Types Of Female Sexual Dysfunction Research Articles

(076) IMPACT OF AN ONLINE EDUCATION INTERVENTION ON HEALTHCARE PROVIDERS' SELF-EFFICIENCY FOR ASSESSMENT AND CARE OF CLIENTS EXPERIENCING FEMALE SEXUAL DYSFUNCTION

Abstract Introduction In the United States, nearly half of all women will report having at least one type of female sexual dysfunction at any given point in their lives. Female Sexual Dysfunction (FSD) is defined as a disturbance in sexual desire, psychophysiological changes that characterize the sexual response cycle, and marked sexual distress and interpersonal difficulty. Most women feel their healthcare provider should discuss their sexual concerns, yet few report being asked or screened about their sexual health. Women may seek care to address their sexual health concerns because sexual concerns can affect their quality of life. Objective The specific aim of this study was to evaluate the effectiveness of an online educational intervention about female sexual dysfunction on the knowledge and self-efficacy of healthcare providers. Methods The project is a single-arm effectiveness study that used a pre-test/post-test design, aiming to improve self-efficacy of physicians, physician assistants, nurse practitioners, and certified nurse-midwives who provide gynecological care. Participants were recruited via convenience and snowball sampling. The participants provided demographic and pre-test data before viewing the educational intervention and completed the post-test immediately following. Results Forty-three participants completed responses to the entire questionnaire, including pre and post-test. The majority of participants identified as female (91%), Caucasian (51%), nurse practitioners (81%) providing gynecological care for 6-15 years (53%) and live in the South (58%). Following the intervention, participants demonstrated a significant increase in confidence in their ability to communicate about sex with older adults (p < 0.001, d 0.51) and with those who have differing sexuality from their own (p <0.00, d 0.53). There was an increase in confidence in the knowledge to care for patients with religious/spiritual convictions about sexuality (p < 0.006, d 0.40) and sexual problems related to a medical, pharmacological, or surgical treatment (p < 0.009, d 0.38). Participants reported fewer learning needs following the educational module with a moderate to large effect size across different competencies. Conclusions Educating health care providers using an online educational module may lead to more confidence in the healthcare providers’ communication with, knowledge of, and attitudes related to female sexual concerns. Healthcare providers can provide the necessary support and care for the women they serve by educating themselves to properly obtain sexual health history screening, physical exams, diagnoses, and treatment options. Online educational modules have enhanced healthcare providers' knowledge on various topics. The results of this study can be useful in creating education for healthcare providers in caring for FSD. Further studies are needed to determine the long-term effect of online education modules on the screening of female sexual dysfunction, attitudes and behaviors, effect on the self-efficacy of healthcare providers. Disclosure No.

(177) Female Sexual Dysfunction: Can it be Addressed During Infertility Treatment?

Abstract Introduction Female sexual dysfunction (FSD) is a highly prevalent and distressing condition in the general population. Women undergoing fertility treatments are at even higher risk of developing sexual dysfunction due to sexual activity being perceived as an obligation to conceive versus for pleasure, stress of whether the current act of intercourse will result in conception, and a sense of sexual activity as being part of a demanding medical treatment regimen. Objective The purpose of this review is to investigate currently used interventions and/or treatments of FSD in the settings of infertility treatment. Methods We conducted a systematic review on the current approaches to treat FSD while undergoing fertility treatments. PubMed, PMC and Google Scholar were queried, and results were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria for this review were female subjects undergoing infertility treatment, sexual health was described and measured, interventions were performed or recommended to the subjects with measured outcomes, and the manuscript was written in English between January 2000 to June 2022. Case reports and studies that did not address conditions of interest were excluded from analysis. Results Queries identified 2,341 studies of which title and summary were screened. Fourteen articles met inclusion criteria and underwent full text review. Although multiple studies described an association between infertility and different types of FSD, no study described outcomes for FSD interventions in the infertility setting. Conclusions There is a complete lack of FSD treatment options for infertility patients. Clinicians treating infertility patients should consider discussing FSD and its treatment options in this population. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast, Sprout Pharmaceuticals.

Female sexual health digital resources: women and health care providers need more options.

