Sexual Function Problems Research Articles

Chemotherapy-Induced Amenorrhea and Menopause Symptoms in Women With Breast Cancer

Chemotherapy is a common adjuvant therapy for breast cancer that improves survival rates by killing residual cancer cells. However, this intervention may damage the germ cells within the ovary and interrupt the menstrual cycle, ultimately leading to chemotherapy-induced amenorrhea (CIA). The incidence of CIA depends on how broadly this term is defined. Around 75% of premenopausal breast cancer women treated with chemotherapy will develop CIA. Age, having a relatively long chemotherapy cycle duration, being estrogen-receptor positive, and using Tamoxifen all increase the risk of CIA. Although CIA may be associated with better prognosis outcomes, breast cancer women must subsequently deal with the various menopausal symptoms that are associated with a CIA-induced drop in estrogen level (such as cognitive function decline, physical and psychological symptoms, vasomotor symptoms, reproductive and sexual function problems, and body weight change). The present article describes the female menstrual cycle, the mechanism and risk factors of CIA, and the range of menopausal symptoms. Furthermore, we summarized methods of assessing menopausal symptoms and compared five common rating scales of menopausal symptoms. By better understanding the potential menopausal symptoms, researchers and clinicians may then select the most appropriate scale based on the situational needs in order to evaluate the severity of menopausal symptoms that are experienced by breast cancer women.

Sexual Function in 16- to 21-Year-Olds in Britain

PurposeConcern about young people's sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people. MethodsA cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16–21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF). ResultsAmong sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties. ConclusionsDistressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties.

A Longitudinal Study of Problems in Sexual Functioning and Related Sexual Distress Among Middle to Late Adolescents

PurposeRates of sexual dysfunctions are high among adults, but little is known about problems in sexual functioning among adolescents. We completed a comprehensive assessment of problems in sexual functioning and related distress over a 2-year period among adolescents (16–21 years). MethodsA sample of 405 adolescents completed five online surveys over 2 years. The main outcome measures were clinical cutoff scores on the International Index of Erectile Function and Premature Ejaculation Diagnostic Tool for male adolescents and the Female Sexual Function Index for female adolescents. A secondary outcome was clinical levels of distress. ResultsThe majority of sexually active adolescents (78.6% of the male and 84.4% of the female) reported a sexual problem over the course; rates did not differ significantly by gender. Common problems for males were low sexual satisfaction (47.9%), low desire (46.2%), and problems in erectile function (45.3%). Common problems for females were inability to reach orgasm (59.2%), low satisfaction (48.3%), and pain (46.9%). Models predicting problems over time showed increased odds among those not in a sexual relationship. Odds of reporting a distressing sexual problem decreased over time for female but not male adolescents. ConclusionsProblems in sexual functioning emerge early in individuals' sexual lives, are often distressing, and appear not to fluctuate over time. Additional efforts to identify key factors linked to onset will help elucidate possible mechanisms.

O029 Sexual function problems in British 16–21 year olds: Cause for concern?

Background/introduction Sexual function is largely absent from the policy discourse on young people’s sexual health. The omission is troubling, given the link between low sexual function and indicators of risk (including higher partner numbers, paying for sex, non-consensual sex and STI diagnosis). An absence of data permits this silence. Aim(s)/objectives To address the gap in empirical data on sexual function problems in young people aged 16 to 21 in Britain. Methods Descriptive statistics from a national probability survey of 15,162 British men and women (Natsal-3), undertaken from 2010–2012 using computer-assisted self-interviews (CASI). Complex survey analyses of data from participants aged 16–21 (854 men and 1021 women sexually active in the last year; 262 men and 255 women sexually experienced but not active in the last year). Results Distressing sexual function problems (>3months in last year) were reported by 9.1% of men and 13.4% of women. Most common among men was reaching a climax too quickly (4.5%) and among women, difficulty reaching climax at all (6.3%). The majority of young people experiencing problems did not seek help, and those that did rarely sought out professionals. Around 6% of those currently sexually active, and 10% of those not so, reported avoiding sex because of sexual function problems. Discussion/conclusion Sexual function problems are common among young people and are largely unaddressed. Addressing these clear needs will have benefits for other aspects of sexual health. Reassurance in clinical settings and information/advice in educational settings are inexpensive and potentially effective strategies.

Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction.

Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee2. Systematic review of the literature with a focus on publications since 2010. Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems in men and women and is observed more consistently for genital arousal than for subjective arousal. Assessment of physical and mental illnesses that commonly occur in later life should be included as part of the initial evaluation in middle-aged and older persons presenting with sexual complaints. Menopausal status has an independent effect on reported changes in sex life and difficulties with intercourse. There is strong support for the use of psychological treatment for sexual desire and orgasm difficulties in women (but not in men). Combination therapies should be provided to men, whenever possible. Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist.

Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society.

Estimating the Prevalence of Sexual Function Problems: The Impact of Morbidity Criteria

Establishing the clinical significance of symptoms of sexual dysfunction is challenging. To address this, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced two new morbidity criteria (duration and symptom severity) to the existing criteria of distress. This study sought to establish the impact of these three criteria on the population prevalence of sexual function problems. The data come from a national probability survey (Natsal-3) and are based on 11,509 male and female participants aged 16–74, reporting at least one sexual partner in the past year. The key outcomes were: proportion of individuals reporting proxy measures of DSM-5 problems, and the proportion of those meeting morbidity criteria. We found that among sexually active men, the prevalence of reporting one or more of four specific sexual problems was 38.2%, but 4.2% after applying the three morbidity criteria; corresponding figures for women reporting one or more of three specific sexual problems, were 22.8% and 3.6%. Just over a third of men and women reporting a problem meeting all three morbidity criteria had sought help in the last year. We conclude that the DSM-5 morbidity criteria impose a focus on clinically significant symptoms.

Psychotropic induced sexual dysfunction for people with a dual diagnosis

Purpose – The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing an assessment of sexual functioning. Third, the role of the pharmaceutical industry is explored. Finally, implications for future research and practice are suggested. Design/methodology/approach – As a commentary this paper draws on the available literature to synthesise what is already known about the relationship between psychoactive substances and sexual functioning. Findings – The limited literature and lack of research attention given to psychotropic induced sexual dysfunction limits our collective understanding of how many people are affected and in what way. Research limitations/implications – A greater focus on psychotropic induced sexual dysfunction is needed for people with a dual diagnosis. There has been an over reliance on single case studies and self-reporting. Large scale epidemiological investigation would help understand the extent and nature of the problem more fully. The demographic shift particularly in relation to an ageing population should be considered as psychotropic substances effect individuals in different ways as they grow older. Practical implications – There is scope for workers to engage more fully in a conversation with clients about their experience of using psychotropic substances and how this has impacted their sexual functioning. The literature suggests that clients want to talk about this issue but staff are unwilling or unable to discuss the topic. Originality/value – To the authors’ knowledge this is the first paper that draws on the available literature to explore the known and likely implications of psychotropic induced sexual dysfunction for this client group.

Men with Sexual Problems and Their Partners: Findings from the International Survey of Relationships.

Epidemiologic studies of sexual function problems in men have focused on the individual male and related sociodemographic characteristics, individual risk factors and lifestyle concomitants, or medical comorbidities. Insufficient attention has been given to the role of sexual and relationship satisfaction and, more particularly, to the perspective of the couple as causes or correlates of sexual problems in men or women. Previously, we reported results of the first large, multi-national study of sexual satisfaction and relationship happiness in 1,009 midlife and older couples in five countries (Brazil, Germany, Japan, Spain, U.S.). For the present study, we examined, within each problem, the association of four major sexual problems in men (loss of sexual desire, erectile problems, premature ejaculation, delayed/absent orgasm) and multiple problems, with male and female partners' assessments of physical intimacy, sexual satisfaction, and relationship happiness, as well as associations with well-known health and psychosocial correlates of sexual problems in men. Sexual problem rates of men in our survey were generally similar to rates observed in past surveys in the general population, and similar risk factors (age, relationship duration, overall health) were associated with lack of desire, anorgasmia, or erection difficulties in our sample. As in previous surveys, there were few correlates of premature ejaculation. As predicted, men with one or more sexual problems reported decreased relationship happiness as well as decreased sexual satisfaction compared to men without sexual problems. Moreover, female partners of men with sexual problems had reduced relationship happiness and sexual satisfaction, although these latter outcomes were less affected in the women than the men. The association of men's sexual problems with men's and women's satisfaction and relationship happiness were modest, as these couples in long-term, committed relationships were notable for their relatively high levels of physical affection and relationship happiness.

