Sexual Dysfunction Research Articles

Effectiveness of Pelvic Floor Muscle and Education-based Therapies on Bladder, Bowel, Vaginal, Sexual, Psychological Function, Quality of Life, and Pelvic Floor Muscle Function in Females Treated for Breast Cancer: A Systematic Review.

Breast malignancy is the most common cancer in females. Symptoms of pelvic floor disorders and sexual dysfunction secondary to systemic cancer treatment may occur. Non-surgical, non-pharmaceutical conservative therapies, namely pelvic floor muscle (PFM) and education-based therapies, could be beneficial to reduce these symptoms in this population. This systematic review aimed to examine the evidence regarding their effectiveness on bladder, bowel, vaginal, sexual, psychological function, quality of life, and PFM function in breast cancer populations. Six databases were searched to identify interventional studies on the effect of PFM therapies, education-based therapies, or combined (multimodal) therapies on any outcome of interest. The search yielded 603 results, from which 12 studies were included. Of these, six (50%) were RCTs, one (8%) was a non-RCT with two groups, and five (42%) were non-RCTs with a single group. Findings suggest that PFM therapies (active) may be beneficial, and education in the format of CBT may improve bladder function. No data were found for bowel function and results from two RCTs were inconclusive to draw conclusions for vaginal function. Sexual function was the most frequently reported outcome. PFM therapies (active > passive) may be beneficial, and education is more likely than not to improve sexual function. For psychological function, PFM therapies (active + passive) may be beneficial, and education is more unlikely than likely to improve psychological function. For quality of life, PFM therapies (active + passive) may be beneficial, and education is more unlikely than likely to improve quality of life, although CBT combined with physical exercise may provide further improvement. PFM therapies (active ± passive) may improve PFM function. Given the limited number of studies and their methodological limitations, caution should be exercised when interpreting these study results. More research is needed to confirm findings and to investigate the clinical value of PFM therapies and combined, multimodal therapies for breast cancer populations. Non-surgical, non-pharmaceutical conservative therapies may be helpful for breast cancer populations. Clinicians should consider the highest level of available evidence to guide their practice and use their clinical judgement to select the treatment components and appropriate dosages.

Effects of inflammatory bowel diseases on sexual function in women.

Inflammatory bowel disease (IBD) is a chronic disease that includes Crohn's disease and ulcerative colitis. Studies found that 40-60% of women diagnosed with IBD have sexual dysfunction (SD). To determine SD and associated factors in women with IBD. Female patients diagnosed with IBD in the Gastroenterology Department who volunteered and healthy volunteers who were examined by a general practitioner were included in the study as the control group. After appropriate training was provided by the researcher, patients and volunteers were asked to fill out the Clinical and Sociodemographic Questionnaire, Hospital Anxiety Depression Scale and Female Sexual Function Index. There were 255 patients in the patient group and 240 patients in the control group. The mean ages of the patient and control groups were 40 ± 12 and 38 ± 11years, respectively. Mean disease duration in IBD patients was 9 ± 5.6years. The SD rate in the patient group (63.5%) was higher than in the control group (23.8%) (p < 0.01). The prevalence of SD was significantly lower in mildly active IBD patients than in moderate and severe IBD patients (p < 0.05). Active disease (OR: 3.82), active perianal disease (OR: 2.15), and severe depression (OR: 3.19) were predictive factors for SD in univariate logistic regression analysis. Previous abdominal surgery was found to be predictive for SD in multivariate analysis (OR: 5.13). The prevalence of SD was high in female IBD patients and its prevalence increased as disease activity increased. History of abdominal surgery in IBD was found to be associated with SD.

Interplay between depression and sexuality

Disorders of sexual function are afrequent comorbidity of depression and have complex interactions on psychological, sexual and relationship qualities. To determine the prevalence of sexual functional disorders in depressed patients, the effects of antidepressant drugs and development of treatment recommendations. Evaluation of the current literature and discussion of fundamental studies. Depression and sexual dysfunction frequently affect each other in complex ways which makes it important to address interpersonal relationship dynamics and to include these in the therapy. The use of serotonergic antidepressants can greatly increase the risk for sexual dysfunction by up to 27times. In addition to (couples) therapeutic interventions, reducing the dose or switching medications to, e.g., bupropion or using additive medications can also be treatment options. Despite the shame associated with the topic, it is crucial for therapists to address sexual topics early and openly. Relationship dynamics should be considered during therapy. If antidepressant medications are used it is recommended to provide a more detailed clarification for patients about their potential sexual side effects and their limited treatment options before starting the medication.