Female sexual health and female sexual dysfunction (FSD) are usually poorly diagnosed and treated because of the numerous barriers providers and patients face. Internet platforms, such as mobile applications (apps) are potential tools that help overcome these barriers and improve patient access to education and management options for FSD. The aim of this review was to identify existing applications on female sexual health and evaluate their educational content and services. We searched the internet and Apple App Store using multiple keywords. A panel of physicians specialized in the treatment of FSD reviewed the apps for content quality, the scientific basis of provided information, interactivity, usability, and whether they would recommend it as a reference tool for patients. Of the 204 apps identified, 17 met the inclusion criteria and were reviewed further. The selected apps were organized into groups based on common themes such as educational (n = 6), emotions and communication (n = 2), relaxation and meditation (n = 4), general sexual health (n = 2), and social and fun (n = 3). All apps from the educational category provided scientific information in collaboration with health experts. When assessed for usability, 1 app received good and 5 received excellent scores based on the System Usability Scale. Most apps (n = 5) provided information on pathology and treatments of orgasmic dysfunction, but only 1 app, created by a physician, provided comprehensive information on all the types of FSD. Digital technology could be an effective way to overcome barriers to accessing information and ultimately care for female sexual health. Our review demonstrated that there is still a need for more accessible educational resources addressing female sexual health and FSD for patients and providers.

Drug flibanserin–in hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is a widely known type of female sexual dysfunction that could also cause emotional distress and relationship problems. Flibanserin, a benzimidazole, was being studied as a treatment for premenopausal women with hypoactive sexual desire disorder because there was no accurate drug therapy available at the time (HSDD). The US Food and Drug Administration (FDA) approved Flibanserin in 2015 for the treatment of generalised acquired HSDD in premenopausal women. It has a high affinity for postsynaptic 5-HT-1A receptors (agonist) and 5-HT-2A receptors (antagonist), and it tends to work by increasing dopamine and noradrenaline levels in the brain while decreasing serotonin levels. This review was to assess Flibanserin efficacy and safety and it is found the drug Flibanserin benefits did not outweigh the risks in premenopausal and postmenopausal women.

Female Sexual Dysfunction After Pelvic Fracture: A Comprehensive Review of the Literature

BackgroundFemale sexual dysfunction (FSD) after pelvic fracture (PFx) has garnered little attention in the urology literature. AimTo review and summarize the current evidence regarding female PFx-related sexual function. MethodsWe performed a systematic review in accordance with PRISMA guidelines, including PubMed, EMBASE, and MEDLINE. We included only English-language manuscripts and abstracts with sufficient data for inclusion. We used the search terms “female sexual dysfunction AND pelvic fracture,” “sexual dysfunction AND pelvic fracture,” and “female pelvic fracture AND sexual dysfunction.” A total of 177 articles were identified; 41 abstracts were reviewed; of which, 19 manuscripts were reviewed. Fifteen met inclusion criteria for analysis. OutcomesThe main outcome measures of this study are rates and types of female sexual dysfunction after pelvic fracture. ResultsFSD is prevalent after PFx, with reported rates between 25% and 62%. Three studies used the validated Female Sexual Function Index. The other 12 used non-validated questionnaires or adapted quality-of-life questionnaires with specific questions regarding FSD. The most common complaints include difficulty with intercourse, dyspareunia, orgasmic dysfunction, genitourinary pain, decreased interest in intercourse, decreased satisfaction with intercourse, and pelvic floor dysfunction. Only 1 study addressed resolution of dysfunction (30 of 98 patients [30.4%]). Clinical ImplicationsFSD is prevalent and an under-recognized sequela of pelvic fracture. This requires future prospective study to better characterize sexual dysfunction and identify effective treatments in trauma survivors. Strength and LimitationsTo Increase awareness of FSD after pelvic trauma and the impact on the quality of life in trauma survivors. The current literature is limited by a lack of standardized assessment of FSD, limited follow-up, and minimal discussion of treatment options, in addition to the inherent bias of retrospective studies. ConclusionsFSD after traumatic PFx is not uncommon, occurs mostly in young women, and can be morbid. FSD after PFx is underreported in the urology literature. Thus, all female PFx patients should be screened for FSD by validated questionnaires. The published literature offers little knowledge as to the epidemiology, evaluation, definition, and potential treatments of FSD after PFx. Prospective studies are needed to better understand female sexual function in trauma survivors and the potential methods for prevention and rehabilitation, all within the context of a multidisciplinary approach.Walton AB, Leinwand GZ, Raheem O, et al. Female Sexual Dysfunction After Pelvic Fracture: A Comprehensive Review of the Literature. J Sex Med 2021;XX:XXX–XXX.

