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Giuseppe PG, Pace G, Vicentini C. Sexual Function in Women with Urinary Incontinence Treated by Pelvic Floor Transvaginal Electrical Stimulation. J Sex Med 2007; 4:702-707. [PMID: 17034409 DOI: 10.1111/j.1743-6109.2006.00318.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Women's sexual dysfunctions (WSD) have been commonly associated with urinary incontinence (UI). Women with UI and who scored low on the Female Sexual Function Index (FSFI) showed an improvement in urinary leakage and also in their sexual life following treatment by transvaginal electrical stimulation (TES). AIMS To determine the effects of TES in 37 women complaining of UI, of whom 23 also had WSD, and to compare the FSFI scores of women with UI and 43 women not affected by UI who underwent routine urologic evaluation. METHODS Thirty-seven women complaining of UI were evaluated by voiding diary and with FSFI before and after 3 months of TES. All had a urogynecologic evaluation and urodynamic study. MAIN OUTCOME MEASURES In the voiding diary the women reported the types of liquid they ingested, urinary frequency, and episodes of urgency and urine leakage. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction, and pain, were calculated. TES was conducted for 15-30 minutes, twice a week for 3 months, using biphasic intermittent current with a frequency of 50 Hz for stress UI (SUI) and 20 Hz for urge UI (UUI), and the most tolerable intensity of stimulation. RESULTS After TES, only two of the 10 women with UUI experienced a few leakage incidents; patients with SUI were completely dry during TES; and only three reported a few episodes of UI during intense activities. The five patients with mixed UI improved mainly as regards urgency. The FSFI scores of patients complaining of UI showed significantly lower desire and sexual satisfaction, and higher sexual pain than controls. After 3 months, the 23 women affected by WSD, of the 37 participants with UI, reported a remarkable improvement in their sexual life. CONCLUSIONS TES was found to be a safe and effective therapy for selected patients affected by mild to moderate UI. Because women with UI also complain of WSD compared with the general female population, an investigation of female sexuality is suggested for these patients.
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Affiliation(s)
| | - Gianna Pace
- University of L'Aquila-Surgery, Laquila, Italy.
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Mas M, Báez D. Abordaje clínico de las disfunciones sexuales femeninas: perspectiva orgánica. Rev Int Androl 2007. [DOI: 10.1016/s1698-031x(07)74039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sexual Dysfunction. PRIMARY CARE IN OBSTETRICS AND GYNECOLOGY 2007. [PMCID: PMC7121092 DOI: 10.1007/978-0-387-32328-2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Female sexual dysfunction or dissatisfaction is a common complaint among obstetric-gynecology patients. These complaints may result from medical treatments and procedures, or may secondarily complicate the management and patient compliance of treatment for other medical issues. Therefore, it is important that clinicians treating females obtain basic information regarding human sexual function and dysfunction. This chapter presents an integration of the clinical research as well as the author’s experience regarding sexual function and the management of sexual problems often presented in an obstetricgynecology practice.
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Chudakov B, Ben Zion IZ, Belmaker RH. ORIGINAL RESEARCH—ENDOCRINOLOGY: Transdermal Testosterone Gel prn Application for Hypoactive Sexual Desire Disorder in Premenopausal Women: A Controlled Pilot Study of the Effects on the Arizona Sexual Experiences Scale for Females and Sexual Function Questionnaire. J Sex Med 2007; 4:204-208. [PMID: 17233786 DOI: 10.1111/j.1743-6109.2006.00405.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Several studies suggest that increased plasma testosterone can improve sexual function and desire in post-oophorectomy or postmenopausal women. However, side effects of chronic daily testosterone raise questions about the generalizability of this treatment approach. Sublingual testosterone was reported to cause testosterone levels to peak after 15 minutes and then decline to baseline levels within 90 minutes. Three to 4 hours after reaching testosterone peak, increased genital sensations and sexual lust were reported. AIM We hypothesized that a single dose of testosterone given 4-8 hours prior to planned intercourse in women with hypoactive sexual desire disorder (HSDD) might increase desire without side effects associated with chronic use. METHODS The design was randomized double-blind crossover. Premenstrual women with HSDD received eight packets of gel or identical placebo for use before intercourse twice weekly for 1 month. For a second month, the alternate treatment was given. MAIN OUTCOME MEASURES Ratings were performed using the patient-rated Arizona Sexual Experiences Scale for females and the clinician-rated Sexual Function Questionnaire (SFQ-V1). RESULTS Ten patients completed the study. On the five-item self-report Arizona, the item "How easily are you aroused?" was significantly improved on testosterone gel vs. placebo, P = 0.03. There were similar trends on the physician-rated SFQ-V1 "arousal-sensation" cluster. CONCLUSIONS These preliminary results suggest that testosterone gel given prn before intercourse has effects on sexual arousal, and further research is needed to define dosage and time schedule to optimize this effect and determine its clinical relevance.