Advancements in Managing Schizophrenia through Classical Approaches, Mechanisms, and Deep Brain Stimulation.

Schizophrenia is a heterogeneous neuropsychological disorder characterized by three distinct sets of symptoms: positive, negative, and cognitive. It carries significant public health implications and is estimated to affect up to 1% of the population. Despite extensive research, the underlying mechanisms of schizophrenia are not entirely understood, and existing antipsychotic treatments have notable limitations. Firstly, these treatments are effective for only approximately half of the patients. Secondly, they primarily alleviate positive symptoms such as misperceptions and thought disorders, which are core to the illness, while neglecting the negative symptoms like flat affect and social withdrawal, as well as cognitive symptoms such as learning and attention difficulties. Thirdly, these treatments come with significant neurofunctional and metabolic side effects, and in some cases, they can lead to issues like sexual dysfunction or agranulocytosis (in the case of Clozapine (CLZ)). In this review, we delve into currently available treatments for schizophrenia, with the utilization of Deep brain stimulation techniques to overcome the limitations of antipsychotics. We also discuss the major clinical trials for schizophrenia along with deep brain stimulation intervention.

&lt;i&gt;Tribulus terrestris&lt;/i&gt; fruit’s potential for synthesizing gold nanoparticles with remarkable biological prospects

Tribulus terrestris is a member of the family Zygophyllaceae commonly known as “puncture vine”. The plant has been used traditionally as an analgesic and to relieve rheumatic pain, eye problems, sexual dysfunction and edema. The aim of this work was to test the use of T. terrestris fruit extract as a reducing agent in synthesizing gold nanoparticles (AuNPs), test their biological activities, and assess their suitability as a therapeutic agent by testing them for potential adverse effects on human cells. Indeed, we have performed the most comprehensive biological testing of AuNPs produced using T. terrestris extracts to date. The aqueous extract of dried powdered T. terrestris fruits was used for the reduction of hydrogen tetrachloroaurate (III) trihydrate (AuCl4·3H2O). The fruit extract's phytochemical components effectively served as reducing, capping and stabilizing agents, resulting in the production of consistent and round-shaped AuNPs with a size range of less than 100 nm. The synthesized AuNPs were subjected to various physicochemical analyses, then evaluated for antibacterial, antifungal and antileishmanial activity, and subjected to hemagglutination, cytotoxicity and antioxidant bioassays. The AuNPs showed inhibition zones against several bacterial and fungal strains, and exhibited antileishmanial activity at high doses. The AuNPs demonstrated positive hemagglutination activity against human Red Blood Cells (RBCs) of blood groups A and B at 10 and 20 µg/mL, but no hemagglutination activity against groups AB and O at up to 40 µg/mL. The AuNPs showed no cytotoxicity against human RBCs at up to 40 µg/mL, suggesting that they may be suitable for use in a clinical setting. The antioxidant activity of the AuNPs was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, and the results indicated a high antioxidant potential.

Patient-reported long-term sexual morbidity in prostate cancer survivors treated with external beam radiation therapy alone or combined with high-dose-rate brachytherapy

