Women's Sexuality Research Articles

Diabetes complications and sexual health: Addressing them without taboos

In France, 1.5 million women live with diabetes. This chronic metabolic disease disrupts every aspect of the lives of sufferers, right down to the most intimate. The impact of diabetes on women's sexuality is less well documented than for men. Yet a holistic approach to the management of the disease is essential to provide quality care.

The Social Reality of Meaning Making: The Dichotomy in the Illness Narratives of Women With Breast Cancer and Biomedical Practitioners in Nigeria.

Despite the increasing burden of breast cancer in the developing world, there is a misunderstanding of the complex and multifaceted relationship between culture and cancer, particularly breast cancer. Hence, a dichotomy of illness narratives exists due to differential meaning making concerning breast cancer. While clinicians always recommend biomedical treatment, women with breast cancer often seek alternative treatment pathways. To explore the experiences of women with breast cancer and clinicians in Nigeria on the dichotomy in the illness narratives. This qualitative study used in-depth interviews and focus group discussion to explore the experiences of 22 women with breast cancer and 7 clinicians in Nigeria on the dichotomy in the illness narratives using grounded theory method analysis. This study revealed that many women living with breast cancer (WLBC) hold health beliefs that are contradictory to the biomedical norm. They mostly sought treatment based on the perceived aetiology of breast cancer. The treatment pathway follows faith and traditional healing as alternatives or sometimes in combination with biomedicine. WLBC reported a constant fear of biomedical treatment, perceived to be harmful to women's sexuality, fertility and body image. Hence, after perceived treatment failure from alternative care, biomedical care becomes the last resort, usually at an advanced stage of breast cancer, often responsible for poor prognosis. There is a dichotomy of illness construction between sufferers and health practitioners. To guide women with breast cancer on the path of care, modern care practitioners should consider some cultural norms and practices without compromising professional ethos.

Diabetes mellitus and female sexual response: what do animal models tell us?

One of the less explored effects of diabetes mellitus (DM) is female sexual dysfunction. Females of different species have been used as models. To analyze the information of animal models of DM and female sexual response (FSR). The literature of FSR in models of DM was reviewed. Paradigm- and diabetes-dependent changes have been found in various aspects of the FSR. Females in a type 1 DM (DM1) model show a decrease in the number of proestrus events, and ovariectomized females treated with sex hormones have been used. In these females, a reduction in lordosis has been reported; in proceptivity, the data are contradictory. These females present a decrease in sexual motivation that was restored after exogenous insulin. In the type 2 DM (DM2) model, females show regular estrous cycles, normal levels of lordosis behavior, and, depending on the paradigm, decreased proceptivity. These females display normal preference for sexually active males or their olfactory cues when having free physical contact; they lose this preference when tested in paradigms where physical interaction is precluded. Preclinical data showing the high deleterious effects of a DM1 model and the less drastic effects under a DM2 model are in accordance with clinical data revealing a much higher prevalence of sexual dysfunction in women with DM1 than DM2. The main strength is the analysis of the changes in various components of FSR in 2 models of DM. The main limitation is the difficulty in extrapolating the data on FSR from rats to women and that most studies focus on evaluating the impact of severe or chronic-moderate hyperglycemia/hyperinsulinemia on the sexual response, without considering other pathophysiologic alterations generated by DM. Females with severe hyperglycemia have a decrease in FSR, while those with moderate hyperglycemia show much less drastic effects.

The impact of gynecologic cancer on female sexuality in Europe and MENA (Middle East and North Africa): a literature review.

