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Freihart BK, Meston CM. Physiological Synchrony During Partnered Sexual Activity. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:498-511. [PMID: 38545911 DOI: 10.1080/0092623x.2024.2321127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Physiological synchrony (PS) refers to the coordination of bodily responses in close relationships. It seems to be linked to relational well-being, satisfaction, closeness, and empathy. Recent research extends these findings to sexual relationships as well, with evidence suggesting that PS may predict attraction and sexual satisfaction. The current study focuses on PS during sexual activity within established couples. Results suggest that PS develops during sexual activity, in certain contexts, and tends to be greater in magnitude during sexual encounters than during non-sexual interactions. Results may shed light on the dyadic psychophysiological factors relevant to sexual experiences.
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Affiliation(s)
- Bridget K Freihart
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Cindy M Meston
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
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Ramírez-Santos J, Cristóbal-Cañadas D, Parron-Carreño T, Lozano-Paniagua D, Nievas-Soriano BJ. The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender. Sex Med Rev 2024; 12:116-126. [PMID: 38336366 DOI: 10.1093/sxmrev/qead058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Sexuality is an integral part of human health, and sexual dysfunctions are prevalent issues that affect men and women. While reviews on sexual dysfunctions in various diseases have been conducted, overall data are scarce. OBJECTIVES To update the overall prevalence of sexual dysfunctions from available prevalence studies on both sexes. METHODS We used a 2-phase selection process to include cross-sectional studies that were conducted on the adult population and published between 2017 and 2022. The extracted data were prevalence, methodology, sample size, and location. Sensitivity and subgroup analyses were conducted to assess heterogeneity. RESULTS This review analyzed 4407 studies. Twenty-three met the established criteria: 9 on the male population and 14 on the female population. The meta-analysis included 7 articles on males and 13 on females. The prevalence of sexual dysfunction was 31% in men and 41% in women, with significant heterogeneity among the studies. Sociocultural differences and use of varying measurement methods were identified as the main factors contributing to heterogeneity. Subgroup analysis revealed decreased heterogeneity among studies that used the Female Sexual Function Index as a diagnostic tool for females. CONCLUSIONS The review highlights the notable variability in results due to methodological and geographic variations. Therefore, enhancing the training of professionals and standardizing the recording of patient data-through the Female Sexual Function Index and Male Sexual Health Questionnaire or by developing new ones for this purpose-could improve the consistency of research on sexual health.
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Affiliation(s)
| | | | - Tesifón Parron-Carreño
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
| | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
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Moradi Z, Shahali S, Ahmadi F, Montazeri A. Correlates of sexual function in women with acute lumbar disc herniation in Iran: a cross-sectional study. Sci Rep 2024; 14:6430. [PMID: 38499726 PMCID: PMC10948880 DOI: 10.1038/s41598-024-57274-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024] Open
Abstract
Evidence suggests that lumbar disc herniation (LDH) influences sexual function to a great deal. However, most existing studies have been conducted on men. Thus, the current study aimed to assess sexual function and its correlates in women with acute LDH. This descriptive cross-sectional study was conducted on 350 women of reproductive age with acute LDH in Fasa, Iran in 2023. The mean score of female sexual function was 21.33 (3.38). Almost 80% of women had sexual dysfunction. Women scored lower on sexual desire and the higher on lubrication. As the severity of LDH increased, arousal, lubrication and sexual pain score decreased and low back pain (LBP) score increased (p < 0.05). The number of sexual activities after disc herniation was significantly lower in the women with sexual dysfunction (p < 0.001). Regression analysis showed a significant association between sexual dysfunction and LBP intensity (OR = 1.13, CI 1.02-1.26, p = 0.01) and lumbar disc herniation intensity (OR = 2.22, CI 1.07-4.62, p = 0.03). Lumbar disc herniation (LDH) may significantly affect women's sexual function. Severity of low back pain and severity of lumbar disc herniation were found to be risk factors for sexual dysfunction in this population.
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Affiliation(s)
- Zahra Moradi
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares Univesity, Tehran, Iran
| | - Shadab Shahali
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares Univesity, Tehran, Iran.
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science & Culture, Tehran, Iran
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Dogan O, Ucar E, Yassa M. Does the Surgical Margin Affect Sexual Function Following Linear Labiaplasty Technique? Aesthet Surg J 2024; 44:NP271-NP278. [PMID: 38092694 DOI: 10.1093/asj/sjad368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND How much labial tissue should be left after labiaplasty is a controversial issue. OBJECTIVES The objective was to investigate the effect of residual labial tissue following labiaplasty operations on sexual function. METHODS A total of 150 females who underwent labiaplasty between 2019 and 2021 and their partners were included in the study. In this retrospective study, linear labiaplasty technique was applied according to the patient's request. Patients were either below 1 cm or above 1 cm according to the remaining labial width at follow-up. The remaining labial tissues were classified according to the Motakef classification. Patients with a labial width above 1 cm were included in Group 1, and patients with a labial width below 1 cm were included in Group 2. Sexual function, sexual experience, body image, and erectile function of their partners were compared preoperatively and 2 years postoperatively with appropriate questionnaires. RESULTS Sexual function, sexual experience, and body image of females improved in all patients. However, the improvement was more apparent with with remaining labial tissue of greater than 1 cm. The increase in the survey results of the partners was found to be similar. CONCLUSIONS The sexual function of the patients was better when the width of the labium was longer than 1 cm. This may be due to better protection of the neurovascular structures. This favorable effect was also seen in the subjective evaluation of the partners. LEVEL OF EVIDENCE: 3
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Mutamba BB, Rukundo GZ, Sembajjwe W, Nakasujja N, Birabwa-Oketcho H, Mpango RS, Kinyanda E. A 'hidden problem': Nature, prevalence and factors associated with sexual dysfunction in persons living with HIV/AIDS in Uganda. PLoS One 2024; 19:e0295224. [PMID: 38451991 PMCID: PMC10919729 DOI: 10.1371/journal.pone.0295224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/20/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND We conducted a clinic-based cross-sectional survey among 710 people living with HIV/AIDS in stable 'sexual' relationships in central and southwestern Uganda. Although sexual function is rarely discussed due to the private nature of sexual life. Yet, sexual problems may predispose to negative health and social outcomes including marital conflict. Among individuals living with HIV/AIDS, sexual function and dysfunction have hardly been studied especially in sub-Saharan Africa. In this study, we aimed to determine the nature, prevalence and factors associated with sexual dysfunction (SD) among people living with HIV/AIDS (PLWHA) in Uganda. METHODS We conducted a clinic based cross sectional survey among 710 PLWHA in stable 'sexual' relationships in central region and southwestern Uganda. We collected data on socio-demographic characteristics (age, highest educational attainment, religion, food security, employment, income level, marital status and socio-economic status); psychiatric problems (major depressive disorder, suicidality and HIV-related neurocognitive impairment); psychosocial factors (maladaptive coping styles, negative life events, social support, resilience, HIV stigma); and clinical factors (CD4 counts, body weight, height, HIV clinical stage, treatment adherence). RESULTS Sexual dysfunction (SD) was more prevalent in women (38.7%) than men (17.6%) and majority (89.3% of men and 66.3% of women) did not seek help for the SD. Among men, being of a religion other than Christianity was significantly associated with SD (OR = 5.30, 95%CI 1.60-17.51, p = 0.006). Among women, older age (> 45 years) (OR = 2.96, 95%CI 1.82-4.79, p<0.01), being widowed (OR = 1.80, 95%CI 1.03-3.12, p = 0.051) or being separated from the spouse (OR = 1.69, 95% CI 1.09-2.59, p = 0.051) were significantly associated with SD. Depressive symptoms were significantly associated with SD in both men (OR = 0.27, 95%CI 0.74-0.99) and women (OR = 1.61, 95%CI 1.04-2.48, p = 0.032). In women, high CD4 count (OR = 1.42, 95% CI 1-2.01, p = 0.05) was associated with SD. CONCLUSION Sexual dysfunction has considerable prevalence among PLWHA in Uganda. It is associated with socio-demographic, psychiatric and clinical illness factors. To further improve the quality of life of PLWHA, they should be screened for sexual dysfunction as part of routine assessment.
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Affiliation(s)
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Wilber Sembajjwe
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Richard Stephen Mpango
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Entebbe, Uganda
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Ribeiro S, Pedro J, Martins MV. Psychosocial experiences of involuntary definitive childless women: a comparative study based on reproductive status. Hum Reprod 2024; 39:559-568. [PMID: 38290160 DOI: 10.1093/humrep/deae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
STUDY QUESTION Do involuntary definitive childless women have lower psychosocial adjustment levels than women with infertility diagnoses actively trying to conceive and presumably fertile women? SUMMARY ANSWER Involuntary definitive childless women have lower levels of sexual functioning than infertile women actively trying to conceive and presumably fertile women, and higher levels of depression than presumably fertile women. WHAT IS KNOWN ALREADY Involuntary definitive childless defines those who wanted to become parents but were unable to do so. Studies have provided evidence about infertility and its psychosocial consequences, but there is a lack of knowledge about the impact of involuntary definitive childlessness, namely on sexual function, social support, marital satisfaction, and psychological adjustment. STUDY DESIGN, SIZE, DURATION This associative study was conducted between July 2021 and January 2022 for involuntary definitive childless women and between July 2016 and February 2018 for women with an infertility diagnosis actively trying to conceive as well as presumably fertile women. An online questionnaire announced in social media and gynaecology and fertility clinics was used. The inclusion criteria for all participants were being childless, in a heterosexual relationship and cohabiting for at least 2 years. Specific inclusion criteria for involuntary definitive childless women were: trying to conceive for at least 2 years; not achieving pregnancy because of biological and medical constraints; and not undergoing fertility treatment or being a candidate for adopting a child at time of the study. For women with an infertility diagnosis the inclusion criteria were: actively trying to conceive (naturally or through fertility treatments); having a primary fertility diagnosis; and aged between 22 and 42 years old. For presumably fertile women, the inclusion criteria were: having a parenthood wish in the future; and not knowing of any condition that could prevent them from conceiving. PARTICIPANTS/MATERIALS, SETTING, METHODS Out of 360 women completing the survey, only 203 were eligible for this study (60 involuntary definitive childless women, 78 women with an infertility diagnosis actively trying to conceive, and 65 presumably fertile women). All participants completed a questionnaire including sociodemographic and clinical data, the Female Sexual Function Index, the 2-Way Social Support Scale, the Relationship Assessment Scale, and Hospital Anxiety and Depression Scale. Binary logistic regression was performed to assess the relation between sexual function, social support, marital satisfaction, anxiety, depression, and reproductive status, adjusting for age, and cohabitation length. Presumably fertile women were used as a reference group. MAIN RESULTS AND THE ROLE OF CHANCE Women were 34.31 years old (SD = 5.89) and cohabited with their partners for 6.55 years (SD = 4.57). The odds ratio (OR) showed that involuntary definitive childless women had significantly lower sexual function than infertile women actively trying to conceive (OR = 0.88, 95% CI = 0.79-0.99) and presumably fertile women (OR = 34.89, 95% CI = 1.98-614.03), and higher depression levels than presumably fertile women (OR = 99.89, 95% CI = 3.29-3037.87). Women with an infertility diagnosis actively trying to conceive did not differ from presumably fertile women in sexual function, social support, marital satisfaction, anxiety, and depression. LIMITATIONS, REASONS FOR CAUTION The majority of childless women underwent fertility treatments, and childlessness for circumstantial reasons owing to lack of a partner was not included, therefore these results may not reflect the experiences of all women with an involuntary childless lifestyle. There was a time gap in the recruitment process, and only the definitive childlessness group filled out the questionnaire after the coronavirus disease 2019 pandemic. We did not ask participants if they self-identified themselves with the groups' terminology they were assigned to. WIDER IMPLICATIONS OF THE FINDINGS Our results emphasize the importance of future research to provide a more comprehensive understanding of the adjustment experiences of childless women and an awareness of the poor adjustment they might experience, highlighting the need to keep following women after unsuccessful treatments. Clinical practitioners must attend to these dimensions when consulting involuntary definitive childless women who might not have gone through treatments but also experience these adverse outcomes. STUDY FUNDING/COMPETING INTEREST(S) This study was partially supported by the Portuguese Foundation for Science and Technology. The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Sara Ribeiro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Juliana Pedro
- Centre for Reproductive Genetics A.Barros, Porto, Portugal
- Center for Psychology at University of Porto, Porto, Portugal
| | - Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto, Porto, Portugal
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Arzola A, Chang E, Rooney MK, Corrigan K, Das P, Ludmir EB, Koay EJ, Minsky BD, Smith GL, Messick C, Morris VK, Nebgen D, Crane CH, Holliday EB. Daily Vaginal Dilator Use During Radiation for Women With Squamous Cell Carcinoma of the Anus: Vaginal Wall Dosimetry and Patient-Reported Sexual Function. Pract Radiat Oncol 2024; 14:e105-e116. [PMID: 37898354 DOI: 10.1016/j.prro.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/19/2023] [Accepted: 10/12/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE At our institution, we treat patients with a daily vaginal dilator (VD) during chemoradiation (CRT) for squamous cell carcinoma of the anus (SCCA). We evaluated compliance with daily VD use, radiation dose to the vaginal wall (VW), and anterior vaginal wall (AVW), and patient-reported long-term sexual function. METHODS AND MATERIALS We included women with SCCA who received definitive, intensity-modulated radiation therapy-based CRT. Women who were alive without evidence of disease received a patient-reported outcome survey, which included the Female Sexual Function Index (FSFI). We identified factors associated with FSFI, such as radiation dose to the VW and AVW using linear regression models and used Youden index analysis to estimate a dose cutoff to predict sexual dysfunction. RESULTS Three hundred thirty-nine consecutively treated women were included in the analysis; 285 (84.1%) were treated with a daily VD. Of 184 women alive without disease, 90 patients (49%) completed the FSFI, and 51 (56.7%) were sexually active with valid FSFI scores. All received therapy with a daily VD. Forty-one women (80%) had sexual dysfunction. Univariate analysis showed higher dose to 50% (D50%) of the AVW correlated with worse FSFI (β -.262; P = .043), worse desire FSFI subscore (β -.056; P = .003), and worse pain FSFI subscore (β -.084; P = .009). Younger age correlated with worse pain FSFI subscale (β .067; P = .026). Age (β .070; P = .013) and AVW D50% (β -.087; P = .009) were significant on multivariable analysis. AVW D50% >48 Gy predicted increased risk of sexual dysfunction. CONCLUSIONS Daily VD use is safe and well tolerated during CRT for SCCA. Using a VD during treatment to displace the AVW may reduce the risk for sexual dysfunction. Limiting the AVW D50% <48 Gy may further reduce the risk but additional data are needed to validate this constraint.
