Total Female Sexual Function Index Research Articles

Female Sexual Orgasmic Dysfunction and Genital Sensation Deficiency

IntroductionMost studies on female sexual dysfunction (FSD), and female sexual orgasmic disorder (FSOD) in particular, have qualitatively examined cultural and educational factors; only few have quantitatively examined physiological factors. AimThe aim of this study was to compare quantitative sensory testing (QST) between women for whom FSOD was their primary complaint and other women with FSD. MethodsIn this retrospective study of women who visited a sexual dysfunction clinic, the study group comprised women for whom FSOD was their primary complaint, and the control group comprised other women with FSD. Sexual dysfunction was assessed by the Female Sexual Function Index (FSFI). QST was performed with a thermal and vibration Genito-Sensory Analyzer (GSA; Medoc Ltd, Israel) aimed at the clitoral and vaginal areas. Main Outcome MeasureThe main outcome was clitoral and vibratory sensory thresholds in accordance with the presence of FSOD. ResultsThe study group comprised 89 (45%) women, with a mean age of 37.6 ± 1.9 years; and the control group comprised 110 (55%) women, with a mean age of 37.5 ± 11.3 years. Both mean FSFI-FSOD and total FSFI scores were significantly lower in the study group than in the control group (0.97 ± 0.94 vs 1.91 ± 1.3, P < 0.001) and (11.9 ± 3.2 vs 15.6 ± 3.6, P < 0.001), respectively. Mean clitoral vibratory sensory thresholds were higher in the study group than in the control group: 2.02 confidence interval (CI) 1.12–2.64 vs 1.55 CI 1.12–2.41, P < 0.001. No statistically significant difference was found between the groups in vaginal vibratory thresholds: 3.7 CI 2.6–6.6 vs 3.4 CI 1.9–5.4, P = 0.14. Clinical ImplicationsThe findings support the role of the clitoris in obtaining sexual orgasm, thus inferring a possible physiologic cause of FSOD in otherwise healthy women, beyond established psychological causes. Strength & LimitationsAssessments using an objective quantitative measure (QST) and a subjective tool (FSFI) in both the FSOD and control groups are strengths of this study. The retrospective design is a limitation. ConclusionQST showed a direct correlation between vibratory clitoral stimulation and FSOD; Compared with the control group, women with FSOD are relatively insensitive to clitoral stimulation, but not to vaginal stimulation.Gruenwald I, Lauterbach R, Gartman I, et al. Female Sexual Orgasmic Dysfunction and Genital Sensation Deficiency. J Sex Med 2020; 17:273–278.

Effect of a structured educational package on women's sexual function during pregnancy.

To explore the effect of a structured educational package based on ADDIE (analysis, design, development, implementation, evaluation) to reduce sexual dysfunction during pregnancy. A randomized controlled trial study among pregnant women attending prenatal clinics in Tehran, Iran, from October 2017 to September 2018. The implementation group received the structured educational package; the control group received training on breastfeeding and normal delivery. The outcome measure was changes in total and domain scores of the Female Sexual Function Index (FSFI) questionnaire before and after the intervention; the groups were compared by repeated-measures analysis of variance (ANOVA). Overall, 70 women completed the study: 36 in the intervention group and 34 in the control group. Sexual desire (P=0.019), arousal (P=0.001), lubrication (P=0.001), orgasm (P=0.001), satisfaction (P=0.007), and total FSFI score (P<0.001) improved significantly in the intervention group as compared with the control group. However, there was no difference in sexual pain after the intervention (P=0.78). The structured educational package was found to reduce sexual dysfunction by improving knowledge of and attitudes toward the physical and psychologic changes that occur during pregnancy among Iranian women attending routine prenatal care visits as part of a healthcare center's program. Iranian Registry of Clinical Trials: IRCT20140907019077N14.

