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As-Sanie S, Shafrir AL, Halvorson L, Chawla R, Hughes R, Merz M. The Burden of Pelvic Pain Associated with Endometriosis among Women in Selected European Countries and the United States: A Restricted Systematic Review. J Minim Invasive Gynecol 2024:S1553-4650(24)00206-1. [PMID: 38729420 DOI: 10.1016/j.jmig.2024.05.002] [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: 12/23/2023] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To evaluate the burden of endometriosis-associated pelvic pain (EAPP) on health-related quality of life (HRQoL) among women living in similar socio-economic conditions. DATA SOURCES Searches were performed in PubMed and Embase on September 26, 2022. The review was performed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) and was registered on PROSPERO (ID: CRD42023370363). METHODS OF STUDY SELECTION Due to the high volume of eligible publications following initial review, inclusion criteria were restricted to studies undertaken in France, Germany, Italy, Spain, the United Kingdom, and the United States. This restriction was applied before screening as these countries have broad social and economic similarities, and previous studies in the literature suggest pain reporting and experience are influenced by numerous socio-cultural factors. Eligible studies were those published between 2013 and 2022 and include a sample size of ≥50 participants. The search strategy identified all relevant publications relating to the burden of illness due to EAPP. A variety of terms are used in the literature to describe pain associated with endometriosis, and this was considered in the design of the search strategy and screening procedure. TABULATION, INTEGRATION, AND RESULTS The database searches resulted in a total of 6139 records. After removal of duplicates, 3855 records were assessed further. A total of 27 publications were identified as eligible. Fourteen (52%) were from Italy, 5 (19%) were multinational studies, 4 (15%) were from the United States, 3 (11%) were from Spain, and 1 (4%) was from Germany. Most studies were cross-sectional (n = 15; 56%); 7 (26%) were case-control studies; 3 (11%) were cohort studies; and 2 (7%) were longitudinal studies. These publications collectively highlighted an association between EAPP and reduced HRQoL. Several studies showed that EAPP was associated with lower HRQoL when compared with endometriosis without pain and potentially with chronic pelvic pain caused by other conditions, although the evidence is limited in this case. Moreover, the studies reported detrimental effects on general HRQoL, mental health functioning, and sexual functioning, culminating in reduced work productivity and difficulties in performing everyday activities. The associations were generally similar across study populations, including adolescents, as well as younger and older women. Results were consistent across the range of different patient-reported outcome tools used to assess HRQoL. CONCLUSION The existing literature suggests that, among women in selected European countries and the United States, EAPP is associated with reduced HRQoL, including impaired mental and sexual functioning, as well as reduced work performance and productivity; each of which may contribute to the societal burden of endometriosis.
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Affiliation(s)
- Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan (Dr. As-Sanie), Ann Arbor, Michigan.
| | - Amy L Shafrir
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School (Dr. Shafrir), Boston, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, MA
| | - Lisa Halvorson
- Bayer US Pharmaceuticals (Dr. Halvorson), Whippany, New Jersey
| | - Rajinder Chawla
- AccuScript Consultancy (Dr. Chawla), Ludhiana, Punjab, India
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Perrotta G. Perrotta Integrative Clinical Interviews-3 (PICI-3): Development, regulation, updation, and validation of the psychometric instrument for the identification of functional and dysfunctional personality traits and diagnosis of psychopathological disorders, for children (8-10 years), preadolescents (11-13 years), adolescents (14-18 years), adults (19-69 years), and elders (70-90 years). IBRAIN 2024; 10:146-163. [PMID: 38915942 PMCID: PMC11193867 DOI: 10.1002/ibra.12148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 06/26/2024]
Abstract
The Perrotta Integrative Clinical Interview, second version (PICI-2) requires structural and functional updates, based on clinical and academic experience, especially in terms of functional traits and interpretation of psychopathological disorders. The Perrotta Integrative Clinical Interviews-3 (PICI-3) was created and structured into four sections, dedicated to dysfunctional traits in children and pre-adolescents (PICI-C-3, 8-13 years) and in adolescents, adults, and the elderly (PICI-TA-3, 14-90 years), to common secondary disorders (PICI-DS-3, 8-90 years) and functional traits (PICI-FT-3, 8-90 years), with the identification of all functional elements and structural aspects of personality according to the model underlying the PICI (IPM). Selecting 1732 subjects, between 8 and 90 years old, the statistical analysis showed that the psychometric test has a well-defined and stable construct, with the variables well represented and positively correlated with other constructs already validated. In particular: (a) the PICI-TA-3 (Section A) was compared with the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), obtaining 99.3% compatibility of results, with a Pearson's coefficient (R) of 0.999 and p < 0.001; (b) the PICI-C-3 (Section B) was compared with the Child Behavior Checklist (CBCL), obtaining 94.1% compatibility of results, with a Pearson coefficient (R) of 0.969 and p < 0.001; (c) the PICI-FT-3 (Section D) was compared with the Big Five Personality Test (Big5), obtaining 89.4% compatibility of results, with a Pearson coefficient (R) of 0.797 and p < 0.001. The PICI-3 is a valid, efficient, and effective psychometric tool to identify the functioning or dysfunction of personality traits for psychopathological diagnosis.
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Barba T, Kettner H, Radu C, Peill JM, Roseman L, Nutt DJ, Erritzoe D, Carhart-Harris R, Giribaldi B. Psychedelics and sexual functioning: a mixed-methods study. Sci Rep 2024; 14:2181. [PMID: 38326446 PMCID: PMC10850066 DOI: 10.1038/s41598-023-49817-4] [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: 05/16/2023] [Accepted: 12/12/2023] [Indexed: 02/09/2024] Open
Abstract
Do psychedelics affect sexual functioning postacutely? Anecdotal and qualitative evidence suggests they do, but this has never been formally tested. While sexual functioning and satisfaction are generally regarded as an important aspect of human wellbeing, sexual dysfunction is a common symptom of mental health disorders. It is also a common side effect of selective serotonin reuptake inhibitors (SSRIs), a first line treatment for depression. The aim of the present paper was to investigate the post-acute effects of psychedelics on self-reported sexual functioning, combining data from two independent studies, one large and naturalistic and the other a smaller but controlled clinical trial. Naturalistic use of psychedelics was associated with improvements in several facets of sexual functioning and satisfaction, including improved pleasure and communication during sex, satisfaction with one's partner and physical appearance. Convergent results were found in a controlled trial of psilocybin therapy versus an SSRI, escitalopram, for depression. In this trial, patients treated with psilocybin reported positive changes in sexual functioning after treatment, while patients treated with escitalopram did not. Despite focusing on different populations and settings, this is the first research study to quantitively investigate the effects of psychedelics on sexual functioning. Results imply a potential positive effect on post-acute sexual functioning and highlight the need for more research on this.