Gynecologic cancer has a negative impact on the sexuality of women who are or have been affected by this disease. In fact, gynecologic cancers cause negative changes in female sexuality, affecting body image and psychophysical well-being, with serious consequences for women's sex lives. The aim of this study is to analyze the differences in sexuality among women who have or have had gynecologic cancer in Europe and in the Middle East and North Africa (MENA). We also explored possible factors that may influence women's sexuality in the 2 populations compared. The literature search was carried out using PubMed and Google Scholar, considering the 10-year period of 2013 to 2023. Studies were initially selected according to the criterion that the title and abstract were in English. We then reviewed all the articles selected in the first phase and analyzed the following information: author, year of publication, type of gynecologic cancer, country in which the study was conducted, design, and materials used. Finally, we defined the inclusion criteria for the present paper: women 18years of age or older, diagnosed with gynecologic cancer, and who had undergone treatment (surgery, chemotherapy, radiotherapy). The studies reviewed were conducted between 2013 and 2023 in Europe and MENA, and all analyzed sexual function after the disease, understood as a general dimension that includes physiological and psychological aspects. The results of this research show that patients in both geographical areas (Europe and MENA) report changes in sexuality as a result of the cancer. Studies show that cancer reduces, interrupts, and impairs women's sexual activity, resulting in experiences of discomfort, anxiety, guilt, inadequacy, pain, and poorer quality of life. The data analyzed in this review show that cancer causes changes and deterioration in sexuality in both populations studied. No cultural or social factors were found to cause differences between the variables studied in the 2 populations. In the future, it may be interesting to carry out further studies to improve the treatment of women with gynecologic cancer, as sexuality is a very important part of a person's life.

Effects of double neonatal stress on female rat sexual behaviour

Neonatal stress affects psychological and physiological development and may be associated with affective disorders. The aim was to examine the effects of double neonatal stress (DNS) – a combination of limited bedding and nesting (LBN) and repeated maternal separation (MS) – on the oestrous cycle and sexual behaviour of adult female rats. LBN was achieved by removing part of the wood shavings from the boxes. In the control group, each box was lined with 100 g of wood shavings, while in the experimental group there were only 10 g of wood shavings. MS was performed from P1 (P0 = day of birth) to P15. At P90, the sexual response of females in oestrus was evaluated. Statistical analysis was performed using two-way analysis of variance followed by Tukey's test. The size and profile of the oestrous cycle and the sexual behaviour of female rats submitted to the DNS were considered, as well as the influence of female behaviour on the sexual response of male rats. Female rats submitted to DNS showed a reduction in the lordosis quotient, suggesting a reduction in female receptivity. These rats also showed a reduction in the number of hops and darts, the number of ear wiggles, and the genital exploration time rate, suggesting a reduction in proceptivity. The males that interacted with the females of the DNS group showed a reduction in intromission ratio. Experimental model that mimics neonatal factors that affect adult female sexual response will allow more effective interventions to prevent and treat such changes. In addition, analysis of the female sexual response makes it possible to assess the general state of health and quality of life. In female rats, DNS exerted inhibitory effects on sexual behaviour. LBN was probably the most important factor. In conclusion, combating childhood poverty can be a key measure to prevent problems in the sex life of adults and improve overall health.

Endometriosis affects natural and ART fertility in different ways: let's look at the whole patient and not at the single lesion

When considering the typical lesions associated with endometriosis, such as endometriomas, and pelvic adherences involving the tubes, it is very clear how this pathology may impair both natural and assisted reproductive technology (ART) fertility. It may be more difficult for clinicians to recognize that endometriosis can reduce female fertility potential through other mechanisms which may be independent of direct damage to ovarian reserve and tubal function. The most recent clinical studies have shown that endometriosis is associated with increased risk of infertility, independent of the type of endometriosis (ovarian, peritoneal and deep endometriosis). In the IVF setting, the cumulative live birth rate in women with endometriosis has been reported to be significantly lower compared with women without endometriosis. Endometriosis is a complex, multifactorial condition that encompasses not only the presence of endometriotic lesions, but also involves women's sexuality, uterine and ovarian compartment. Endometriosis should always be considered a severe risk factor for infertility and ART failure.

Sexuality & Mental Health: Sexual Responses of Young Blind Females Experienci A Romantic Relationship

The study presented herein delves into the sexual responses of young blind females involved in romantic relationships. More specifically, it focuses on the four stages of sexual response—Excitement/Arousal Response, Plateau Response, Orgasm Response, and Resolution Response—within the context of mental health. The primary objective of this research endeavor is to garner insights into the navigation and response of these individuals to sexual experiences within the framework of romantic relationships, as well as to comprehend the impact of said experiences on their mental well-being. To achieve this objective, a qualitative exploratory approach was employed, with the participants being seven adolescent blind females ranging in age from 16 to 19 years old. It is noteworthy that these individuals were interviewed at a specialized school for the visually impaired in West Java. The findings unveiled that sensory experiences, communication with partners, and societal misconceptions significantly influence the sexual response experiences of young Blind females, which in turn are intertwined with their mental well-being. This research aims to understand how young blind women's sexuality and mental health intersect in romantic relationships.