Editorial Comment on: Changes in Autonomic Nervous System Activity are Associated with Changes in Sexual Function in Women with a History of Childhood Sexual Abuse.

Child sexual abuse (CSA) is a heterogeneous experience with no standard operational definition. Despite the heterogeneity of CSA and variability in how it is assessed, an extensive literature demonstrates differences between women who are exposed to CSA versus those who are not. Women who experience CSA are more likely to develop a broad range of mental health disorders, including bipolar disorder, borderline personality disorder, eating disorders, substance use disorders, and anxiety—particularly posttraumatic stress disorder (PTSD) [1]. Physical health issues such as cardiovascular disease, gastrointestinal issues, obesity, and diabetes, with accompanying higher use of health care services, are also common in adult women with a history of CSA [2]. Differences in sexual behavior following CSA are similarly well documented and include earlier sexual debut, larger numbers of partners, higher rates of behaviors associated with elevated risk of HIV and other sexually transmitted infections, higher rates of sexual functioning problems, and evidence of inhibited genital responding to sexual stimuli [3].

Sexual Health Concerns Among Cancer Survivors: Testing a Novel Information-Need Measure Among Breast and Prostate Cancer Patients.

While it is recognized that cancer treatment can contribute to problems in sexual function, much less is currently known about the specific sexual health concerns and information needs of cancer survivors. This study tested a new instrument to measure cancer survivors' sexual health concerns and needs for sexual information after cancer treatment. The Information on Sexual Health: Your Needs after Cancer (InSYNC), developed by a multidisciplinary team of experts, is a novel 12-item questionnaire to measure sexual health concerns and information needs of cancer survivors. We tested the measure with a sample of breast and prostate cancer survivors. A convenience sample of 114 cancer survivors (58 breast, 56 prostate) was enrolled. Results of the InSYNC questionnaire showed high levels of sexual concern among cancer survivors. Areas of concern differed by cancer type. Prostate cancer survivors were most concerned about being able to satisfy their partners (57%) while breast cancer survivors were most concerned with changes in how their bodies worked sexually (46%). Approximately 35% of all cancer survivors wanted more information about sexual health. Sexual health concerns and unmet information needs are common among breast and prostate cancer survivors, varying in some aspects by type of cancer. Routine screening for sexual health concerns should be included in comprehensive cancer survivorship care to appropriately address health care needs. The InSYNC questionnaire is one tool that may help clinicians identify concerns facing their patients.

Genital image, sexual anxiety, and erectile dysfunction among young male military personnel.

More than a third of young military personnel report experiencing some level of erectile dysfunction (ED). Preoccupation with body image, particularly genitals, is a distraction that can influence sexual anxiety (SA) and sexual functioning problems (SFPs), particularly ED. This study assessed the relationships between male genital self-image (MGSI), SA, and ED in a sample of male military personnel age 40 or younger. Data were from a larger study on SFPs in military populations. This sample consisted of 367 male military personnel age 40 or younger. Hierarchical regression analyses and process modeling using mediation analysis were performed to examine the effects of MGSI on ED with SA as an intermediate variable. We predicted that SA would mediate the relationship between MGSI and ED. ED severity was assessed with the International Index of Erectile Function. MGSI was assessed using the MGSI Scale. SA was assessed with the SA subscale of the Sexual Needs Scale. As hypothesized, greater satisfaction with MGSI was predictive of significantly lower SA (F[8, 352] = 4.07, P = 0.001) and lower ED (F[8, 352] = 13.20, P = 0.001). Lower levels of SA were predictive of lower levels of ED (F[8, 354] = 21.35, P < 0.001). Additionally, results also revealed a significant indirect effect of MGSI on ED through SA (b = -0.07, standard error = 0.03, confidence interval = [-0.14,-0.02], P < 0.05), indicating mediation of MGSI on ED via SA. This study underscores the complex etiologic basis of SFPs, particularly ED, and highlights the importance of considering psychologic contributors to ED, such as SA and MGSI. Strategies aimed at reducing SA may be useful in improving ED in young military populations and are worth considering as complements to strategies that improve SFPs.