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Affiliation(s)
| | - Enoch Chang
- Departments of Gastrointestinal Radiation Oncology
| | | | | | - Prajnan Das
- Departments of Gastrointestinal Radiation Oncology
| | | | | | | | | | | | | | - Denise Nebgen
- Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christopher H Crane
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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Johannesson U, Amato M, Forsgren C. Pelvic floor and sexual function 3 years after hysterectomy - A prospective cohort study. Acta Obstet Gynecol Scand 2024; 103:580-589. [PMID: 38071460 PMCID: PMC10867362 DOI: 10.1111/aogs.14751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/17/2023] [Accepted: 11/23/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Long term effects after hysterectomy, such as a worsening of pelvic floor and sexual function, have been studied with diverse results. Therefore, we investigated the long-term effects of hysterectomy for benign indication on pelvic floor and sexual function as well as differences in outcome depending on mode of hysterectomy. MATERIAL AND METHODS In a prospective clinical cohort study, we included 260 women scheduled for hysterectomy who answered validated questionnaires; pelvic floor impact questionnaire (PFIQ-7), pelvic floor distress inventory (PFDI-20) and female sexual function index (FSFI). Participants were followed up to 3 years after surgery. Nonparametric statistics and mixed effect models were used in analyses of the data. RESULTS After exclusions, 242 women remained in the study, with a response rate at the 3-year follow-up of 154/242 (63.6%) for all questionnaires. There was an improvement of pelvic floor function with a mean score of PFIQ-7 at baseline of 42.5 (SD 51.7) and at 3 years 22.7 (SD 49.4), (p < 0.001) and mean score of PFDI-20 at baseline was 69.6 (SD 51.1) and at 3 years 56.2 (SD 54.6), (p = 0.001). A deterioration of sexual function was seen among the sexually active women after 3 years with a mean score of FSFI at baseline 25.2 (SD 6.6) and after 3 years 21.6 (SD 10.1), (p < 0.001). However, this was not consistent with the unaltered sexual function for the whole cohort. No difference in pelvic floor or sexual function was detected when comparing robotic assisted laparoscopic hysterectomy, laparoscopic hysterectomy and abdominal hysterectomy. CONCLUSIONS Three years after surgery robotic assisted laparoscopic hysterectomy, total laparoscopic hysterectomy and abdominal hysterectomy improve pelvic floor function to the same extent. Among the sexually active women, a decline of sexual function was seen after 3 years, not consistent with the entire cohort and independent of surgical methods. Whether this is a trend associated with aging or menopausal transition remains to be studied.
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Affiliation(s)
- Ulrika Johannesson
- Department of Clinical SciencesDanderyd Hospital, Karolinska InstitutetStockholmSweden
- Department of Obstetrics and GynecologyDanderyd HospitalStockholmSweden
| | - Martina Amato
- Department of Clinical SciencesDanderyd Hospital, Karolinska InstitutetStockholmSweden
- Department of Obstetrics and GynecologyDanderyd HospitalStockholmSweden
| | - Catharina Forsgren
- Department of Clinical SciencesDanderyd Hospital, Karolinska InstitutetStockholmSweden
- Department of Obstetrics and GynecologyDanderyd HospitalStockholmSweden
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Nappi RE, Martella S, Tiranini L, Cucinella L, Palacios S. Efficacy and safety of a device that combines multipolar radiofrequency with pulsed electromagnetic field for the treatment of vulvovaginal atrophy: a randomized, sham-controlled trial. J Sex Med 2024; 21:203-210. [PMID: 38286753 DOI: 10.1093/jsxmed/qdad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/26/2023] [Accepted: 11/09/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Vulvovaginal atrophy (VVA) negatively affects the sexual well-being and quality of life of postmenopausal women, yet it is underreported and undertreated. AIM The study sought to investigate the efficacy and safety of a nonablative, noncoagulative multipolar radiofrequency (RF) and pulsed electromagnetic field-based device (PEMF) in treatment of symptoms related to VVA. METHODS Seventy-six women ≥19 years of age with symptoms associated with VVA were enrolled into this prospective, randomized, sham-controlled, multicenter clinical study. Subjects were randomized to receive 3 RF + PEMF treatments (active group) or sham treatments (sham group) delivered to vaginal tissue at monthly intervals. The Vaginal Health Index (VHI), along with the Female Sexual Function Index (FSFI), subject sexual satisfaction and vaginal laxity (VL) score, treatment-associated pain, and adverse events were assessed at 4 follow-up (FU) visits between 1 and 12 months after treatment. OUTCOMES Changes from baseline VHI, pH, FSFI, VL, and sexual satisfaction scores between the active and sham groups were compared before and after treatment. RESULTS Mean VHI scores in the active group were significantly better compared with the sham group after treatment at all but the last FU visit (P < .001). A greater decrease in pH (active over sham) was seen at 1 and 4 months after treatment (P < .05). FSFI improvement was shown in the active group; however, it was not significantly better than sham improvement at all FU visits. Subject sexual satisfaction in the active group showed better improvement over sham at all FU visits (P < .05), while VL evaluations saw greater improvement in the active group at 4, 6, and 12 months posttreatment (P < .05). Treatment satisfaction was greater in the active group and pain was minimal in both groups. No serious adverse effects were reported. CLINICAL IMPLICATIONS As a noninvasive alternative to traditional surgical and topical procedures, 3 sessions of noninvasive combination RF/PEMF safely demonstrated improvement in symptoms related to VVA. STRENGTHS AND LIMITATIONS This study was strengthened by the randomized, sham-controlled design; large sample size; and extended FU period. The study assessments were decreased at later FU visits due to the global COVID pandemic, and this was a key limitation to the study. CONCLUSION Nonablative, noncoagulative multipolar RF/PEMF therapy was safe, improved symptoms associated with VVA, and improved female sexual function while yielding high subject satisfaction.
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Affiliation(s)
- Rossella E Nappi
- University of Pavia, Pavia 27100, Italy
- IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | - Silvia Martella
- Unit of Preventative Gynecology, IRCCS European Institute of Oncology, Milan 20141, Italy
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Eickman K, Maxwell R, McGinnis LK, Stanczyk F, Legro R, Lindheim SR. Total and bioavailable 25-hydroxyvitamin D is not associated with improved sexual dysfunction following vitamin D supplementation in women with polycystic ovarian syndrome: a pilot study. J Sex Med 2024; 21:240-247. [PMID: 38303661 PMCID: PMC10906494 DOI: 10.1093/jsxmed/qdad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Vitamin D (Vit D) deficiency has been linked to symptoms of polycystic ovary syndrome (PCOS), yet little is known about Vit D supplementation as a treatment for sexual dysfunction (SDy) in women with PCOS. AIM To explore the implications of serum total 25-hydroxyvitamin D (25[OH]D) and bioavailable 25[OH]D (bio-25[OH]D) status and replacement on women with PCOS and SDy. METHODS Reproductive-age women with PCOS who were not desiring fertility were eligible provided that they also had SDy, as assessed by the Female Sexual Function Index (FSFI), and were without severe depression, as evaluated by the Beck Depression Inventory II (BDI-II). Participants were given the recommended dietary allowance of Vit D (600 IU daily) plus hormonal contraception (HC; cyclic ethinyl estradiol/drospirenone) or no HC for 6 months. Comparisons between groups were analyzed by chi-square test and t-test, and Pearson's correlation coefficient analyzed correlations between FSFI with demographics, BDI-II, androgen levels, and total and bio-25[OH]D. OUTCOMES The outcomes included SDy (FSFI <26.55), total and serum bio-25[OH]D levels, and total and free testosterone. RESULTS A total of 42 women without severe depression completed the FSFI, with 28 (66.7%) having SDy. All FSFI domains, including arousal, lubrication, orgasm, and pain, were significantly lower as compared with women without SDy, with no associations with respect to demographics, total and free testosterone, or total and bio-25[OH]D. Vit D replacement was initiated with HC (n = 18) or no HC (n = 10), and for those completing the study, FSFI improved (score >26.55) in 61% (11/18) regardless of the treatment group. A time-treatment effect showed a significant change for the domain of orgasm, suggesting that HC had more of an impact than Vit D replacement. Improvement in sexual function as a dichotomous variable was not associated with age, body mass index, other demographics, total and free testosterone, total and bio-25[OH]D, or HC use. CLINICAL IMPLICATIONS Due to the prevalence of SDy in women with PCOS, efficacious treatment options are necessary. STRENGTHS AND LIMITATIONS This study is the first to analyze the effect of Vit D supplementation on SDy in women with PCOS. Limitations included the small number of participants who completed the study, thus limiting meaningful conclusions and generalizability. CONCLUSION Vit D status was not associated with SDy and BDI-II. While HC may have played a role, standard Vit D supplementation could not account for the noted improvement in FSFI in women with PCOS.
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Affiliation(s)
- Kira Eickman
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL 32827, United States
| | - Rose Maxwell
- Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Fairborn, OH 45324, United States
| | - Lynda K McGinnis
- Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, United States
| | - Frank Stanczyk
- Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, United States
| | - Richard Legro
- Department of Obstetrics and Gynecology, College of Medicine, Penn State University, State College, PA 16801, United States
| | - Steven R Lindheim
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL 32827, United States
- Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Fairborn, OH 45324, United States
- Center for Reproductive Medicine, Renji Hospital; School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
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Chongcharoen P, Choobun T, Khanuengkitkong S. Female sexual function index for screening of female sexual dysfunction using DSM-5-TR criteria in Thai women: A prospective cross-sectional diagnostic study. PLoS One 2024; 19:e0298935. [PMID: 38386669 PMCID: PMC10883536 DOI: 10.1371/journal.pone.0298935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Thai Female Sexual Function Index discrimination using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria has not been investigated. This study aimed to evaluate the Female Sexual Function Index as a tool for assessing sexual symptoms and to determine the prevalence of female sexual dysfunction in Thai women using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. This prospective cross-sectional diagnostic study included sexually active women aged ≥18 years, interviewed from January to June 2023. The participants completed the Thai version of a comprehensive of the Female Sexual Function Index questionnaire encompassing general information and self-reported assessments of female sexual function, followed by a semi-structured interview of distress symptom severity. Female sexual function was determined by screening of the total Female Sexual Function Index score, whereas female sexual dysfunction was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. Using receiver operating characteristic curves, a clinical cutoff for the Female Sexual Function Index score of 23.1 was determined to identify female sexual dysfunction (area under the curve, 0.76; 95% confidence interval, 0.71-0.80; sensitivity, 75.6%; specificity, 67.7%; positive predictive value, 77.7%; negative predictive value, 65%). A prevalence of 40.2% for female sexual dysfunction was observed in the study population. The results of this study could be used as practical guidance for the screening of women affected by female sexual dysfunction in Thailand in the future.
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Affiliation(s)
- Patthamaphorn Chongcharoen
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thanapan Choobun
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Siwatchaya Khanuengkitkong
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Çelikkol Ö, Gülseren V, Güngördük K, Özdemir İA. Effects of human papillomavirus and LEEP on sexual function. Ir J Med Sci 2024; 193:285-288. [PMID: 37261673 DOI: 10.1007/s11845-023-03415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection in humans. AIMS We evaluated the sexual function of human papillomavirus positive patients after colposcopy and loop electrosurgical excision procedure (LEEP). METHODS This study enrolled 344 patients with an HPV infection detected on routine screening in 2020-2022. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of six sections: desire, arousal, lubrication, orgasm, satisfaction, and pain. RESULTS The mean age of the 344 HPV-positive patients was 37.2 ± 8.2 years, and 28.2% of them were unmarried. Colposcopy, cervical biopsy, and LEEP were performed in 251 (73.0%), 189 (54.9%), and 42 (12.2%) patients, respectively. The sexual history and FSFI scores of the patients were recorded. The total and individual parameter scores on the FSFI decreased significantly after colposcopy. Similarly, the total and individual parameter scores on the FSFI were lower at 8 weeks after LEEP compared to those before LEEP. CONCLUSION Cancer-related fear and anxiety and LEEP may cause sexual dysfunction in HPV-positive patients.
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Affiliation(s)
- Özgü Çelikkol
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of gynecologic oncology, Sıtkı Koçman University, Muğla, Turkey
- Department of Obstetrics and Gynecology, Özgü Clinic, Muğla, Turkey
| | - Varol Gülseren
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of gynecologic oncology, Erciyes University, Kayseri, Turkey.
| | - Kemal Güngördük
- Faculty of Medicine, Department of Obstetrics and Gynecology, Division of gynecologic oncology, Sıtkı Koçman University, Muğla, Turkey
| | - İsa Aykut Özdemir
- Department of Obstetrics and Gynecology, Division of gynecologic oncology, Medipol University, İstanbul, Turkey
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Cihan E, Vural F. Effect of a telephone-based perioperative nurse-led counselling programme on unmet needs, quality of life and sexual function in colorectal cancer patients: A non-randomised quasi-experimental study. Eur J Oncol Nurs 2024; 68:102504. [PMID: 38310665 DOI: 10.1016/j.ejon.2024.102504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients. METHOD This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used. RESULTS Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05). CONCLUSIONS Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.