Sexual Functioning Is Frequently and Markedly Impaired in Female Patients with Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is common, chronic, and debilitating, and has serious effects on quality of life and mental health. Three of 4 patients with CSU are women. The impact of CSU on female sexual functioning remains largely unknown. To determine the prevalence of sexual dysfunction in female patients with CSU and to characterize their impairment of sexual functioning and its drivers. Fifty-six female patients with CSU and 55 female aged-matched healthy control subjects were evaluated for sexual functioning with the Female Sexual Function Index. Patients were also assessed for their duration, activity, and control of disease, as well as angioedema, anxiety, depression, fatigue, and quality-of-life impairment. Sexual functioning, that is, total Female Sexual Function Index scores and all subscores, was markedly reduced in female patients with CSU versus control subjects, and 2 of 3 patients (67.9%) had sexual dysfunction. Impaired sexual functioning was linked to high disease activity and poor disease control. Sexual dysfunction was more common in patients with CSU with angioedema and vice versa. Angioedema was a significant predictor of sexual dysfunction in female patients with CSU (odds ratio, 7.3). Reduced sexual functioning was associated with anxiety, depression, and fatigue and significantly linked to impaired quality of life, more so in patients with angioedema as compared with those without. CSU has strong negative effects on female sexual function, especially in patients with angioedema. Additional studies on sexual health in patients with CSU are needed and should focus on the impact of effective treatment on sexual functioning.

The effects of aerobic physical exercises on body image among women with polycystic ovary syndrome

BackgroundBoth physical and mental health care for women with polycystic ovary syndrome (PCOS) require a multidisciplinary approach. We evaluated the effects of continuous (CAT) and intermittent (IAT) aerobic training in different protocols that measure body image, anxiety, depression and sexual dysfunction in women with PCOS. MethodsIn this controlled clinical trial, women with PCOS were randomly allocated for 16 weeks to 1 out of 3 groups: CAT (n = 28), IAT (n = 29), or control group (CG, n = 30). For data collection, we used the Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Measurement Scales (HADS). ResultsNo effects of CAT, IAT or CG groups were identified in the perceptual dimension of body image. The dis(satisfaction) grade improved after exercise in the CAT group (p ≤ 0.01) compared to the CG, as well as improved within CAT and IAT groups. Total FSFI, and HADS-A and HADS-D scores improved after exercise in the both groups. At baseline and after the study period, there were positive correlations between scores for dis(satisfaction), HADS-A and HADS-D scores. HADS-A and HADS-D scores had a negative correlation with FSFI total in the IAT (p = =0.02) group compared to the CG, as well as within CAT and IAT groups. LimitationsThe participants were not matched for body mass index (normal, overweight and obese) which may interfere on body image dimensions. ConclusionAerobic exercise improves sexual function and indices related to anxiety and depression. Likewise, it interferes in cognitive-affective dimension of the body image.

Evaluation of Obesity Influence in the Sexual Function of Postmenopausal Women: A Cross-Sectional Study.

The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0-29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p = 0.028 and p = 0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p < 0.05). The total FSFI score statistically differed among the BMI categories (p = 0.027). In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.

Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women.

ABSTRACTIntroduction and Objective:Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD.Materials and Methods:There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery.Results:Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners.Conclusion:Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.

Association Between Pelvic Floor Muscle Strength and Sexual Function in Postmenopausal Women