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Affiliation(s)
- Tommaso Barba
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK.
| | - Hannes Kettner
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, United States
| | - Caterina Radu
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Joseph M Peill
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Leor Roseman
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
| | - David J Nutt
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
- Psychedelics Division, Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, United States
| | - Bruna Giribaldi
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK
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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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Lara LA, Cartagena-Ramos D, Figueiredo JB, Rosa-E-Silva ACJ, Ferriani RA, Martins WP, Fuentealba-Torres M. Hormone therapy for sexual function in perimenopausal and postmenopausal women. Cochrane Database Syst Rev 2023; 8:CD009672. [PMID: 37619252 PMCID: PMC10449239 DOI: 10.1002/14651858.cd009672.pub3] [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] [Indexed: 08/26/2023]
Abstract
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms, including sexual complaints. This review is an update of a review first published in 2013. OBJECTIVES We aimed to assess the effect of hormone therapy on sexual function in perimenopausal and postmenopausal women. SEARCH METHODS On 19 December 2022 we searched the Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, ISI Web of Science, two trials registries, and OpenGrey, together with reference checking and contact with experts in the field for any additional studies. SELECTION CRITERIA We included randomized controlled trials that compared hormone therapy to either placebo or no intervention (control) using any validated assessment tool to evaluate sexual function. We considered hormone therapy: estrogen alone; estrogen in combination with progestogens; synthetic steroids, for example, tibolone; selective estrogen receptor modulators (SERMs), for example, raloxifene, bazedoxifene; and SERMs in combination with estrogen. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. We analyzed data using mean differences (MDs) and standardized mean differences (SMDs). The primary outcome was the sexual function score. Secondary outcomes were the domains of sexual response: desire; arousal; lubrication; orgasm; satisfaction; and pain. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 36 studies (23,299 women; 12,225 intervention group; 11,074 control group), of which 35 evaluated postmenopausal women; only one study evaluated perimenopausal women. The 'symptomatic or early postmenopausal women' subgroup included 10 studies, which included women experiencing menopausal symptoms (symptoms such as hot flushes, night sweats, sleep disturbance, vaginal atrophy, and dyspareunia) or early postmenopausal women (within five years after menopause). The 'unselected postmenopausal women' subgroup included 26 studies, which included women regardless of menopausal symptoms and women whose last menstrual period was more than five years earlier. No study included only women with sexual dysfunction and only seven studies evaluated sexual function as a primary outcome. We deemed 20 studies at high risk of bias, two studies at low risk, and the other 14 studies at unclear risk of bias. Nineteen studies received commercial funding. Estrogen alone versus control probably slightly improves the sexual function composite score in symptomatic or early postmenopausal women (SMD 0.50, 95% confidence interval (CI) (0.04 to 0.96; I² = 88%; 3 studies, 699 women; moderate-quality evidence), and probably makes little or no difference to the sexual function composite score in unselected postmenopausal women (SMD 0.64, 95% CI -0.12 to 1.41; I² = 94%; 6 studies, 608 women; moderate-quality evidence). The pooled result suggests that estrogen alone versus placebo or no intervention probably slightly improves sexual function composite score (SMD 0.60, 95% CI 0.16 to 1.04; I² = 92%; 9 studies, 1307 women, moderate-quality evidence). We are uncertain of the effect of estrogen combined with progestogens versus placebo or no intervention on the sexual function composite score in unselected postmenopausal women (MD 0.08 95% CI -1.52 to 1.68; 1 study, 104 women; very low-quality evidence). We are uncertain of the effect of synthetic steroids versus control on the sexual function composite score in symptomatic or early postmenopausal women (SMD 1.32, 95% CI 1.18 to 1.47; 1 study, 883 women; very low-quality evidence) and of their effect in unselected postmenopausal women (SMD 0.46, 95% CI 0.07 to 0.85; 1 study, 105 women; very low-quality evidence). We are uncertain of the effect of SERMs versus control on the sexual function composite score in symptomatic or early postmenopausal women (MD -1.00, 95% CI -2.00 to -0.00; 1 study, 215 women; very low-quality evidence) and of their effect in unselected postmenopausal women (MD 2.24, 95% 1.37 to 3.11 2 studies, 1525 women, I² = 1%, low-quality evidence). We are uncertain of the effect of SERMs combined with estrogen versus control on the sexual function composite score in symptomatic or early postmenopausal women (SMD 0.22, 95% CI 0.00 to 0.43; 1 study, 542 women; very low-quality evidence) and of their effect in unselected postmenopausal women (SMD 2.79, 95% CI 2.41 to 3.18; 1 study, 272 women; very low-quality evidence). The observed heterogeneity in many analyses may be caused by variations in the interventions and doses used, and by different tools used for assessment. AUTHORS' CONCLUSIONS Hormone therapy treatment with estrogen alone probably slightly improves the sexual function composite score in women with menopausal symptoms or in early postmenopause (within five years of amenorrhoea), and in unselected postmenopausal women, especially in the lubrication, pain, and satisfaction domains. We are uncertain whether estrogen combined with progestogens improves the sexual function composite score in unselected postmenopausal women. Evidence regarding other hormone therapies (synthetic steroids and SERMs) is of very low quality and we are uncertain of their effect on sexual function. The current evidence does not suggest the beneficial effects of synthetic steroids (for example tibolone) or SERMs alone or combined with estrogen on sexual function. More studies that evaluate the effect of estrogen combined with progestogens, synthetic steroids, SERMs, and SERMs combined with estrogen would improve the quality of the evidence for the effect of these treatments on sexual function in perimenopausal and postmenopausal women.