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Affiliation(s)
- Emel Cihan
- Department of Surgical Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, 43100, Kutahya, Turkey.
| | - Fatma Vural
- Department of Surgical Nursing, Faculty of Nursing, Dokuz Eylul University, 35100, Izmir, Turkey.
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Seehuus M, Fertig M, Handy AB, Clifton J, Stanton AM. The impact of COVID-19 and long COVID on sexual function in cisgender women. J Sex Med 2024; 21:129-144. [PMID: 38055615 DOI: 10.1093/jsxmed/qdad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Research suggests that COVID-19 impairs sexual function in men, but little is known about the impact of COVID-19 (or long COVID) on sexual function in women. AIM We sought to compare the sexual function of cisgender women who had never had COVID-19, who had COVID-19 but not long COVID, and who had long COVID, and assessed whether long COVID symptoms and/or emotional distress mediate the relationship between COVID-19 history and sexual function. METHODS In total, 2329 adult cisgender women were recruited online as study participants. Half of these women reported having had COVID-19, and the other half reported never having had COVID-19. Of those who had COVID-19, 25% (n = 170) reported having long COVID. We compared the mean Female Sexual Function Index (FSFI) scores by using t-tests for each of the primary comparison categories (never COVID vs COVID and only COVID vs long COVID). Four path models were used to test the hypotheses that (1) long COVID symptoms or (2) depression, anxiety, and/or stress assessed with the subscales of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) mediated the relationship between COVID-19 and sexual function. OUTCOMES Sexual function was measured with the FSFI, long COVID symptoms were assessed using the Centers for Disease Control working symptom set, and emotional distress was measured with the DASS-21. RESULTS In total, 1313 participants provided data suitable for analysis. The never-COVID group (n = 645, 49.1%) had higher scores on the Desire, Arousal, Lubrication, and Satisfaction subscales of the FSFI (mean [M] [SD] FSFI total Mnever COVID = 27.98 [4.84] vs MCOVID = 27.05 [5.21]) than the combined only-COVID (n = 498, 37.9%) and long-COVID (n = 170, 12.9%) groups. The FSFI subscale scores were significantly higher in the only-COVID group than in the long-COVID group for the Arousal, Lubrication, and Orgasm and lower for the Pain subscales and higher for overall sexual function (FSFI total Monly COVID = 27.49 [5.00] vs Mlong COVID = 25.77 [5.61]. None of the proposed mediation models had adequate model fit. CLINICAL IMPLICATIONS Clinicians treating cisgender women who have COVID-19 should consider proactively discussing sexual function with their patients and offering available resources. STRENGTHS AND LIMITATIONS In this study we used a large and diverse sample, but this sample did not include transgender or gender-diverse persons. This study was also correlational; as such, causal conclusions cannot be drawn. Further, the mechanism of action remains unexplained. CONCLUSIONS The study findings suggest the following: (1) COVID-19 infection is associated with impaired sexual function in cisgender women, and (2) that women with long COVID experienced incrementally more impaired sexual function than women with COVID-19 who did not develop long COVID.
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Affiliation(s)
- Martin Seehuus
- Department of Psychology, Middlebury College, Middlebury, VT, United States
- Vermont Psychological Services, University of Vermont, Burlington, VT, United States
| | - Madison Fertig
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | | | - Jessica Clifton
- Department of Medicine, University of Vermont, Burlington, VT, United States
- Parhelia Wellness, Santa Rosa, CA, United States
| | - Amelia M Stanton
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
- Fenway Health, Boston, MA, United States
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Armeni A, Armeni E, Augoulea A, Delialis D, Angelidakis L, Papaioannou M, Kaparos G, Alexandrou A, Georgopoulos N, Vlahos N, Stamatelopoulos K, Lambrinoudaki I. Sexual function scores are associated with arterial stiffness in postmenopausal women. J Sex Med 2024; 21:145-152. [PMID: 38048636 DOI: 10.1093/jsxmed/qdad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Female sexual dysfunction (FSD) has been suggested to be correlated with the burden of cardiovascular risk factors. AIM We aimed to evaluate the possible association between functional indices of vascular function and FSD scores in apparently healthy postmenopausal women. METHODS This cross-sectional study included 116 postmenopausal women who underwent assessment of endothelial function with measurement of flow-mediated dilation (FMD) of the branchial artery and arterial stiffness estimation with measurement of the carotid-femoral pulse wave velocity (PWV). We used the Greene Climacteric Scale to evaluate vasomotor symptomatology, the Female Sexual Function Index (FSFI) to evaluate FSD and the Beck Depression Inventory to evaluate mood disorder. Low sexual function was defined as an FSFI score <26.55. OUTCOMES These included FSFI and low sexual function scores as well as measures of PWV and FMD. RESULTS Sexual function scores were associated with measures of blood pressure (normal vs low sexual function; systolic blood pressure: 120.2 ± 15.0 mm Hg vs 113.4 ± 14.6 mm Hg; analysis of covariance P = .026; diastolic blood pressure: 75.9 ± 10.5 mm Hg vs 70.3 ± 9.9 mm Hg; analysis of covariance P = .012; both adjusted for age, body mass index, current smoking, and PWV). Systolic blood pressure, but not diastolic blood pressure, was associated with FSFI (B = 0.249, P = .041) and PWV (B = 0.392, P < .001). PWV measures were associated with FSFI (B = -0.291, P = .047) and pulse pressure (B = 0.355, P = .017). FMD measures were also associated with FSFI (B = 0.427, P = .033). All models were adjusted for age, body mass index, current smoking, insulin resistance, vasomotor symptomatology, and Beck Depression Inventory. CLINICAL IMPLICATIONS Our findings demonstrate that lower scores of sexual function are associated with deteriorated vascular function mainly manifested as arterial stiffening, further contributing to systolic blood pressure changes. STRENGTHS AND LIMITATIONS The strength of this study is the carefully selected healthy sample of postmenopausal women, with simultaneous assessment of climacteric symptomatology and mood disorders. The limitations include the small sample size, the cross-sectional design, and the recruitment of consecutive outpatients of a university menopause clinic. CONCLUSION Longitudinal studies and interventions to improve FSD should further assess the clinical relevance of these findings.
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Affiliation(s)
- Anastasia Armeni
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
- Royal Free Hospital NHS Foundation Trust, UCL Medical School, London NW3 2QG, United Kingdom
| | - Areti Augoulea
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Dimitrios Delialis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Lasthenis Angelidakis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Maria Papaioannou
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - George Kaparos
- Biochemical Laboratory, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Neoklis Georgopoulos
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Nicolaos Vlahos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
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Diaz-Mohedo E, Hita-Contreras F, Castro-Martin E, Pilat A, Perez-Dominguez B, Valenza-Peña G. Using Myofascial Therapy to Improve Psychological Outcomes, Quality of Life, and Sexual Function in Women with Chronic Pelvic Pain-A Case Series. Healthcare (Basel) 2024; 12:304. [PMID: 38338190 PMCID: PMC10855135 DOI: 10.3390/healthcare12030304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/19/2023] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Chronic pelvic pain represents a prevalent condition afflicting women. Research has highlighted the presence of psychological distress and sexual dysfunction in these individuals. Regrettably, myofascial pelvic pain often goes unnoticed and untreated despite its integral role in chronic pelvic pain. (2) Methods: By employing a longitudinal case series design, we studied eighteen women afflicted with chronic pelvic pain. Over a 12-week period, these participants underwent 15 sessions of myofascial therapy. Data encompassing sociodemographic particulars, the Hospital Anxiety and Depression Scale, the Medical Outcomes Study Short Form 12 questionnaire, and the Female Sexual Function Index were collected at baseline, 12 weeks post-intervention, and again at the 24-week mark. (3) Results: After a span of 12 weeks subsequent to the intervention, the participants demonstrated noteworthy enhancements (p < 0.001) in their depression and anxiety scores, their overall Mental Component scores in the Medical Outcomes Study Short Form 12, as well as sexual function. Importantly, these gains were sustained at the 24-week juncture post-therapy. (4) Conclusions: The findings stemming from our prospective case study underscore the potential utility of myofascial therapy for women grappling with chronic pelvic pain. This form of intervention yields significant advancements in alleviating anxiety, depression, health-related quality of life, and sexual function.
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Affiliation(s)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, 23071 Jaen, Spain;
| | - Eduardo Castro-Martin
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (G.V.-P.)
| | - Andrzej Pilat
- Myofascial Therapy School “Tupimek”, Physiotherapy School ONCE, Universidad Autonoma, 28049 Madrid, Spain;
| | | | - Geraldine Valenza-Peña
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (G.V.-P.)
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Boudreau G, Brassard A, Beaulieu N, Audet A, Péloquin K. Attachment and Sexual Functioning in Couples Seeking Fertility Treatment: The Role of Infertility-Specific Coping Strategies. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:395-412. [PMID: 38254305 DOI: 10.1080/0092623x.2024.2302019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Couples facing infertility often experience sexual difficulties. Yet, little is known about the factors associated with these difficulties. We examined whether infertility-related coping strategies explain the associations between attachment insecurities (anxiety, avoidance) and sexual function and satisfaction in 97 couples seeking fertility treatment. Anxiety was associated with one's lower sexual satisfaction and function via self-neglect coping strategies. Anxiety was also associated with the partner's lower sexual satisfaction via self-blame coping. Avoidance was associated with lower partner support-seeking and sexual satisfaction. These findings support the roles of attachment and coping in the experience of sexual difficulties among couples seeking fertility treatment.
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Affiliation(s)
- Gabrielle Boudreau
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Noémie Beaulieu
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ariane Audet
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Katherine Péloquin
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
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Alharbi A, Alomar TH, Alharbi TS, Alamri RS, Alharbi AK, Almadani BS. Saudi Female Sexual Dysfunction After Bariatric Surgery: A Cross-Sectional Survey. Cureus 2024; 16:e53196. [PMID: 38425602 PMCID: PMC10902206 DOI: 10.7759/cureus.53196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Obesity disrupts the equilibrium of sexual hormones, resulting in decreased sexual desire, arousal, and orgasm. The aim of this study was to investigate the effects of substantial weight loss after bariatric surgery on sexual function, psychological health, and the overall quality of sexual life in a group of Saudi females. Method The study used a cross-sectional design and was conducted at King Fahad Hospital in Medina, Saudi Arabia. The study included adult female patients who had previously undergone bariatric surgery. We used the Sexual Quality of Life for Female (SQoL-F) and the Female Sexual Function Index (FSFI) questionnaires to collect data. The study was extended from January 1, 2021, to December 30, 2022. Results A total of 100 participants were included in this study, all the samples underwent vertical sleeve gastrectomy, their mean age was 36.7±9.3, 94% (n=94) of the respondents had high school education or above, 50.0% (n=50) were unemployed, and around 13% (n=13) of the samples had a psychiatric history. Surgery complications were reported in 10% (n=10), which were reported as esophagitis (n=4), gastric ulcer (n=2), gastric stricture (n=1), infection (n=2), and leakage (n=1). The median of the FSFI and SQoL-F was 47.0 and 24.5, respectively. Approximately 66% of the respondents agreed that their sexual lives improved after surgery, 22% did not feel any difference before and after surgery, and 9% witnessed deterioration. In total, 61.0% had female sexual dysfunction (FSD) (25% had no dysfunction afterward, 45% had mild dysfunction, 27% suffered mild to moderate dysfunction, and only 2% had severe dysfunction). Regarding SQoL-F, the mean score was 5.59 for sexual repression, 6.1 for self-worthlessness, 18.56 for sexual and relationship satisfaction, and 16.4 for psychological feelings. Conclusions Bariatric surgery was associated with the improvement of female sexual function.
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Affiliation(s)
- Abdulhamid Alharbi
- General Surgery Obesity Center, King Fahad General Hospital, Medina, SAU
| | - Taif H Alomar
- Medicine, College of Medicine, Taibah University, Medina, SAU
| | - Taif S Alharbi
- Medicine and Surgery, College of Medicine, Taibah University, Medina, SAU
| | - Ranad S Alamri
- Medicine, College of Medicine, Taibah University, Medina, SAU
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Nguyen A, Schaff HV, Calderon-Rojas R, Qrareya MN, Ommen SR, Dearani JA, Todd A, Nishimura RA, Geske JB. Improvement in Sexual Dysfunction in Patients With Hypertrophic Cardiomyopathy Undergoing Septal Myectomy: A Prospective Study. JACC. ADVANCES 2024; 3:100763. [PMID: 38939809 PMCID: PMC11198599 DOI: 10.1016/j.jacadv.2023.100763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 06/29/2024]
Abstract
Background Septal myectomy improves symptoms in the majority of patients with obstructive hypertrophic cardiomyopathy (HCM), but there are limited prospective data on functional outcomes after operation. Objectives The authors investigated quality of life measures and prevalence of sexual dysfunction before and after septal myectomy for obstructive HCM. Methods Between January 2018 and October 2019, 436 patients underwent transaortic septal myectomy at our clinic. All patients were screened for eligibility, and 197 (45.2%) were enrolled in this prospective survey study. Patients received a questionnaire pertaining to quality of life and sexual health before and within 4 to 6 months postoperatively, and 113 (57.4%) completed the follow-up survey. Results The mean age of the 54 (47.8%) women and 59 (52.2%) men was 54.7 ± 14.1 years. Quality of life, including both mental and physical components, improved significantly in both men (P < 0.001) and women (P < 0.001). Women reported mild sexual dysfunction at baseline, and following septal myectomy, they experienced significant (P < 0.05) improvement in most domains pertaining to sexual health. In men, the International Index of Erectile Function median score was 23 (IQR: 7.0-29.5), which is consistent with mild dysfunction at baseline, and there was significant improvement following surgery in young (age ≤55 years) men (P < 0.001). Conclusions Quality of life is significantly improved following septal myectomy in patients with obstructive HCM. Both women and men reported mild sexual dysfunction at baseline, and women and younger men (age ≤55 years) experienced significant improvements in sexual health.