IntroductionAlthough pelvic floor muscle (PFM) weakness can be associated with pelvic floor dysfunctions, knowledge about the relationship with sexual dysfunction is limited. AimThe aim of this study was to evaluate the association between PFM strength and sexual function in postmenopausal women. MethodsAn analytical cross-sectional study was conducted on 226 sexually active heterosexual women aged 45−65 years with amenorrhea >12 months and without pelvic floor disorders. The Female Sexual Function Index (FSFI) was used for the evaluation of sexual function (total score ≤26.5 indicating sexual dysfunction). PFM strength was assessed by bidigital vaginal palpation using the modified Oxford scale (score 0−5) and was categorized into nonfunctional (scores 0−1, without contraction) and functional (scores 2−5, with contraction). Three-dimensional transperineal ultrasound was used to evaluate total urogenital hiatus area, transverse and anteroposterior diameters, and levator ani muscle thickness. Main Outcome MeasureThe main outcome measure was to determine the relationship between sexual dysfunction and PFM strength. ResultsThe participants were classified as functional PFM (n = 143) and nonfunctional PFM (n = 83). There were no differences between groups in clinical and anthropometric parameters. A higher percentage of menopausal hormone therapy users was observed in the group with functional PFM (39.2%) compared to the nonfunctional group (24.1%; P = .043). Women classified as functional PFM exhibited greater levator ani muscle thickness than those classified as nonfunctional (P = .049). Women with nonfunctional PFM had poorer sexual function in the desire (P = .005), arousal (P = .001), and orgasm (P = 0.006) domains and in total FSFI score (P = .006) compared to the functional group. There was a weak positive correlation of PFM strength with the desire (r = 0.35; P = .0003), arousal (r = 0.21; P = .013), and orgasm (r = 0.23; P = .033) domains and with total FSFI score (r = 0.28; P = .004). Ultrasonographic levator ani muscle thickness showed a weak positive correlation with PFM strength (r = 0.21; P = .046) and with the arousal domain (r = 0.23; P = .044). Risk analysis adjusted for age, time since menopause, parity, and body mass index showed a lower risk of sexual dysfunction in menopausal hormone therapy users (odds ratio = 0.26; 95% CI 0.11−0.60; P = .002) and in women with greater levator ani muscle thickness (odds ratio = 0.85; 95% CI 0.73−0.98; P = .025). Clinical ImplicationsThe maintenance of PFM strength in the climacteric period is an important factor in postmenopausal women’s sexual function. Strength & LimitationsThe main strength of the study is that, to our knowledge, this is the first study that evaluated the correlation of PFM strength and 3D transperineal ultrasound with different domains of sexual function in postmenopausal women. The main limitation is the cross-sectional design does not permit to establish a cause-effect relationship. ConclusionPostmenopausal women with PFM dysfunction have poorer sexual function than women with functional PFM.Omodei MS, Marques Gomes Delmanto LR, Carvalho-Pessoa E, et al. Association Between Pelvic Floor Muscle Strength and Sexual Function in Postmenopausal Women. J Sex Med 2019;16:1938–1946.

Sexual Functioning in Pregnant Women.

Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish women’s sexual activity during each trimester of pregnancy. A total of 624 women were included in the study and filled in the questionnaire three times, once during each trimester of pregnancy. The first part of the survey included questions about socio-demographic characteristics, obstetric history, and medical details of a given pregnancy. The second part was the Polish version of the female sexual function index (FSFI) questionnaire. Comparison of the mean scores for the overall sexual function of each trimester revealed clinically relevant sexual dysfunction in the second and third trimesters (mean values 25.9 ± 8.7 and 22.7 ± 8.7, respectively; p < 0.01). Women were most sexually active during their second trimester. In the first trimester of pregnancy, women were most likely to choose intercourse in the missionary position. Women with vocational education were characterized by the lowest and homogenous FSFI values. Total FSFI score depended on the martial status—the highest value pertained to married women (25.2 ± 6.9; p = 0.02).

Impact of Bariatric Surgery on Female Sexual Function in Obese Patients: a Meta-Analysis.

We aimed to make a meta-analysis regarding the effect of bariatric surgery on female sexual function. PubMed, EMBASE, and CENTRAL were searched from database inception through August 2019. Articles were eligible for inclusion if they examined the effect of bariatric surgery on obese women's sexual function assessed by the Female Sexual Functioning Index (FSFI) or/and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Twenty articles were included into meta-analysis. Bariatric surgery was associated with significant increase in the total FSFI score. When parameters included in the FSFI scoring system were separately evaluated, significant improvements were observed in sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and sexual pain. However, the PISQ-12 and FSFI scores in women with pelvic floor disorders (PFDs) were not significantly changed postoperatively. Bariatric surgery improves female sexual function in obese patients, but not in women with PFD.

Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence.