(066) EXPLORING THE IMPACT OF ALCOHOL ON SEXUAL FUNCTION IN PERIMENOPAUSAL WOMEN

Abstract Introduction Sexual well-being is an important quality of life component to women throughout life, and during menopausal transition and beyond. Female sexual response cycle includes desire, arousal, orgasm, and resolution phases. Female sexual dysfunction (FSD) encompasses all phases of sexual response cycle and can lead to distress for both the woman and her partner and warrant further investigation. Research has indicated both positive and negative associations between alcohol consumption and sexual health, our review goal is to further explore the relationship between alcohol consumption and sexual function in perimenopausal women. Objective We aim to review the current literature regarding the influence of alcohol use on sexual health during the menopausal transition and beyond. Methods The examination of alcohol consumption and its effects on sexual health in menopausal women was performed through reviewing existing literature. The literature search was completed in the Ovid MEDLINE database (1946- Present) in August 2023. 16 articles were identified in the initial search. 12 articles met our inclusion criteria and were independently reviewed by the authors. Results from these articles were summarized. The search was limited to the English language and the last 20 years (2003-current). Keywords included: menopause, pre-menopause, post menopause, perimenopause, alcohol use, alcohol related disorder, and sexual function. Results Seven out of 16 articles reviewed linked a negative association between alcohol consumption and female sexual function. Seven indicated a positive association between alcohol use and sexual function and 2 articles did not reveal an association. The findings of our review indicate a complex relationship of alcohol on women's sexual function. Studies indicating a positive association between mild alcohol consumption (equal or less than 0.21 FL oz. alcohol/day) and improved sexual function. This effect was theorized due to alcohol increasing endogenous estrogen or due to behavioral changes such as disinhibition, influencing sexual activities influenced by alcohol or subjective arousal due to drinking. Additionally, a positive association was seen between increased alcohol consumption and Female Sexual Function Index (FSFI) scores. However no significant influence on Female Sexual Distress Scale scoring was identified which is a key component to FSD. Other studies showed that excessive or prolonged alcohol consumption (more than 1.00 FL oz. alcohol per day) found to be associated with worsening sexual function and can impact all 6 domains on the FSFI (which include: desire, arousal, lubrication, orgasm, satisfaction, and pain) even after abstinence. These findings were reflected in another study that showed women (however not exclusively menopausal) who were seeking treatment for alcohol dependency diagnosis experienced low sexual desire, inability to achieve orgasm and less satisfaction. Initiating alcohol consumption at a younger age, along with an extended and more intense period of dependency, was correlated with a higher likelihood of experiencing increased sexual dysfunction. A meta-Analysis of 7 studies showed increased odds of sexual dysfunction with alcohol consumption. Another study showed that moderate alcohol consumption was found to be an independent risk factor for FSD and Genitourinary syndrome of menopause (GSM) which can lead to FSD. Conclusions The impact of alcohol on sexual health in postmenopausal women is multifaceted, based on varying levels of consumption influencing various aspects of sexual function. This relationship can also be influenced by other factors such as pre-existing sexual problems and the utilization of alcohol as a coping mechanism to reduce anxiety, release stress or to increase sexual behavior through enhancing arousal. A study indicated that menopausal symptoms may trigger a craving for alcohol, leading to increased alcohol consumption. Further research is essential to elucidate the direct and indirect effects of alcohol consumption on sexual dysfunction. In addition, the impact of abstinence from alcohol on sexual dysfunction in postmenopausal women needs to be further explored. Understanding the impact of alcohol consumption on sexual function of postmenopausal women is critical for healthcare professionals, to provide appropriate guidance and interventions. These findings highlight the need for further research and increased awareness regarding the impact of alcohol use on sexual health during in pre-menopausal, peri and postmenopausal women. Disclosure No.

