Sexual Function In Young Women Research Articles

BMI, Body image, Self-esteem and its association with sexual function: a study of young women in Singapore

Objectives: Obesity is thought to be a negative predictor of sexual function but the relationship between body mass index (BMI) and sexual function has been inconsistent in the literature, possibly because this relationship is mediated by body image and self-esteem. This study aims to examine the association of BMI, body image and self-esteem with sexual function in young women, before and after adjustment of demographic variables.

Association between body mass index, body image and self-esteem with sexual function: A survey of young women in Singapore.

Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women. A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55). BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78). Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.

Impaired Sexual Function in Young Women With PCOS: The Detrimental Effect of Anovulation

BackgroundEven though polycystic ovary syndrome (PCOS) is a common reproductive disorder affecting young women, its impact on their sexual health is not well known. AimTo examine the different aspects of female sexuality in young women with PCOS and attempt to associate hormonal changes and ovulatory status with their sexual function. MethodsAnthropometric characteristics, hormonal levels and sexual function based on the Female Sexual Function Index (FSFI) questionnaire were assessed in 76 young women with PCOS and 133 matched controls. OutcomesSexual function is significantly impaired in young women with PCOS. ResultsWomen with PCOS demonstrated lower scores than controls in arousal (5.04 ± 1.19 vs 4.48 ± 1.44, P < .001), lubrication (5.29 ± 1.17 vs 4.69 ± 1.54, P < .001), orgasm (4.78 ± 1.40 vs 4.11 ± 1.61, P = .001), satisfaction (5.22 ± 1.10 vs 4.78 ± 1.31, P = .016), and total score of the FSFI (29.51 ± 5.83 vs 26.76 ± 6.81, P < .001), even after correction for BMI. When corrected for total testosterone, the domains of lubrication, satisfaction, and total score of FSFI remained significantly impaired in women with PCOS (P values .037, .024, & .044 respectively). In multivariate logistic regression analysis, after adjusting for the effect of BMI and hormone levels, dysfunction in orgasm, satisfaction and the total FSFI score were still 3–4 times more common in PCOS (adjusted OR [95% CI]: 3.54, P = .020; 2.96, P = .050; 3.87, P = .027). Even though no statistically significant differences were observed between women with ovulatory PCOS and controls, we detected statistically significant differences in all domains of sexual function apart from pain between controls and PCOS women with anovulation (desire P value .04, arousal P value <.001, lubrication P value <.001, orgasm P value .001, satisfaction P value .001 and FSFI total score P value <.001). Clinical ImplicationsWomen with PCOS have compromised sexual function, which is independent of their BMI and highly dependent on their ovulatory status. Strengths and LimitationsThis is the first study in women with PCOS that implicates anovulation as a risk factor for sexual impairment in PCOS. Further studies are needed to elucidate the mechanisms implicated and to examine the effect of PCOS therapy on the patients’ sexual function. ConclusionThe adverse effect of PCOS status on the female sexual function is independent of BMI and only partially dependent on hormonal changes characterizing the syndrome. Anovulation appears to be the major determinant of sexual impairment among women with PCOS.Mantzou D, Stamou MI, Armeni AK, et al. Impaired Sexual Function in Young Women With PCOS: The Detrimental Effect of Anovulation. J Sex Med 2021;18:1872–1879.

Adapting healthy life style program is more effective than atorvastatin in improving sexual function in hypercholestrolemic females: A pilot prospective study