IntroductionStress urinary incontinence (SUI) is often associated with female sexual dysfunction. We investigated which pelvic floor muscle (PFM) parameters (strength, power, and endurance) are associated with improvement of sexual function after 8 weeks of transcutaneous electrical stimulation (TES) training.AimThis study was performed to determine the effects of TES in the seated position on PFM parameters and female sexual function and to identify correlation between improved PFM parameters and sexual function after 8 weeks of TES training in women with SUI.MethodsThe present study was performed between August 2018 and November 2018 in women with SUI who were randomized into a TES group (n = 17) or a control group (n = 17). One subject in each of the TES and control groups ultimately withdrew during the intervention due to a lack of time. Both groups were measured at baseline and after 8 weeks of intervention.Main Outcome MeasureAs outcome measures, PFM parameters (strength, power, and endurance) and female sexual function were assessed using a perineometer and the Female Sexual Function Index (FSFI), respectively.ResultsThe final study population consisted of 32 women with SUI. There were significant differences in PFM strength, power, and endurance and FSFI domain scores (desire, arousal, orgasm, satisfaction, and total score) in both between-group analyses (TES vs control group) and within-group analyses (pre-TES vs post-TSE). Change in PFM endurance had the highest association with change in total FSFI total score (r = 0.437; P = .006), and change in PFM power had the highest association with change in FSFI satisfaction (r = 0.420; P = .008).ConclusionTES in a seated position showed a beneficial effect on sexual function in females with SUI. Consideration of PFM parameters associated with FSFI domain scores may be important when developing intervention guidelines to improve female sexual function.Hwang UJ, Lee MS, Jung SH, et al. Pelvic Floor Muscle Parameters Affect Sexual Function After 8 Weeks of Transcutaneous Electrical Stimulation in Women with Stress Urinary Incontinence. Sex Med 2019;7:505–513.

Sexual Quality of Life in Patients with Cervical Cancer Undergoing Radiotherapy

To investigate the sexual quality of life and its influencing factors in patients with cervical cancer undergoing radiotherapy. Methods Totally 205 patients with cervical cancer who received radiotherapy in Peking Union Medical College Hospital from December 2013 to December 2018 were enrolled in this study.The Female Sexual Function Index(FSFI)scale was used to assess the sexual quality of life of these patients.The demographic data(including age,education level,marital status,family status,and occupation)and clinical data(including tumor stage and treatment method)were collected.Mann-Whitney U test and Kruskal-Wallis test were used to analyze the influence of various factors on the sexual quality of life. Results Female sexual dysfunction was common among patients with cervical cancer undergoing radiotherapy.The total FSFI score was 5.5(3.6,16.3),and the scores of subscales were as follows:desire,1.20(0,1.80);sexual arousal,0.90(0,1.80);vaginal lubrication,0.30(0,3.30);orgasm,0(0,2.80);satisfaction,2.40(1.60,3.60);and sexual pain,0(0,2.80).Age(P=0.010),duration of radiotherapy(P=0.008),marital status(P=0.020),family status(P=0.010),and occupation(P=0.024)were influential factors of sexual quality of life in cervical cancer patients undergoing radiotherapy. Conclusions The sexual quality of life of patients with cervical cancer undergoing radiotherapy is affected by multiple factors.Instructions on treatment,mental status,and post-treatment sexual life should be offered in an individualized way to improve the sexual quality of life of these patients.

Bakteriyel vajinoz ve tedavisinin cinsel fonksiyonlar üzerine etkileri: Bir kesitsel anket çalışması

Aim: To investigate the effects of bacterial vaginosis, which is the most frequent vaginal infection in women, and its treatment on sexual functions.Methods: Patients who had applied to our gynecology outpatient clinic with bacterial vaginosis based on the culture results were included in this observational questionnaire study. Patients with an accompanying disease possibly resulting in sexual dysfunction and those with vaginitis etiology other than bacterial vaginosis were excluded from the study. Patients were asked to fill the Female Sexual Function Index (FSFI) during the diagnosis of bacterial vaginosis and 1 month later than the treatment.Results: Seventy-two patients who had applied to our outpatient clinic between January 2018 and January 2019 and who met the study criteria were included in this study. Statistically significant improvement was found in post-treatment orgasm and pain scores and in total FSFI scores of the patients upon comparison of FSFI scores of patients before and after the treatment (p&amp;lt;0.001). However, no statistically significant differences were found in sexual desire, arousal, lubricity and general satisfaction scores before and after the treatment (p&amp;gt;0.05 for all). Conclusion: It was found that sexual dysfunction was more common in patients with bacterial vaginosis and improvement was seen in some sexual functions with treatment.