Background: Prostate cancer can be treated with external beam radiation therapy (EBRT) alone or combined with high-dose-rate brachytherapy (HDR-BT+), usually with additional hormonal treatment (HT). The aim of this long-term cross-sectional study was to compare patient-reported sexual function, hormonal symptoms and quality of life (QoL) after EBRT-only or HDR-BT+. Methods: In 2016, minimum 5 years after treatment, men treated with HDR-BT+ (n = 248) or EBRT-only (n = 91) responded to a questionnaire containing the Expanded Prostate Cancer Index Composite (EPIC)-26 and the Short Form-12 (SF-12). Results: Median age at time of answering the questionnaire was 74 years (range 54–86). The majority in the HDR-BT+ group received HT for ≥ 2 years compared to 1/3rd in the EBRT-only group. In crude analyses, the sexual domain summary score (DSS) was significantly higher in the HDR-BT+ compared to the EBRT-only group (32.3 vs. 24.1). All sexual items were significantly better in the HDR-BT+ group except sexual problem. Significantly less fatigue was seen in the HDR-BT+ group despite longer duration of HT. Physical and mental health were similar in both groups. When adjusted for possible confounders, the differences between treatment groups were no longer statistically significant. Only age was significantly associated with lower sexual scores. Low hormonal DSS was significantly associated with decreased QoL. Conclusion: Patients treated with HDR-BT+ had not worse long-term sexual function than men treated with EBRT-only. However, this difference disappeared when adjusted for possible confounders. Thus, the interplay of age, HT and fatigue indicates a strong impact on both QoL and sexual function.

Development and preliminary validation of the dyadic sexual self-esteem inventory

Abstract Previous research has consistently shown a close relationship of sexual health with the dynamics within a romantic relationship. However, most measurements in this field have traditionally focused solely on the individual level, thus neglecting relationship aspects. In the present study, we introduce a new theoretical framework and the Dyadic Sexual Self-Esteem Inventory (DSSEI) as a measurement tool designed to evaluate sexual self-esteem from an interpersonal perspective. Using data from individuals in monogamous relationships (N = 784), we conducted confirmatory factor analyses, tested measurement invariance, and assessed the instrument’s reliability and validity. The results demonstrate that the DSSEI is a reliable and valid 30-item tool that consists of one higher-order factor (Dyadic Sexual Self-Esteem), five second-order factors (Evaluation of the Self, Perceived Partner’s Influence on Self, Perceived Partner’s Self-Evaluation, Perceived Influence on Partner, Couple Evaluation) and ten first-order factors that differentiate between sexual self-worth and sexual self-efficacy within dyadic sexual self-esteem. The DSSEI exhibits partial scalar invariance across gender and measurement points for the second-order factors. Reliability analyses demonstrate good internal consistency and stability over time. The validity analyses incorporated Pearson product-moment correlations and regression analyses, revealing significant associations between dyadic sexual self-esteem and sexual self-esteem, sexual subjectivity, self-esteem, sexual function, sexual satisfaction, relationship satisfaction, and emotional intimacy. Additionally, the DSSEI differentiates between individuals with and without sexual dysfunction and between those with high and low relationship satisfaction. The DSSEI has implications for both sexual health research and clinical practice and adds to an understanding of couples’ sexual interactions as a product of their dyadic experiences rather than the sum of individual predispositions.

Efficacy comparison of optimal natural orifice specimen extraction for robotic middle rectal cancer resection in women: transanal or transvaginal orifice

PurposeThis study aimed to determine the optimal natural orifice specimen extraction (NOSE) method for robotic-assisted mid-rectal cancer resection in women.MethodsThis retrospective propensity score-matched (PSM) study was to analyze the clinical data prospectively collected from female rectal cancer patients who underwent either robotic-assisted transvaginal specimen extraction (RATV) or robotic-assisted transanal specimen extraction (RATA) at our center between June 2016 and December 2022. The main outcome measures were urinary, anal, and sexual function. Disease-free survival (DFS), and overall survival (OS) were also included .ResultsAnal function, assessed by the Wexner score, was better in the RATV group than in the RATA group (P = 0.034). Additionally, pre-menopausal women in RATV group exhibited superior anal function over those in RATA group (P = 0.031). There was no statistically significant difference in urinary function between the groups for both pre-menopausal and peri-menopausal patients (P = 0.711, P = 0.106). No difference was observed in sexual function between the two groups (P = 0.351); however, pre-menopausal patients in RATA group had better sexual function than those in RATV group (P = 0.045). Univariate logistic regression analysis showed surgical procedure was not a significant factor for the occurrence of sexual dysfunction. There were no significant difference in DFS (P = 0.845)and OS (P = 0.642) between the two groups.ConclusionThough the postoperative efficacy of the RATA and RATV was equivalent on urinary and sexual function, RATV is an optimal natural orifice specimen extraction for robotic middle rectal cancer resection in women based on anal function.