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Affiliation(s)
- Anita Nguyen
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Hartzell V. Schaff
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Mohammad N. Qrareya
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Steve R. Ommen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph A. Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Austin Todd
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Rick A. Nishimura
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey B. Geske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Günerhan G, Aykanat C, Uçkun OM, Aslan Y, Divanlıoğlu D, Işıtan E, Tunç B, Tuncel A, Belen AD, Dalgıç A. Evaluation of Sexual Function in Patients with Lower Lumbar Disc Herniation: A Comparison of Pre- and Postoperative Status. J Neurol Surg A Cent Eur Neurosurg 2024; 85:26-31. [PMID: 37263291 DOI: 10.1055/s-0042-1759824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Neuroregulation of sexual functions requires coordination of parasympathetic, sympathetic, and somatosensory neuronal pathways. The nerves formed by the lower lumbar plexus provide the innervation of the urogenital organs. Lower lumbar disc hernias (LDHs) might impair the neuroregulation of sexual functions by compressing the neural structures. This prospective study aims to evaluate the effect of lower LDHs on libido and sexual dysfunctions. METHODS A total of 61 sexually active patients diagnosed with single-level LDH who underwent unilateral microdiscectomy were included in the study. The patients' healthy sex partners were included in study as controls. The International Sexual Function Index-5 (IIEF-5) and Female Sexual Function Index (FSFI) were used for sexual assessment of male and female participants, respectively. Visual Analog Scale (VAS) was used for pain assessment. RESULTS According to the FSFI scores, all 20 female patients had preoperative sexual dysfunction, which improved in 15 (75%) patients after surgery (p < 0.001). According to the IIEF-5 score for men, 38 of 41 male patients had preoperative sexual dysfunction, which improved in 26 (68.4%) patients postoperatively (p < 0.001). CONCLUSION The preoperative sexual dysfunctions of LDH patients improved significantly after the microdiscectomy.
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Affiliation(s)
- Göksal Günerhan
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Can Aykanat
- Department of Urology, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Ozhan Merzuk Uçkun
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Yılmaz Aslan
- Department of Urology, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Denizhan Divanlıoğlu
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Egemen Işıtan
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Bekir Tunç
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Altuğ Tuncel
- Department of Urology, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Deniz Belen
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Ali Dalgıç
- Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey
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Flotyńska J, Szybiak W, Naskręt D, Zozulińska-Ziółkiewicz D, Grzelka-Woźniak A, Uruska A. Methods of Assessment of Physical Capacity in People with Diabetes Mellitus Type 1. Curr Diabetes Rev 2024; 20:e080623217810. [PMID: 37291777 DOI: 10.2174/1573399820666230608123917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/26/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND The article aims to present the most popular methods of assessing physical capacity. Moreover, the article sheds light on the beneficial impact of improving physical capacity in people with Diabetes Mellitus type 1 (DM1). METHODS A computer-based literature search of PubMed, SCOPUS and Web of Science included studies up to September 2022. RESULTS The significant role of regular physical exertion could be observed in the group of people suffering from DM1, which implicates a positive correlation between the activity and the remission time. A suitable and objective indicator of sport influence on the organism is physical capacity (PC), which describes the efficiency of the cardiovascular system and its correlation between BMI, sex, and age. PC is mostly shown as VO2max. Well metabolically controlled DM1 is not a contraindication to stress test. Even though physical activity is closely related to human history, the range of research into the importance of PC is still limited to particular groups of patients, which presents an opportunity for further research and future conclusions. CONCLUSIONS Undertaking physical activities has a multidirectional influence on the organism. According to up-to-date knowledge, various methods of PC assessment are available. Patients can choose more easily accessible, simpler, and cheaper options like CRT, RT, and HST which do not need specialized equipment and skills. They can also decide on more advanced examinations like ergospirometry, where direct measurements of VO2max and other cardiorespiratory parameters are made.
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Affiliation(s)
- Justyna Flotyńska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Weronika Szybiak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
| | - Dariusz Naskręt
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
| | - Dorota Zozulińska-Ziółkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
| | - Agata Grzelka-Woźniak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
| | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Poznan, Poland
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72
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Nguyen TTB, Hsu YY, Sari YP. The Effect of Pelvic Floor Muscle Training on Health-Related Quality of Life in Postmenopausal Women With Genitourinary Syndrome: A Systematic Review and Meta-Analysis. J Nurs Res 2024; 32:e316. [PMID: 38271065 DOI: 10.1097/jnr.0000000000000597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Genitourinary syndrome is commonly reported in postmenopausal women. Kegel's exercise is a noninvasive therapy that improves pelvic floor muscle parameters. However, the effect of Kegel's exercise on health-related quality of life (HRQoL) in postmenopausal women with genitourinary syndrome has not been synthesized or shown. PURPOSE This study was designed to systematically review and analyze the previous literature to determine whether Kegel's exercise enhances HRQoL in postmenopausal women with genitourinary syndrome of menopause. METHODS A systematic review and meta-analysis of randomized controlled trials was conducted, and six databases were searched, including Embase, MEDLINE, Cochrane, CINAHL, Web of Science, and Scopus, from their dates of inception to November 2021. Eligible studies evaluated the effects of Kegel's exercise on HRQoL in postmenopausal women with urinary, sexual, or genital symptoms. Review Manager software was used to perform the meta-analysis using a random-effects model. Chi-square and I2 tests were used to evaluate heterogeneity among the studies. Meta-analysis was performed based on the symptoms (i.e., urinary, sexual, and genital) identified in the quality-of-life questionnaires. RESULTS This systematic review covered five studies with 268 participants. The research appraisal found most of these studies had a low risk of bias. The intervention periods ranged from 4 to 12 weeks. Compared with non-Kegel's exercise or regular activity, Kegel's exercise was found to significantly improve HRQoL-related urinary symptoms (three studies, standardized mean difference = -0.95, 95% CI [-1.35, -0.54], I2 = 0%). However, the effect of this exercise on HRQoL-related sexual symptoms did not differ from non-Kegel's exercise or regular activity (two studies, standardized mean difference = 1.11, 95% CI [-0.25, 2.47], I2 = 94%). None of the covered studies examined the effect of Kegel's exercise on HRQoL-related genital symptoms. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Kegel's exercise is an effective intervention for improving HRQoL-related urinary symptoms in postmenopausal women. However, there remains insufficient evidence to assess the effectiveness of Kegel's exercise on HRQoL-related genital symptoms in this population. The results support using Kegel's exercise as a useful intervention to manage urinary symptoms in postmenopausal women.
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Affiliation(s)
- Tram Thi Bich Nguyen
- MS, RN, Doctoral Student, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Lecturer, Medical Simulation Center, Duy Tan University, Vietnam
| | - Yu-Yun Hsu
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
| | - Yanti Puspita Sari
- MSN, RN, Doctoral Candidate, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan; and Assistant Professor, Maternity and Child Health Nursing Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
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73
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Rooney MK, Pasli M, Chang GJ, Das P, Koay EJ, Koong AC, Ludmir EB, Minsky BD, Noticewala SS, Peacock O, Smith GL, Holliday EB. Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy. Cancers (Basel) 2023; 16:153. [PMID: 38201580 PMCID: PMC10778006 DOI: 10.3390/cancers16010153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Despite the increasing utilization of sphincter and/or organ-preservation treatment strategies, many patients with low-lying rectal cancers require abdominoperineal resection (APR), leading to permanent ostomy. Here, we aimed to characterize overall, sexual-, and bladder-related patient-reported quality of life (QOL) for individuals with low rectal cancers. We additionally aimed to explore potential differences in patient-reported outcomes between patients with and without a permanent ostomy. METHODS We distributed a comprehensive survey consisting of various patient-reported outcome measures, including the FACT-G7 survey, ICIQ MLUTS/FLUTS, IIEF-5/FSFI, and a specific questionnaire for ostomy patients. Descriptive statistics and univariate comparisons were used to compared demographics, treatments, and QOL scores between patients with and without a permanent ostomy. RESULTS Of the 204 patients contacted, 124 (60.8%) returned completed surveys; 22 (18%) of these had a permanent ostomy at the time of survey completion. There were 25 patients with low rectal tumors (≤5 cm from the anal verge) who did not have an ostomy at the time of survey completion, of whom 13 (52%) were managed with a non-operative approach. FACTG7 scores were numerically lower (median 20.5 vs. 22, p = 0.12) for individuals with an ostomy. Sexual function measures IIEF and FSFI were also lower (worse) for individuals with ostomies, but the results were not significantly different. MLUTS and FLUTS scores were both higher in individuals with ostomies (median 11 vs. 5, p = 0.06 and median 17 vs. 5.5, p = 0.01, respectively), suggesting worse urinary function. Patient-reported ostomy-specific challenges included gastrointestinal concerns (e.g., gas, odor, diarrhea) that may affect social activities and personal relationships. CONCLUSIONS Despite a limited sample size, this study provides patient-centered, patient-derived data regarding long-term QOL in validated measures following treatment of low rectal cancers. Ostomies may have multidimensional negative impacts on QOL, and these findings warrant continued investigation in a prospective setting. These results may be used to inform shared decision making for individuals with low rectal cancers in both the settings of organ preservation and permanent ostomy.
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Affiliation(s)
- Michael K. Rooney
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Melisa Pasli
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - George J. Chang
- Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA
| | - Prajnan Das
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Eugene J. Koay
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Albert C. Koong
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Ethan B. Ludmir
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Bruce D. Minsky
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Sonal S. Noticewala
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Oliver Peacock
- Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA
| | - Grace L. Smith
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
| | - Emma B. Holliday
- Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.K.R.); (M.P.); (S.S.N.)
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Verberkt C, Stegwee SI, Van der Voet LF, Van Baal WM, Kapiteijn K, Geomini PMAJ, Van Eekelen R, de Groot CJM, de Leeuw RA, Huirne JAF. Single-layer vs double-layer uterine closure during cesarean delivery: 3-year follow-up of a randomized controlled trial (2Close study). Am J Obstet Gynecol 2023:S0002-9378(23)02191-9. [PMID: 38154502 DOI: 10.1016/j.ajog.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The rising rate of cesarean deliveries has led to an increased incidence of long long-term complications, including niche formation in the uterine scar. Niche development is associated with various gynecologic complaints and complications in subsequent pregnancies, such as uterine rupture and placenta accreta spectrum disorders. Although uterine closure technique is considered a potential risk factor for niche development, consensus on the optimal technique remains elusive. OBJECTIVE We aimed to evaluate the effect of single-layer vs double-layer closure of the uterine incision on live birth rate at a 3-year follow-up with secondary objectives focusing on gynecologic, fertility, and obstetrical outcomes at the same follow-up. STUDY DESIGN A multicenter, double-blind, randomized controlled trial was performed at 32 hospitals in the Netherlands. Women ≥18 years old undergoing a first cesarean delivery were randomly assigned (1:1) to receive either single-layer or double-layer closure of the uterine incision. The primary outcome of the long-term follow-up was the live birth rate; with secondary outcomes, including pregnancy rate, the need for fertility treatment, mode of delivery, and obstetrical and gynecologic complications. This trial is registered on the International Clinical Trials Registry Platform www.who.int (NTR5480; trial finished). RESULTS Between 2016 and 2018, the 2Close study randomly assigned 2292 women, with 830 of 1144 and 818 of 1148 responding to the 3-year questionnaire in the single-layer and double-layer closure. No differences were observed in live birth rates; also there were no differences in pregnancy rate, need for fertility treatments, mode of delivery, or uterine ruptures in subsequent pregnancies. High rates of gynecologic symptoms, including spotting (30%-32%), dysmenorrhea (47%-49%), and sexual dysfunction (Female Sexual Function Index score, 23) are reported in both groups. CONCLUSION The study did not demonstrate the superiority of double-layer closure over single-layer closure in terms of reproductive outcomes after a first cesarean delivery. This challenges the current recommendation favoring double-layer closure, and we propose that surgeons can choose their preferred technique. Furthermore, the high risk of gynecologic symptoms after a cesarean delivery should be discussed with patients.
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Affiliation(s)
- Carry Verberkt
- Department of Obstetrics and Gynecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Sanne I Stegwee
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Lucet F Van der Voet
- Department of Obstetrics and Gynecology, Deventer Hospital, Deventer, The Netherlands
| | - W Marchien Van Baal
- Department of Obstetrics and Gynecology, Flevo Hospital, Almere, The Netherlands
| | - Kitty Kapiteijn
- Department of Obstetrics and Gynecology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Peggy M A J Geomini
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
| | - Rik Van Eekelen
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
| | - Christianne J M de Groot
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Robert A de Leeuw
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Judith A F Huirne
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Department of Obstetrics and Gynecology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
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Bottorff EC, Gupta P, Ippolito GM, Moore MB, Rodriguez GM, Bruns TM. Acute dorsal genital nerve stimulation increases subjective arousal in women with and without spinal cord injury: a preliminary investigation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.24.23288935. [PMID: 37163021 PMCID: PMC10168483 DOI: 10.1101/2023.04.24.23288935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Introduction Female sexual dysfunction (FSD) impacts an estimated 40% of women. Unfortunately, female sexual function is understudied, leading to limited treatment options for FSD. Neuromodulation has demonstrated some success in improving FSD symptoms. We developed a pilot study to investigate the short-term effect of electrical stimulation of the dorsal genital nerve and tibial nerve on sexual arousal in healthy women, women with FSD, and women with spinal cord injury (SCI) and FSD. Methods This study consists of a randomized crossover design in three groups: women with SCI, women with non-neurogenic FSD, and women without FSD or SCI. The primary outcome measure was change in vaginal pulse amplitude (VPA) from baseline. Secondary outcome measures were changes in subjective arousal, heart rate, and mean arterial pressure from baseline. Participants attended one or two study sessions where they received either transcutaneous dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS). At each session, a vaginal photoplethysmography sensor was used to measure VPA. Participants also rated their level of subjective arousal and were asked to report any pelvic sensations. Results We found that subjective arousal increased significantly from before to after stimulation in DGNS study sessions across all women. TNS had no effect on subjective arousal. There were significant differences in VPA between baseline and stimulation, baseline and recovery, and stimulation and recovery periods among participants, but there were no trends across groups or stimulation type. Two participants with complete SCIs experienced genital sensations. Discussion This is the first study to measure sexual arousal in response to acute neuromodulation in women. This study demonstrates that acute DGNS, but not TNS, can increase subjective arousal, but the effect of stimulation on genital arousal is inconclusive. This study provides further support for DGNS as a treatment for female sexual dysfunction.