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Affiliation(s)
- Bella Chudakov
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel
| | - Itzhak Z Ben Zion
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel
| | - R H Belmaker
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel.
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Bitzer J, Platano G, Tschudin S, Alder J. ORIGINAL RESEARCH—EDUCATION: Sexual Counseling for Women in the Context of Physical Diseases—A Teaching Model for Physicians. J Sex Med 2007; 4:29-37. [PMID: 17233774 DOI: 10.1111/j.1743-6109.2006.00395.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Chronic medical conditions are frequently associated with sexual difficulties and problems, which are often underreported and underdiagnosed. Patients may feel that sexual problems in the context of disease are not important enough to be mentioned to their physicians, and physicians may feel uncomfortable and sometimes incompetent. Furthermore, the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders-IV and International Classification of Diseases-10 are focused on the phenomenology of the sexual response without any specificity regarding diseases. AIM To facilitate access for patients and physicians, we wanted to develop a tool for assessment and discussion of sexual problems in the context of disease. This tool should be broadly applicable, easy to use and learn for nonmental health professionals. MAIN OUTCOME MEASURES Content analysis with respect to the integration of general sexological and disease-specific dimensions. Formulation of a diagnostic and therapeutic algorithm that can be used as a teaching tool. METHODS Based on our experience as a liaison-consultation sexological division of the university hospital of Basel, we analyzed the sexological diagnostic workup performed with the following group of female patients: women with benign gynecologic conditions; women with incontinence; oncological patients (mammary carcinoma, genital carcinoma); neurological patients (multiple sclerosis, spine injury, Parkinson's); patients with metabolic and endocrine disorders (diabetes, metabolic syndrome, polycystic ovarian syndrome); and patients with mental health disorders (depression, anxiety disorder, schizophrenia). We extracted the commonly used steps in the workup to construct a tool with easy-to-remember elements, which would help the physician to evaluate patients' sexual problems and plan for referral or therapy. RESULTS We could differentiate three diagnostic dimensions. The first were person-related preexisting factors, such as sexual satisfaction and function, age, body image, and general well-being. The second were the disease-specific implications, which could be summarized under the 8 Ds: Danger, Destruction, Disfigurement, Disability and pain, Dysfunction, Dysregulation, Disease load, and Drugs. The third was the patient's and partner's general response to the disease determined by affective response, coping style, body image impact, and changes in relationship dynamics. CONCLUSION Sexual problems are frequent in many clinical conditions, but are not yet a routine part of diagnostic workup and therapeutic planning. We have developed a tool to help physicians in different clinical settings to evaluate sexual problems of the female patients with specific clinical conditions in order to facilitate access to recognition and possible treatment.
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Affiliation(s)
- Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland;.
| | - Giacomo Platano
- Department of Gynecologic Social Medicine and Psychosomatics, University Hospital Basel, Basel, Switzerland;; Department of Clinical Psychology and Psychotherapy, University Hospital Basel, Basel, Switzerland
| | - S Tschudin
- Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
| | - Judith Alder
- Department of Gynecologic Social Medicine and Psychosomatics, University Hospital Basel, Basel, Switzerland
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Heard-Davison A, Heiman JR, Kuffel S. Genital and Subjective Measurement of the Time Course Effects of an Acute Dose of Testosterone vs. Placebo in Postmenopausal Women. J Sex Med 2007; 4:209-217. [PMID: 17233787 DOI: 10.1111/j.1743-6109.2006.00406.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Recent research on the impact of testosterone (T) on female sexual function has yielded inconsistent results, and few studies have used physiological measures of genital arousal. AIM This study examined the effects of an acute dose of methyltestosterone (MT) on physiological (genital) and subjective sexual response in postmenopausal women. MAIN OUTCOME MEASURES Vaginal pulse amplitude (VPA) and self-reported sexual response. METHODS Randomized, double-blind, crossover, placebo-controlled trial of 5 mg MT, consisting of two separate 8-hour visits. Participants were 10 postmenopausal women without sexual dysfunction. Participants viewed both neutral and erotic video segments during five post-dose trials while their genital and subjective responses were monitored. RESULTS The Wilcoxon signed rank test indicated a significant difference in VPA between the T (M = 0.018, SD = 0.018) and placebo (M = 0.016, SD = 0.017) conditions at 4.5 hours post-dose (P = 0.03). Higher difference scores were noted for 80% of subjects during the T condition at 4.5 hours, in contrast with only 50% of subjects responding to T at the other four time points. No differences were found on VPA relative change scores or subjective sexual arousal scores. When summed across all five time points, genital and subjective measures were correlated regardless of medication condition (0.62 and 0.60 for self-reported physical and mental sexual arousal scores, respectively). CONCLUSIONS These findings in postmenopausal women combined with those of two previous investigations in premenopausal women demonstrate a probable acute-dose time delay for genital sexual effects of exogenous T with no change in self-reported sexual arousal. Further investigation is needed to determine whether acute dosing of T has a consistent and predictable impact on genital arousal that has promise for the treatment of any subgroup of women with sexual disorders.