Sexual Dysfunction in Patients with Chronic Non-Genital Physical Disease: An Umbrella Review

Many primary studies and reviews have been published on the influence of chronic diseases (CDs) on sexual dysfunction (SD), but CDs not involving the genitals are less well represented in the literature. Aim: To determine the prevalence of SD in patients with non-genital CD and assess the overall impact on sexual functioning. Methods: An umbrella review was performed of published systematic reviews on the relationship between the occurrence of CDs not involving the genitals and patients’ sexual functioning, following the PRISMA guidelines. PubMed, EMBASE, the Cochrane Library, PsycInfo, Scopus, and CINAHL were used to find publications for inclusion in the review, with two independent researchers performing the search and selection of articles, data extraction, and quality assessment. The relative risk (RR) or odds ratio (OR) with 95% confidence was used as an indicator of the association between CD and SD across studies. The quality of studies included in the review was assessed using Amstar-2. Outcomes: Forty-three systematic reviews, thirty of which included a meta-analysis, met the inclusion criteria, representing a total of 880,586 patients (756,629 (85.9%) men, 68,388 (7.8%) women, and 55,569 (6.3%) unspecified). Results: Among men, CD is associated with erectile dysfunction, and among females, with lower levels of desire, arousal, lubrication, orgasm, and sexual satisfaction and with increased pain during intercourse. For both men and women, depression, anxiety, and fatigue are also reported, while women with CD are more affected by a poor body image than men. Clinical implications: Patients with CD, especially females, should be more routinely assessed for the impact of their condition on sexual functioning. The impact of CD on men’s sexuality has been extensively studied in terms of erectile capacity, but other aspects of their sexuality are largely neglected. Strengths and limitations: This is the first umbrella review to bring together the documented findings regarding sexual dysfunction among patients with various non-genital CDs. While the heterogeneity of the CDs makes the study unique and clinically relevant, it renders the interpretation of the results more difficult. The overrepresentation of men in existing studies reflects the current state of research but limits the applicability of the findings for women. Conclusion: Women and men with non-genital CDs can suffer from SD or reduced sexual function. Health professionals should pay more attention to managing these sexual disorders, even when the disease does not affect the genitals.

Injection of hyaluronic acid versus platelet rich plasma for treatment of vulvovaginal atrophy in post-menopausal females.

Female sexual dysfunction is highly prevalent among postmenopausal females approaching 50%, with vulvovaginal atrophy (VVA) being a cardinal sign. For decades, hormone replacement therapy was the only solution to relieve symptoms associated with this atrophy. However, it was limited by its serious side effects, raising the need for new treatment strategies. This study aims to compare the efficacy and safety of injection of hyaluronic acid (HA) versus platelet rich plasma (PRP) in post-menopausal females presented with VVA to improve female sexual dysfunction. Twenty post-menopausal females presented with VVA were randomly divided into two groups, 10 patients in each group. Both groups received three sessions of injections into the vulva and vagina, one month apart. Group I was injected with non cross linked HA while Group II received PRP injection. Subjective assessment was carried out through female sexual function index questionnaire and global aesthetic improvement scale.While objective assessment was carried out by measuring the labia majora length and reviewing the histopathological changes occurring in the vulva through skin biopsies before and after treatment. The change in vaginal thickness was estimated by transvaginal ultrasound. Results showed that both HA as well as PRP were effective in the treatment of post-menopausal vulvovaginal atrophy. However, HA showed more significant improvement in female sexual dysfunction. There were also higher values in vaginal wall thickness as measured by transvaginal ultrasound in favor of HA injected group. Histopathological assessment showed more collagen deposition in papillary dermis in HA treated group. No complications were reported in both groups.

Sexuality of the couple during pregnancy after assisted reproductive technology: a comparative study.

