinary tract infection had a lower Female Sexual Function Index score (<26.55) and a higher Female Sexual Distress Scale score (>11), suggestive of sexual dysfunction, in 59.4% and 58.1% of cases, respectively (P<.001), whereas such scores were found among 22.6% and 19.1% of patients without recurrent urinary tract infection, respectively (P<.001). Relationship status and bowel history were independent predictors of Female Sexual Distress Scale score of >11. Nearly 60% of sexually active women of reproductive age with recurrent urinary tract infection had low Female Sexual Function Index and high Female Sexual Distress Scale scores, which are suggestive of sexual dysfunction. Thus, every patient with recurrent urinary tract infection should be evaluated for sexual dysfunction to improve quality of life.

SEXUAL DYSFUNCTION IN FEMALE PATIENTS WITH TYPE 2 DIABETES MELLITUS PRESENTING TO A TERTIARY CARE HOSPITAL

Objective: To determine the sexual dysfunction in female patients suffering from Type 2 diabetes mellitus presenting to the Endocrinology Department, Hayatabad Medical Complex Peshawar. Methodology: A descriptive cross-sectional study was conducted on women suffering from Type 2 diabetes mellitus presenting to the Endocrinology Department, Hayatabad Medical Complex Peshawar. A validated questionnaire: the Female Sexual Function Index (FSFI) was administered to the study participants. Data analysis was performed by SPSS Version 25. A P-value of 0.05 was considered to be significant. Results: One hundred and fifty female patients were enrolled. Mean age was 42.46±4.2 years. The mean FSFI score was 25. The frequency of Sexual Dysfunction was found to be 66.9%. Among these, 76.7% had issues with lubrication, 68.6% reported decreased libido, 78 arousal-related related complaints, 47.3% complains about dyspareunia, and 60.6% complained of abnormal orgasm and 61.6% reported decreased satisfaction. Conclusion: The study revealed that sexual dysfunction is quite prevalent in our local population of diabetic women. Therefore, Physicians treating women having type 2 diabetes should have knowledge of possible sexual dysfunction in these patients and the problem should be addressed.

Female sexual dysfunction in patients with urinary incontinence and lower urinary tract symptoms.

This study was conducted to determine the frequency of female sexual dysfunction in patients with urinary incontinence and lower urinary tract symptoms (UI/LUTS). Female patients between 18 and 60 years of age with lower urinary tract symptoms for more than three months were included and Female Sexual Function Index (FSFI) questionnaire was administered. Ninety-seven patients with mean age of 48±12.61 years were included in this cross sectional study. Median FSFI score of our patients was 46 (IQR34-58). Moderate to severe effect of urinary symptoms on sexual life was reported by 71 (73%) patients. When patients with sexual dysfunction (FSFI<27) were compared with those without sexual dysfunction (FSFI>27) there was no difference in age, parity, menopausal status or severity of LUTS between the two groups. We conclude that sexual dysfunction is common among female patients presenting with LUTS irrespective of age, menopausal status or severity of LUTS.

Relationship of steroid sex hormones with female sexual dysfunction in female patients having urinary incontinence

To investigate serum estradiol, progesterone and dehydroepiandrosterone levels on FSD in females having urinary incontinence (UI), we studied 150 females [100 having UI (50 with FSD and 50 without FSD) and 50 controls]. There were significant lower estradiol and progesterone and higher DHEA serum levels in patients than controls (P = 0.001for all). In UI patients, females having sexual disruption had significantly low levels of estradiol (p = 0.001). Low estradiol serum level represented an isolated predictive factor for sexual dysfunction in incontinent female patients (p = 0.001). A low estradiol serum level might be a possible risk factor for FSD in women having UI.

Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study.

Difficulties in sexual functioning are very frequent in patients with chronic kidney disease (CKD). Sexual dysfunction (SD) can significantly diminish the quality of life (QOL) of affected individuals. The aim of this study was to determine the prevalence of SD in female patients undergoing chronic hemodialysis (CHD) and after renal transplantation (RTx) and to compare these groups with each other and with healthy control. The survey was conducted among 123 female participants in a relationship, 28 of them undergoing CHD, 39 after RTx, and 56 healthy women without CKD. For the assessment of the sexual function and comorbidities, the Female Sexual Function Index (FSFI) questionnaire and Ifudu Comorbidity Index were used, respectively. Median age of all female participants was 60 (50-68). The median age of female CHD patients was 66 (61.3-72.8), RTx patients 56 (48-61), and the control group 59.5 (47.5-67.75). Among all participants, CHD female patients had the lowest scores in all sexual functioning domains. Compared to their age-adjusted control group, CHD patients had lower scores in desire, orgasm, and FSFI full score, whereas RTx patients had lower total FSFI scores and scores in all domains except for desire compared to their controls. Women with lower education, in marriage, and with more comorbidities had lower scores in sexual function domains. Our study shows that SD in female patients undergoing CHD treatment or those after RTx is substantially higher than that in healthy women. We suggest that female patient treated for CKD should have proper care regarding their sexual health, and differences in demographic and medical factors should be taken into consideration during the treatment management.