PD9-03 QUALITY OF LIFE IN 112 MEN AND 33 WOMEN WITH BLADDER CANCER UNDERGOING ILEAL CONDUIT: A MULTICENTRE STUDY AMONG LONG-TERM SURVIVORS

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion I1 Apr 2015PD9-03 QUALITY OF LIFE IN 112 MEN AND 33 WOMEN WITH BLADDER CANCER UNDERGOING ILEAL CONDUIT: A MULTICENTRE STUDY AMONG LONG-TERM SURVIVORS Salvatore Siracusano, Stefano Ciciliato, Renato Talamini, Laura Toffoli, Francesco Visalli, Tommaso Silvestri, Emanuele Belgrano, Mauro Niero, Cristina Lonardi, Maria Angela Cerruto, Ciro Imbimbo, Marco Racioppi, Massimo Iafrate, Carolina D'Elia, Giovanni Cacciamani, Davide De Marchi, Paolo Verze, Pierfrancesco Bassi, and Walter Artibani Salvatore SiracusanoSalvatore Siracusano More articles by this author , Stefano CiciliatoStefano Ciciliato More articles by this author , Renato TalaminiRenato Talamini More articles by this author , Laura ToffoliLaura Toffoli More articles by this author , Francesco VisalliFrancesco Visalli More articles by this author , Tommaso SilvestriTommaso Silvestri More articles by this author , Emanuele BelgranoEmanuele Belgrano More articles by this author , Mauro NieroMauro Niero More articles by this author , Cristina LonardiCristina Lonardi More articles by this author , Maria Angela CerrutoMaria Angela Cerruto More articles by this author , Ciro ImbimboCiro Imbimbo More articles by this author , Marco RacioppiMarco Racioppi More articles by this author , Massimo IafrateMassimo Iafrate More articles by this author , Carolina D'EliaCarolina D'Elia More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Davide De MarchiDavide De Marchi More articles by this author , Paolo VerzePaolo Verze More articles by this author , Pierfrancesco BassiPierfrancesco Bassi More articles by this author , and Walter ArtibaniWalter Artibani More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.930AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients undergoing urinary radical cystectomy (RC) and urinary diversion for bladder cancer had some early and late complications, and experience substantial limitations in health-related quality of life (HRQOL). At present, there are sparse studies that evaluated the levels of discomfort in long-terms survivors. In the present study, we used the validated Italian version of QLQ-BLM30 and QLQ-C30 from EORTC to assess bladder cancer-specific HRQOL in men and women with ileal conduit (IC) after RC and with long term follow-up. METHODS From June 2007 to September 2013, a total of 145 consecutive patients with bladder cancer (112 males and 33 females), who underwent RC with IC from five urological academic centres, were included in this study. All patients had no evidence of tumor recurrence and were actively followed-up. Clinical and pathological data as well as clinical outcomes were retrospectively analyzed. Quality of life was analyzed using Italian versions of the EORTC BLM30 and QLQ-C30 questionnaires. Mean values with standard deviations (±SD) were computed for all items. Wilcoxon rank test was used to verify differences by sex in the long-term follow-up. Statistical significance was achieved if p-value was ≤0.05 (two-sides). RESULTS The median age of men was 72 years (range:49-95) and 71 years (range:52-86) in women undergoing IC. The median of follow-up was 34 months (range:49-95) in men and 40 months (range:6-153) in the 33 women with IC. Our data showed that women with IC had greater problems than men in cognitive functioning (higher score means a better functionality) (77.3±27.9 and 87.8±18.6 respectively; p=0.04) as well in future perspective (lower score means a low level of symptomatology/problems) (42.4±34.4 and 21.9±24.6 respectively; p=0.001). Instead men undergoing IC had more problems in sexual functioning than women (23.3±24.5 and 7.0±20.3 respectively; p=0.001). CONCLUSIONS Our study based on long-term follow-up in women and men undergoing RC with IC showed a better cognitive functioning and a more optimistic vision of the future in men than in women, and a worse sexual function in men in comparison with women. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e195-e196 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Salvatore Siracusano More articles by this author Stefano Ciciliato More articles by this author Renato Talamini More articles by this author Laura Toffoli More articles by this author Francesco Visalli More articles by this author Tommaso Silvestri More articles by this author Emanuele Belgrano More articles by this author Mauro Niero More articles by this author Cristina Lonardi More articles by this author Maria Angela Cerruto More articles by this author Ciro Imbimbo More articles by this author Marco Racioppi More articles by this author Massimo Iafrate More articles by this author Carolina D'Elia More articles by this author Giovanni Cacciamani More articles by this author Davide De Marchi More articles by this author Paolo Verze More articles by this author Pierfrancesco Bassi More articles by this author Walter Artibani More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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