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Affiliation(s)
- Lucia A Lara
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Jaqueline Bp Figueiredo
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
- Ultrasonography and Retraining Medical School of Ribeirao Preto (EURP), Ribeirao Preto, Brazil
| | - Ana Carolina Js Rosa-E-Silva
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Rui A Ferriani
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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Heřmánková B, Špiritović M, Oreská S, Štorkánová H, Mann H, Pavelka K, Šenolt L, Vencovský J, Bečvář R, Tomčík M. Effect of an 8-Week Tailored Physiotherapy Program on Sexual Health in Women with Scleroderma and Myositis: A Controlled Pilot Study. Rheumatol Ther 2023; 10:1089-1105. [PMID: 37221419 PMCID: PMC10326194 DOI: 10.1007/s40744-023-00559-9] [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: 02/15/2023] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM) are very rare rheumatic diseases burdened by a high prevalence of sexual dysfunctions. However, no specific treatment has been proposed to date. To our knowledge, this is the first (pilot) study aiming to investigate the effect of an 8-week tailored physiotherapy program on the sexual health of women with SSc and IIM. METHODS In total, 12 women with SSc and 4 women with IIM were enrolled in the study. Based on the patients' capability to participate in the program, they were divided into an intervention group (IG) (mean ± SD age 46.8 ± 8.6 years) and a control group (CG) (mean ± SD age 46.3 ± 8.5 years). IG underwent the 8-week program (1 h of supervised physiotherapy twice weekly), whereas CG received no physiotherapy. At weeks 0 and 8, all patients filled in questionnaires assessing sexual function (Female Sexual Function Index [FSFI], Brief Index of Sexual Functioning for Women [BISF-W]), sexual quality of life (Sexual Quality of Life-Female [SQoL-F]), functional ability (Health Assessment Questionnaire [HAQ]), quality of life (Medical Outcomes Short Form-36 [SF-36]), and depression (Beck's Depression Inventory-II [BDI-II]). The changes were analyzed with two-way ANOVA and Friedmann's test. RESULTS Compared to the statistically significant deterioration in CG over weeks 0-8, we found statistically significant improvements in the total scores of FSFI and BISF-W, and some of their domains, functional status, and the physical component of quality of life. CONCLUSION Our 8-week physiotherapy program not only prevented the natural course of progressive deterioration of functional ability but also led to a significant improvement in sexual function and quality of life in women with SSc and IIM. However, due to the lack of randomization and a relatively small sample size resulting from the strict inclusion criteria, further validation of our results is needed. TRIAL REGISTRATION NUMBER ISRCTN91200867 (prospectively registered).
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Affiliation(s)
- Barbora Heřmánková
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Maja Špiritović
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Sabína Oreská
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Štorkánová
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Heřman Mann
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Radim Bečvář
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Tomčík
- Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic.
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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Pugliese D, Parisio L, Schepis T, Privitera G, Calvez V, Gasbarrini A, Armuzzi A. Patient-Reported Outcomes for the Assessment of Sexual Health Among Patients Affected by Inflammatory Bowel Disease. Rev Recent Clin Trials 2022; 17:250-258. [PMID: 35786192 DOI: 10.2174/1574887117666220630114054] [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: 12/24/2021] [Revised: 04/07/2022] [Accepted: 05/11/2022] [Indexed: 01/15/2023]
Abstract
Patients affected by inflammatory bowel disease (IBD) frequently report impaired quality of sexual life and complain of sexual dysfunctions. Both disease-specific features and psychological factors can be held responsible for these conditions. However, sexuality and all matters relating to sexual health are often wrongfully considered unrelated to IBD and, therefore, overlooked during medical visits. To overcome these difficulties and to best assess patients' perceptions about their sexual health status, the use of patient-reported outcomes (PROs) could represent a valid strategy. In real-world studies, several non-IBD specific questionnaires, exploring different domains of sexuality, have been applied and validated for the IBD population. This review summarizes the available evidence on sexual health among IBD patients and the data supporting the application of PROs to screen the quality of sexual life, as well as the rate and types of sexual dysfunctions, among IBD patients.
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Affiliation(s)
- Daniela Pugliese
- CEMAD, Inflammatory Bowel Disease Unit, Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Laura Parisio
- CEMAD, Inflammatory Bowel Disease Unit, Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Tommaso Schepis
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Privitera
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentin Calvez
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- CEMAD, Inflammatory Bowel Disease Unit, Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Armuzzi
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Battle CR, Rubin RS, Kingsberg SA, Alzweri L. Ethnic Minority Representation in Female Sexual Dysfunction Questionnaire Validation: A Scoping Review. J Sex Med 2022; 19:1824-1838. [PMID: 36272968 DOI: 10.1016/j.jsxm.2022.09.004] [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: 05/09/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Female sexual dysfunction (FSD) is a significant cause of distress for an estimated 12-24% of women, and over the past 5 decades several questionnaires have been developed for clinical practice. AIM The purpose of this scoping review is to evaluate the ethnic representation of sample populations used in the studies to validate FSD questionnaires. METHODS A scoping review was performed using electronic databases, including PubMed and Scopus, to identify FSD questionnaires validated between 1976 and 2021. Weighted averages from the combined ethnicity data were compared to population data from 2019 US census data and 2018 healthcare workforce reports to evaluate epidemiologic diversity. Ethnicity data from each questionnaire were also investigated longitudinally to evaluate trends in representation over the past 50 years. OUTCOMES Our outcome of interest was comparison of the weighted averages for ethnicity categories from validation populations to the US female general population, US female health care workforce, and US census data. RESULTS 48 validation studies were reviewed and showed that the average ethnic representation of the study populations relative to the US general population and US female health care workforce, respectively, was: Caucasian (83.7% vs 62.7% and 68.5%), Black (7.8% vs 13.3% and 8.3%), Hispanic (3.6% vs 16.0% and 9.6%), Native American (0.1% vs 0.8% and 0.3%), Asian (0.6% vs 6.4% and 6.2%), and Other (3.1% vs 0.7% and 1.4%). CLINICAL IMPLICATIONS FSD questionnaires are relied upon in research and clinical settings, so lack of diversity in validation populations could lead to under recognition and undertreatment in ethnic minority women. STRENGTHS & LIMITATIONS Our results are dependent on the quality of data available from previously published validation studies. We attempted to account for biases in lack of data and size of validation populations by using weighted averages for making comparisons. We chose the US general population and female healthcare workforce for comparison and analyzed validation populations across multiple decades and geographic locations. Many of the validation studies were performed at least 10 years ago and may not reflect the current state of FSD and potential of questionnaire responses of ethnic minority women. This manuscript raises critical awareness regarding the lack of validated instruments for FSD in ethnically diverse women. CONCLUSION Study populations used to validate FSD questionnaires demonstrate a trend of ethnic minority underrepresentation relative to the US female general and healthcare workforce populations. Battle CR, Rubin RS, Kingsberg SA, et al. Ethnic Minority Representation in Female Sexual Dysfunction Questionnaire Validation: A Scoping Review. J Sex Med 2022;19:1824-1838.