We aimed in our study to evaluate the impact of atorvastatin therapy against adapting healthy life style program on sexual function in young women with high cholesterol levels. Sixty hypercholestrolemic female participants were divided into two equal groups, group (A) received atorvastatin (20–40 mg/d for 6 months) and group (B) underwent life style modification only. The international index of female sexual function index score, lipid profile, systolic blood pressure. There was no statistical difference in baseline sexual function between patients in groups (A) and (B). Interestingly, patients in group (B) who adapted healthy life style program for 6 months had demonstrated significant improvement in all domains of female sexual function index (FSFI) (total score, sexual desire, sexual arousal, lubrication, satisfaction) compared to patients in group (B) who received atorvastatin for 6 months (32.71 ± 3.0, 30.56 ± 3.1, P = 0.008; 5.58 ± 0.41, 4.87 ± 0.51, P < 0.001; 5.56 ± 0.43, 4.94 ± 0.43, P < 0.001; 5.38 ± 0.5, 5.12 ± 0.33, P = 0.02; 5.40 ± 0.48, 5.13 ± 0.43, P = 0.02, respectively). In contrast, women who received atorvastatin for 6 months had demonstrated significant reduction in pain sensation compared to those who adapted healthy life style (5.02 ± 0.34, 5.31 ± 0.41, P = 0.004). Moreover, both groups had shown non-significant improvement in orgasm domain compared to base line (5.47 ± 0.52, 5.48 ± 0.45, P = 0.936). Although, atorvastatin was associated with significant reduction in pain sensation during intercourse and non-significant improvement in orgasm domain, yet, adapting healthy life style program can be more effective on improving sexual function especially in young healthy females.

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

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

Assessing sexual function and vulvovaginal symptoms in young patients with vulvar dystrophy

Aim: to comparatively assess sexual function and intensity of vulvovaginal symptoms in patients with vulvar lichen sclerosus and mixed vulvar dystrophy. Materials and Methods. There were examined 57 patients with vulvar lichen sclerosus and 63 patients with mixed vulvar dystrophy, with mean patient age 35.0 ± 0.6 (18–45) years. Prior to therapy, the study participants completed the Female Sexual Function Index (FSFI) and the Vulvovaginal Symptoms Questionnaire (VSQ). Results. Severe sexual dysfunction (FSFI score 2) was detected in 14 % of cases (n = 8) in group 1 (sclerotic lichen vulva) and 17 % (n = 11) in group 2 (mixed dystrophy). Remaining respondents had total score below the normal cut-off. The mean FSFI score for group 1 and 2 was 17.68 and 16.78, respectively. VSQ testing found that most common complaint in both groups was itching (91 and 95 %, respectively). The majority of patients also noted a deteriorated emotional state and disease-related limitations in everyday life. The maximum VSQ score was 20 corresponding to the peak negative disease impact found in 23 % and 37 % patients in group 1 (n = 13) and group 2 (n = 23), respectively. Many patients also noted lack of lubrication most likely associated with discomfort and pain during intercourse, as well as worsened relationship with partner. Conclusion. The vulvar dystrophy negatively affects sexual function in young women. Symptoms typical to such conditions impose marked restrictions on intimate life, relationships and quality of general life. It accounts for why it is important to include questionnaires in the set of measures to assess sexual function and vulvovaginal symptoms both before and after treatment.

Abstract P1-11-17: Effects of depression, anxiety, and sexual functioning on quality of life among young breast cancer patients in Mexico