Female Sexual Dysfunction and Schizophrenia: A Clinical Review

Female sexual dysfunction (FSD) is understudied and unexplored in clinical practice. There is a need for psychiatrists to acknowledge the same and explore this symptom in patients with schizophrenia. The following article is a clinical review that looks at various facets of FSD in relation to schizophrenia. The various types of FSD seen in schizophrenia are elaborated and factors that affect the same are discussed. The role of various factors and antipsychotic-induced FSD is also discussed. The role of estrogens in women with schizophrenia from a clinical and sexual perspective, the role of oral contraceptives in schizophrenia, schizophrenia and pregnancy related complications along with menopause, and its effect on schizophrenia and sexual function in these patients are discussed. The neurobiology of FSD is explored briefly along with the role of female sexuality in recovery and enhancing outcome in schizophrenia is also elaborated. The victimization of female patients with schizophrenia and future research needs in FSD in schizophrenia are laid out.

2129 Let’s talk about sex: Does language create a barrier to women reporting and receiving treatment for dyspareunia in the Spanish-speaking community?

OBJECTIVES/SPECIFIC AIMS: Dyspareunia is a type of female sexual dysfunction estimated to affect 8%–22% of women of all ages. There is concern that these statistics do not depict the true prevalence, because it frequently goes undiagnosed and untreated. By 2050, Latinos will make up 30% of the total population in the United States. As our patient population becomes more diverse, we need to ensure that our healthcare practices accommodate the changes. Our goals are to determine the prevalence of dyspareunia within our patient population and to identify if language impacts patients reporting symptoms of sexual dysfunction to their healthcare provider. METHODS/STUDY POPULATION: Our study is a convenience sample, cross-sectional survey of English and Spanish-speaking women, ages 18–45, who present to university-affiliated clinics. In total, 100 women from each language group will be studied. The survey will be completed in REDCap and will include the validated questionnaires for the Female Sexual Function Index (FSFI), Visual Analog Scales for pain, and Patient Global Impression of Severity and Improvement. Additional data on demographics and patient discussion of pain with their healthcare provider will be collected. RESULTS/ANTICIPATED RESULTS: The demographic and pain discussion questions will identify reporting rates. The FSFI score will be used to identify patients with sexual dysfunction and dyspareunia and calculate the prevalence in each language group. The domains will be analyzed to assess variations between populations. DISCUSSION/SIGNIFICANCE OF IMPACT: Dyspareunia has a great impact on patients’ quality of life when untreated. This study will allow us to identify barriers to diagnosing and treating cases of dyspareunia. If we detect differences in reporting rates between the language groups, future research could be tailored and conducted to identify the specific problems in communication. With this knowledge, we can improve how we discuss sexual health in clinic and ultimately improve quality of care for all patients.

Subclinical hypothyroidism would not lead to female sexual dysfunction in Chinese women

BackgroundThere is dearth of research about female sexual dysfunction (FSD), especially in China, because of conservative beliefs. Previous studies indicated the relationship between subclinical hypothyroidism and anxiety and depression. However, there is dearth of research regarding the relationship between subclinical hypothyroidism and FSD in Chinses women.MethodA hospital-based research was conducted. Female sexual function was measured by CVFSFI which includes 19 items. Participants were identified as FSD if CVFSFI ≤ 23.45. Logistics analysis was used to determine risk factor of FSD. All of them finished CVFSFI, Beck Depression Inventory (BDI) self-reporting questionnaires and had thyroid hormone tests. Based on presence and absence of subclinical hypothyroidism, participants were divided into two groups. Risk factors of FSD were identified.ResultOne thousand one hundred nineteen participants with CVFSFI score 25.8 ± 3.9 were enrolled in final analysis. Incidence of subclinical hypothyroidism and FSD in Chinese women was 15.0% and 26.5% respectively. There were no significant difference between subclinical hypothyroidism and control group in FSFI score and prevalence of FSD. Age, Depression (medium risk) was identified as risk factors for nearly all types of FSD, and Income (ranges from 40,000 to 100,000 RMB/year) as protective factor. Subclinical hypothyroidism had no significant relationship with FSD.ConclusionSubclinical hypothyroidism is not the risk factor for FSD in urban women of China.