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Affiliation(s)
- Elizabeth C. Bottorff
- University of Michigan, Biomedical Engineering Department, Ann Arbor, MI, USA
- University of Michigan, Biointerfaces Institute, Ann Arbor, MI, USA
| | - Priyanka Gupta
- University of Michigan, Department of Urology, Ann Arbor, MI, USA
| | | | - Mackenzie B. Moore
- University of Michigan, Biomedical Engineering Department, Ann Arbor, MI, USA
| | - Gianna M. Rodriguez
- University of Michigan, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI, USA
| | - Tim M. Bruns
- University of Michigan, Biomedical Engineering Department, Ann Arbor, MI, USA
- University of Michigan, Biointerfaces Institute, Ann Arbor, MI, USA
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Gil-Perotin S, Reddam S, González-Mingot C, Gil-Sánchez A, González-Suarez I, Peralta S, Escrivá P, Barea-Moya L, Sánchez-Sánchez B. Reliability, validity and distribution of the Spanish female sexual function index in women with relapsing multiple sclerosis. BMC Womens Health 2023; 23:663. [PMID: 38082275 PMCID: PMC10712072 DOI: 10.1186/s12905-023-02811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The Female Sexual Function Index (FSFI) is a widely recognized tool for assessing sexual dysfunction (SD). However, its validation for Spanish women suffering from multiple sclerosis (MS) has not yet been conducted. AIM The study aimed to examine the psychometric properties of the 19-item Spanish version of the FSFI (svFSFI) in women with relapsing MS. METHOD A total of 137 women with relapsing MS from three Spanish centers participated in the study and completed the svFSFI. The psychometric properties of the questionnaire were evaluated. The prevalence of SD in the study cohort was determined, and its association with clinical and sociodemographic variables was analyzed using bi- and multivariate regression analyses. RESULTS The svFSFI demonstrated excellent test-retest reliability and substantial-to-excellent internal consistency in the context of relapsing MS. There was significant convergent validity in the intercorrelations of domains. Discriminant validity showed differences in SD between women with high and low neurological disability, as measured by the Expanded Disability Status Scale (EDSS) scores. An exploratory factor analysis indicated a five-factor structure for the svFSFI. The prevalence of SD in the MS cohort was found to be 42.6%, with the 'desire' and 'arousal' domains being the most affected. Factors such as EDSS score, fatigue, depression, and having a stable partner were found to influence the total svFSFI score. CONCLUSION The study validates the svFSFI as a reliable and valid instrument for evaluating sexual dysfunction in Spanish women with MS.
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Affiliation(s)
- Sara Gil-Perotin
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- CIBER, Instituto de Salud Carlos III, Madrid, Spain.
| | - Salma Reddam
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Anna Gil-Sánchez
- Multiple Sclerosis Unit, Hospital Arnau de Vilanova, Lleida, Spain
| | | | - Silvia Peralta
- Multiple Sclerosis Unit, Hospital Arnau de Vilanova, Lleida, Spain
| | - Patricia Escrivá
- Sexual and Reproductive Health Unit, Centro de Salud Trinitat, Valencia, Spain
| | - Lucas Barea-Moya
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Beatriz Sánchez-Sánchez
- Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Physiotherapy in Women's Health (FPSM) Research Group, Madrid, Spain.
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Pigeon WR, Youngren W, Carr M, Bishop TM, Seehuus M. Relationship of insomnia to sexual function and sexual satisfaction: Findings from the sleep and sex survey II. J Psychosom Res 2023; 175:111534. [PMID: 37871507 DOI: 10.1016/j.jpsychores.2023.111534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Research suggests that healthy sleep is a key component of sexual function. When evaluating sexual function, however, poor sleep is often overlooked as a contributing factor. This cross-sectional survey expands prior work by exploring relationships among insomnia severity, sexual satisfaction, and sexual function with an updated battery of measures for the Sleep and Sex Survey. METHOD The sample (N = 1266) consisted of 618 men, 648 women recruited via Prolific, an online survey platform. The Sleep and Sex Survey II included measures addressing insomnia, fear of sleep, nightmares, sexual function, sexual satisfaction, sexual activity, depression, anxiety, posttraumatic stress, and alcohol use. RESULTS Recent sexual activity was correlated with better sleep, lower anxiety, and lower scores on a posttraumatic stress disorder screener. Insomnia severity was negatively correlated with sexual satisfaction (r = 0.22, p < .001) and the presence of insomnia was associated with higher rates of sexual dysfunction in women (53.8% vs. 31.8%; p < .001) and men (22.7% vs. 12.5%; p = .036). In regression analyses, after accounting for depression and anxiety, insomnia had a statistically significant association with sexual function for women (β = 0.12; p < .01) but not men (β = 0.11; p = .60). CONCLUSION Findings support a relationship of insomnia to sexual function and satisfaction with some gender differences. Future work may be enhanced by assessing these relationships in a gender diverse population including objective sleep measures and addressing contributing mechanisms. Clinically, findings support the assessment of sleep when evaluating patients for sexual dysfunction.
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Affiliation(s)
- Wilfred R Pigeon
- University of Rochester Medical Center, Department of Psychiatry, USA; U.S. Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, USA.
| | - Westley Youngren
- University of Missouri-Kansas City, Department of Psychology, USA
| | - Michelle Carr
- University of Montreal, Department of Psychiatry and Addictology, Canada
| | - Todd M Bishop
- University of Rochester Medical Center, Department of Psychiatry, USA; U.S. Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, USA
| | - Martin Seehuus
- Middlebury College, Psychology Department, USA; University of Vermont, Vermont Psychological Services, USA
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Iuliano S, Zagari MC, Frasca Polara G, Rotella G, LA Vignera S, Greco EA, Liuzza MT, Aversa A. Global olfactory function correlates with global sexual functioning in men and women. Minerva Med 2023; 114:785-794. [PMID: 37382520 DOI: 10.23736/s0026-4806.23.08753-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Olfaction is intimately involved in reproductive behaviors. However, there is limited evidence about the relationship between olfactory and sexual functioning, and whether this relationship is modulated by gender. This study aimed to investigate the correlates between olfactory and sexual functioning in a cohort of young healthy individuals; secondary outcomes were the possible correlates between disgust and perceived vulnerability to illness, with particular relation to sexual attitudes. METHODS Between January 2019 and December 2022, we enrolled 125 participants (51 males and 74 females) without known sexual disorders. The mean age was 28.47±8.6, and the mean Body Mass Index (BMI) was 23.86±3.3 without major disease or concomitant drug assumption, except for nutraceutical use. Olfactory sensitivity was tested with the Sniffin' Sticks Test (SST). Body Odor Disgust Scale (BODS) and Perceived Vulnerability to Disease (PVD) questionnaires were administered for the evaluation of perceived susceptibility to illness along with the Sexual Attitude Scale (SAS) for the evaluation of sexual attitudes. Sexual function was evaluated by the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) questionnaires, respectively. RESULTS Overall, a close relationship between sexual function and olfaction in both sexes (P<0.05) was found. In the male sample, better olfactive scores were positively correlated to all IIEF sub-domains but negatively with BMI and age, respectively (P<0.05). Moreover, olfaction was negatively correlated with a restrictive attitude towards sexuality (SAS) (P<0.05). The latter was also positively correlated with PVD (P<0.01). In the female sample, all FSFI subscales but sexual desire was positively correlated with olfaction (P<0.05). CONCLUSIONS We herein confirm that olfactory capacities positively correlate with sexual behavior in both sexes. In males, these findings were mostly dependent upon increasing age and BMI. In females all domains of sexual function but sexual desire correlated with olfactory capacity, thus suggesting independent neural pathway activation for sexual desire. Finally, better olfactory capacities seem to determine sexual attitudes and disease avoidance behaviors irrespective of gender.
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Affiliation(s)
- Stefano Iuliano
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Maria C Zagari
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Gabriele Frasca Polara
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Giovanna Rotella
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Sandro LA Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Marco T Liuzza
- Department of Surgical and Medical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy -
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Tian X, Ruan X, Du J, Cheng J, Ju R, Mueck AO. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2221736. [PMID: 37302412 DOI: 10.1080/09513590.2023.2221736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18-45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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80
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Sousa Rodrigues Guedes T, Barbosa Otoni Gonçalves Guedes M, Mikael Lopes J, de Castro Santana R, Borba de Vasconcelos J, Regina de Medeiros E, Leandro da Cunha V, Almeida Gomes Dantas A, Jerez-Roig J, Bezerra de Souza DL. Sexual dysfunction in women with breast cancer of Northeast Brazil: a retrospective longitudinal study. Sci Rep 2023; 13:20441. [PMID: 37993511 PMCID: PMC10665323 DOI: 10.1038/s41598-023-47684-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
Breast cancer treatment leads to physical and psychological changes. The aim of this study was to analyze the incidence of sexual dysfunction and its risk factors in women diagnosed with breast cancer. This retrospective cohort study included women diagnosed and treated for breast cancer (exposed group, n = 90) and healthy women (non-exposed group, n = 93). Data were collected from February 2019 to October 2021 in the state of Rio Grande do Norte (Northeast Brazil), from medical records and using the Female Sexual Function Index (FSFI) questionnaire. Data were collected from medical records and using the Female Sexual Function Index (FSFI) questionnaire. Primary outcomes were analyzed using binary logistic regression. The Mann-Whitney test was used to analyze FSFI domains between groups. The exposed group had a 74% incidence of sexual dysfunction and 3.9 times increased chances of having sexual dysfunction compared with the non-exposed group (OR 3.9, CI 1.8 to 8.2, p < 0.001). Presence of comorbidities increased the chances of sexual dysfunction by 2.5 times (OR 2.5, CI 1.2 to 4.9, p = 0.009). Women diagnosed and treated for breast cancer had a higher incidence of sexual dysfunction than healthy women. Furthermore, comorbidities also increased the chances of sexual dysfunction regardless of exposure to breast cancer.
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Affiliation(s)
- Thais Sousa Rodrigues Guedes
- Graduate Program in Health Science, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | | | | | - Rebeca de Castro Santana
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Jamily Borba de Vasconcelos
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Eva Regina de Medeiros
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Vitor Leandro da Cunha
- Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Amanda Almeida Gomes Dantas
- Graduate Program in Health Science, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models, and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, 08500, Vic, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain.
| | - Dyego Leandro Bezerra de Souza
- Department of Public Health, Graduate Program in Health Science, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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81
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Naert E, Decruyenaere A, Bultijnck R, De Jaeghere EA, Orije MRP, Salihi R, Verstraelen H, Tummers P, Denys HG, Vandecasteele K. Vaginal morbidity, sexual functioning, and health-related quality of life in cervical cancer survivors: a cross-sectional multicenter study (VAMOS). Support Care Cancer 2023; 31:703. [PMID: 37975947 DOI: 10.1007/s00520-023-08155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To compare sexual/vaginal functioning between early cervical cancer (ECC) and locally advanced cervical cancer (LACC) survivors. METHODS VAMOS was a multicenter, cross-sectional, questionnaire, noninferiority study including ECC patients treated with surgery and, if clinically indicated, adjuvant (chemo)radiotherapy and LACC patients treated with neoadjuvant (chemo)radiotherapy followed by surgery. Patient-reported outcomes (PROs) were assessed using the EORTC QLQ-C30, EORTC QLQ-CX24, and Female Sexual Functioning Index (FSFI) questionnaires. Clinical reported outcomes (ClinROs) consisted of vaginal morbidity scored according to the CTCAE v4.0 scoring system. RESULTS One hundred forty-three patients were included. Compared to ECC patients (n = 97), LACC patients (n = 46) were significantly less sexually active in the 4 weeks prior to completion of the questionnaires (65% vs. 41%; p = .005). The primary endpoint was not met: LACC patients reported a higher mean score (more problems) for sexual/vaginal functioning than ECC patients, with a non-clinically relevant mean difference of 6.38 ([95% CI: - 6.41, 19.17]; p = .570 for noninferiority). Regarding the secondary endpoints, the prevalence of sexual dysfunction between the two groups did not differ significantly (p = 0.124). Compared to ECC patients, LACC patients did not have significantly more vaginal morbidity (adjusted odds ratio [OR] 1.51 [95% CI: 0.22, 10.29]; p = .674). Moreover, there was poor agreement between any vaginal morbidity and sexual dysfunction (Cohen's kappa of 0.17). CONCLUSION Compared to ECC survivors, LACC survivors were significantly less sexually active and reported equivalent or worse sexual/vaginal functioning, although the proportion of patients with sexual dysfunction was similar. Clinical assessment of vaginal morbidity was poorly correlated with sexual dysfunction.
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Affiliation(s)
- Eline Naert
- Department of Medical Oncology, Ghent University Hospital, 9000, Ghent, Belgium.