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Affiliation(s)
- Amy Heard-Davison
- University of Washington-Psychiatry and Behavioral Sciences, Seattle, WA, USA
| | - Julia R Heiman
- The Kinsey Institute, Indiana University, Bloomington, IN, USA.
| | - Stephanie Kuffel
- University of Washington-Psychiatry and Behavioral Sciences, Seattle, WA, USA
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Abstract
INTRODUCTION Many women experience improved sexual function after hysterectomy. However, a sizeable minority of women report worsened sexual function after the surgery, and concerns about the effect of surgery on sexual function are common among women planning to undergo hysterectomy. AIM The present study examined the role of education about the potential sexual consequences of hysterectomy in predicting self-reported outcomes and satisfaction with the procedure. METHODS We conducted a cross-sectional survey of 204 women who had undergone simple hysterectomy in the preceding 3-12 months. Participants volunteered in response to a Web-based advertisement. MAIN OUTCOME MEASURES Participants indicated their current sexual function using the Female Sexual Function Index (FSFI), and reported positive and negative sexual outcomes experienced after hysterectomy using a checklist. Participants also completed questionnaire items regarding satisfaction with hysterectomy and education from their physicians about sexual risks and benefits prior to surgery. RESULTS Current sexual function scores were related to self-reports of positive and negative sexual outcomes following hysterectomy and overall satisfaction with hysterectomy. Education from a physician about possible adverse sexual outcomes was largely unrelated to self-reports of having experienced those outcomes. However, education about possible negative sexual outcomes predicted overall satisfaction with hysterectomy when controlling for self-reports of positive and negative sexual outcomes. CONCLUSION Education about potential negative sexual outcomes after surgery may enhance satisfaction with hysterectomy, independent of whether negative sexual outcomes were experienced. Including a discussion of potential sexual changes after surgery may enhance the benefits of presurgical counseling prior to hysterectomy.
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Affiliation(s)
- Andrea Bradford
- Department of Psychology, University of Texas at Austin, Austin, TX, USA.
| | - Cindy Meston
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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Nijland E, Davis S, Laan E, Schultz WW. REVIEW: Female Sexual Satisfaction and Pharmaceutical Intervention: A Critical Review of the Drug Intervention Studies in Female Sexual Dysfunction. J Sex Med 2006; 3:763-777. [PMID: 16942521 DOI: 10.1111/j.1743-6109.2006.00285.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION A considerable number of double-blind randomized controlled studies investigating the effects of pharmaceutical intervention on female sexual functioning have been published in recent years. However, a comparison between outcomes of various studies is difficult as no generally accepted/correct approach to research has been established yet. To be able to translate trial results to daily clinical practice, current limitations and issues in drug intervention studies in female sexual dysfunction (FSD) need to be clarified. AIM To evaluate the needs in research into intervention in FSD by reviewing published studies. METHODS A systematic review of double-blind randomized controlled intervention trials on FSD. MAIN OUTCOME MEASURES Definitions of study populations, inclusion and exclusion criteria, use of power calculations, outcome measures and treatment duration. RESULTS A total of 25 double-blind randomized controlled trials investigating the effects of pharmaceutical intervention on female sexual functioning have been published. Of these, 11 studies required the diagnosis of FSD as an inclusion criterion. A standard methodology for research in this field is lacking. Significant differences in population inclusion requirements and tools for the measurement of change in sexual functioning were identified as major limiting factors. CONCLUSIONS The investigation of FSD is an evolving area in that new definitions and a new model for female sexual functioning have been recently proposed. There is a need for experts in the field and regulating authorities to reach a consensus regarding appropriate inclusion and exclusion criteria for FSD trials and main outcome measures appropriate for the evaluation of drug interventions. This consensus should also determine which treatment effect is considered to be clinically relevant. Treatment efficacy and clinical relevance should be related to outcomes which are meaningful for affected women.