(071) IMPROVING TRAINEE COMFORT IN ASSESSMENT AND MANAGEMENT OF FEMALE SEXUAL HEALTH AND MENOPAUSE THROUGH AN INTERACTIVE WORKSHOP

Abstract Introduction Concerns related to female sexual health and menopause are common in clinical practice, but these topics are often inadequately covered during training. Many medical schools and residency programs lack a formal curriculum, and trainees in internal medicine, family medicine, and obstetrics and gynecology often graduate feeling uncertain in their management of these conditions. Objective Improve resident comfort with assessment and management of female sexual health and menopause through an interactive workshop. Methods We created a 90-minute, interactive workshop focused on female sexual health and menopause. Residents in internal medicine at a large academic medical center were invited to participate. A multidisciplinary group including physicians, advanced practice providers, registered nurses and a certified sex therapist were recruited to lead the workshop. Results Participants rotate through three 30-minute sessions targeted to learning objectives. One session focuses on conducting a symptom-based pelvic exam. A 3-dimensional model is used to review the anatomy of the female pelvic floor and demonstrate physical exam techniques to evaluate vaginal and vulvar symptoms, pelvic pain, and dyspareunia. Diagnostic skills include vulvar inspection to assess for skin and mucosal changes, cotton swab test of the vestibule, and assessment of pelvic floor musculature. A second session focuses on the genitourinary syndrome of menopause (GSM). The pathophysiology, presentation and treatment of GSM is introduced. Next, registered nurses with expertise in female sexual health and menopause lead an interactive demonstration of vaginal moisturizers and lubricants. Advice for counseling patients on the proper use and application of vaginal estrogens is also reviewed. The final session focuses on sexual health counseling, including sexual history-taking skills. Participants are taught about the domains of sexual function, female sexual response cycle, types of desire, patient resources, and sexual aids. Feedback following the initial iteration of this workshop was very positive. All participants felt that the experience was an effective use of time, would recommend it to others, and were confident in their ability to apply skills to their clinical practice. Conclusions This interactive workshop led by a multidisciplinary group of providers aims to improve trainee comfort in evaluation and management of female sexual health and menopause. Given the commonplace nature of these topics in primary care and paucity of existing curricula, consideration could be given to the inclusion of a similar educational experience into internal medicine, family medicine and/or obstetrics and gynecology residency programs. Disclosure No.

(073) WOMEN'S SEXUAL DYSFUNCTION TRAINING MODULE INCREASES SCREENING COMFORT

Abstract Introduction Sexual dysfunction in women affects approximately 40% of patients, however, many providers fail to screen for it. The continual lack of screening presents limited opportunities for healthcare trainees to observe, learn and master this skill. Approximately half of medical students feel inadequately prepared to discuss these diagnoses with patients. For this reason, experts advocated a multidisciplinary, longitudinal sexual health education approach to address the exposure of women’s sexual health in the clinical setting. In order to address this issue, our institution created a module focusing on sexual dysfunction in women to educate healthcare students on screening, assessment and baseline treatment for the most common dysfunction, hypoactive sexual desire disorder or decreased libido. This module was created by a gynecologist and reviewed by professors in the psychology department and graduate nursing school. Additionally, it was approved by the medical school for use. It simulates a clinical rotation to emphasize screening for sexual dysfunction in women and baseline evaluation of decreased libido using a biopsychosocial model. Objective The primary aim of this study is to evaluate changes in students’ comfort level who screen for women’s sexual dysfunctions after completion of the Female Sexual Dysfunction Module. Additionally, we aim to assess the over baseline level of comfort in screening and determine if knowledge about when to screen is gained through the module. Methods This study was IRB approved. US medical students and graduate nursing students were approached via email to complete demographic information, a pre-survey, module, and post-survey. In the redcap survey, participants were asked to identify scenarios appropriate to broach the subject of a patient's sexual functioning. Additionally, they were asked to rate their comfort level asking patients about sexual desire, dyspareunia, and anorgasmia as well as general knowledge-based questions about sexual dysfunction in women. Results This study surveyed 425 medical students and nursing students from over 70 institutions across the US. Compared to their pre-module response, more respondents felt it was appropriate to query patients about their sexual functioning following the module (all p < .05). Respondents were also far more comfortable asking patients about their sexual health after the module compared to pre-module responses (all p < .05). Compared to their pre-module response, more respondents correctly identified the components of the linear female sexual response cycle created by Masters and Johnson (24.8% versus 61.6%; p < .001), and more respondents identified the components of the Plisst screening model (6.3% versus 53.7%; p < .001). Conclusions This nationwide study demonstrates our module provides statistical improvement in students’ comfort level when screening for female sexual dysfunction. It agrees with previous studies in terms of healthcare trainees’ overall lower baseline aptitude with this diagnosis and shows that this module statistically increases knowledge These results support using interactive modules in healthcare training curricula in order to standardize training. It can be especially helpful for schools where clinical exposure to this diagnosis is sparse. To further elucidate the most efficacious method of teaching, this study recommends future directions to assess the various models of sexual medicine education. Disclosure No.