Abstract Background: Despite the disproportionately high-rates of breast cancer (BC) in young women in Mexico, cancer-control efforts have been predominantly aimed at improving oncological treatment, bypassing survivorship issues and supportive care for this group. The “Joven &amp; Fuerte” cohort, the first supportive care and research program for young BC patients in Latin America, aims to describe and assess the burden of BC in young Mexican women. In this study, we focused on evaluating the association between quality of life (QoL) and anxiety, depression, and sexual functioning in young women with BC (≤ 40 years). Methods: This study included non-metastatic and non-recurrent patients belonging to the cohort's pilot phase. QoL was assessed with the EORTC QLQ-C30 global score. Patients were classified in the domains of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) as either probable case, doubtful case, or not a case. Sexual functioning was assessed with the Female Sexual Function Index (FSFI) and the sexual functioning and enjoyment domains of the EORTC QLQ-BR23. Assessments were performed at baseline, 6 months, 1 year, and 2 years. Pearson chi-square and analysis of variance (ANOVA) were used for analysis. Nominal unadjusted significance is reported with p&amp;lt;0.05. Results: 73 out of 96 (76%) pilot phase patients met the inclusion criteria and had complete assessments up to 2 years follow-up. Global QoL was significantly worse for cases with anxiety and depression at baseline (means for non-cases, doubtful cases and cases, respectively: for anxiety, 81.09, 69.54, and 61.54, p&amp;lt;.001; and for depression, 75.63, 64.17, and 55.00, p=0.01) and depression at 6 months (76.55, 66.67, and 35.42, respectively, p&amp;lt;.001). Classification of case level anxiety was associated with FSFI morbidity during the first year (baseline, p=0.03; 6 months, p=0.09; 1 year, p=0.04). There was no significant association between case level depression and FSFI morbidity in the first 2 years. Neither anxiety nor depression was generally associated with significantly different BR23 sexual functioning or sexual enjoyment; however, a sporadic association was observed between anxiety and BR23 sexual functioning at 6 months (p=0.04). Conclusion: This study confirmed an association between anxiety and/or depression and worse QoL at diagnosis of BC and after 6 months. Additionally, worse sexual function was significantly associated with the classification of case level anxiety. These findings support the current recommendation that physicians should regularly assess patients' psychosocial health and sexual functioning and provide prompt referral to corresponding supportive care services. Additional efforts must be conducted in low-resource settings, where sexual health and psychosocial care are not considered routine cancer treatment. Dedicated programs that promote multidisciplinary and supportive care services, such as “Joven &amp; Fuerte”, should be incorporated into institutional health-care protocols to systematically address patients' emerging needs and improve QoL. Citation Format: Villarreal-Garza C, Platas A, Miaja M, Lopez-Martinez EA, Muñoz-Lozano JF, Fonseca A, Pineda C, Barragan-Carrillo R, Martinez-Cannon BA, Chapman J-AW, Goss PE, Bargallo-Rocha JE, Mohar A, Castro-Sanchez A. Effects of depression, anxiety, and sexual functioning on quality of life among young breast cancer patients in Mexico [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-17.

Sexual functioning and depressive symptoms in women with various types of prediabetes - a pilot study.

No previous study has investigated sexual functioning in prediabetic women. This study was aimed at investigating sexual function in young women with various types of prediabetes. The study included four groups of women: women with isolated impaired fasting glucose (Group A; n=19), isolated impaired glucose tolerance (Group B; n=18), presence of both impaired fasting glucose and impaired glucose tolerance (Group C; n=18), as well as matched healthy controls (Group D; n=19). All participants completed questionnaires evaluating sexual function (Female Sexual Function Index - FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II). The total FSFI and BDI-II scores were lower in Group C than in the remaining groups of women, while the total FSFI score was lower in Groups A and B than in Group D. Patients with both impaired fasting glucose and impaired glucose tolerance had lower scores in all domains (sexual desire, arousal, lubrication, orgasm, sexual satisfaction and dyspareunia). Compared to Group D, Group A was characterized by lower domain scores for sexual desire and sexual satisfaction, while Group B by lower domain scores for desire, arousal and orgasm. In all groups of prediabetic women, the overall FSFI score correlated negatively with the degree of insulin resistance and weakly with the total BDI-II score. Impaired fasting glucose and impaired glucose tolerance may disturb sexual functioning and induce depressive symptoms.

Vaginal development and sexual functioning in young women after stem cell transplantation, chemotherapy, and/or radiotherapy for childhood hematological diseases.