Female Sexual Dysfunction among Contraceptive User in Malaysia

Background: Women in reproductive age are at risk of getting female sexual dysfunction (FSD). Contraception has been recognized as one of the causes of FSD. This study aims to determine the prevalence of FSD and types of FSD among contraceptive user. Methods: This is a cross-sectional study involving 262 women who were on contraception in eleven primary care clinics in Malaysia. Malay version of Female Sexual Function Index (MVFSFI) was used in this study. Results: The prevalence of FSD among contraceptive user in Malaysia was 9.5% (n=25). The highest types of female sexual dysfunction in this study were sexual dissatisfaction (29.8%, n=78) and sexual desire disorder (29.4%, n=77). Majority of the participants were Malay (83.6%). Of twenty-five women with FSD, one-third of them was Indian ethnic. Most of the women (11.2%) with FSD had received education up to secondary school and non- employed (11.6%). Twenty-two (9.9%) women with FSD were practising hormonal contraception and most of them were dissatisfied with their marital relationship (35.7%, n=5). Conclusions: The result indicates that one in ten contraceptive users had FSD. The highest percentage of female sexual dysfunction domain was sexual dissatisfaction and sexual desire disorder. Hormonal contraception was the most common method used among women with FSD. Further research is needed to determine the associated factor of female sexual dysfunction among women using contraception.

Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index: an internet-based survey

Objectives: Female sexual dysfunction (FSD) is a very common sexual health problem worldwide. The prevalence of FSD in Chinese women is, however, unknown. This is the first study to investigate a large number of young women throughout China via the internet, to determine the prevalence and types of FSD and to identify the risk factors for FSD. Methods: The primary endpoint was the Female Sexual Function Index (FSFI) score, with additional questions on contraception, sexual activity, relationship stability, pregnancy and other factors which may influence sexual function. The online questionnaire was completed by women from 31 of the 34 Chinese provinces. Results: A total of 1618 completed questionnaires were received, and 1010 were included in the analyses after screening (62.4%). The mean age of the respondents was 25.1 ± 4.5 years. The mean total FSFI score was 24.99 ± 4.60. According to FSFI definitions (cut-off score 26.55), 60.2% of women were at risk of FSD. Based on domain scores, 52 were considered at high risk of dysfunction for pain (5.1%), 35 for orgasm (3.5%), 33 for desire (3.3%), 20 for arousal (2.0%), 6 for satisfaction (0.6%) and 2 for lubrication (0.2%). Conclusions: The prevalence of FSFI scores indicating risk of sexual dysfunction was about 60% in Chinese women. An unstable relationship, pressure to become pregnant, non-use of contraception, negative self-evaluation of appearance and increasing age were significantly associated with FSD in young Chinese women.

Prevalence and types of female sexual dysfunction of perimenopausal women in China assessed by validated scores

The questionnaires were available in both paper-based and electronic form and comprised demographic data; health data including, climacteric symptoms, bone health, pelvic floor, sexuality and medication use. It was used for data collection Questionnaire MUMENESP and Women Sexual Function validated in Spanish. The study was carried out at the outpatient clinics of the departments of gynecology of public and private institutions throughout Spain in the routine clinical setting. Results:

Female sexual dysfunction.

Female sexual dysfunction is a common patient concern. After providing an overview regarding the various types of female sexual dysfunction, we will focus on history taking and treatment options for desire, arousal, orgasm, and pain disorders. Testosterone therapy and management of selective serotonin reuptake inhibitor-associated sexual dysfunction are reviewed. Treatments for atrophic vaginitis are appraised. Patient cases lead the discussion, providing the reader with clinically relevant information.