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Affiliation(s)
- Carissa R Battle
- School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA
| | - Rachel S Rubin
- Department of Urology, Georgetown University Hospital, Washington, DC, USA
| | | | - Laith Alzweri
- Division of Urology, Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
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9
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Peragine DE, Skorska MN, Maxwell JA, Impett EA, VanderLaan DP. A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults. JOURNAL OF SEX RESEARCH 2022; 59:1092-1109. [PMID: 35081013 DOI: 10.1080/00224499.2022.2027855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.
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Affiliation(s)
| | | | | | - Emily A Impett
- Department of Psychology, University of Toronto Mississauga
| | - Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga
- Child and Youth Psychiatry, Centre for Addiction and Mental Health
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10
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Ogallar-Blanco AI, Lara-Moreno R, Godoy-Izquierdo D. Going beyond "With a Partner" and "Intercourse": Does Anything Else Influence Sexual Satisfaction among Women? The Sexual Satisfaction Comprehensive Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10232. [PMID: 36011867 PMCID: PMC9408228 DOI: 10.3390/ijerph191610232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
The validated tools for measuring sexual satisfaction (SS) assess in fact other phenomena such as sexual functioning, assess SS within the context of a romantic heterosexual relationship and intercourse-type activity or were designed to be applied only in therapeutic or rehabilitation contexts. Consequently, they offer an incomplete understanding of SS, particularly among women. We thus developed an alternative measure of SS, the Sexual Satisfaction Comprehensive Index (SSCI), considering both the individual and with-a-partner dimensions, as well as the actual and desired experiences of satisfaction, along with other dimensions affecting SS, and explored its psychometric properties. A total of 1080 young to mid-aged women with different sociodemographic, relationship and sexual identity backgrounds voluntarily completed several measures of SS, including the SSCI. Results showed that the SSCI is a reliable measure for assessing SS. An exploratory and a confirmatory factor analysis confirmed the latent multidimensional structure of the SSCI, supporting its factorial validity. In addition, the SSCI showed appropriate convergent validity with other measures commonly used to assess SS. In sum, the SSCI was revealed to be a useful multidimensional index of SS for research and practice contexts which allows the practitioner or the researcher to make decisions on which dimension(s) are to be evaluated. This study focused on women's SS, and future research with other gender, sexual and cultural identities is necessary to support its utility in multi-identity and multi-sexuality scenarios.
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Affiliation(s)
- Adelaida I. Ogallar-Blanco
- Health Psychology and Behavioral Medicine Research Group (CTS-267), Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Cartuja University Campus, 18071 Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Cartuja University Campus, 18071 Granada, Spain
| | - Raquel Lara-Moreno
- Health Psychology and Behavioral Medicine Research Group (CTS-267), Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Cartuja University Campus, 18071 Granada, Spain
- Department of Social Psychology, Faculty of Psychology, University of Granada, Cartuja University Campus, 18071 Granada, Spain
| | - Débora Godoy-Izquierdo
- Health Psychology and Behavioral Medicine Research Group (CTS-267), Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Cartuja University Campus, 18071 Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Cartuja University Campus, 18071 Granada, Spain
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11
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Chen B, Zhou B, Song G, Li H, Li R, Liu Z, Wei C, Wang T, Wang S, Ma D, Liu J, Yuan X, Liu X. Inflammatory bowel disease is associated with worse sexual function: a systematic review and meta-analysis. Transl Androl Urol 2022; 11:959-973. [PMID: 35958893 PMCID: PMC9360519 DOI: 10.21037/tau-22-190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Several studies report that sexuality is often affected by inflammatory bowel diseases (IBD). The aim of this meta-analysis was to investigate the association between IBD and sexual function. Methods A literature search was conducted in PubMed, Web of Science, and EMBASE databases (up to September 1, 2020). Scores of sexual functions with a standard deviation and odds ratio (OR) or relative risk (RR) with a 95% CI were used to analysis the association between IBD and sexual function. Results Eleven studies with 7,018 male IBD cases and 1,803 female IBD cases were included in the meta-analysis. In male individuals, the pooled results revealed that IBD was significantly associated with impaired erectile function and poor sexual satisfaction (RR for erectile function =1.50, 95% CI: 1.22 to 1.84, P<0.0001; standard mean difference for sexual satisfaction =−0.24, 95% CI: −0.33 to −0.15, P<0.0001). And among female individuals, IBD had impact on most sub-domains of sexual function, except pains. Conclusions IBD is associated with worse sexual function. It has significant impact on erectile function and satisfaction for male individuals and has impact on most sub-domains of sexual function for female individuals.
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Affiliation(s)
- Bingliang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bingyan Zhou
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Clinical Center of Hirschsprung's disease and Allied Disorders, Wuhan, China
| | - Guoda Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Second Clinical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wei
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Delin Ma
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyi Yuan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Attanasio M, Masedu F, Quattrini F, Pino MC, Vagnetti R, Valenti M, Mazza M. Are Autism Spectrum Disorder and Asexuality Connected? ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2091-2115. [PMID: 34779982 DOI: 10.1007/s10508-021-02177-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/10/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
Asexuality is a lack of sexual attraction to any gender. There is some evidence to suggest that many self-identified asexuals have a formal diagnosis of autism spectrum disorder which is characterized by deficits in social interaction and communication, as well as by restricted and repetitive interests and behaviors. Additionally, the literature shows that asexuality and lack of sexual attraction or low sexual interest is overrepresented in people with autism spectrum disorder compared with neurotypical samples. Nevertheless, no studies have been conducted to investigate the relationship between autism and asexuality in depth. We conducted a systematic review of the literature to examine whether asexuality and autism spectrum disorder are connected. We conclude that asexuality and autism share various aspects, such as a possible role of prenatal factors, reference to romantic dimensions of sexual attraction and sexual orientation, and non-partner-oriented sexual desire, but future research should explore and clarify this link.