Evaluation of sexual function and depression in married women with interstitial lung diseases

BackgroundLittle is known about female sexual function and interstitial lung disease (ILD). The purpose of this study was to evaluate sexual function and depression in married women with ILD.Patients and methodsOf the 65 participants enrolled, 45 patients with ILD fulfilled the inclusion criteria, comprising 12 patients with idiopathic pulmonary fibrosis, 25 with connective tissue disease-associated interstitial pneumonias, eight patients with other interstitial pneumonias. Moreover, 20 age-matched normal individuals were recruited as controls. All participants were evaluated for clinical data, including age, BMI, comorbidities, duration of ILD, usage of glucocorticoids (dose and duration), and number of exacerbation within the past year. All women fulfilled the female sexual function index (FSFI) and Beck depression inventory.ResultsThe mean age of the ILD group was 40.4±8.9 years. Overall, 33.3% were hypertensive and 53.3% had pulmonary hypertension, whereas diabetes mellitus and dyslipidemia were found in 26.6 and 15.5%, respectively. The mean duration since diagnosis of ILD and using glucocorticoids was 8.46±2.77 and 9.23±2.31 years. No differences in forced vital capacity and forced expiratory volume in 1 s were observed. There was a significant decrease in mean diffusion capacity (diffusion lung capacity for carbon monoxide) (61.8±7.10 vs. 68.7±6.86%) when compared with control (P=0.000*). Using FSFI, there was a significant decrease in global FSFI score and each domain in patients with ILD as compared with control (P=0.000*). The overall prevalence of depression was 80%. Correlation was found between total FSFI and disease duration, duration of glucocorticoids and dosage (≥20 mg), and depression (Beck depression inventory).ConclusionDespite mild impairment in pulmonary function, female patients with ILD have reported sexual dysfunction and increased depression. Thus, physicians should be reminded that patients with ILD need a comprehensive evaluation for sexual function.

Long-Term Safety and Efficacy of Fractional CO2 Laser Treatment in Post-Menopausal Women with Vaginal Atrophy.

We have previously reported improvement of clinical symptoms of genitourinary syndrome of menopause (GSM) at 3 and 6 months following three CO2 laser treatments. The current paper presents the results of long term follow up at 12, 15- and 18-months post laser treatment. Twenty subjects (mean age 60.65 ± 6.34 years) who had completed the core study participated in follow-up. Subjects were evaluated at 12, 15, and 18 months following final laser therapy. An optional maintenance treatment was offered during Month 12 and Month 15 to those women who failed to increase their Vaginal Health Index Score (VHIS) by more than 34% from their individual baseline, or if the subject desired an additional treatment. At each study visit, VHIS and vulvovaginal atrophy (VVA) symptom severity were recorded. Sexual function was assessed using the Female Sexual Function Index (FSFI). Fifteen subjects were eligible for a single maintenance treatment (N = 2, at 12 months, and N = 13 at 15 Months). The mean VHIS (± standard deviation) remained significantly improved at 12 months following their last laser treatment (16.3 ± 4.5 vs. Baseline 12.4 ± 4.0; p < 0.05) and at the 15- and 18-months follow up visits as well (16.9 ± 4.6 and 17.1 ± 4.6, respectively; p < 0.05 compared to Baseline). Almost all VVA symptoms were significantly improved at 12 months following the third treatment compared to Baseline and this improvement was sustained at 15 and 18 months. At the 12 Months visit, the total FSFI score increased significantly (N = 15, 24.4 ± 6.9; p < 0.05), and at the 15- and 18-month follow-up visits, the total FSFI remained significantly higher than Baseline (22.2 ± 6.7, 25.8 ± 6.6). Fractional CO2 laser treatments are effective in alleviating symptoms of VVA and sexual dysfunction in post-menopausal women, and that effects are sustained over the long-term.

Fractional CO2 laser versus promestriene and lubricant in genitourinary syndrome of menopause: a randomized clinical trial.

The aim of this study was to compare the effects of fractional CO2 laser therapy, promestriene, and vaginal lubricants on genitourinary syndrome treatment and sexual function in postmenopausal women. We performed a randomized clinical trial including 72 postmenopausal women over the age of 50 years. The women were randomized into three intervention groups to receive one of the following treatments: three sessions of intravaginal fractional CO2 laser therapy; 10 mg of intravaginal promestriene cream 3 times a week; and vaginal lubricant application alone. Vaginal maturation, Vaginal Health Index (VHI) score, and Female Sexual Function Index (FSFI) were evaluated at baseline and after 14 weeks of therapy. We observed an improvement in the vaginal elasticity, volume, moisture, and pH in the CO2 laser and promestriene groups. The VHI score at 14 weeks was higher in the CO2 laser group (mean score 18.68) than in the promestriene (15.11) and lubricant (10.44) groups (P < 0.001). Regarding vaginal maturation, basal cells were reduced and superficial cells were increased after treatment. This improvement was more significant in the CO2 laser group (P <0.001). The FSFI score only showed improvement in the desire and lubrication domains in the CO2 laser group. There were no differences in total FSFI score among the three treatment groups. There were no adverse effects associated with any of the treatments. The use of fractional CO2 laser therapy to treat genitourinary syndrome resulted in better short-term effects than those of promestriene or lubricant with respect to improving the vaginal health in postmenopausal women.