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Affiliation(s)
- Esmé Nijland
- Organon-Medical Services Women's Health, Oss, the Netherlands.
| | - Susan Davis
- Alfred Hospital-Women's Health Program, Monash University, Clayton, Australia
| | - Ellen Laan
- Department of Sexology and Psychosomatic Obstetrics/Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Goldstein I. EDITORIAL: The Power of the Written Word. J Sex Med 2006; 3:379-81. [PMID: 16681464 DOI: 10.1111/j.1743-6109.2006.00244.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
INTRODUCTION Hypoactive sexual desire disorder (HSDD) is a common problem that is often treatment refractory. This refractoriness to treatment is reflective of our lack of knowledge concerning the determinants of sexual libido in women. AIM To review the development and current status of information concerning the diagnosis and treatment of HSDD. METHODOLOGY Literature on HSDD published between 1950 and 2005 was reviewed. RESULTS Historically, HSDD was considered to be a psychiatric disorder. Thus, the diagnostic criteria utilized in studies of interventions for this disorder are based on the Diagnostic and Statistical Manual of the American Psychiatric Association. This system was never designed to encompass organic causes of sexual dysfunction and has evolved by expert opinion. If the syndrome is poorly defined by these diagnostic criteria, this could limit progress in this field. Epidemiological studies have found that approximately 24-43% of women complain of low sexual desire in the preceding year. The percentage of the population meeting diagnostic criteria for HSDD is probably much lower. There has been considerable progress in the development of psychometrically sound instruments for the assessment of libido. The development of approaches to treatment was reviewed. Approaches to treatment have evolved in three major areas: psychological, hormonal, and use of psychopharmacological agents. There is some evidence of efficacy utilizing all three approaches. The major evidence of efficacy concerns the use of testosterone therapy. Long-term safety data concerning this treatment are absent. CONCLUSION There is a rapidly expanding knowledge base concerning the diagnosis and treatment of HSDD. However, the contemporary clinician is faced with the absence of an approved treatment for this disorder and the lack of clear guidelines concerning the indications and safety of the use of non-approved agents.
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Affiliation(s)
- Robert Segraves
- Department of Psychiatry, MetroHealth, Cleveland, OH 44122, USA.
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Goldstein I, Alexander JL. Practical aspects in the management of vaginal atrophy and sexual dysfunction in perimenopausal and postmenopausal women. J Sex Med 2006; 2 Suppl 3:154-65. [PMID: 16422792 DOI: 10.1111/j.1743-6109.2005.00131.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The decline in circulating estrogen levels in peri- and postmenopause has a wide range of physiological effects, including atrophy of tissues in the urogenital tract. Vaginal atrophy is an important contributor to postmenopausal sexual dysfunction. AIM To provide a framework for clinical evaluation and clinical management of sexual dysfunction secondary to vaginal atrophy. METHOD Conduct a brief overview of literature on evaluation and treatment of vaginal atrophy, augmented with the authors' clinical observations and experience. RESULTS Estrogen decline disrupts many physiological responses characteristic of sexual arousal, including smooth muscle relaxation, vasocongestion, and vaginal lubrication; genital tissues depend on continued estrogen and androgen stimulation for normal function. An upward shift in vaginal pH as the result of vaginal atrophy alters the normal vaginal flora. Reduced lubrication capability and reduced tissue elasticity, in addition to shortening and narrowing of the vaginal vault, can lead to painful and/or unpleasant intercourse. At the same time, diminished sensory response may reduce orgasmic intensity. Other contributors to peri- and postmenopausal sexual dysfunction include reduced androgen levels, aging of multiple body systems, and side-effects of medications. Workup of sexual health problems starts by taking a comprehensive sexual, medical, and psychosocial history, followed by complete physical examination and laboratory evaluation. Clinical management includes measures to preserve and enhance overall health, adjustment of medication regimes to reduce or avoid side-effects, and topical or systemic hormone supplementation with estrogens and/or androgens. CONCLUSIONS No single therapeutic approach is appropriate for every woman with peri- or postmenopausal sexual dysfunction; instead, treatment should be based on a comprehensive evaluation and consideration of medical and psychosocial contributors to the individual's dysfunction. Further research is required to establish optimal regimens of hormonal and nonhormonal agents, including dosages/dosage forms and duration of treatment, for specific subtypes of sexual dysfunction.