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Affiliation(s)
- Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy.
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy.
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Fabrizio Quattrini
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
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13
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Peixoto MM. Sexual Satisfaction in Portuguese Women: Differences Between Women With Clinical, Self-Perceived and Absence of Sexual Difficulties. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:197-208. [PMID: 38596531 PMCID: PMC10903668 DOI: 10.1080/19317611.2022.2040685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 04/11/2024]
Abstract
Objectives Female sexual functioning and satisfaction are affected by the presence of sexual difficulties. The current study examines differences in sexual satisfaction according to three groups of women: (i) clinical sexual difficulties assessed by the Female Sexual Functioning Index (FSFI) cutoff; (ii) self-perceived sexual difficulties at a non-clinical level; and (iii) sexually healthy. Methods A convenience sample of 329 Portuguese women, with a mean age of 28.69 (SD = 8.78), answered a specific question on the presence of self-perceived sexual difficulties, the Sexual Satisfaction Scale for Women and the FSFI. From the 329 women, 56 were assigned to the group with clinical sexual difficulties, 60 were assigned to the group with self-perceived sexual difficulties at non-clinical level, and 213 constituted the sexually healthy group. Results Sexually healthy women were more sexually satisfied compared with women who self-perceived sexual difficulties and women who had clinical sexual difficulties according to the FSFI. In addition, women who self-perceived sexual difficulties were also more sexually satisfied compared to women with clinical sexual difficulties according to the FSFI. Conclusions Women's sexual satisfaction was negatively affected by sexual difficulties assessed by the FSFI cutoff. Although with less impact, self-perceived sexual difficulties also negatively affect women's sexual satisfaction.
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Affiliation(s)
- Maria Manuela Peixoto
- Centro de Investigação em Psicologia para o Desenvolvimento Positivo, Instituto de Psicologia e Ciências da Educação, Universidade Lusíada do Porto, Porto, Portugal
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14
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Rodriguez-Blazquez C, Forjaz MJ. Scales and assessments of sexual dysfunction. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:35-52. [PMID: 35397788 DOI: 10.1016/bs.irn.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual dysfunction is a very frequent non-motor symptom in Parkinson's disease (PD). However, patients are often reluctant to declare their sexual problems and many clinicians do not inquire about them during routine visits. The use of validated rating scales and questionnaires allows overcoming these difficulties, characterizing the nature and causes of the patient's sexual dysfunction, and helping to implement and monitor the most adequate interventions. There is a wide range of instruments available for assessing sexual dysfunction in PD, including generic and specific ones. In this chapter, we review the most used rating scales and questionnaires, with a description of its components, characteristics and psychometric attributes.
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Affiliation(s)
- Carmen Rodriguez-Blazquez
- National Epidemiology Centre, Carlos III Institute of Health, Madrid, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Institute of Health, Madrid, Spain; Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
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15
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Heřmánková B, Špiritović M, Šmucrová H, Oreská S, Štorkánová H, Komarc M, Pavelka K, Šenolt L, Vencovský J, Bečvář R, Tomčík M. Female Sexual Dysfunction and Pelvic Floor Muscle Function Associated with Systemic Sclerosis: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:612. [PMID: 35010872 PMCID: PMC8744868 DOI: 10.3390/ijerph19010612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/25/2021] [Accepted: 12/27/2021] [Indexed: 02/04/2023]
Abstract
Only a few studies have addressed sexual health in patients with systemic sclerosis (SSc). This study aimed to compare female sexual function and pelvic floor muscle function in SSc patients with healthy controls (HC) matched by age, and to identify the potential implications of clinical features on sexual function. Our cohort included 90 women with SSc and 90 HC aged 18-70 years that completed six well-established and validated questionnaires assessing sexual function (Brief Index of Sexual Function for Women, Female Sexual Function Index, Sexual Quality of Life Questionnaire-Female, Sexual Function Questionnaire) and pelvic floor function (Pelvic Floor Impact Questionnaire-Short Form 7 and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form). Results from women with SSc and HC were contrasted and correlated with relevant clinical features. The prevalence of female sexual dysfunction was 73% in SSc patients (vs. 31% in HC). Women with SSc reported significantly worse pelvic floor function and sexual function than HC. Impaired sexual function was correlated with higher disease activity, the presence of dyspnea and interstitial lung disease, increased systemic inflammation, reduced physical activity, functional disability, more severe depression, more pronounced fatigue, and impaired quality of life. We demonstrate that sexual dysfunction is highly prevalent among women with SSc. This aspect of the disease deserves more attention both in clinical care and at the level of international research collaboration.
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Affiliation(s)
- Barbora Heřmánková
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, 162 52 Prague, Czech Republic
| | - Maja Špiritović
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, 162 52 Prague, Czech Republic
| | - Hana Šmucrová
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
| | - Sabína Oreská
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Hana Štorkánová
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, 162 52 Prague, Czech Republic;
| | - Karel Pavelka
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Radim Bečvář
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Michal Tomčík
- Institute of Rheumatology, 128 00 Prague, Czech Republic; (B.H.); (M.Š.); (H.Š.); (S.O.); (H.Š.); (K.P.); (L.Š.); (J.V.); (R.B.)
- Department of Rheumatology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
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Heřmánková B, Špiritović M, Oreská S, Štorkánová H, Komarc M, Klein M, Mann H, Pavelka K, Šenolt L, Vencovský J, Tomčík M. Sexual function in patients with idiopathic inflammatory myopathies: a cross-sectional study. Rheumatology (Oxford) 2021; 60:5060-5072. [PMID: 33956947 PMCID: PMC8566285 DOI: 10.1093/rheumatology/keab397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To date, there is almost no information concerning the sexual health of patients with idiopathic inflammatory myopathies (IIM). This cross-sectional study aimed to compare sexual function in patients with IIM to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function. METHODS In total, 122 women (61 with IIM, 61 age-matched HC) and 22 men (11 with IIM, 11 age-matched HC) aged 18-80 years completed gender-specific selection of 7 well-established and validated questionnaires assessing sexual health and function (Female Sexual Function Index, Brief Index of Sexual Function for Women, Sexual Function Questionnaire, Sexual Quality of Life Questionnaire-Female, International Index of Erectile Function, Male Sexual Health Questionnaire, Sexual Quality of Life Questionnaire-Male). Results were compared between patients and HC and correlated with selected disease-related features. RESULTS The prevalence of sexual dysfunction in IIM was 59% in women (vs 40% in HC), and 64% (vs 9% in HC) in men. Men and women with IIM reported significantly impaired sexual function compared with sex-/age-matched HC. Decreased sexual function was associated with muscle weakness, disability, physical inactivity, fatigue, depression and decreased quality of life. CONCLUSIONS Our results suggest that sexual dysfunction is common among IIM patients and more attention should be paid to this aspect of the disease.