Book Review

BackgroundRecently, increasing attention and controversy have focused on whether weight loss can improve female sexual function, so we performed this study to explore this question.MethodsWe searched the PubMed, Embase, and Cochrane Library databases to identify all studied variables; the search terms included “weight loss”, “bariatric surgery”, “no surgery weight loss”, and “female sexual function”. We compared the female sexual function index (FSFI) scores before and after weight loss through bariatric surgery or exercise.ResultsTen studies comprising a total of 494 patients met the inclusion criteria. The data synthesized from these studies indicated that weight loss improved the total FSFI score (p < 0.00001) and the score on some individual items—desire (p < 0.00001); arousal (p = 0.0005); lubrication (p = 0.01); orgasm (p < 0.0001); and satisfaction (p = 0.0004)—but did not ameliorate pain experienced by women during sex (p = 0.18).ConclusionWeight loss through bariatric surgery or exercise is beneficial for sexual function in overweight women, according to the data analyzed from ten studies.

MON-216 Sexual Dysfunction and Eating and Sleeping Disorders in Women with PCOS: A Systematic Review and Meta-Analysis

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting up to 10% of women in the reproductive age. Prior studies indicate PCOS can be associated with increased risk of eating and sleep disorders. Methods: A comprehensive search including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through August 01, 2018 was conducted for studies reporting the prevalence of any eating or sleep disorders in patients with PCOS. Independent reviewers selected studies and extracted data. A random-effects model was utilized to generate pooled odds ratios (OR) and 95% confidence intervals (CI) for binary outcomes, and mean difference (MD) and 95% CI for continuous outcomes. Results: We included 36 studies with 349,529 patients. Compared to women without PCOS, women with PCOS were more likely to have bulimia nervosa (OR 1.37; %CI, 1.17 to 1.60), binge eating (OR 2.95; 95%CI, 1.61 to 5.42), or any eating disorder (OR 1.96; 95% CI 1.18 to 3.24); but not anorexia nervosa (OR 0.92; 95%CI, 0.78 to 1.10). Women with PCOS were more likely to have sleep disorders such as hypersomnia (OR 4.39; %CI, 1.07 to 18.07) and obstructive sleep apnea (OR 10.81; %CI, 2.39 to 48.83). Women with PCOS had lower sexual satisfaction when assessed with a visual analogue scale of 0-100 (MD -29.67; 95% CI, -36.97 to -22.37) but no difference in Total Female Sexual Function Index (FSFI) scale of 0-36 (MD -0.06; 95% CI, -0.51 to 0.38). Conclusion: PCOS can be associated with an increased risk of eating, sleep and sexual satisfaction disorders. Timely screening for these disorders may allow appropriate intervention and mitigation of long term morbidity.

Sexual Dysfunction in Women Treated for Type 1 Diabetes and the Impact of Coexisting Thyroid Disease.