Do gynecologists talk about sexual dysfunction with their patients?

Female sexual problems and dysfunctions have a high prevalence, ranging from 12% to 80%, depending on the definition being used, underlying comorbidities, and age. Despite the high prevalence, there are only scarce data about the approach gynecologists use to address female sexual dysfunction. The aim of this study is to evaluate the approach of Swiss gynecologists to addressing sexual problems among their outpatients. After a pilot study including 56 physicians, a modified 19-item self-administered questionnaire was sent to 856 Swiss gynecologists to evaluate their methods of management of patients with sexual issues and their attitudes regarding the integration of sexual health issues into the gynecological consultation. Besides demographic information, the self-administered questionnaire included questions about addressing sexual health as part of consultation routine, estimated frequency of symptoms, reasons for not addressing sexuality, clinical conditions in which sexuality was addressed, and methods of management of sexual problems. Of the 341 responding gynecologists (39.8% response rate), 40.4% reported having at least brief (at least 1-2 days) of training in sexual medicine, 7.9% of the respondents routinely explored sexual issues with more than 80% of their patients, 28.2% of the respondents offered appointments specifically for sexual issues, and 85% proposed referrals to specialized colleagues. Lack of motivation for therapy on the part of the patient was mentioned as the most common cause for persisting symptoms (63.3%). Dyspareunia was quoted as the most/second most prevalent type of female sexual dysfunction by 77.1% of the respondents. We conclude that among Swiss gynecologists, sexual problems are regarded as an important issue in gynecological outpatient care, but addressing patients' sexuality is not yet part of routine practice. Swiss gynecologists seem to be most likely to consider hormonal changes (although not so much those due to oral contraceptives) to necessitate discussion of sexual health issues, while psychosocial transitions or stress seem to be considered less important.

Current Literature Review

Female sexual problems and dysfunctions have a high prevalence, ranging from 12% to 80%, depending on the definition being used, underlying comorbidities, and age. Despite the high prevalence, there are only scarce data about the approach gynecologists use to address female sexual dysfunction.The aim of this study is to evaluate the approach of Swiss gynecologists to addressing sexual problems among their outpatients.After a pilot study including 56 physicians, a modified 19‐item self‐administered questionnaire was sent to 856 Swiss gynecologists to evaluate their methods of management of patients with sexual issues and their attitudes regarding the integration of sexual health issues into the gynecological consultation.Besides demographic information, the self‐administered questionnaire included questions about addressing sexual health as part of consultation routine, estimated frequency of symptoms, reasons for not addressing sexuality, clinical conditions in which sexuality was addressed, and methods of management of sexual problems.Of the 341 responding gynecologists (39.8% response rate), 40.4% reported having at least brief (at least 1–2 days) of training in sexual medicine, 7.9% of the respondents routinely explored sexual issues with more than 80% of their patients, 28.2% of the respondents offered appointments specifically for sexual issues, and 85% proposed referrals to specialized colleagues. Lack of motivation for therapy on the part of the patient was mentioned as the most common cause for persisting symptoms (63.3%). Dyspareunia was quoted as the most/second most prevalent type of female sexual dysfunction by 77.1% of the respondents.We conclude that among Swiss gynecologists, sexual problems are regarded as an important issue in gynecological outpatient care, but addressing patients' sexuality is not yet part of routine practice. Swiss gynecologists seem to be most likely to consider hormonal changes (although not so much those due to oral contraceptives) to necessitate discussion of sexual health issues, while psychosocial transitions or stress seem to be considered less important. Kottmel A, Ruether‐Wolf KV, and Bitzer J. Do gynecologists talk about sexual dysfunction with their patients? J Sex Med 2014;11;2048–2054.