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Affiliation(s)
- Barbora Heřmánková
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Maja Špiritović
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
- Institute of Rheumatology, Prague, Czech Republic
| | - Sabína Oreská
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Štorkánová
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Martin Klein
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Heřman Mann
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Karel Pavelka
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ladislav Šenolt
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Vencovský
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Tomčík
- Institute of Rheumatology, Prague, Czech Republic
- Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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17
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Sexual and Gender Minority Persons' Perception of the Female Sexual Function Index. J Sex Med 2021; 18:2020-2027. [PMID: 34732309 DOI: 10.1016/j.jsxm.2021.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/09/2021] [Accepted: 09/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Patient-reported outcome instruments to assess sexual functioning typically assume that patients are heterosexual and have a single sexual partner, thus they may have limited applicability for sexual and gender minority (SGM) populations as well as for nonpartnered individuals or those with multiple partners. AIM To explore the perceptions of SGM persons regarding the Female Sexual Function Index (FSFI), a commonly used sexual functioning questionnaire. METHODS We conducted 2 rounds of cognitive interviews with 27 SGM persons with and without a cancer diagnosis. Interviews were audio-recorded and transcribed. Two researchers independently coded the transcripts using inductive thematic analysis to identify major themes. OUTCOMES Themes identified via qualitative analysis. RESULTS Cognitive debriefing with the participants provided critical insights about the way we ask questions about sexual functioning in the oncology clinic. Three overarching themes arose from the data: (i) Certain aspects of the questionnaire were felt to unnecessarily medicalize sexuality; (ii) FSFI domains were perceived to represent a narrow and heteronormative experience of sexuality focused on penile-vaginal intercourse; (iii) Questionnaire domains emphasizing sexual "performance" were perceived as male-oriented. CLINICAL IMPLICATIONS Questionnaires such as the FSFI that were developed in research studies with specific eligibility criteria need to be adapted to the broader population seen in clinical practice. STRENGTHS & LIMITATIONS Strengths of the study include purposive sampling of SGM persons through LGBTQ networks. Our sample included individuals of different sexual orientations, gender identities, marital status, and cancer histories. However, a limitation is that the the majority of the sample was white and college-educated. Other limitations of the study include the potential sampling bias of self-selected participants with a particular interest in the study questions. CONCLUSION The findings provide important evidence for the development of a more inclusive sexual function measure, moving away from the traditional heteronormative, cisnormative approach to measuring sexual function. Austria MD, Lynch K, Le T, et al. Sexual and Gender Minority Persons' Perception of the Female Sexual Function Index. J Sex Med 2021;XX:XXX-XXX.
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18
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Swann SA, Kaida A, Nicholson V, Brophy J, Campbell AR, Carter A, Elwood C, Gebremedhen T, Gormley R, King EM, Lee M, Lee V, Maan EJ, Magagula P, Nyman S, Pang D, Pick N, Povshedna T, Prior JC, Singer J, Tognazzini S, Murray MCM, Cote HCF. British Columbia CARMA-CHIWOS Collaboration (BCC3): protocol for a community-collaborative cohort study examining healthy ageing with and for women living with HIV. BMJ Open 2021; 11:e046558. [PMID: 34362800 PMCID: PMC8351488 DOI: 10.1136/bmjopen-2020-046558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Women living with HIV (WLWH) experience accelerated ageing and an increased risk of age-associated diseases earlier in life, compared with women without HIV. This is likely due to a combination of viral factors, gender differences, hormonal imbalance and psychosocial and structural conditions. This interdisciplinary cohort study aims to understand how biological, clinical and sociostructural determinants of health interact to modulate healthy ageing in WLWH. METHODS AND ANALYSIS The British Columbia Children and Women: AntiRetroviral therapy and Markers of Aging-Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CARMA-CHIWOS) Collaboration (BCC3) study will enrol WLWH (n=350) and sociodemographically matched HIV-negative women (n=350) living in British Columbia. A subset of BCC3 participants will be past participants of CARMA, n≥1000 women and children living with and without HIV, 2008-2018 and/or CHIWOS, n=1422 WLWH, 2013-2018. Over two study visits, we will collect biological specimens for virus serologies, hormones and biological markers as well as administer a survey capturing demographic and sociostructural-behavioural factors. Sociodemographics, comorbidities, number and type of chronic/latent viral infections and hormonal irregularities will be compared between the two groups. Their association with biological markers and psychostructural and sociostructural factors will be investigated through multivariable regression and structural equation modelling. Retrospective longitudinal analyses will be conducted on data from past CARMA/CHIWOS participants. As BCC3 aims to follow participants as they age, this protocol will focus on the first study visits. ETHICS AND DISSEMINATION This study has been approved by the University of British Columbia Children's and Women's Research Ethics Board (H19-00896). Results will be shared in peer-reviewed journals, conferences and at community events as well as at www.hivhearme.ca and @HIV_HEAR_me. WLWH are involved in study design, survey creation, participant recruitment, data collection and knowledge translation. A Community Advisory Board will advise the research team throughout the study.