Distribution of prostatic markers in glands of the female urethra and anterior vaginal wall-a rapid autopsy study.

There are varying reports of immunohistochemically detected prostatic marker protein distribution in glands associated with the female urethra that may be related to tissue integrity at the time of fixation. In this study we used tissue derived from rapid autopsies of female patients to determine the distribution of glandular structures expressing prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PSAP) along the female urethra and in surrounding tissues, including the anterior vaginal wall (AVW). Tissue blocks from 7 donors that contained the entire urethra and adjacent AVW were analyzed. These tissue samples were fixed within 4-12hours of death and divided into 5-mm transverse slices that were paraffin embedded. Sections cut from each slice were immunolabeled for PSA or PSAP and a neighboring section was stained with hematoxylin and eosin. The sections were reviewed by light microscopy and analyzed using QuPath software. In tissue from all donors, glandular structures expressing PSA and/or PSAP were located within the wall of the urethra and were present along its whole length. In the proximal half of the urethra from all donors, small glands expressing PSAP, but not PSA, were observed adjacent to the and emptying into the lumen. In the distal half of the urethra from 5 of the 7 donors, tubuloacinar structures lined by a glandular epithelium expressed both PSA and PSAP. In addition, columnar cells at the surface of structures with a multilayered transitional epithelium in the distal half of the urethra from all donors expressed PSAP. No glands expressing PSA or PSAP were found in tissues surrounding the urethra, including the AVW. Greater understanding of the distribution of urethral glands expressing prostatic proteins in female patients is important because these glands are reported to contribute to the female sexual response and to urethral pathology, including urethral cysts, diverticula, and adenocarcinoma. Strengths of the present study include the use of rapid autopsy to minimize protein degradation and autolysis, and the preparation of large tissue sections to demonstrate precise anatomical relations within all the tissues surrounding the urethral lumen. Limitations include the sample size and that all donors had advanced malignancy and had undergone previous therapy which may have had unknown tissue effects. Proximal and distal glands expressing prostate-specific proteins were observed in tissue from all donors, and these glands were located only within the wall of the urethra.

Endocrine effect of phthalate metabolites and a butterfly effect of prenatal exposure to androgens on qualitative aspects of female sexual response- an initial survey.

There is growing evidence that endocrine disruptive chemicals have deleterious effects on sexual and reproductive function. To examine subjective sexual functions in human females and their relationship to postnatal phthalate exposure and perinatal androgenization, a Sexuality Score (SS) was established from a first-stage survey questionnaire of subjective sexual function filled out by female university students (n = 68; average age 25.23 ± 5.17 years; rural 25.51 ± 6.74 vs. urban 25.85 ± 1.43 years). Seventeen phthalate metabolites in urine samples were analyzed by high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). Females were also assessed for the 2D:4D digit ratio as an index of perinatal androgenization. The mean age of menarche was 12.82 ± 1.35 years (rural 12.59 ± 1.39 vs. urban 13.18 ± 1.27; p = 0.01). The mean age at first sexual intercourse was 14.88 ± 6.89 years (rural 14.62 ± 7.20 vs. urban 15.24 ± 6.55), and as the age of first sexual intercourse increases, the SS score tends to increase as well, albeit moderately (r = 0.25, p = 0.037). Mono-iso-butyl phthalate, mono(2-ethyl-5-carboxypentyl) phthalate, mono(hydroxy-n-butyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate (p ≤ 0.05) and mono(2-carboxymethylhexyl) phthalate (p ≤ 0.01) were negatively associated with SS. A compounding butterfly effect of prenatal exposure to androgens was observed with disruptive effects of mono(2-ethyl-5-oxohexyl) phthalate and mono(2-ethyl-5-carboxypentyl) phthalate on sexual function. Exposure to phthalates in adult females may lead to disruption of subjective sexual function, especially concerning sexual desire and sexual satisfaction, and perinatal androgenization could augment these effects.