IntroductionMore sexual problems are reported among people treated for diabetes; however, this situation is less explored in women than in men.AimTo analyze the presence and causal links of female sexual dysfunction (FSD) among Czech women treated for type 1 diabetes.Methods40 women completed a national version of the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-revised (FSDS-R), and Beck’s Depression Inventory–II (BDI-II). A metabolic and endocrine analysis was done using blood samples. Data were statistically analyzed using SPSS v.24 and the R environment.Main Outcome MeasuresPatient details (personal information, diabetes-related data, and sex history), sexual performance (the FSFI and FSDS-R scores), and level of depression (the BDI-II score) were measured.ResultsFSD was present in 58% of the participants (based on the FSFI score), and 38% women declared significant sexual distress (according to their FSDS-R score). Even though only 4 women fulfilled the criteria for depression, we observed a strong association between BDI-II and FSFI (for total FSFI score P = .012, ρ = −0.394) resp. FSDS-R scores (P < .001, ρ = 0.552). Although we were not able to establish a clear direct connection between FSD and metabolic control, BDI-II scores were closely correlated with glycosylated hemoglobin (P = .009, ρ = 0.407). The duration of diabetes (based on FSDS-R: P = .046) but neither age nor the presence of chronic diabetic microvascular complications was associated with a higher FSD occurrence. We also observed an association between FSD and the presence of autoimmune hypothyroidism, even when successfully treated (FSDS-R: P = .009; FSFI: P = .067).ConclusionFSD is more common in women with type 1 diabetes than in healthy women, and coexisting thyroid autoimmune disease seems to exacerbate FSD. Women suffering from type 1 diabetes, and particularly those with additional endocrinopathies, should be actively screened for FSD.Stechova K, Mastikova L, Urbaniec K, et al. Sexual Dysfunction in Women Treated for Type 1 Diabetes and the Impact of Coexisting Thyroid Disease. Sex Med 2019;7:217–226.

Female Sexual Dysfunction Among Married Women from the Nile Delta of Egypt

Objectives: Sexuality is an essential part of every woman’s life. Information about female sexuality is scant in Egypt and many other Islamic countries due to cultural barriers. Thus, epidemiological investigations regarding the prevalence and risk factors of female sexual dysfunction (FSD) are limited. We aimed at being the first to assess the prevalence and possible risk factors of FSD among a sample of married Egyptian women from the Nile Delta region in Egypt. Methods: Participants of this cross-sectional descriptive hospital-based study were 5,600 married women 18–59 years’ old attending the Dermatology and Andrology and Family planning outpatient clinic of Benha University Hospitals and/or their relatives. Female Genital Mutilation was assessed using the Female Sexual Function Index (FSFI) questionnaire. Data were analyzed using appropriate methods used for statistical purposes. Results: On evaluating sexual function, desire and orgasm were the most affected domains. Considering the total FSFI score of ≤26.55 was the cutoff value for the diagnosis of FSD, 45.6% of studied participants were suffering from sexual dysfunction versus 54.6 who had normal sexual functioning (p = 0.003). Logistic regression analysis was conducted for prediction of factors associated with sexual dysfunction using age, duration of marriage, education level, residence, and female genital mutilation as covariates. Older age, longer duration of the marriage, lower educational level, female genital mutilation, older male partner age, male erection, and ejaculation problems were associated with sexual dysfunction in univariable and multivariable analyses, respectively. Conclusions: The current study is one of the first attempts to evaluate the prevalence of FSD among married women from the Nile Delta of Egypt. It was revealed that FSD was highly prevalent among studied participants. Combined female participant and male partner factors were significantly associated with the high prevalence of this problem.

Effect of mode of delivery on female sexual function: A cross-sectional study.

A growing body of evidence has suggested a significant impact of mode of delivery on female sexual function. In the present study, we aimed to investigate the effect of mode of delivery on postpartum sexual function. We conducted a cross-sectional study on 684 women during their first year after their first delivery. The sexual function of the included women was assessed using the Arabic version of the Female Sexual Function Index (FSFI). Data analysis was carried out using SPSS version 22 for Microsoft Windows. The present study included 684 primiparous women, in which 320 women had a history of vaginal delivery (VD0 and 364 women had a history of Cesarean section (CS). In terms of FSFI items, women with a history of CS had statistically significant higher FSFI total score than women with VD (31.34 ± 3.8 vs 30.23 ± 3.6, respectively; P < 0.001). Moreover, patients with more than 6 months since birth had a statistically significant higher total FSFI score than patients with less than 6 months since birth (30.97 ± 3.5 vs 29.97 ± 3.5, respectively; P < 0.001). However, the difference was clinically subtle. In addition, women who breastfed their babies had statistically significant lower total FSFI score than women who used artificial methods of lactation (29.61 ± 4.2 vs 30.27 ± 3.3, respectively; P < 0.001). In conclusion, the present study showed that the mode of delivery was not clinically associated with clinical impairment in sexual function within 1 year after delivery, despite the statistically significant difference. It is recommended that the decision to perform CS should not rely on the fear of the risk of postpartum sexual dysfunction.