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium.
| | - Alexander Decruyenaere
- Department of Medical Oncology, Ghent University Hospital, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Renée Bultijnck
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Emiel A De Jaeghere
- Department of Medical Oncology, Ghent University Hospital, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Marjolein R P Orije
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Rawand Salihi
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, 9000, Ghent, Belgium
- Department of Gynaecology, AZ Sint-Lucas, Ghent, Belgium
| | - Hans Verstraelen
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Philippe Tummers
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Obstetrics & Gynaecology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Hannelore G Denys
- Department of Medical Oncology, Ghent University Hospital, 9000, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Katrien Vandecasteele
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Gynecological Pelvic Oncology Network (GYPON), Ghent, Belgium
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, 9000, Ghent, Belgium
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82
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Borgmann M, Brandner LM, D'Urso D, Gonin-Spahni S, Znoj HJ, Werner MA. A Psychometric Study of a Trait and State Assessment of Sexual Pleasure - The Amsterdam Sexual Pleasure Inventory. JOURNAL OF SEX RESEARCH 2023:1-27. [PMID: 37971277 DOI: 10.1080/00224499.2023.2261439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
We studied the Amsterdam Sexual Pleasure Inventory's (1.0) psychometric properties. The ASPI, a revised self-report battery designed to measure domains of state and trait sexual pleasure in diverse gender, sex, and relationship populations, is based on a recently proposed conceptual framework of sexual pleasure. We collected quantitative (n = 1371) and qualitative data (n = 637) using a cross-sectional multi-method design targeting the general (German-speaking) population. After pre-processing, we conducted analyses on a sample of n = 706 participants. The theory-based 5-factor exploratory structural equation model and the principal component analyses of the two general exploratory index-scales showed good and acceptable structural validity evidence respectively. Measurement invariance was confirmed separately for male and female participants and for those with sexually functional-scoring and dysfunctional-scoring levels. Coefficient omega indicated that all scales, except those of one facet, showed acceptable to very good internal consistency. The ASPI's convergent and discriminant associations with sexological and psychological constructs demonstrated good overall construct validity. Participants understood the items as intended and felt that the ASPI covered relevant facets of sexual pleasure. The ASPI might help understand how individuals differ in experiencing sexual pleasure and how different contexts enable some people to experience pleasure while disadvantaging others.
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Affiliation(s)
- M Borgmann
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - L M Brandner
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - D D'Urso
- Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University
| | - S Gonin-Spahni
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - H J Znoj
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - M A Werner
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam Reproduction & Development, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam
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83
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Serquiz N, Sarmento ACA, Almeida NR, Nobre ML, Medeiros KS, Oliveira RD, Costa APF, Gonçalves AK. Laser and radiofrequency for treating genitourinary syndrome of menopause in breast cancer survivors: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e075841. [PMID: 37949628 PMCID: PMC10649472 DOI: 10.1136/bmjopen-2023-075841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Breast cancer survivors (BCSs) experience more severe symptoms of genitourinary syndrome of menopause (GSM) than healthy postmenopausal women. As hormonal therapy with oestrogen should be avoided in BCSs, finding an effective and safe therapy to address vaginal symptoms and sexual dysfunction is urgently needed. Physical methods may be promising alternatives for the specificities of this group of women. This review aims to evaluate the efficacy and safety of physical methods (laser and radiofrequency) for treating GSM in BCSs. METHODS AND ANALYSIS The PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov databases will be searched. A search strategy was developed to retrieve clinical trials that evaluate the efficacy and safety of any physical method (laser or radiofrequency) used for GSM in BCSs. No date or language restrictions will be imposed. Two authors will independently select studies by title, abstract and full text to meet the inclusion criteria. Data will be extracted, and the risk of bias will be evaluated using the Cochrane risk-of-bias tool (RoB 2). Review Manager 5.4.1 will be used for data synthesis. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the strength of the evidence. ETHICS AND DISSEMINATION This study reviews the published data; thus, obtaining ethical approval is unnecessary. The findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42023387680.
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Affiliation(s)
- Nicoli Serquiz
- Postgraduate Program student in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Obstetrics and Gynecology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ayane Cristine Alves Sarmento
- Postgraduate Program student in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Natalie Rios Almeida
- Postgraduate Program student in Obstetrics and Gynecology, UNICAMP, Campinas, Brazil
| | - Maria Luisa Nobre
- Postgraduate Program student in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Surgery, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Ronnier de Oliveira
- Graduate medical student, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana Paula Ferreira Costa
- Postgraduate Program student in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Institute of Teaching, Research and Innovation, League Against Cancer, Natal, Brazil
| | - Ana Katherine Gonçalves
- Postgraduate Program student in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Obstetrics and Gynecology, Federal University of Rio Grande do Norte, Natal, Brazil
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84
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Morrel B, van der Avoort IAM, Ewing‐Graham PC, Damman J, Schappin R, van Zeijl KN, Voorham QJM, ten Kate‐Booij MJ, Burger CW, Pasmans SGMA. Long-term consequences of juvenile vulvar lichen sclerosus: A cohort study of adults with a histologically confirmed diagnosis in childhood or adolescence. Acta Obstet Gynecol Scand 2023; 102:1469-1478. [PMID: 37632250 PMCID: PMC10577632 DOI: 10.1111/aogs.14668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Vulvar lichen sclerosus (VLS) occurs in at least one in 900 girls. There is limited knowledge as to what extent the disease persists in adulthood and what the repercussions in adulthood may be. The aim of this study is to evaluate the long-term consequences of VLS diagnosed in childhood or adolescence. MATERIAL AND METHODS The population of females histologically diagnosed with VLS in childhood or adolescence in the Netherlands between 1991 and 2015 was identified through the national pathology database. Histological specimens were retrieved and re-evaluated. Potential participants for whom the diagnosis was reconfirmed and who are now adults, were then traced and surveyed. Descriptive statistics were calculated and compared with the literature. Main outcome measures are the demographics of the cohort, their scores on standardized quality of life (QoL) and sexuality questionnaires and answers to additional questions regarding patients' experience with the disease. The questionnaires used were the Dermatology Life Quality Index (DLQI), the Skindex-29, the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). Secondary outcome measures include obstetric history and histological features found in the original tissue specimens. RESULTS A total of 81 women participated, median age 29.0 years, median follow-up from childhood diagnosis 19.5 years. Both QoL and sexuality were somewhat affected in 51.9% of cases. Less than half (45%) reported having regular check-ups. Forty-five (56%) reported symptoms within the past year; of those with symptoms, 14 (31%) were not under surveillance. Cesarean section rate (14.5%) was comparable to the general population, and there were more high-grade obstetric anal sphincter injuries with vaginal deliveries than expected. Sixteen respondents (20%) were not aware of the childhood diagnosis prior to this study. CONCLUSIONS Symptoms due to VLS are reported by most adults diagnosed as juveniles. QoL and sexuality are affected and correlate to recent symptoms. VLS as a juvenile does not preclude a vaginal delivery. Women diagnosed with VLS in childhood or adolescence are often lost to follow-up.
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Affiliation(s)
- Beth Morrel
- Department of Obstetrics and GynecologyErasmus MC University Medical CenterRotterdamThe Netherlands
- Department of DermatologySophia Children's Hospital‐Center of Pediatric Dermatology; Erasmus MC University Medical Center Rotterdam‐Sophia Children's HospitalRotterdamThe Netherlands
| | | | | | - Jeffrey Damman
- Department of PathologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Renske Schappin
- Department of DermatologySophia Children's Hospital‐Center of Pediatric Dermatology; Erasmus MC University Medical Center Rotterdam‐Sophia Children's HospitalRotterdamThe Netherlands
| | - Kelly N. van Zeijl
- Department of DermatologySophia Children's Hospital‐Center of Pediatric Dermatology; Erasmus MC University Medical Center Rotterdam‐Sophia Children's HospitalRotterdamThe Netherlands
| | | | | | - Curt W. Burger
- Research and Development Office (RDO)Erasmus MC University Medical CenterRotterdamThe Netherlands
| | - Suzanne G. M. A. Pasmans
- Department of DermatologySophia Children's Hospital‐Center of Pediatric Dermatology; Erasmus MC University Medical Center Rotterdam‐Sophia Children's HospitalRotterdamThe Netherlands
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85
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Hashim R, Forde R, Ausili D, Forbes A. Prevalence and associated factors of sexual dysfunction in premenopausal women with type 1 diabetes: A systematic review and meta-analysis. Diabet Med 2023; 40:e15173. [PMID: 37403653 DOI: 10.1111/dme.15173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) in women with diabetes is a multifaceted complication driven by hormonal, neuropathic and psychosocial factors. It has been reported that the prevalence of SD is higher in women with type 1 diabetes compared to both women with type 2 diabetes and women without diabetes. However, prevalence estimates of SD in women with type 1 diabetes are variable, due to the heterogeneity of the conducted studies and the various confounding factors that are associated with SD. AIM This review aimed to estimate the prevalence of SD in premenopausal women with type 1 diabetes compared to women without diabetes; consider current methods for measuring SD; and identify factors associated with SD in women with type 1 diabetes. METHOD A systematic review of the literature was conducted. Four electronic databases (Embase, MEDLINE, CINAHL, PsycINFO) were searched between 15 March and 29 April 2022, the search was updated on 4 February 2023 to identify studies that assessed SD in women with type 1 diabetes. FINDINGS The search yielded in 1104 articles; of these, 180 were assessed for eligibility. A meta-analysis of eight eligible studies revealed that the odds of experiencing SD is three times higher in women with type 1 diabetes compared to women without diabetes (OR = 3.8 95%CI 1.8-8.0, p < 0.001). The most commonly used measure of SD was the female sexual function index (FSFI); in three studies, this was combined with the female sexual distress scale (FSDS). Factors that have shown significant association with SD are depression, anxiety and duration of diabetes. CONCLUSION This review has shown that SD is a significant issue for women with type 1 diabetes. These findings should encourage diabetes professionals and policymakers to give more attention to female SD (FSD) by incorporating it into care pathways and clinical guidelines.
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MESH Headings
- Female
- Humans
- Sexual Dysfunctions, Psychological/epidemiology
- Sexual Dysfunctions, Psychological/etiology
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/psychology
- Prevalence
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/epidemiology
- Sexual Dysfunction, Physiological/epidemiology
- Sexual Dysfunction, Physiological/etiology
- Sexual Dysfunction, Physiological/psychology
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Affiliation(s)
- Rahab Hashim
- Division of Care in Long-Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Diabetes Centre, University Hospital Bristol and Weston NHS Trust, Weston General Hospital, North Somerset, UK
| | - Rita Forde
- Division of Care in Long-Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Davide Ausili
- Dipartimento di Medicina e Chirurgia, Milano-Bicocca UNIMIB, Milan, Italy
| | - Angus Forbes
- Division of Care in Long-Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Capezzuoli T, Maseroli E, Barra F, Vannuccini S, Vignozzi L, De Mitri P, Baggio S, Ceccaroni M, Petraglia F. Endometriosis and sexual disorders: the effect of surgical and medical treatment, a multicentre cross-sectional study. F1000Res 2023; 12:1424. [PMID: 39006305 PMCID: PMC11240085 DOI: 10.12688/f1000research.141537.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 07/16/2024] Open
Abstract
Background Sexual health is a major concern in women with endometriosis, however only a few controlled studies have examined this with validated instruments. The effect of hormonal treatments on sexual function in endometriosis is also an underrated topic. The aim of this study was to investigate sexual function of patients with endometriosis by a specific tool to better evaluate their sexual function (including different domains), and the influence of hormonal treatment or surgery on these parameters. Methods An observational, cross-sectional, multicentre study was conducted in a group (n=194) of sexually active, women aged 25-45 years old, with surgical or ultrasonographic diagnosis of endometriosis, referred to the Endometriosis Center of Careggi University Hospital or Negrar di Valpolicella. Sexual function was assessed by administering the Female Sexual Function Index (FSFI), which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction and pain. FSFI scores were compared to those of a control group (n=58) and according to the treatment received by patients with endometriosis. Results Ovarian endometriosis was present in 50 patients (25.8%), deep infiltrating endometriosis in 65 patients (33.5%) and both in 79 patients (40.7%). Adenomyosis coexisted in 102 patients (52.6%). Women with endometriosis reported a mean total FSFI score of 18.3 [4.2-25.8] (< 26.55), indicating female sexual dysfunction (FSD) in all patients. At multivariate analysis, after adjusting for confounders (BMI and hormonal therapy), women with endometriosis presented significantly lower scores than controls in all the FSFI (p<0.001). Patients with endometriosis under hormonal treatments (n=124; 64%), regardless of the type, had significantly lower scores in all FSFI subscales and total score, even after adjusting for confounders-age, BMI and history of surgery. Conclusions Patients with endometriosis are at risk for FSD, encompassing not only dyspareunia, but all domains of sexual function. Hormonal treatments do not result in improvement in sexual symptoms.
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Affiliation(s)
- Tommaso Capezzuoli
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Fabio Barra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Liguria, Italy
- Unit of Obstetrics and Gynecology, P.O. "Ospedale del Tigullio"- ASL4, Genoa, Italy
| | - Silvia Vannuccini
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Tuscany, Italy
| | - Paola De Mitri
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Silvia Baggio
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Felice Petraglia
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
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Mollà-Casanova S, Muñoz-Gómez E, Sempere-Rubio N, Inglés M, Aguilar-Rodríguez M, Moreno-Cervera N, Serra-Añó P. Fibromyalgia syndrome is associated with sexual dysfunction regardless of physical activity status: a cross-sectional study. J Sex Med 2023; 20:1285-1291. [PMID: 37740987 DOI: 10.1093/jsxmed/qdad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. AIM The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. METHODS The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. OUTCOMES The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. RESULTS There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). CLINICAL IMPLICATIONS Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. STRENGTHS AND LIMITATIONS The main limitation is that the outcome measures were self-reported. CONCLUSION We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.