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Affiliation(s)
- Shayda A Swann
- Experimental Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Angela Kaida
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Valerie Nicholson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jason Brophy
- Division of Infectious Diseases, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Amber R Campbell
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Faculty of Medicine, The Kirby Institute, Sydney, New South Wales, Australia
| | - Chelsea Elwood
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Obstetrics and Gynecology, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Tsion Gebremedhen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Rebecca Gormley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Elizabeth M King
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Melanie Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Vonnie Lee
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Evelyn J Maan
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Patience Magagula
- Afro-Caribbean Positive Network of BC, Vancouver, British Columbia, Canada
| | - Sheila Nyman
- Bear Rock Consulting, Lone Butte, British Columbia, Canada
| | - Davi Pang
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Neora Pick
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Division of Infectious Diseases, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Tetiana Povshedna
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Centre for Menstrual Cycle and Ovulatory Research, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Joel Singer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shelly Tognazzini
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Melanie C M Murray
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Division of Infectious Diseases, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Helene C F Cote
- British Columbia Women's Hospital and Health Centre Women's Health Research Institute, Vancouver, British Columbia, Canada
- Pathology and Laboratory Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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Audier-Bourgain M, Baubet T, Pham-Scottez A, Corcos M, Nicolas I. Eating disorders and sexuality: A quantitative study in a French medically assisted procreation course. Brain Behav 2021; 11:e02196. [PMID: 34142465 PMCID: PMC8413734 DOI: 10.1002/brb3.2196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Among medically assisted procreation (MAP) patients, the prevalence of eating disorders (ED), clinical or subclinical, current or past, is considerable. In addition to metabolic repercussions, the literature suggests that these patients present with more sexual dysfunction, leading to anxiety. This quantitative research on a population of women consulting a MAP department for unexplained or ovulatory infertility proposed to study the sexuality of this population by comparing the sexuality of patients suffering from or having suffered from an ED to the sexuality of the non-ED group. METHOD Patients (n = 61) filled out the Eating Disorder Examination Questionnaire (EDE-Q), the Brief Index of Sexual Functioning for Women (BISF-W), the ED Whole Life Research Questionnaire, the Hospital Anxiety and Depression Scale (HADS) and the Kansas Marital Satisfaction Scale (KMSS). RESULTS We found a prevalence of 54% of ED, current or past. Even though these patients reported the same prevalence of sexual intercourse, they had significantly more physical problems (e.g., anorgasmia, vaginismus, headache) affecting their sexuality (p = .01) than the non-ED group, after adjusting for depression. Approximately 10% of the study population reported no intravaginal intercourse during the last month. DISCUSSION This study provides evidence for the existence of more sexual dysfunction in patients who have a fertility disorder and have ED or a history of ED. Future research should evaluate the results of psychological or sexological care that may be more suitable for the infertility of these patients.
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Affiliation(s)
- Marie Audier-Bourgain
- Department of Children and Adolescents, Psychopathology, Avicenna Hospital, General Psychiatry and Addictology Specialized, Bobigny, France
| | - Thierry Baubet
- Department of Children and Adolescents, Psychopathology, Avicenna Hospital, General Psychiatry and Addictology Specialized, Bobigny, France
| | - Alexandra Pham-Scottez
- Psychiatric Orientation And Reception Center, GHU Paris Psychiatry and Neurosciences, Paris Cedex 14, France
| | - Maurice Corcos
- Department of adolescent and young adult psychiatry, Institut Mutualiste Montsouris, Paris cedex 14, France
| | - Isabelle Nicolas
- Department of adolescent and young adult psychiatry, Institut Mutualiste Montsouris, Paris cedex 14, France
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20
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Panzeri M, Dadomo H, Ronconi L, Fontanesi L. Validation of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) in Italy: Assessing Gender and Age Differences of Sexual Functioning. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2755-2772. [PMID: 34363195 PMCID: PMC8416846 DOI: 10.1007/s10508-021-01972-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 06/10/2020] [Accepted: 02/25/2021] [Indexed: 05/29/2023]
Abstract
The Sexual Inhibition Scales and Sexual Excitation Scales (Janssen et al., 2002a), based on the dual control model by Bancroft and Janssen (2000), are part of a 45-item self-report questionnaire evaluating individual tendencies to sexual inhibition or excitation according to three factors: two inhibition factors, SIS1, threat of performance failure, and SIS2, threat of performance consequences, and one excitation factor, SES. In this paper, we aimed to validate and explore psychometric properties of the SIS/SES in a sample of 2260 Italian men and women aged 18 to 75 years. Confirmatory factor analyses showed that the three-factor structure proposed in the original version of the scales fit with our sample. Moreover, our data confirmed the results of the original validation sample: Women scored higher on the SIS and lower on the SES than men did, but no significant differences appeared in the factor scores by age group, except for a gender × age interaction, where younger women had higher SIS2 scores. The SIS/SES appeared to be an effective, appropriate cross-cultural measurement of human sexuality in Italian samples, also shedding light on sexual arousal differences in women and men in our country. We also discuss clinical and therapeutic aspects.
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Affiliation(s)
- Marta Panzeri
- Department of Developmental Psychology and Socialisation, Università Degli Studi di Padova, via Venezia 8, 35131, Padua, Italy.
| | - Harold Dadomo
- Unity of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Lucia Ronconi
- FISPPA, Università degli studi di Padova, Padua, Italy
| | - Lilybeth Fontanesi
- Department of Psychological, Humanistic and Territorial Sciences, University of Chieti, Chieti, Italy
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21
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Women's Sexual Health During the Pandemic of COVID-19: Declines in Sexual Function and Sexual Pleasure. CURRENT SEXUAL HEALTH REPORTS 2021; 13:76-88. [PMID: 34248426 PMCID: PMC8254666 DOI: 10.1007/s11930-021-00309-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/14/2022]
Abstract
Purpose of the Review The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women’s sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women’s sexual health during this period. Recent Findings Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period. Summary Research identified a deterioration of women’s sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women.
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22
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Folco KL, Fridberg DJ, Arcurio LR, Finn PR, Heiman JR, James TW. Neural mechanisms of sexual decision-making in women with alcohol use disorder. Psychopharmacology (Berl) 2021; 238:1867-1883. [PMID: 33738536 PMCID: PMC8238910 DOI: 10.1007/s00213-021-05815-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE The co-occurrence of alcohol consumption and sexual activity is associated with increased risk for sexual assault, sexually transmitted disease, and unplanned pregnancy among young adult women with alcohol use disorder (AUD). There is considerable previous work demonstrating neural reactivity to alcohol cues in AUD. Because alcohol consumption and sexual behavior are both rewarding and tend to co-occur, sexual cues may produce similar neural reactivity in women with AUD, possibly indicating a shared mechanism underlying reactivity to both types of cues. Alternatively, reactivity to alcohol versus sexual cues may be distinct, suggesting domain-specific mechanisms. OBJECTIVES We investigated whether the decision vulnerabilities in AUD women regarding sexual activity were related to differences in brain activation compared to control women. METHODS Women with (n = 15) and without (n = 16) AUD completed a hypothetical decision-making task during fMRI that presented low- or high-risk scenarios involving visual sexual, appetitive, and neutral cues. RESULTS Results showed that sexual cues were more often endorsed by women with AUD compared to controls and elicited differential brain activation patterns in frontal, visual, and reward regions. During high-risk decisions, women with AUD failed to downregulate activation, causing hyperactivation compared to controls. CONCLUSIONS Visual sexual cues produced reactivity like that previously demonstrated for alcohol cues, suggesting a shared or domain-general mechanism for alcohol and sexual cue reactivity in women with AUD. Riskier sexual decisions in women with AUD may be a consequence of repeatedly pairing alcohol use and sexual activity, a characteristic behavior of this population.