Psychometric Properties of the Iranian Version of the Female Sexual Distress Scale-Revised in Women

Several tools for the assessment of sexuality-related distress are now available. The Female Sexual Distress Scale (FSDS) and its revised version (FSDS-R) are extensively validated and among the most widely used tools to measure sexually related personal distress. The aim of the study was to determine the psychometric properties of the Iranian version of the FSDS-R in a population sample of Iranian women. A total of 2,400 married and potentially sexually active women were recruited and categorized into three groups including (i) a healthy control group; (ii) a group of women with hypoactive sexual desire disorder (HSDD); and (iii) a group of women suffering from other female sexual dysfunction (FSD). Participants were asked to complete a set of questionnaires including the Iranian version of the Female Sexual Function Index (FSFI-IV), the FSDS-R, and the Hospital Anxiety and Depression Scale. Sexuality-related distress and FSD as assessed by the Iranian version of the FSDS-R and the FSFI-IV are the main outcome measures. Internal consistencies and test-retest reliability of the FSDS-R across the three assessments points for the three groups were >0.70. The FSDS-R correlated significantly with anxiety, depression, and the FSFI total score. Significant differences in the FSDS-R scores were found between healthy women, women with HSDD, and women with other types of FSD. Factor analysis of the FSDS-R yielded a single-factor model with an acceptable fit. The Persian version of the FSDS-R is a valid and reliable instrument for the assessment of sexuality-related distress in Iranian women and can be used to screen patients with HSDD.

Impact of Breast Cancer Treatment on Female Sexual Function: A Systematic Review

INTRODUCTION: Breast cancer (BC) is the most common cancer in women worldwide and, nowadays, advances in BC screening and treatments have led to increasing rates of survival. This factor leads to a special concern about this women’s quality of life and among them, the sexuality. Sexual changes can become the most problematic aspect of a woman’s life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The aim of this study was to identify the most common type of female sexual dysfunction (FSD) after the treatment for BC. METHODS: It was performed a systematic review of studies published in the literature until July 2012 in the following database: MEDLINE, Pubmed, SciELO e Lilacs. It was used as used the descriptor: “breast cancer” associated with the following: “sexual dysfunction”, “sexual function” and “sexuality”. It were included studies which evaluated quantitatively the sexual dysfunction presence after BC treatment. It was considered sexual dysfunctions: disorders of desire, lubrication, arousal, orgasm and the presence of pain during the sexual intercourse. The exclusion criteria were narrative review, editorials, case studies and qualitative researches, because there is no objective data, making its compilation impossible. One researcher performed the studies search and two researchers, independently, evaluated the articles to be analyzed by means of structured guide with the following items: 1) sample characterizes, 2) type of treatment for BC and 3) method used to evaluate female sexual function. RESULTS: By reading the title, were chosen for inclusion in 97 articles, of which 85 were excluded after reading the abstract and another 2 were excluded after reading the entire article. It was included 10 studies which evaluated a total of 8. 465 women. The most frequent treatment for BC were: chemotherapy (100%), surgeries for BC (100%) and radiotherapy (83%). The most frequent sexual dysfunction were: decrease of desire/sexual interest (66%), difficulty in lubrication (50%), lack of arousal (33%) and pain during the sexual intercourse (11%). Other associated symptoms were described as fatigue, insomnia, physical problems, lack of satisfaction, shortness of intercourse, feeling less attractive, partner lack of understanding about their feelings and concern about partner desire/interest. DISCUSSION: in a recent study it was questioned the assessment of sexual function during a routine visits. The evidence showed that this theme approach increases the FSD diagnostic capability and improves access to treatment. Due to the high prevalence of these disorders in women who underwent treatment of BC and the various non-hormonal treatment options, it is important to underscore the tackling of this issue by Breast Cancer Specialist and/or Oncologist during consultation and forward for treatment when necessary. CONCLUSION: The FSD were identified as hypoactive sexual desire, lubrication difficult and lack of arousal. The studies demonstrated that the various treatment of BC negatively impact female sexual function.