To study vaginal development and sexual functioning in young women after childhood hemopoietic stem cell transplantation (HSCT) and radio/chemotherapy. Observational case-control study on 30 young sexually active women survived after HSCT and/or radio/chemotherapy for childhood malignancies or hematologic diseases and 48 controls matched for age. Female Sexual Function Index was lower (median 24.05, IQR = 17.30-28.30 vs. 29.00, IQR = 25.30-31.40, p = 0.001), Female Sexual Distress Scale higher (median 16.00, IQR = 8.00-23.00 vs. 2.00, IQR = 0.00-4.00, p < 0.001), vaginal length shorter (mean difference = 21.1 mm; 95% CI = 19.3-23, p < .001) and vaginal maturation index worst in cases than in controls. Subjects treated by irradiation before HSCT had lower FSFI (median 21.85, IQR = 9.60-31.10 vs. 24.90, IQR = 17.30-28.30) and shorter vaginal length (median 45.55, IQR = 42.60-45.80 vs. 50.10, IQR = 45.30-52.90) compared to those who had not received conditioning treatment (p-values = 0.004 and p = 0.05, respectively). Compared to untreated subjects, women receiving hormonal replacement therapy had higher overall FSFI (p = 0.02), lower FSDS (0.04), and better VMI. Gonadotoxic therapies have adverse effects on vaginal development, sexual functioning, and distress in young females. Hormonal replacement therapy should be shortly considered after main gonodatoxic treatments to improve vaginal and sex health.

Associations Between Personality Disorder Characteristics, Psychological Symptoms, and Sexual Functioning in Young Women

BackgroundRecently, the etiology of sexual dysfunctions in women has been approached from different angles. In clinical practice and in previous studies, it has been observed that women with sexual problems experience anxiety problems and express more rigid and perfectionistic personality traits than women without these problems. AimTo investigate whether personality disorder characteristics according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) and psychological symptoms are associated with sexual problems in women. Methods188 women 18 to 25 years old participated in this cross-sectional study. Questionnaires measuring sexual functioning (Female Sexual Function Index), personality disorder characteristics (Assessment of DSM-IV-TR Personality Disorders Questionnaire), and psychological symptoms (Brief Symptom Inventory and Center for Epidemiological Studies Depression Scale) were used. OutcomeThe main outcome measure used was sexual functioning assessed by self-report. ResultsResults, using analysis of variance, indicated that women with sexual problems report significantly more cluster A (specifically schizoid) and C (specifically avoidant and obsessive-compulsive) personality disorder characteristics than women without sexual problems. Furthermore, using multiple regression analyses, higher cluster A (specifically schizoid) and lower cluster B (specifically borderline and antisocial) personality disorder characteristics indicated lower levels of sexual functioning. Psychological symptoms partly mediated the effect of cluster A personality disorder characteristics on sexual functioning. Clinical ImplicationsThe results of this study indicate that clinical practice should extend its scope by focusing more on improving adaptive personality characteristics, such as extraversion and individualism seen in cluster B personality characteristics, and decreasing the perfectionistic, introvert, and self-doubting characteristics seen in cluster C personality characteristics. Strengths and LimitationsBecause of the correlational design and use of self-report measures, causal relations cannot be established between personality disorder characteristics and sexual functioning. ConclusionOverall, the results indicate that personality disorder characteristics can play an important associative role in the development and maintenance of sexual functioning problems in women.Grauvogl A, Pelzer B, Radder V, van Lankveld J. Associations Between Personality Disorder Characteristics, Psychological Symptoms, and Sexual Functioning in Young Women. J Sex Med 2018;15:192–200.

Sexual function and depressive symptoms in young women with elevated macroprolactin content: a pilot study.