To study the sexuality of pregnant women after Assisted Reproductive Technology (ART). This was a prospective multicenter study based on two questionnaires: the Female Sexual Function Index (FSFI) and the Couple Satisfaction Index 32 (CSI 32). Two groups were compared: pregnancies following ART and spontaneous pregnancies. A total of 401 women participated: 215 in the ART group and 186 in the spontaneous pregnancy group. Sexual dysfunction was observed in 49.8% of women in the ART group (n=108/215) and 44.1% in the spontaneous pregnancy group (n=82/186). The FSFI score was not significantly lower in the second trimester (24.0 ± 9.3 for ART vs 25.9 ± 7.3 for spontaneous pregnancy, p=0.07) but was significantly reduced across all trimesters (23.4 ± 9.2 vs 25.4 ± 5.8, p=0.02). Couple relationship quality (CSI 32) was similar between the two groups (134.4 ± 22.2 vs 133.9 ± 23.9, p=0.85). Only 13.9% of ART women (n=30/215) and 8.6% of spontaneous pregnancy women (n=16/186) had discussed their sexuality during pregnancy with a healthcare professional. The prevalence of sexual dysfunction during pregnancy is high, particularly among women followed for ART. However, the quality of the couple's relationship remains comparable between the two groups.

The impact of hysterectomy for benign uterine tumors on subsequent ovarian reserve, lower urinary tract symptoms, and sexual function: A prospective multidirectional short-term analysis.

To evaluate the effects of hysterectomy for benign uterine tumors on subsequent ovarian reserve, sexual function, and lower urinary tract symptoms (LUTS). The present study was a prospective longitudinal analysis that recruited patients aged 35-45 years who underwent simple hysterectomy without oophorectomy for symptomatic benign uterine tumors. Anti-Müllerian hormone (AMH) and serum sex hormone profiles, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and total testosterone, were measured at four timepoints: before hysterectomy, and 3, 6, and 12 months postoperatively. Participants completed the following questionnaires at these timepoints: Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence and Sexual Function Questionnaire (PISQ-12) short form. A total of 36 patients completed the study. Serum AMH levels significantly declined post-hysterectomy compared with preoperative levels. Both UDI-6 and IIQ-7 scores significantly decreased post-hysterectomy compared with preoperative scores. No differences were observed in serum FSH, LH, estradiol, progesterone, and testosterone levels before and after hysterectomy. No significant differences were found in the short form of PISQ-12 before and after hysterectomy. The present study demonstrated that simple hysterectomy with ovarian preservation had detrimental effects on ovarian reserves, whereas LUTS showed improvement. Furthermore, sexual dysfunction was not likely to occur within the first postoperative year.

Who is a candidate at the initial presentation? Prediction of positive lateral lymph node and survival after dissection.

Metastatic lateral pelvic lymph node (LPN) in rectal cancer has a significant clinical impact on the prognosis and treatment strategies. But there are still debates regarding prediction of lateral pelvic lymph node metastasis and its oncological impact. This review explores the evidence for predicting lateral pelvic lymph node metastasis and survival in locally advanced rectal cancer. Until now many studies have reported that magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) are considered as essential tools for predicting metastatic LPN, with MRI-based size criteria, particularly the short-axis diameter of LPN. But several studies have reported that the addition of tumor location or artificial intelligence (AI) can further enhance diagnostic accuracy. Western practices focus more on neoadjuvant chemoradiation (nCRT), while Eastern countries focus more on lateral pelvic lymph node dissection (LPND). LPND has been shown to reduce lateral local recurrence (LLR) rates compared to total mesorectal excision (TME) alone, particularly in patients with enlarged LPNs, but its impact on overall survival is uncertain. The decision to perform LPND should be individualized according to LPN size and response to nCRT; and through selective LPND based on those criteria, patients could achieve a balance between the benefit of local control and the risk of surgical complications from LPND, such as sexual and urinary dysfunction.