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Goldstein I, Fisher WA, Sand M, Rosen RC, Mollen M, Brock G, Karlin G, Pommerville P, Bangerter K, Bandel TJ, Derogatis LR. Women's sexual function improves when partners are administered vardenafil for erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled trial. J Sex Med 2006; 2:819-32. [PMID: 16422806 DOI: 10.1111/j.1743-6109.2005.00147.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION There are limited data concerning the sexual function of women whose male partners receive pharmacological treatment for erectile dysfunction (ED). AIM One objective of this research was to prospectively compare the efficacy of vardenafil vs. placebo administered to men with ED in improving men's and women partners' sexual function and satisfaction. Another goal was to assess the relationship of erectile function changes in men with ED receiving treatment with sexual function changes in women partners not directly receiving treatment. METHODS A randomized, double-blind, placebo-controlled, multi-institutional comparison of vardenafil vs. placebo was performed in 229 couples (treated man with ED>6 months and untreated woman partner). Co-primary outcomes for which this research was statistically powered were Sexual Encounter Profile (SEP3) (treated man with ED) and Sexual Life Quality Questionnaire (mSLQQ-QOL) (untreated woman partner). MAIN OUTCOME MEASURES Erectile function changes in men with ED receiving vardenafil vs. placebo were compared at last observation carried forward (LOCF) in SEP3, International Index of Erectile Function (IIEF-EF) and Erection Quality Scale (EQS). Sexual function at LOCF in women partners was determined by mSLQQ-QOL and Female Sexual Function Index (FSFI). RESULTS Compared with placebo at LOCF, vardenafil significantly increased least square (LS) mean scores in: (i) overall per-treated male SEP3 success rate, IIEF-EF, and EQS; and (ii) mSLQQ-QOL, total FSFI and sexual desire, subjective arousal, lubrication, orgasm and satisfaction FSFI domains in untreated women partners. Treatment-related improvement in erectile function as assessed by IIEF-EF and EQS was correlated reliably with improvement in women partners' FSFI total and individual domain scores. CONCLUSIONS Vardenafil is an effective ED treatment in men that also significantly improves sexual function/satisfaction in untreated women partners. Women partners' sexual function improvements relate significantly and consistently to treatment-related improvements in men's erectile function. ED management should emphasize both members of the couple.
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Papaharitou S, Nakopoulou E, Kirana P, Iraklidou M, Athanasiadis L, Hatzichristou D. Women's Sexual Concerns: Data Analysis from a Help‐Line. J Sex Med 2005; 2:652-7. [PMID: 16422823 DOI: 10.1111/j.1743-6109.2005.00116.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE To report female sexual problems and concerns, as presented by women calling a help-line, and to evaluate women's help-seeking behavior regarding sexual matters. MATERIALS AND METHODS The study included all telephone calls from women who called for sexual concerns to a help-line dedicated to sexual problems during a 5-year period. During the call, the counselor addresses demographic characteristics of the caller, the sexual problem reported, their sexual function, any previous doctor contacts, coexisting physical and mental health problems, couple's relationship, and lifestyle factors that may influence sexual function. Data processing employed descriptive statistics and logistic regression analysis in order to detect possible associations between categorical variables. RESULTS Of a total of 3,523 calls made by women, 2,287 full forms were analyzed, reflecting a response rate of 64.9%. Most women (46.6%) called for problems encountered by their partners, 45.1% called for their own sexual problems, while 5.9% were calling for their children. Only 34.3% of them had already consulted a doctor. The most frequently reported difficulties were achieving orgasm (25.6%), reduced sexual desire (16.9%), and pain during intercourse (6.1%). Women in the 40-49 age group had the higher odds ratios for the sexual problems reported (reduced sexual desire: odds ratio [OR] 5.0; difficulties achieving orgasm: OR 6.3; pain during intercourse: OR 5.8). Both married and single women had high risk of experiencing low levels of sexual desire (40% and 30%, respectively). CONCLUSIONS Women's sexual concerns are not devoted to their sexual problems, but also their partner's and children's problems. Most frequently reported sexual problems are difficulties in reaching orgasm and reduced sexual desire. However, women are reluctant to seek medical advice on their sexual concerns. There is a need for general practitioners and family doctors to become aware of the possibility of a sexual problem and to be trained on how to manage this at a primary care level.
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Affiliation(s)
- Stamatis Papaharitou
- Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Goldstein I. EDITORIAL: Passion and Hard Work: Expanding the Role of The Journal of Sexual Medicine (JSM ) in 2005. J Sex Med 2005. [DOI: 10.1111/j.1743-6109.2005.20101.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Goldstein I. Evidence‐Based Medicine for Clinical Decision Making in Sexual Health Care Management: Role of The Journal of Sexual Medicine. J Sex Med 2004. [DOI: 10.1111/j.1743-6109.2004.04020.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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