Clarice and the sweet pea of her sexual desires

In the aftermath of Iran's Islamic revolution, the representation and expression of women's sexuality have undergone stringent official censorship. Zoya Pirzad stands out among Iranian female authors for subtly challenging the Islamic regime's censorship of Iranian women's bodies and sexuality in her writings. In Things We Left Unsaid (2012), while articulating the sexual desires of her protagonist, Pirzad adeptly employed indirect writing techniques to safeguard her work from censorship. This article delves into the author's nuanced literary techniques, including similes, metaphors, idioms, symbols, allusions, haptic perception, and the portrayal of bodily effects, as means to subvert Iran's official censorship. Pirzad employs these literary tactics to discreetly depict her protagonist's illicit sexual relationship, interwoven with the author's critique of the government's repressive policies on women's rights. To understand the intricate dance between the said and unsaid in Pirzad's work, this article draws upon the insights of affect theory.

Relationship between sleep and sexual functioning in Indian females

IntroductionSexual dysfunction is a taboo. It is a subject in many countries that negatively affects quality of life and may often be responsible for psychopathological disturbances. There is a little research on effect of sleep on female sexual response and behaviour.ObjectivesThe aim of the study was to assess prevalence of sexual dysfunction and sleep problems in adult females visiting OBGY OPD in a tertiary health care institution in a developing country and to observe the correlation between both.MethodsA cross-sectional observational study was conducted in a tertiary health care center in India. Female Patients presenting to Department of Gynecology and Obstetrics for any complaints were assessed for their sexual functioning and sleep profileResultsThe mean age of the sample was 33.5 (6.2) years. All the female participants were married. Most of the participants were housewife and were living in a joint family. Almost 27 percent of the sample reported having sleep problems. The median sleep latency was 30 (15,60) minutes. The subjective total sleep time was 356.5 (60.3) minutes. The mean PSQI score was 4(2,6). The mean FSFI score was 26 (3.2). More than 50 percent of the females reported mild sexual problems and 10 percent reported mild to moderate problems. Most of the females didn’t have any symptoms suggestive of depression. Only two females reported moderate depression.ConclusionsDepression and anxiety have more effect on sexual functioning.Disclosure of InterestNone Declared

A Discourse Analysis of Women Sexuality in the Lyrics of an Anonymous Turkish Folk Song

This qualitative study examines the gender dynamics and societal expectations embedded within a traditional song and its associated story. Focusing on the themes of virginity and women purity, the research investigates the power structures, control, and cultural implications reflected in the narrative. Through a comprehensive literature review, we explore existing scholarship on gender studies and societal norms surrounding virginity. The song and story are analyzed, highlighting the depiction of the character Nazife, a fifteen-year-old girl whose worth is tied to her virginity. Drawing upon gender theories, feminist theory and intersectionality, the study critically deconstructs the societal norms and power dynamics present in the narrative. The research uncovers a patriarchal notion that women sexuality is controlled by men, who act as gatekeepers of a woman's virtue. Moreover, the study examines the social stigma and shaming faced by women who do not conform to traditional expectations of purity. By analyzing the cultural and historical context, the study provides insights into the gendered dynamics prevalent during the song's origin. This research contributes to the understanding of how societal constructs impact women's agency and the importance of challenging gender norms to achieve gender equality.

The effect of exposure to emotional violence on sexual function, sexual quality of life and psychological well-being in women: Structural equation modeling