The Role of Gut Microbiota Dysbiosis in Erectile Dysfunction: From Pathophysiology to Treatment Strategies

Erectile dysfunction (ED) is a prevalent male sexual disorder characterized by the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. While its etiology is multifactorial, encompassing vascular, neurological, hormonal, and psychological components, emerging evidence suggests a significant role for gut microbiota dysbiosis in its development. The gut microbiota influences various metabolic, inflammatory, and neuropsychological processes critical to erectile function. Dysbiosis can lead to systemic inflammation, endothelial dysfunction, hormonal imbalances, and altered neurotransmitter production, all of which are key factors in ED pathogenesis. This narrative review synthesizes current research on the association between gut microbiota alterations and ED, highlighting specific bacterial taxa implicated in ED through mechanisms involving inflammation, metabolic disturbances, and hormonal regulation. This review explores potential mechanisms linking gut microbiota and ED, including pro-inflammatory cytokines, gut barrier integrity disruption, metabolic disorders, psychological factors via the gut–brain axis, and hormonal regulation. Furthermore, the gut microbiota offers promising avenues for developing non-invasive biomarkers and therapeutic interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation. Future research should focus on longitudinal studies, mechanistic explorations, and clinical trials to validate these findings and translate them into clinical practice. Understanding the interplay between the gut microbiota and erectile function could unveil novel diagnostic biomarkers and pave the way for innovative treatments targeting the microbiota, ultimately improving men’s sexual and overall health.

Sexual Dysfunctions in Breastfeeding Females: Systematic Review and Meta-Analysis

Background: The prevalence of sexual dysfunctions varies from 35.5% to over 80% among postpartum women. Controversy exists regarding the risk factors for female sexual dysfunction (FSD) in the postpartum period. It remains unclear whether breastfeeding types contribute to the development of FSDs differently. Aims: The primary goal of this meta-analysis was to explore the role of baby feeding practices in developing sexual dysfunctions in women. Methods: We conducted a systematic literature search using the biomedical databases Scopus, CINAHL, Embase, the Web of Science, and PubMed/Medline. We looked for peer-reviewed, original studies written in English, Polish, and Arabic and published between January 2000 and June 2023. We included publications that reported scores in sexuality domains assessed with the Female Sexual Dysfunction Index (FSFI) and any sexuality-related issues during postpartum. The FSFI scores were combined in a meta-analysis using the random-effects inverse-variance model. Other findings were synthesized with a narrative review. Results: Eighteen articles met the eligibility criteria for the systematic review and meta-analysis. Sexual dysfunctions were detected in all the women, irrespective of the feeding type. Better overall sexual functioning was reported among women using complementary feeding than among those who breastfed exclusively or used baby bottles: 22.16, 95% CI [21.68; 22.65]; 21.61, 95% CI [20.27; 22.95]; and 20.18, 95% CI: [20.93; 61.30], respectively. Slightly lower scores were reported in all the FSFI subscales in exclusively breastfeeding women compared to those using the complementary method. Conclusions: Breastfeeding females experience difficulties in sexual life during the postpartum period, irrespective of the feeding type. These findings can help in designing preventive measures for tackling postpartum sexual dysfunctions in women.

Reducing Trauma: Antenatal Perineal Massage

Minimising the risk of perineal trauma for women during childbirth is a widely discussed topic in maternity care. The perineum is the muscular area between the vagina and anus, which stretches and relaxes to allow a baby to be born vaginally.1 Approximately 85% of women experience some degree of perineal trauma during childbirth, which is evaluated using a classification system that categorises the severity of the tearing into four degrees, from first to fourth.2 A large number of perineal traumas require suturing which can cause some pain or discomfort for the woman.3 Third and fourth-degree tears may cause long-term damage due to the involvement of the anal passage. These tears are often associated with urinary and faecal incontinence and sexual dysfunction.3,4 Perineal damage may not only cause physical injury but may negatively affect the mothers psychological and emotional state.2

N49 Sexual and reproductive health of Australian women who live with Inflammatory Bowel Disease