Actualización sobre el trastorno del deseo sexual hipoactivo femenino

Hypoactive sexual desire disorder (HSDD) is the most common type of female sexual dysfunction (FSD). A diagnosis of HSDD requires evidence of personal distress or interpersonal difficulty associated with low sexual desire that cannot be better accounted for by another psychiatric condition and is not due exclusively to a medical condition or substance. HSDD can have a major impact on women's emotional wellbeing and relationships and occurs in both pre- and post-menopausal women. Until recently, diagnosis of HSDD required an extensive diagnostic interview conducted by a clinician with experience in the diagnosis of FSD. The decreased sexual desire screener (DSDS) is a brief diagnostic instrument that has been developed to aid clinicians who are not experts in FSD to diagnose generalized acquired HSDD in women. There is a need for greater understanding of the etiology of HSDD and for more therapeutic options.

Hormone Replacement Therapy in Female Sexual Dysfunction

Female sexual function is highly complex and deeply influenced by hormonal and non-hormonal factors. As sexual dysfunction becomes a common and important problem for women of all ages with related quality of life issues, we need to understand more about the effect of sex steroid hormones in female sexual function. However, there are limited data about the correlation between the value of sex steroid hormonestestosterone, in particular-and female sexual function. In a certain type of female sexual dysfunction (FSD), hypoactive sexual desire disorder, for example, there is evidence that treatment with androgens or with estrogens is effective. To widen the therapeutic options of hormone replacement therapy in FSD, further research is needed as to the benefits and risks of hormonal treatments in both preand post-menopausal women. Although important unanswered questions still exist in hormonal treatment of FSD, new therapeutic strategies are being studied and many ongoing clinical trials are expecting favorable results leading to more successful treatment of FSD. 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

EDiary and Female Sexual Distress Scale© in Evaluating Distress in Hypoactive Sexual Desire Disorder (HSDD)

Sex-related distress is integral to the diagnosis of hypoactive sexual desire disorder (HSDD). This article describes the results of three prospective, non-treatment validation studies (two North American and one European), each testing over 200 participants with HSDD, other types of female sexual dysfunction (FSD), or no FSD in which the 12-item Female Sexual Distress Scale© (FSDS©), the 13-item FSDS–Revised©(FSDS–R©), and a single question asked using a daily electronic diary (the eDiary For HSDD Trials©; eDiary) were used to measure sex-related distress. FSDS results with 30- and seven-day recall were equivalent. The results observed with FSDS–R Item 13 (a single question assessing concern due to low sexual desire) were comparable to the FSDS. Mean eDiary monthly distress scores were closer to the minimum possible score (equivalent to “a little bit” of distress) and were about twice as variable as FSDS or FSDS–R Item 13 scores in participants with HSDD. All three measures confirmed that there is more distress in women with HSDD compared to women with no sexual dysfunction at all time points, demonstrating discriminant validity.

Prevalence of Sexual Dysfunction and Impact of Contraception in Female German Medical Students

Female sexual dysfunction (FSD) is a very common disorder, with an estimated prevalence of having at least one sexual dysfunction of about 40%. To investigate the prevalence and types of FSD and the relationship between hormonal contraception (HC) and FSD in female German medical students. Female Sexual Function Index (FSFI) with additional questions on contraception, sexual activity, and other factors that may influence sexual function. An online questionnaire based on the FSFI was completed by students from six medical schools. Obtained data were screened for inconsistencies by programmed algorithms. A total of 1,219 completed questionnaires were received, and 1,086 were included in the analyses after screening. The mean total FSFI score was 28.6 +/- 4.5. 32.4% of women were at risk for FSD according to FSFI definitions. Based on domain scores, 8.7% for were at risk for FSD concerning orgasm, 5.8% for desire, 2.6% for satisfaction, 1.2% for lubrication, 1.1% for pain and 1.0% for arousal. The method of contraception and smoking were factors with significant effect on the total FSFI score whereby hormonal contraception was associated with lower total FSFI scores and lower desire and arousal scores than no contraception and non-hormonal contraception only. Other variables such as stress, pregnancy, smoking, relationship and wish for children had an important impact on sexual function as expected according to earlier studies. The prevalence of students at high risk for FSD was consistent with the literature although domain subscores differed from samples previously described. The contraception method has a significant effect on the sexual functioning score and women using contraception, especially hormonal contraception, had lower sexual functioning scores. Stress and relationship among other variables were found to be associated with sexual function and may thus provide insight into the etiology of sexual disorders.