Emotional violence is all of the destructive behaviors that humiliate the individual and cause him/her to feel under pressure to disrupt mental health. These destructive behaviors can affect women's sexuality. In this study, it was aimed to determine the effect of exposure to emotional violence on sexual function, sexual life quality, and psychological well-being in women. The study was conducted in a descriptive and relational screening model. The sample of the study consisted of 213 women. Personal information forms, the female sexual function index, the sexual quality of life questionnaire, the exposure to emotional violence scale, and the psychological well-being scale were used in the study. Structural equation modeling was used to determine the direct and indirect predictive power of the independent variable on the dependent variable.The effect of exposure to emotional violence on psychological well-being (β = −0.323; p < 0.001), and the effect of quality of sexual life on psychological well-being were statistically significant (β =0.315; p < 0.001). Moreover, the effect of exposure to emotional violence on sexual life quality was determined to be statistically significant (β = −0.665; p < 0.001). The effect of quality of sexual life on female sexual function was statistically significant (β = −0.288; p = 0.002). Furthermore, while the effect of psychological well-being on the female sexual function index was not statistically significant (β = −0.101; p = 0.266), the effect of exposure to emotional violence scale on the female sexual function index was statistically significant (β = −0.087; p = 0.373). The mediating role of exposure to emotional violence in the relationship between sexual life quality and psychological well-being was high. Furthermore, the sexual life quality of 43.6 % of women was explained by exposure to emotional violence. On the other hand, 28.7 % of psychological well-being score was explained by the sexual life quality and exposure to emotional violence.

(236) Does MDMA Have Treatment Potential in Sexual Dysfunction? A Systematic Review of Outcomes Across the Female and Male Sexual Response Cycles

Abstract Introduction Sexual health is a fundamental dimension of overall human well-being, deeply intertwined with physical health, interpersonal relationships, and the overall quality of life. However, sexual dysfunction is prevalent among both men and women. Despite it's common occurrence, it often remains underdiagnosed and undertreated. In an attempt to improve the treatment landscape and offer new hope for those suffering from sexual dysfunction, researchers have turned to explore unconventional therapies, examining substances beyond the traditional medicinal spectrum. Compounds typically associated with recreational use, like cannabis and LSD, have been subjects of recent studies, exploring their potential therapeutic value. Notably, 3,4-Methylenedioxymethamphetamine (MDMA), colloquially known as 'Ecstasy,' has been attracting significant scientific interest. This synthetic amphetamine is known for its psychostimulant and entactogenic properties, and anecdotally noted for its potential effects on the sexual response cycle. Objective To examine the existing literature on the effects of MDMA on male and female sexual responsiveness and the potential role of MDMA in treating sexual dysfunction of various etiologies. Methods We conducted a systematic review on the effects of MDMA on each domain of the female and male sexual response cycles. PubMed, MEDLINE, and EMBASE were queried, and results were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms utilized were “MDMA” or “Ecstasy” in combination with “desire,” “arousal”, “lubrication”, “orgasm”, “pleasure”, “libido”, “erection” and “ejaculation”. Inclusion criteria for this review were MDMA use by study subjects, sexual outcomes in at least one domain of the female and/or male sexual response cycles were described and measured. Randomized control trials (RCT), cohort studies (both prospective and retrospective), surveys, and literature reviews published between January 2000 and June 2022 were included. Results We identified 181 studies, of which six met criteria for assessment of the female sexual response cycle and eight met criteria for assessment of the male sexual response cycle. Four of six studies reported increased sexual desire with MDMA use among women. Arousal and lubrication were improved with MDMA use in three of four studies, but they were not affected in one randomized control study. In men, seven studies evaluated the effects of MDMA on desire and/or arousal, five studies measured impact on erection, three on orgasm, and two on ejaculation. Sixty percent of interview-based studies reported increased sexual desire in men, while 40% reported mixed or no effect. Two studies reported impairment of erection, two reported mixed effects, and one reported “fear of erection impairment.” In both men and women, all studies evaluating orgasm reported delay in achieving orgasm, but increased intensity and pleasure if achieved. Primary outcome measures were variable and largely qualitative. Conclusions Our findings suggest that MDMA generally increases sexual desire and intensifies orgasm when achieved. While producing conflicting evidence on sexual arousal in both sexes, MDMA may impair erectile and ejaculatory function in men. Disclosure No.