Abstract Background Robust research in the field of inflammatory bowel disease is readily available, however an exploration of gender issues which are specific for women who live with inflammatory bowel disease remain limited in the literature. Currently much of the literature regarding sexual health is limited to reproduction and sexual dysfunction and the broader impact that inflammatory bowel disease has on sexual wellbeing is not well understood. By exploring sexual and reproductive health issues for Australian women who live with inflammatory bowel disease, this research aims to draw attention to the current limitations within the literature and to stimulate discussion and inform future directions for research, policy, and practice. Methods An exploratory concurrent mixed methods study, using an online survey and qualitive interviews, was employed to develop an understanding of the sexual and reproductive health needs of Australian women who live with inflammatory bowel disease. The survey included questions specific to women’s physical and emotional health, their self-esteem, their satisfaction with life and women’s pregnancy related knowledge specific to inflammatory bowel disease. Additionally qualitative interviews allowed for further exploration of women’s experiences accessing health services and more detail regarding the challenges for them as women and the impact of inflammatory bowel disease on their identify. In keeping with feminist frameworks, qualitative data collection and analysis was informed by Anderson and Jack (1991) and Hesse-Biber (2014). This included the interviewer actively listening and encouraging women to talk about their day-to-day experiences and feelings which were related to their sexual and reproductive health and how this may have been impacted by their diagnosis of inflammatory bowel disease. Results Australian women participated in conversational interviews and completed an online survey. Preliminary themes which have emerged from this research include Sexuality, Sexual and reproductive health; Feeling vulnerable and dismissed. Conclusion Research which focuses specifically on the sexual health experience of women living with inflammatory bowel disease is important to inform acute and chronic models of care which are relevant across women’s lifespan. Findings may help to inform nursing curricula, primary healthcare service delivery and sexual and reproductive health services policy development. References Anderson, K., &amp; Jack, D. (1991). Learning to listen: Interview techniques and analyses. In S. Berger-Gluck, &amp; D. Patai (Eds.), Women’s words: The feminist practice of oral history (pp.11 – 26). Routledge Publications. Braun, V., &amp; Clarke, V. (2016). Thematic Analysis. In E. Lyons &amp; A. Coyle (Eds.), Analysing qualitative data in Psychology (2nd ed., pp.84 – 103). SAGE publications. Hesse- Biber, S. (2014). Feminist approaches to in-depth interviewing. In S. Hesse- Biber (Ed.), Feminist Research Practice (pp. 182 – 232). SAGE publications.

N32 Providing sexual well-being support to patients with Inflammatory Bowel Disease: analyzing the practices of international nurses

Abstract Background Inflammatory bowel disease (IBD) is often diagnosed in early adulthood and affects individuals’ sex life. People living with IBD report sexual dysfunction and reduced sexual satisfaction. While previous studies have demonstrated patients’ need for information about sexual health from healthcare providers, nurses’ practices for individuals’ sexual well-being (SWB) remain unclear. This study aimed to identify international nurses’ SWB support practices for patients with IBD. Methods This is an international qualitative study. Nurses with substantial experience in IBD nursing were recruited between May 2023 and October 2024 using a snowball sampling method, and online semi-structured and focus group interviews were conducted. After completing data coding, the results for each country were merged and analyzed as one dataset. Thematic analysis was used to analyze the data. Results A total of 29 nurses (male: 5; female: 24) from Japan, the UK, Ireland, Australia, and Canada were interviewed, and the focus group interviews were conducted at two sites in Japan. The mean years of experience in IBD nursing were 13 years. The thematic analysis led to the overarching theme of ‘Careful exploration in real life practice’ with the identification of the following primary themes: ‘Building the foundation for SWB care’, ‘Addressing SWB issues as a team’, ‘Identifying SWB needs’, and ‘Providing personalized nursing support’. These themes reflected the lack of SWB education in the foundation of nursing training, resulting in nurses being unprepared and lacking confidence in providing support, and the ways that support is provided in practice in the absence of formal education to address SWB as a tailored practice. Nurses strive to support SWB among individuals with IBD despite the challenges they encounter and the reticence to initiate the conversation. Conclusion All nurses reported that SWB support for patients with IBD was provided after establishing trust and working together as a team to support them. In addition, as sexual concerns are highly individualized, the nurses assessed each person’s life events and situations of need and engaged in practices tailored to their concerns. This was done by creating an environment that encouraged individuals to share their thoughts. Cultural aspects that make discussing SWB difficult stem from a general view of sex as taboo; this was observed regardless of the participants’ geographical provenience. Finally, nurses’ training needs for SWB education are similar, regardless of the participants’ demographics.