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

Sexual Function and Problems with Adolescents and Young Adults

Despite high rates of sexual dysfunctions among adults, little research attention has been given to the sexual function and problems of adolescents and young adults. There are few community-based samples and no population-based data to date. Age is clearly linked to onset of dysfunctions, yet most studies explore late stages of adulthood. Work in this field is hampered by the lack of standardized measures or validated cutoff scores appropriate for use with young people. Several studies have explored specific forms of dysfunctions among young people or recall by adults of sexual problems experienced when younger, and these collectively reveal that sexual functioning can certainly be problematic for many. Two studies with comprehensive assessments of problems in sexual functioning are reviewed. They reveal that a sizable minority of young people experience difficulties, often significantly distressing in nature. This paper concludes with a call for researchers to explore this domain in full.

Sexual function in patients supported with left ventricular assist device and with heart transplant.

Sexual dysfunction is common among patients with heart failure (HF) and considered an important hamper to quality of life. While implantation of left ventricular assist device (LVAD) may prolong and improve life in advanced HF, limited data are available on its impact on sexual function. The aim of this study is to evaluate sexual function in LVAD patients and compare this with patients after heart transplantation (HTx). Sexual activity and satisfaction of stable patients with durable LVAD or after HTx were evaluated using a validated questionnaire and visual analogue scale from 0 to 10. Data were collected from 31 patients (mean age 59 ± 12 years, 87% male), 17 after HTx and 14 with LVAD. Pleasure or satisfaction with sex was significantly higher in HTx patients (P = 0.0005). In total, 29% LVAD patients and 71% HTx patients reported content with sexual activity. Recalled satisfaction with sex life pre-operation was comparable between the groups. During support, satisfaction with sex life using visual analogue scale was 7.6 ± 3.1 for HTx versus 3.9 ± 4.0 for LVAD patients (P = 0.017). In total, 11 LVAD patients (79%) reported specific problems in sexual function including erectile dysfunction or vaginal dryness (8, 57%); problems with the LVAD, cable, or batteries (5, 36%); problems with orgasm (4,29%); and other problems such as fear of injury, feeling depressed, partner issues, self-image, and pain (1, 7% each). Sexual dysfunction occurs in patients with LVAD support and may be more prominent than after HTx. Problems limiting sexual function related to physiological, psychological, and equipment merit consideration during follow-up.

Sexual concerns among kidney transplant recipients.

Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type. This study employed a cross-sectional, descriptive, correlational design. Sexual concerns were identified using the Sexual Concerns Questionnaire, which contains seven subscales. QOL was measured with the SF-8 and the QOL Uniscale. Nearly 73% of subjects rated sexuality as important. Subscales indicating highest area of sexual concerns were communication with healthcare providers about sexuality (Mean (M)=2.70) and sexual pleasure concerns (M=2.45). Higher concern ratings regarding health consequences of sexual activity, quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly, inversely related to QOL. Women had significantly higher scores on the Sexual Pleasure and Communication with Healthcare Providers subscales than men. This study reports the sexual concerns of KTx recipients' who are an average of fouryr since surgery, and the relationship of these concerns to QOL.

Sexual functioning in military personnel: preliminary estimates and predictors.