Elevated prolactin levels seem to be associated with impaired sexuality. The clinical significance of macroprolactinemia, associated with the predominance of high molecular mass circulating forms of prolactin, is still poorly understood. This study was aimed at investigating sexual function in young women with macroprolactinemia. The study enrolled 14 young women with macroprolactinemia, 14 with increased monomeric prolactin levels, as well as 14 age- and weight-matched healthy women. All patients completed a questionnaire evaluating female sexual function (Female Sexual Function Index—FSFI), as well as a questionnaire assessing the presence and severity of depressive symptoms (Beck Depression Inventory Second Edition—BDI-II). Apart from total prolactin levels and macroprolactin content, circulating levels of thyrotropin, total testosterone, and 17-β estradiol were also measured. Patients with elevated monomeric prolactin levels had a lower total FSFI score, as well as lower scores for all domains: sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and dyspareunia. These scores correlated with total and monomeric prolactin levels. In turn, women with macroprolactinemia were characterized by a lower score for sexual desire, and only this score correlated with total prolactin levels and macroprolactin content. The total score in the BDI-II questionnaire was higher in patients with hyper- and macroprolactinemia than in the control subjects. Contrary to multidimensional impairment of sexual function in women with elevated monomeric prolactin, macroprolactinemia only seems to disturb sexual desire.

Sexual Functioning in Young Women and Men: Role of Attachment Orientation

Prior research has documented various ways in which adult attachment styles are characteristic of differential behavioral and cognitive patterns within romantic relationships and sexuality. However, few studies have examined the direct influence of anxious or avoidant attachment orientation on sexual function. The aim of the present study was to assess the impact of insecure attachment on sexual function. Undergraduate students completed questionnaires measuring attachment style and sexual functioning. Among women, attachment avoidance tended to be associated with impairments in all aspects of sexual function, whereas anxious attachment tended to be associated with declines in arousal, satisfaction, and ability to achieve orgasm. A different trend was seen in men: Anxious attachment tended to be associated with multiple facets of sexual dysfunction, while avoidant attachment did not correlate with any sexual function deficits and was associated with superior physiological competence. These results suggest that both anxious and avoidant attachment styles are important yet differential predictors of sexual function in men and women.

Daily affect and female sexual function.

The specific affective experiences related to changes in various aspects of female sexual function have received little attention as most prior studies have focused instead on the role of clinical mood and anxiety disorders and their influence on sexual dysfunction. We sought to understand the transaction between daily affect and female sexual function in effort to provide a more nuanced understanding of the interplay between affective and sexual experiences. The present study used a 2-week daily diary approach to examine same-day and temporal relations between positive and negative affect states and sexual function in young women. We examined the unique relations between positive (i.e., joviality, serenity, self-assurance) and negative (i.e., fear, sadness, hostility) affects and female sexual response (i.e., desire, subjective arousal, vaginal lubrication, orgasmic function, and sexual pain) while controlling for higher order sexual distress, depression, and anxiety, as well as age effects and daily menstruation. Analyses revealed different aspects of both positive and negative affects to be independently related to sexual response indices. Specifically, results indicated that joviality was related to same-day sexual desire and predicted increased desire the following day. This latter relation was partially mediated by sexual activity. Further, greater sexual desire predicted next-day calmness, which was partially mediated by sexual activity. Notably, fear was related to same-day subjective arousal, lubrication, orgasmic function, and vaginal pain, whereas poorer orgasmic function predicted greater next-day sadness. These findings describe the manner in which changes in affect correspond to variations in female sexual function, thus highlighting the inextricability of mental and sexual health. Further, these findings may offer insight into the progression of normative levels of affect and sexual function as they develop into comorbid depression, anxiety, and sexual dysfunction.