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Affiliation(s)
- Sara Mollà-Casanova
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Elena Muñoz-Gómez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Núria Sempere-Rubio
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Inglés
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Aguilar-Rodríguez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Noelia Moreno-Cervera
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Pilar Serra-Añó
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
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Zeleke FT, Ezedin S, Aleminew F, Alem KG, Tefera DT, Demissie M, Beriso Jima G, Endeshaw F, Belay A, Ayele A, Andebet D, Zegeye AM. Sexual dysfunction and its associated factors among reproductive-age women at Gurage Zone, Southern Ethiopia, 2023. BMC Public Health 2023; 23:2029. [PMID: 37853332 PMCID: PMC10583327 DOI: 10.1186/s12889-023-16938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Female sexual dysfunction is commonly neglected, under-investigated, and under-treated in Ethiopia. Therefore, this study aimed to determine the prevalence and its associated factors of female sexual dysfunction among reproductive-aged women at Gurage zone hospitals, in southern Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 424 reproductive-age group women. A systematic random sampling method was employed and structured questionnaires were used to collect the data through a face-to-face interview. Data were entered into EpiData version 4.6 and analyzed by SPSS version 25.0. Descriptive statistics, and bivariable, and multivariable logistic regression were conducted. Statistical significance was declared at a p-value of < 0.05. RESULT Four hundred two participants completed the interview with a response rate of 94.8%. Arousal dysfunction 91.0% and pain during sexual intercourse 39.3% were the most and the least prevalent domains of female sexual dysfunction respectively. Overall 32.1% of the respondents had female sexual dysfunction. Body mass index (AOR = 3.6; 95% CI: 1.2, 10.8), history of pelvic surgery (AOR = 3.5; 95% CI: 1.3, 9.2), marriage satisfaction (AOR = 3.9; 95% CI: 1.4, 1o.6), a satisfaction of spouses' sex ability (AOR = 3.1; 95% CI: 1.2, 8.5), breastfeeding (AOR = 3.3; 95% CI: 1.6, 7.0), and mode of delivery [vaginal delivery with tear and episiotomy (AOR = 3.7; 95% CI: 1.6, 8.8), instrument assisted vaginal delivery (AOR = 7.0; 95% CI: 1.2, 39.8)], were statistically associated with female sexual dysfunction. All-encompassing professional counseling addressing psychological and interpersonal acts and weight management interventions are needed for couples to maintain sexual functioning.
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Affiliation(s)
- Fentahun Tamene Zeleke
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
| | - Semer Ezedin
- Wolkite University Specialized Hospital, Wolkite, Ethiopia
| | - Fentahun Aleminew
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kassa Genetu Alem
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Daniel Tsega Tefera
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mebratu Demissie
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Gudeta Beriso Jima
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fikremariam Endeshaw
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Aynalem Belay
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Alemitu Ayele
- College of Health Sciences, Department of Midwifery, Madawalabu University, Robe, Ethiopia
| | - Demeke Andebet
- Department of Midwifery, Hailu Alemu College, Gojjam, Ethiopia
| | - Ambaye Minayehu Zegeye
- Department of Midwifery, College of Medicine and Health Sciences, Asossa University, Asossa, Ethiopia
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Fischer VJ, Andersson G, Billieux J, Infanti A, Vögele C. The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:123-136. [PMID: 37822263 DOI: 10.1080/0092623x.2023.2264863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
We investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies.
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Affiliation(s)
- Vinicius Jobim Fischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Alexandre Infanti
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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90
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Daescu AMC, Dehelean L, Navolan DB, Pop GN, Stoian DL. Psychometric properties of the Romanian version of the female sexual function index (FSFI-RO). BMC Womens Health 2023; 23:528. [PMID: 37803305 PMCID: PMC10559518 DOI: 10.1186/s12905-023-02676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Female sexual dysfunction (FSD) is a highly prevalent health disorder and no self-report questionnaire on female sexual function is available in Romanian. Therefore we considered the Female Sexual Function Index (FSFI) to be the most appropriate due to its excellent psychometric properties. The FSFI is a measuring scale with 19 items that assess the six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction and pain. The paper aims to analyze the psychometric reliability and validity of the FSFI-RO (Romanian Version of the Female Sexual Function Index). METHODS 385 women (aged 18 to 51) enrolled in the present study. To assess the presence of FSD we used the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for sexual dysfunction. Then we categorized the participants into two groups: the FSD group (41%) and the healthy control group (59%). Women were then asked to fill out a form that included sociodemographic information and the FSFI-RO questionnaire. A sample of 50 women agreed to re-answer FSFI-RO in a 4-week interval in order to evaluate the test-retest validity of the questionnaire. The data were summarized using descriptive statistics: the test-retest reliability was measured by the intraclass correlation coefficient (ICC); Cronbach's alpha was employed to evaluate the internal consistency of the Romanian version of the FSFI, and validity was assessed by the content and construct validity. RESULTS The results showed high test-retest reliability, with ICC from 0.942 to 0.991 in the domains and 0.987 in the total score. Regarding the internal consistency of the FSFI-RO, Cronbach's α coefficients were found to be high (α = 0.944). Convergent construct validity proved to be moderate to high in desire, arousal, lubrication, orgasm and, satisfaction domains, and weak correlation in the pain domain. Regarding the discriminant construct validity, the scores for each domain and the total score showed statistically significant differences between the FSD group and the control group. CONCLUSIONS The FSFI-RO showed similar psychometric properties to those of the original version, therefore being a reliable and valid instrument that can be used in Romanian-speaking women.
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Affiliation(s)
- Ana-Maria Cristina Daescu
- PhD School Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Liana Dehelean
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania.
| | - Dan-Bogdan Navolan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Gheorghe Nicusor Pop
- Department of Cardiology, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Dana Liana Stoian
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
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91
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Fabricio AMF, Sato TO, Gomes da Silva S, Poli GG, de Araujo Silva CM, Padovez RDFCM, Rodrigues de Souza DP, Driusso P, Beleza ACS. Prevalence and factors associated with sexual dysfunction in brazilian women: a cross-sectional study. Int Urogynecol J 2023; 34:2507-2511. [PMID: 37222738 DOI: 10.1007/s00192-023-05562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/15/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Changes in the mechanisms that modulate sexual response can contribute to the development of female sexual dysfunction (FSD). Although the prevalence of FSD in Brazil has been established, its associated risk factors have not been thoroughly examined. This study aimed to determine the prevalence of FSD in Brazilian women and identify any factors that may be associated with its presence. METHODS This study used a cross-sectional design and included women aged 18 years or older who had engaged in sexual activity within the past four weeks. Participants completed the Female Sexual Function Index (FSFI) and a sociodemographic and health questionnaire. Two groups were created based on FSFI scores: those with risk for FSD (score >26.55) and those without. The study used t-tests for independent samples to compare quantitative variables between the groups, and the chi-squared test, to compare categorical variables. Binomial logistic regression was used to test the association between sociodemographic and health variables and FSD. RESULTS FSD had a prevalence of 31.7% (95% CI: 28.2%-35.5%). The results indicated that practice of physical activity was inversely associated with FSD (OR: 0.64, 95% CI: 0.45-0.92), whereas urinary incontinence (OR: 2.55, 95% CI: 1.68-3.87) and post-menopause (OR: 4.69, 95% CI: 1.66-13.3) were directly associated with FSD. CONCLUSIONS A high prevalence of FSD was observed among Brazilian women in this study. Physically active women are less likely to have FSD. Menopause and the presence of urinary incontinence can negatively impact female sexual function.
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Affiliation(s)
| | - Tatiana Oliveira Sato
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | - Stéfany Gomes da Silva
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | - Giovana Garçoni Poli
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | | | | | | | - Patricia Driusso
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
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Ferrández Infante A, Novella Arribas B, Khan KS, Zamora J, Jurado López AR, Fragoso Pasero M, Suárez Fernández C. Obesity and female sexual dysfunctions: A systematic review of prevalence with meta-analysis. Semergen 2023; 49:102022. [PMID: 37331210 DOI: 10.1016/j.semerg.2023.102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/20/2023]
Abstract
Obesity represents a major global health challenge. Female sexual dysfunctions have a negative impact on quality of life and overall health balance. A higher rate of female sexual dysfunctions in obese women has been suggested. This systematic review summarized the literature on female sexual dysfunction prevalence in obese women. The review was registered (Open Science Framework OSF.IO/7CG95) and a literature search without language restrictions was conducted in PubMed, Embase and Web of Science, from January 1990 to December 2021. Cross-sectional and intervention studies were included, the latter if they provided female sexual dysfunction rate data in obese women prior to the intervention. For inclusion, studies should have used the female sexual function index or its simplified version. Study quality was assessed to evaluate if female sexual function index was properly applied using six items. Rates of female sexual dysfunctions examining for differences between obese vs class III obese and high vs low quality subgroups were summarized. Random effects meta-analysis was performed, calculating 95% confidence intervals (CI) and examining heterogeneity with I2 statistic. Publication bias was evaluated with funnel plot. There were 15 relevant studies (1720 women participants in total with 153 obese and 1567 class III obese women). Of these, 8 (53.3%) studies complied with >4 quality items. Overall prevalence of female sexual dysfunctions was 62% (95% CI 55-68%; I2 85.5%). Among obese women the prevalence was 69% (95% CI 55-80%; I2 73.8%) vs 59% (95% CI 52-66%; I2 87.5%) among those class III obese (subgroup difference p=0.15). Among high quality studies the prevalence was 54% (95% CI 50-60%; I2 46.8%) vs 72% (95% CI 61-81%; I2 88.0%) among low quality studies (subgroup difference p=0.002). There was no funnel asymmetry. We interpreted that the rate of sexual dysfunctions is high in obese and class III obese women. Obesity should be regarded as a risk factor for female sexual dysfunctions.
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Affiliation(s)
- A Ferrández Infante
- Coordinator of the Primary Care Physicians Spanish Society (SEMERGEN) Sexology Working Group, Guadarrama Continuity Care Center, 28440 Madrid, Spain.
| | - B Novella Arribas
- Grupo de Investigación 49, Instituto de Investigación del Hospital Universitario de La Princesa, Foundation for Biomedical Research and Innovation in Primary Care of the Community of Madrid (FIIBAP), 28006 Madrid, Spain
| | - K S Khan
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
| | - J Zamora
- Head of the Clinical Biostatistics Unit, Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - A R Jurado López
- Member of the Primary Care Physicians Spanish Society (SEMERGEN) Sexology Working Group, President of the European Institute of Sexology, 29602 Marbella, Spain
| | - M Fragoso Pasero
- Biostatistician, Grupo de Investigación 49, Instituto de Investigación del Hospital Universitario de La Princesa, Foundation for Biomedical Research and Innovation in Primary Care of the Community of Madrid (FIIBAP), 28006 Madrid, Spain
| | - C Suárez Fernández
- Head of the Internal Medicine Service of the Hospital Universitario de La Princesa, 28006 Madrid, Spain
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93
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Puri I, Sharma R, Dewan D, Angurana S, Abrol D, Kumar D. Sexual function status after adjuvant radiation including vaginal cuff brachytherapy in survivors of cancer cervix. J Cancer Res Ther 2023; 19:1721-1724. [PMID: 38376270 DOI: 10.4103/jcrt.jcrt_114_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 02/21/2024]
Abstract
CONTEXT Adjuvant radiation therapy plays an important role in the management of high-risk cervical cancer after radical hysterectomy or inadvertent hysterectomy. The prime concern with the use of dual modality is steep decline in sexual well-being in cervical cancer survivors. Intravaginal brachytherapy (IVBT) delivered by vaginal cylinder or ovoids is essential for local control but at the cost of impairment of sexual function. AIM The purpose of this study was to assess the sexual well-being of cervical cancer survivors, who underwent surgery followed by adjuvant radiation and compare the subgroups of ovoids with sorbo brachytherapy. SETTINGS AND DESIGN This was an observational, cross-sectional, and analytical study, whereby we evaluated sexual function of cervical cancer survivors by the Female Sexual Function Index (FSFI) instrument. SUBJECTS AND METHODS Seventy-five women, identified as cervical cancer survivors who had received adjuvant radiation and IVBT, were administered FSFI questionnaire in face-to-face interviews. RESULTS The mean age of 75 interviewed women was 48.64 years. Fifty survivors had received IVBT with a sorbo applicator and twenty-five with ovoids. FSFI full score ranged from 4.4 to 32.40. The mean full score for the whole group was 11.3. The mean FSFI full score was 24.91 (± standard deviation [SD] 5.71) in the ovoid group versus 4.49 (± SD 0.35) in the sorbo group. On Pearson's correlation analysis, age and type of brachytherapy were significantly correlated with FSFI full score (P = 0.006) with correlation coefficient of - 0.312 and - 0.948, respectively. CONCLUSIONS Sexual dysfunction was found prevalent in 83% of cervical cancer survivors. The patients treated with IVBT with sorbo had worse sexual functioning than those treated with ovoids.
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Affiliation(s)
- Isha Puri
- Department of Radiotherapy and Oncology, Government Medical College, Kathua, India
| | - Rahul Sharma
- Department of Radiotherapy and Oncology, Government Medical College, Kathua, India
| | - Deepika Dewan
- Department of Community Medicine, Government Medical College, Kathua, India
| | - Shabab Angurana
- Department of Radiotherapy and Oncology, Government Medical College, Kathua, India
| | - Deepak Abrol
- Department of Radiation Oncology, Government Medical College, Kathua, India
| | - Dinesh Kumar
- Department of Community Medicine and Dean Academics, AIIMS, Jammu and Kashmir, India
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Reis YA, Akay A, Aktan B, Tetik S, Fıratlıgil FB, Kayıkçıoğlu F. The Effect of Clinical Pilates Exercises and Prenatal Education on Maternal and Fetal Health. Z Geburtshilfe Neonatol 2023; 227:354-363. [PMID: 37473767 DOI: 10.1055/a-2096-6454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The mental, physical and sexual health of women as well as maternal and fetal health should be considered during the prenatal and postnatal periods. Investigating the effect of clinical Pilates exercises and prenatal education (CPE & PE) on obstetric and neonatal outcomes as well as the mental, physical, and sexual health of women was intended. METHODS In the second trimester, mothers with singleton pregnancies who attended (n=79, study group) or did not attend (n=80, control group) CPE & PR were recruited to this prospective cohort study, and were evaluated in the prenatal and postnatal periods. Depression was assessed with Beck Depression Inventory (BDI), sexual functions with Female Sexual Function Index (FSFI), muscle strength with Gross Muscle Scales (GMS), and labor pain with Visual Analogue Scale (VAS). In addition, the presence of low back pain (LBP) was questioned. RESULTS No significant association of CPE & PE with obstetric outcomes such as cesarean rates, preterm birth, and neonatal outcomes such as birth weight and Apgar scores were identified. Changes in VAS scores, the incidence of perineal trauma, and episiotomy were not associated with CPE & PE. However, CPE & PE was associated with lower BDI scores, a gradual increase in the total scores of FSFI, increased GMS, and reduced LBP. CONCLUSION CPE & PE had no adverse effects on obstetric and neonatal outcomes and was associated with improved mental, physical, sexual health scores during pregnancy and postpartum.