Although the military is a young and vigorous force, service members and veterans may experience sexual functioning problems (SFPs) as a result of military service. Sexual functioning can be impaired by physical, psychological, and social factors and can impact quality of life (QOL) and happiness. This study aims to estimate rates and correlates of SFPs in male military personnel across demographic and psychosocial characteristics, to examine the QOL concomitants, and to evaluate barriers for treatment seeking. This exploratory cross-sectional study was conducted using data from a larger nationwide study conducted between October 2013 and November 2013. This sample consists of 367 male active duty service members and recent veterans (military personnel) age 40 or younger. Erectile dysfunction (ED) was determined using the five-item International Index of Erectile Function, sexual dysfunction (SD) was determined using the Arizona Sexual Experiences Scale, Male, and QOL was determined using the World Health Organization Quality of Life, Brief. SFPs were associated with various demographic, physical, and psychosocial risk factors. The rates of SD and ED were 8.45% and 33.24%, respectively, for male military personnel aged 21-40. Those who were 36-40, nonmarried, nonwhite, and of lower educational attainment reported the highest rates of SFPs. Male military personnel with poor physical and psychosocial health presented the greatest risk for ED and SD. SFPs were associated with reduced QOL and lower happiness, and barriers for treatment were generally related to social barriers. SFPs in young male military personnel are an important public health concern that can severely impact QOL and happiness.

Sexual Concerns Among Simultaneous Kidney Pancreas (SPK) Transplant Recipients.

The aims of this study are to 1) describe sexual concerns of SPK transplant recipients, 2) examine the relationship between sexual concerns and Quality of Life (QoL) after transplant, and 3) examine changes in sexual concerns from pre to post transplant. Participants were sent questionnaires which included demographic and disease related questions, QoL measures (SF-12 and QoL uniscale), and Sexual Concerns Questionnaires (SCQ). The SCQ-pre transplant contains 24 questions and 6 subscales and the SCQ-post transplant contains 28 questions and 7 subscales. Participants rate each item on a 6-point scale from 0 (Not at all) to 5 (Extremely). Higher scores indicate a higher level of concern. Mean age of the sample (n = 145) was 50 years, 54.9% were male, 94.4% were white, and 71.5% were in a relationship. Subscales indicating the highest area of sexual concerns after transplant were sexual pleasure concerns and communication with providers about sexuality. Participants were most concerned about spontaneity of sexual activity, sexual concerns being important to providers, ED, sex drive, and vaginal lubrication. Having concerns about quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly associated with lower QoL (p < .01) after transplant. Thirteen sexual concerns got significantly worse from pre to post SPK transplant. These concerns were related to sexual functioning (i.e. vaginal dryness, ED, and sex drive) and partner concerns (i.e. partner finding sexually attractive and satisfying needs). Seven sexual concerns improved after transplant. These concerns were related to communicating with providers about sexuality. Figure 1 illustrates effect sizes of select concerns that significantly changed from pre to post transplant.Figure: No Caption available.Findings provide a more comprehensive understanding of sexual concerns after SPK transplant and the link to QoL. This study dispels the assumption that all aspects of QoL improve after transplantation, as sexuality, an important component of QoL, did not improve.

Prevalence and Characteristics of Sexual Functioning among Sexually Experienced Middle to Late Adolescents

Little is known about problems in sexual functioning among young people, despite the high rates found in adult samples. It is unclear which problems are most prevalent or how common sexual distress is for young people experiencing problems. This study aims to assess the prevalence, range, and correlates of sexual problems and distress among a sample of adolescents (16-21 years). Participants (mean age 19.2) were recruited from community and area high schools. Male adolescents (n = 114) completed online the International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT). Female adolescents (n = 144) completed the Female Sexual Function Index (FSFI). Both completed the Female Sexual Distress Scale (FSDS) and the measures of background, relationship characteristics, and sexual histories. Clinical cutoff scores on the IIEF, PEDT, FSFI, and FSDS were used to determine whether there was a significant sexual problem. Adolescents reported extensive sexual experience, most in relationship contexts. Half of the sample (51.1%) reported a sexual problem; 50.0% reported clinically significant levels of distress associated with it. Similar rates of problems and distress were found among male and female adolescents. For the most part, adolescent characteristics, backgrounds, and experience were not associated with adolescents' sexual problems. Sexual problems are clearly prevalent among adolescents, and distressing to many who experience them, emphasizing a strong need to develop programs to address this issue.