PO82 Sexual functioning in young women after breast cancer treatment

PO82 Sexual functioning in young women after breast cancer treatment

OR34 Sexual functioning in young women with breast cancer

OR34 Sexual functioning in young women with breast cancer S. Rosenberg *, R. Tamimi, S. Gelber, K. Ruddy, S. Kereakoglow, V. Borges, S. Come, L. Schapira, E. Winer, A. Partridge. Harvard School of Public Health, Department of Epidemiology, Boston, USA, Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, USA, University of Colorado-Denver, Department of Medical Oncology, Denver, USA, Beth Israel Deaconess Medical Center, Department of Medical Oncology, Boston, USA, Massachusetts General Hospital, Department of Medical Oncology, Boston, USA

Quality of life and sexual functioning in young women with early‐stage breast cancer 1 year after lumpectomy

The breast cancer (BC) and its treatment (mastectomy, radiotherapy, and chemotherapy) have considerable psychosexual impacts on women's life. This study evaluated sexual functioning, quality of life, and self-esteem in young women with early-stage BC. A total of 186 women with stage I or II BC and 204 age-matched controls aged 25-45 years were recruited. To be eligible, patients had to be disease-free and sexually active. They also had to have undergone lumpectomy at least 1 year previously and have completed chemotherapy and/or radiotherapy. Subjects completed Female Sexual Function Index, Short Form-36 Health Survey, and Rosenberg Self-Esteem questionnaire. Serum sex hormones were also measured in all subjects. Of BC patients, 57% experienced lubrication disorder followed by satisfaction disorder in 53.8%, desire disorder in 42.5%, and arousal disorder in 37.0% (all patients vs. healthy controls <0.01). Hormone-treated patients were more likely to report sexual dysfunctions (p = 0.006). The radiotherapy + chemotherapy + hormone therapy was associated with an about sixfold increased risk of lubrication and satisfaction disorders (adjusted odds ratios = 6.4, 95%CI = 4.6-12.6, and adjusted odds ratios = 5.7, 95%CI = 3.4-11.4, respectively). Cancer patients had lower scores for all components of the Short Form-36 Health Survey, except for pain. Levels of self-esteem did not differ significantly between the two groups. Young lumpectomized BC women reported a marked impairment in sexual functioning and quality of life.

Sexual functioning in young women with breast cancer.

9100 Background: Sexual dysfunction is a known complication of adjuvant therapy for breast cancer and an important determinant of quality of life. Little is known about the frequency and magnitude of this problem among very young women with breast cancer during the year following diagnosis. Methods: 298 sexually-active women enrolled in an ongoing multi-center cohort study with Stage 0-III breast cancer at or before age 40 were included in this analysis. Treatment data was self-reported on a survey mailed to participants at enrollment. Sexual functioning was assessed using the sexual interest and dysfunction subscales from the Cancer Rehabilitation Evaluation System (CARES). Scores range from 0-4, with higher scores indicative of poorer function. The survey included a measure of anxiety and depression (Hospital Anxiety and Depression Scale), of body image (CARES) and of physical and menopausal symptoms (Breast Cancer Prevention Trial Symptom Checklist). Mean differences in CARES scores between treatment groups (chemotherapy vs. none; hormone therapy vs. none; lumpectomy vs. mastectomy vs. mastectomy + reconstruction vs. no surgery; radiation vs. none) were compared using T-tests and ANOVA. Multiple regression models were fit to assess symptoms thought to be mediators of the treatment-sexual functioning association. Results: Mean age at diagnosis was 36 (range: 22-40) years and mean time from diagnosis to survey completion was 5 months (range: 1-16). Mean CARES sexual interest and dysfunction scores were higher in women who received chemotherapy compared to those who did not (p&lt;0.0001). In the multivariate analysis, chemotherapy was no longer associated with decreased sexual interest or function. Anxiety, depression, musculoskeletal pain, and poorer body image were predictive of both decreased sexual interest and function. Vaginal pain symptoms were associated with greater dysfunction, while unhappiness with appearance was associated with decreased interest. Conclusions: Young women who receive chemotherapy are at risk for problems related to sexual functioning early in the survivorship period. This effect appears to be mediated through several physiologic and psychologic mechanisms, underscoring the need for interventions that target both.