(047) Experience of Sexuality After Breast Cancer: A Qualitative Study

Abstract Introduction Breast cancer is the most frequently diagnosed cancer in women. But its efficient therapeutic arsenal have major impacts on the quality of life of breast cancer survivors. Breasts are symbolic of sexuality, femininity and beauty. Their invasion by cancerous cells or mutilated by local treatments can disrupt a woman's sexual life, endangering their couples' relationships. Objective We aim to evaluate the qualitative impact of breast cancer on survivors' sexuality after mastectomy. Methods A prospective qualitative study was carried out using semi-structured interviews until saturation of findings. The patients included were women diagnosed and treated for breast cancer, followed in our department. All participants were sexually active and no older than 55. The study enrolled 20 participants over a 6-month period (February 2022-July 2022). Results Exploring the sexual health of breast cancer patients following surgery and treatment with chemotherapy and/or radiotherapy, we found that the participants had a common pattern to adapt to the significant changes in their bodies and cope with the modifications concerning their sexuality. Some important and recurrent themes resulted of the analysis of our interviews: participants reported lower desire, arousal and satisfaction of their sexual life. They also asked for more emotional bonding and sexual bonding with their partners. Conclusions Knowledge of the psychosocial and cultural aspects that influence women's sexuality after breast cancer is important in helping to improve healthcare. Disclosure No.

(211) Study of Postpartum Sexuality in Tunisian Women

Abstract Introduction Childbirth is a period of imbalance responsible for multidimensional changes that can influence sexual life. The aim of the study is to study the sexuality of women after childbirth, to specify the factors that influence it and to analyze the aspects of sexual dysfunction that accompany this period. Objective Evaluate women's postpartum experience and sexuality, while identifying difficulties that may arise during this high-risk period. Assess women's satisfaction with the information they receive on sexuality during perinatal and post-partum consultations. Methods This was a descriptive study that was spread over a period of 6 months from July 1, 2021 to December 31, 2021.200 women who gave birth in the six months preceding the study were included in the study. Two self-questionnaires were sent by internet through a social network. Results Our population of 200 women had a mean age of 34.3 years and the majority of women were urban, and university-educated. fourty-five per cent were second gestations and 58,5% of them had given birth by cesarean section. The average FSFI score in our sample was 21,99/36 postpartum, which implied sexual dysfunction in 72% of the women in our population. The delay in resumption of sexual activity was later in primiparous women, women with vaginal delivery and breastfeeding women. There was an association between instrumental delivery and the degree of dyspareunia. No difference was found in sexuality between vaginal delivery and caesarean section, nor for scheduled or emergency caesarean section. All areas of female sexual function were affected with mainly pain associated with sexuality. Some factors influencing the resumption of sexual activity could be identified such as breastfeeding, the presence of perineal tears, lack of lubrication and fear of becoming pregnant. Conclusions The majority of women in our population had sexual dysfunction in the postpartum period. The different areas of female sexual function were affected and correlated with the different parameters related to childbirth and the postpartum period. Disclosure No.

(055) Vaginal Lubrication: Equally Important for Orgasm in Premenopausal, Postmenopausal, and Post-Partum Women?

Abstract Introduction The female sexual response cycle is complex with interconnected domains. Studies have shown that vaginal lubrication is affected by age and hormonal changes; however, the relationship between lubrication and orgasm has not been well described in premenopausal women, women who are postpartum, and postmenopausal women. Objective The objective of this study is to evaluate the relationship between vaginal lubrication and orgasm among premenopausal, postpartum, and postmenopausal women Methods A post-market analysis was performed of all women who had utilized the sexual wellness application Rosy between February 2022 and November 2022. Application users complete the Female Sexual Function Index (FSFI) short form (6-item) upon initial use of the application. We utilized multivariable linear regression models to determine significant effects between lubrication score and orgasm scores score controlling for whether the patient was on birth control, postpartum, or menopausal Results We reviewed a large database of 30,358 women from across the United States. Among these, 2,599 women were menopausal, 2, 011 were premenopausal women, and 795 were postpartum. The mean lubrication scores on FSFI -6 were: menopausal = 1.93, premenopausal = 2.68, postpartum = 2.73. Mean scores for orgasm were 2.2, 2.62, 2.31 respectively. Premenopausal women had higher overall scores on FSFI- 6, with orgasm scores improving with age. Higher scores in lubrication domain had less impact on orgasm domain in pre-menopausal women compared to post-menopausal women (p=0.04). No correlation between improvement in lubrication and orgasm noted among post-partum women when compared to post-menopausal women (p=0.87) Conclusions Lubrication has a higher impact on orgasm among post-menopausal women compared to pre-menopausal women and not correlated with orgasmic function among women in the post-partum period. These findings enhance our knowledge and refine current management of anorgasmia. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Rosy.