P0261 The hidden impact of surgery for inflammatory bowel disease: a qualitative exploration of sexual function and intimacy

Abstract Background Surgery for inflammatory bowel disease (IBD) often carries a hidden cost in terms of sexual function. Traditionally, when measuring outcomes, the focus has been on those easily measured, quantified, analysed and applied to health economics, such as mortality, morbidity and disease recurrence. Whilst research in this subject area is expanding, there are limited qualitative data specifically investigating patient experiences of sexual dysfunction post-surgery for IBD. This study aims to produce an in-depth exploration of patient perspectives of sexual dysfunction after surgery, and to assess the broader impact on relationships, intimacy and quality of life. Methods An exploratory qualitative study was performed following the ‘Standards for reporting qualitative research’ (SRQR) recommendations. Purposive sampling was employed to recruit a diverse group with differing ages, genders, ethnicities, sexual orientations, religions and relationship status. Participants were recruited from clinical settings, social media and national IBD charities. An interview guide was developed iteratively, with input from an expert patient, qualitative researchers, sexual function experts, gastroenterologists and colorectal surgeons. Semi-structured interviews were conducted via Microsoft Teams/Zoom and audio-recorded, transcribed and analysed. Thematic analysis was conducted using the Framework analysis method (open coding with an inductive approach). Results Qualitative interviews were conducted (n=10, 5 females, 5 males, median age 47, age range 24-69), including patients with Crohn’s disease (n=6) and ulcerative colitis (n=4). Participants were of varying sexualities: heterosexual (n=8), pansexual (n=1) and asexual (n=1). Surgeries included fistula surgery, stoma formation, proctectomy and ileo-anal pouch formation. Thematic analysis revealed physical dysfunction including loss of sensation, impaired pelvic muscle control, erectile and ejaculatory dysfunction, diminished orgasmic sensation and adjustments to sexual positions. Psychological impacts were prominent, including loss of desire, altered body image and a sense of shame/stigma. The impact on spontaneity, intimacy and the overall sexual experience was substantial. Crucially, this often led to relationship strain and breakdown, resulting in further isolation and frustration. Conclusion Patients who retain ‘normal’ sexual function after surgery can still experience psychological challenges that significantly impact their sexual desire, spontaneity, relationships, intimacy, and sexual experience. These interviews have revealed the often unspoken effects of surgery for inflammatory bowel disease, emphasising the need for healthcare professionals to address these issues in clinical practice.

P0923 Impact of Inflammatory Bowel Disease on Women’s Health

Abstract Background Inflammatory bowel disease presents chronic challenges that disrupt physical well-being and create significant psychosocial stressors. Despite known gender-specific issues, data on how IBD affects women, particularly in a socio-cultural context, remain limited. Methods We conducted a cross-sectional study with 202 women diagnosed with IBD, recruited from a tertiary care center in north India. Participants were subjected to a structured questionnaire covering health domains influenced by IBD, including menstrual and reproductive health, sexual function, social dynamics, mental health, financial burdens, and access to healthcare services in a face-to-face interview. Results The median age of participants was 41 years, with a median disease duration of 5 years. Menstrual irregularities were reported by 50%, and 57% females experienced severe menstrual pain. Among sexually active participants, 82.5% showed signs of sexual dysfunction. Reproductive concerns were prevalent, with 55.4% worried about heritability, while only 2.5% received guidance on cervical cancer screening. The median SICC-IBD score of 0.6 (0.4-0.6) indicated substantial social impacts, with family and societal stigma reported by 43% of participants, leading to strained relationships and decreased quality of life. Financial concerns were notable, with nearly 25% of monthly income being spent on IBD medications. Mental health concerns were significant; 95% reported moderate-severe stress, and 70% had symptoms suggestive of moderate to severe anxiety or depression. (Figure 1) Conclusion IBD significantly impacts the lives of women beyond clinical symptoms, affecting menstrual, sexual, and reproductive health, and exacerbating social, mental, and financial strains. Limited access to healthcare support and social stigmatization further complicate disease management. Addressing these unique challenges requires holistic and multidisciplinary interventions that incorporate reproductive health counseling, mental health support, and tailored socio-cultural interventions to improve the overall well-being of women with IBD. This study underscores the need for gender-specific approaches in managing IBD in resource-limited settings.