Pregnancy after anterior spinal surgery: fertility, cesarean-section rate, and the use of neuraxial anesthesia

Background context Previous publications have reported results with respect to functional outcome and sexual function in young women after traumatic injuries to the pelvis. It is well known that anterior spinal surgery has the possibility of causing reproductive dysfunction in men. Little has been described concerning deleterious effects of anterior spinal surgery in women of childbearing age. Purpose The purpose of the study was to determine the fertility, cesarean section rate, and the use of neuraxial anesthesia in a population of women of childbearing age who have undergone anterior spinal surgery. Study design/setting This was a retrospective chart review combined with a telephone questionnaire of the patients who had undergone anterior spinal surgery by a single orthopedic surgeon. Methods Demographic data were collected from hospital and office records. Patients were asked if they had tried to become pregnant, if their pregnancy had come to term, the use of spinal or epidural anesthesia for that labor and delivery, and the type of delivery. Results Seventy-nine potential subjects were identified and 67 patients were contacted to determine their fertility status. Ninteen patients had tried to become pregnant after their anterior spinal surgery. All patients who reported that they tried to become pregnant were successful at having a child. Seven of the 19 women had children who were born by cesarean section (37%). Only two patients received an epidural as analgesia for their delivery. Conclusions Although the cesarean-section rate appears high, it is consistent with the current obstetrical trends. Anesthesiologists appear less inclined to offer neuraxial anesthesia to a population which has undergone anterior spinal surgery.

Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency

To assess sexual function in women with spontaneous 46,XX primary ovarian insufficiency after at least 3 months of a standardized hormone replacement regimen. Cross-sectional cohort, controlled. National Institutes of Health Clinical Research Center. Women with primary ovarian insufficiency (n = 143) and regularly menstruating controls (n = 70). Self-administered questionnaires, 100 microg/day E(2) patch, oral medroxyprogesterone acetate 10 mg for 12 days each month for patients. Derogatis Interview for Sexual Function Self-Report (DISF-SR). Women with primary ovarian insufficiency had significantly lower DISF-SR composite scores compared with control women. Their serum total testosterone levels were significantly correlated with DISF-SR composite score, although this accounted for only 4% of the variance in this measure. Patients with testosterone levels below normal tended to have lower DISF-SR composite scores. Of patients with primary ovarian insufficiency, 9 of 127 (7%) scored below the second percentile on the composite sexual function score, compared with 1 of 49 control women (2%). As assessed by the DISF-SR, sexual function is in the normal range for most young women with 46,XX spontaneous primary ovarian insufficiency who are receiving physiologic E(2) replacement. However, as a group, these young women score significantly lower on this sexual function scale than control women.

Randomised controlled trial to compare plasma and dopamine for the hypotensive very low birthweight (VLBW) infant

Previous publications have reported results with respect to functional outcome and sexual function in young women after traumatic injuries to the pelvis. It is well known that anterior spinal surgery has the possibility of causing reproductive dysfunction in men. Little has been described concerning deleterious effects of anterior spinal surgery in women of childbearing age.The purpose of the study was to determine the fertility, cesarean section rate, and the use of neuraxial anesthesia in a population of women of childbearing age who have undergone anterior spinal surgery.This was a retrospective chart review combined with a telephone questionnaire of the patients who had undergone anterior spinal surgery by a single orthopedic surgeon.Demographic data were collected from hospital and office records. Patients were asked if they had tried to become pregnant, if their pregnancy had come to term, the use of spinal or epidural anesthesia for that labor and delivery, and the type of delivery.Seventy-nine potential subjects were identified and 67 patients were contacted to determine their fertility status. Ninteen patients had tried to become pregnant after their anterior spinal surgery. All patients who reported that they tried to become pregnant were successful at having a child. Seven of the 19 women had children who were born by cesarean section (37%). Only two patients received an epidural as analgesia for their delivery.Although the cesarean-section rate appears high, it is consistent with the current obstetrical trends. Anesthesiologists appear less inclined to offer neuraxial anesthesia to a population which has undergone anterior spinal surgery.