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Affiliation(s)
- Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Arife Akay
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Berrin Aktan
- Physiotherapist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Sinan Tetik
- Psychologist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fahri Burçin Fıratlıgil
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fulya Kayıkçıoğlu
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
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Schroeder JE, Michaeli T, Luria M, Itshayek E, Kaplan L. Long-Term Effects on Sexual Function in Women Treated With Scoliosis Correction for Adolescent Idiopathic Scoliosis. Global Spine J 2023; 13:2239-2244. [PMID: 35225030 PMCID: PMC10538342 DOI: 10.1177/21925682221079263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study with a cross-sectional comparison. OBJECTIVES To assess sexual function and experience in adult women who had scoliotic correction for adolescent idiopathic scoliosis (AIS). METHODS Women ages 18-40 years with a history of scoliosis, who were braced or underwent uncomplicated posterior scoliosis correction for AIS, followed for two years or more since treatment were included. Sexual function was assessed using the Female Sexual Distress Scale-Revised (FSDS-R) and the Female Sexual Function Index (FSFI) questionnaires. Participants' scores were compared to those of a control group consisting of age-matched healthy women. RESULTS Of 115 women who responded to the questionnaires, 40 (35%) had surgical treatment (mean age 25.1; range 19-35 years; mean time since surgery 8.2 years; range 3-12 years) and 35 (30%) were braced (mean age 23.3; range 18-27 years; mean time since treatment 3.6 years; range 3-5 years). The control group consisted of a cohort of 40 (35%) aged-matched healthy women. According to the FSDS-R, significantly more women with scoliotic correction for AIS reported sexual distress compared to healthy controls (25% vs 12%, respectively), and the difference in the total mean scores (7.05 vs 5.34, respectively), was significant (P < .001). Additionally, the mean overall FSFI score for scoliotic-corrected women was 24.2 (range 17.5-29.1) within the pathological range (<26.55) of sexual dysfunction. CONCLUSIONS High rates of sexual distress and dysfunction were reported in women with a history of AIS, thus, there appears to be long-term consequences years after deformity correction by brace or surgical correction.
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Affiliation(s)
- Josh E. Schroeder
- Department of Orthopedics, Spine Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Tal Michaeli
- Department of Orthopedics, Spine Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Mijal Luria
- Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem Israel
| | - Eyal Itshayek
- Department of Neurosurgery, Beilinson medical Center, Petah Tikva, Israel
| | - Leon Kaplan
- Department of Orthopedics, Spine Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Stone MA, Lissenberg-Witte BI, de Bree R, Hardillo JA, Lamers F, Langendijk JA, Leemans CR, Takes RP, Jansen F, Verdonck-de Leeuw IM. Changes in Sexuality and Sexual Dysfunction over Time in the First Two Years after Treatment of Head and Neck Cancer. Cancers (Basel) 2023; 15:4755. [PMID: 37835448 PMCID: PMC10571543 DOI: 10.3390/cancers15194755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/18/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
The aim of this study was to investigate changes in sexuality and sexual dysfunction in head and neck cancer (HNC) patients in the first two years after treatment, in relation to the type of treatment. Data were used of 588 HNC patients participating in the prospective NETherlands Quality of life and Biomedical Cohort Study (NET-QUBIC) from diagnosis to 3, 6, 12 and 24 months after treatment. Primary outcome measures were the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). The total scores of the IIEF and FSFI were dichotomized into sexual (dys)function. In men, type of treatment was significantly associated with change in erectile function, orgasm, satisfaction with intercourse, and overall satisfaction. In women, type of treatment was significantly associated with change in desire, arousal, and orgasm. There were significant differences between treatment groups in change in dysfunctional sexuality. A deterioration in sexuality and sexual dysfunction from baseline to 3 months after treatment was observed especially in patients treated with chemoradiation. Changes in sexuality and sexual dysfunction in HNC patients were related to treatment, with an acute negative effect of chemoradiation. This effect on the various domains of sexuality seems to differ between men and women.
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Affiliation(s)
- Margot A. Stone
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.A.S.); (C.R.L.); (F.J.)
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands;
| | - Birgit I. Lissenberg-Witte
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands;
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CS Utrecht, The Netherlands;
| | - Jose A. Hardillo
- Department of Otorhinolaryngology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands;
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - C. René Leemans
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.A.S.); (C.R.L.); (F.J.)
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands;
| | - Robert P. Takes
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Femke Jansen
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.A.S.); (C.R.L.); (F.J.)
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands;
| | - Irma M. Verdonck-de Leeuw
- Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.A.S.); (C.R.L.); (F.J.)
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands;
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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97
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Khajoei Nejad F, Rafati F, Rafati S, Dastyar N. The association between sexual function, quality of marital relationship and associated factors in women with a history of ectopic pregnancy: a cross-sectional study in Iran. BMC Womens Health 2023; 23:506. [PMID: 37735651 PMCID: PMC10512585 DOI: 10.1186/s12905-023-02635-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Ectopic pregnancy (EP) has many adverse effects on the relationship between couples. The present study aims to assess the association between sexual function (SF), quality of marital relationship (QMR) and associated factors in women with a history of EP. METHOD This cross-sectional study was performed on 220 women with a history of EP in Kerman in 2022. Convenience sampling method was applied. Data were collected using the female sexual function index (FSFI) and the perceived relationship quality components scale (PRQC) questionnaires and were analyzed with descriptive and inferential statistics (median regression) in Stata software version 17. A P-value < 0.05 was considered statistically significant. RESULTS Of the female participants, 20.4% had sexual dysfunction (SD). Longer duration of marriage (P = 0.045) and increase in the number of EPs (P < 0.001) were associated with a decrease in SF. A quarter of women experienced poor QMR. Increase in spouse age (P = 0.047), longer duration of marriage (P = 0.028), and increase in the number of EPs (P < 0.001) were associated with a decrease in QMR. There was a significant direct relationship between SF and the QMR (r = 0.857; P < 0.001). CONCLUSION The present study showed a significant relationship between SF and the QMR in women with a history of EP. Therefore, SF and the QMR are necessary to be considered in future health promotion programs of these women.
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Affiliation(s)
- Fateme Khajoei Nejad
- Midwifery Department, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Foozieh Rafati
- School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Shideh Rafati
- Social Factors in Health Promotion Research Center, Hormozgan Health Research Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Neda Dastyar
- Student Research Committee, Jiroft University of Medical Sciences, Jiroft, Iran.
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98
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Shahmoradi N, Davarinejad O, Brühl AB, Brand S. Effects of Aphrodite (an Herbal Compound) on SSRI-Induced Sexual Dysfunctions and Depression in Females with Major Depressive Disorder: Findings from a Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1663. [PMID: 37763782 PMCID: PMC10538161 DOI: 10.3390/medicina59091663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Almost by default, people with major depression disorder (MDD) also report sexual health issues. This holds even more true when sexual dysfunctions are SSRI-induced. Herbal compounds may have the power to counterbalance such sexual dysfunctions, though research is still scarce. Therefore, we assessed females with diagnosed MDD treated with a standard SSRI (sertraline) and reporting SSRI-induced sexual dysfunctions, and we asked whether compared to placebo, Aphrodite (a blend of ginger, saffron, cinnamon, thistle, and Tribulus terrestris) may favorably impact on sexual dysfunctions, and on symptoms of depression, anxiety, and sleep disturbances. Materials and Methods: A total of 41 females (mean age: 35.05 years) with diagnosed MDD, treated with sertraline (a standard SSRI) at therapeutic dosages, and reporting SSRI-induced sexual dysfunction, were randomly assigned either to Aphrodite or to the placebo condition. At baseline and four and eight weeks later (study end), participants completed a series of self-rating questionnaires covering symptoms of sexual dysfunction, depression, anxiety, and sleep complaints. Results: Symptoms of sexual dysfunction, depression, and anxiety decreased over time, but more so in the Aphrodite condition, compared to the placebo condition (significant p-values and large effect sizes). Over time, sleep disturbances decreased irrespective of the study condition. Conclusions: The pattern of results suggests that compared to placebo, Aphrodite appeared to improve symptoms of sexual dysfunction, depression, and anxiety among females with diagnosed MDD and SSRI-induced sexual dysfunction. Further and similar studies should investigate the underlying psychophysiological mechanisms.
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Affiliation(s)
- Nasrin Shahmoradi
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
| | - Omran Davarinejad
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
| | - Annette Beatrix Brühl
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1417466191, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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99
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Minoia C, Viviani S, Silvestris E, Palini S, Parissone F, De Palma G, Fedina A, Cormio G, Guarini A, Gini G, Montano L, Merli F, Peccatori FA. Fertility preservation and monitoring in adult patients diagnosed with lymphoma: consensus-based practical recommendations by the Fondazione Italiana Linfomi & Società Italiana della Riproduzione Umana. Front Oncol 2023; 13:1252433. [PMID: 37766870 PMCID: PMC10520955 DOI: 10.3389/fonc.2023.1252433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Fertility preservation (FP) and monitoring has considerable relevance in the multidisciplinary approach to cancer patients. In these consensus-based practical recommendations, the scientific societies Fondazione Italiana Linfomi (FIL) and Società Italiana della Riproduzione Umana (SIRU) reviewed the main aspects and identified the optimal paths which aim to preserve and monitor fertility in patients diagnosed with lymphoma at the different phases of the disease and during long-term survivorship. Methods For the Panel, eleven experts were selected for their expertise in research and clinical practice on onco-fertility and lymphoma. The Panel's activity was supervised by a chairman. A series of rank-ordering key questions were proposed according to their clinical relevance and discussed among the Panel, focusing on patients diagnosed with non-Hodgkin's lymphomas and Hodgkin lymphoma. Agreement among all the Panelists on the content and terminology of the statements was evaluated by a web-based questionnaire according to the Delphi methodology. Results From the literature review a total of 78 questions or sentences, divided into the 6 areas of interest, were identified. By applying the Gwet's AC, k was: Section 1: 0,934 (Very good); Section 2: 0,958 (Very good); Section 3: 0,863 (Very good); Section 4: 0,649 (Good); Section 5: 0,936 (Very good); Section 6 raw agreement 100%. Two rounds of Delphi allowed to provide the maximum agreement. All statements were newly discussed in a round robin way and confirmed for the drafting of the final recommendations. Discussion These recommendations would be useful for onco-hematologists, gynecologists, urologists, and general practice physicians who take care of young lymphoma patients to guarantee an evidence-based oncofertility assessment and treatment during the oncologic pathway.
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Affiliation(s)
- Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simonetta Viviani
- Division of Onco-Hematology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Erica Silvestris
- Gynecologic Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simone Palini
- Physiopathology of Reproduction Unit, Cervesi Hospital, Cattolica, Italy
| | - Francesca Parissone
- Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata di Verona, Università di Verona, Verona, Italy
| | - Giuseppe De Palma
- Institutional BioBank, Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Anna Fedina
- Data Office Fondazione Italiana Linfomi, Alessandria, Italy
| | - Gennaro Cormio
- IRCCS Istituto Tumori Departiment of Interdisciplinary Medicine (DIM), University of Bari, Bari, Italy
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Guido Gini
- Clinic of Hematology Azienda Ospedaliera Universitaria (AOU) delle Marche, Ancona, Italy
| | - Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL), Salerno, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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100
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Krull E, Lambat Emery S, Viviano M, Aerts L, Petignat P, Dubuisson J. Assessment of women's sexual quality of life after benign adnexal surgery using vNOTES approach in comparison to conventional laparoscopy: protocol for a randomised controlled trial. BMJ Open 2023; 13:e073691. [PMID: 37678943 PMCID: PMC10496722 DOI: 10.1136/bmjopen-2023-073691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has already proven its non-inferiority to conventional abdominal laparoscopy (CAL) for hysterectomy without conversion. The results in terms of efficacy and safety are promising. However, we note a lack of medical literature and no specific randomised controlled trial assessing women's sexual function after vNOTES for benign adnexal surgery. The aim of this RCT is to confirm the non-inferiority of the vNOTES approach for benign adnexal pathology compared with CAL on women's sexual function. Secondary outcomes will evaluate vNOTES's efficiency, morbidity and postoperative complications compared with CAL for benign adnexal surgery. The relationship between adnexal mass morcellation and the quality of the histological analysis will also be evaluated as secondary outcome. METHODS AND ANALYSIS Women aged 18-70 years undergoing a benign adnexal surgery at the Geneva University Hospitals will be eligible and randomised with a 1:1 ratio to the CAL arm or the vNOTES arm, if inclusion criteria are met. Participants will complete the Female Sexual Function Index, the Couple Satisfaction Index-16 and a self-reported questionnaire on dyspareunia within 4 weeks prior to randomisation and at 3+6 months after surgery. General and clinical data will be collected when the patient is enrolled in the study, during hospitalisation and at 1 month postoperative to assess secondary outcomes.An absence of impairment on sexual function will be confirmed with a stability or an improvement of the evaluated scores in each group at 3 and 6 months postoperative compared with the preoperative scores. We expect to have no statistically significant difference in sexuality questionnaires scores between the two groups. ETHICS AND DISSEMINATION Protocol of this study was validated by the Cantonal Research Ethics Commission of Geneva, Switzerland, on 9 August 2022. We aim to publish the study's results in peer-reviewed journals within 3 years. TRIAL REGISTRATION NUMBER NCT05761275.
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Affiliation(s)
- Eloïse Krull
- Human medicine, University of Geneva Faculty of Medicine, Geneva, Switzerland
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Shahzia Lambat Emery
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Manuela Viviano
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Leen Aerts
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Patrick Petignat
- Human medicine, University of Geneva Faculty of Medicine, Geneva, Switzerland
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Jean Dubuisson
- Human medicine, University of Geneva Faculty of Medicine, Geneva, Switzerland
- Division of Gynecology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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