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Affiliation(s)
- Kess L Folco
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
| | - Daniel J Fridberg
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Lindsay R Arcurio
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
| | - Peter R Finn
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA
| | - Thomas W James
- Department of Psychological and Brain Sciences, Indiana University, 1101 E 10th St, Bloomington, IN, 47405, USA.
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Sensibility, Sensation, and Nerve Regeneration after Reconstructive Genital Surgery: Evolving Concepts in Neurobiology. Plast Reconstr Surg 2021; 147:995e-1003e. [PMID: 34019514 DOI: 10.1097/prs.0000000000007969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sensory recovery following phalloplasty and vaginoplasty for gender dysphoria is essential to the overall success of gender-confirming surgery. Anecdotal evidence suggests that superior reinnervation results are seen in genitoplasty compared to other peripheral nerve repair scenarios. Despite these observed differences, the quality of available literature is poor. METHODS The authors reviewed the body of English language literature regarding sensory outcomes following genitoplasty for gender confirmation. RESULTS The available body of literature discussing the basic science and clinical science aspects of sensory recovery following gender-confirming genitoplasty is small. Available data show that sensory recovery following vaginoplasty produces high rates of reported orgasmic ability, largely through the neoclitoris, and a neovagina with vibratory and pressure sensation similar to that of the native vagina. Phalloplasty sensory outcomes are variable, with the largest series reporting return of sensation in the neophallus that is slightly less than what is measured in control men. Erogenous sensation, including the ability to orgasm, is present in nearly all patients after several months. CONCLUSIONS Existing series indicate that genitoplasty patients experience faster and more complete recovery than any other peripheral nerve regeneration scenarios. However, there are many potential confounding factors in assessment and reporting, and more consistent and reproducible measure endpoints measures are needed. Further research is needed to better understand both the basic science and clinical science of peripheral nerve regeneration in genitoplasty, which may change fundamental aspects of current paradigms of peripheral nerve regeneration.
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Sexual Dysfunction in Ostomized Patients: A Systematized Review. Healthcare (Basel) 2021; 9:healthcare9050520. [PMID: 33946735 PMCID: PMC8145568 DOI: 10.3390/healthcare9050520] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 11/17/2022] Open
Abstract
The impact of an ostomy has a negative influence on sexuality. Healthcare professionals focus the care on surgery, and consider the sexual life is little relevant to the patient recovery. The aim of this systematized review is to give visibility to the sexual problems that ostomy patients have, to know what kind of sexual dysfunction occurs in this patients, to give information to the nursing staff about sexual disturbances and to recommend some resources to restart sexual activity. The research was conducted following de PRISMA guidelines and performed in several databases. Twelve papers were used to perform the systematized review. After ostomy, sexual dysfunction is different in men and women. It is related by the psychological aspects (low self-esteem, body image deterioration, etc.), the physical aspects (type of resection, complications, etc.) and the acceptance by the partner. A personalized sexual education focused on sexual problems that appear in ostomy patients is necessary to implement. In this way, adequate support, information and resources before and after surgery could be given for both, patients and their partners.
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25
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Auger LP, Aubertin M, Grondin M, Auger C, Filiatrault J, Rochette A. Assessment methods in sexual rehabilitation after stroke: a scoping review for rehabilitation professionals. Disabil Rehabil 2021; 44:4126-4148. [PMID: 33689511 DOI: 10.1080/09638288.2021.1889047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to identify and describe the assessment methods used by rehabilitation professionals to evaluate sexuality for individuals post-stroke, as well as the domains of sexuality addressed. METHODS Seven databases were selected for this scoping review. Articles needed to meet these inclusion criteria: published studies with a sample of ≥ 50% stroke clients and describing a quantitative or qualitative assessment method that could be used by rehabilitation professionals. This study was conducted following the PRISMA guidelines and domains of sexuality were categorized using the ICF core set for stroke. RESULTS Of the 2447 articles reviewed, the 96 that met the selection criteria identified a total of 116 assessment methods classified as standardized assessment tools (n = 62), original questionnaires (n = 28), semi-structured interviews (n = 16) or structured interviews (n = 10). Sexual functions were predominantly assessed using standardized tools, while intimate relationships and partner's perspective were generally addressed more by original questionnaires and qualitative methods. A stepwise approach combining relevant assessment methods is presented. CONCLUSIONS Individually, these diverse assessment methods addressed a limited scope of relevant domains. Future research should combine quantitative and qualitative methods to encompass most domains of sexuality of concern to post-stroke individuals.IMPLICATIONS FOR REHABILITATIONMost of the studies reviewed here used quantitative methods to assess sexuality, rather than qualitative methods, and mostly used standardized assessment tools.Few assessment methods covered all domains related to sexuality.Qualitative methods and standardized assessment tools were shown to be complementary, therefore emphasizing the added value of mixed methods in assessing sexuality after a stroke.Among the methods that were reviewed, certain would be more suitable for the identification of the need to address sexuality (e.g., Life Satisfaction Checklist-11) and others to assess more thoroughly sexuality (e.g., Change in Sexual Functioning Questionnaire (CSFQ-14)).
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Affiliation(s)
- Louis-Pierre Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Mélanie Aubertin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Myrian Grondin
- Marguerite-d'Youville Library, Université de Montréal, Montreal, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Johanne Filiatrault
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Montreal Geriatric University Institute Research Center, Montreal, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
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26
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Sexual Function of Men and Women With Spina Bifida: A Scoping Literature Review. Sex Med Rev 2021; 9:244-266. [PMID: 33608247 DOI: 10.1016/j.sxmr.2020.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/30/2020] [Accepted: 09/06/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION As most adults with spina bifida are either sexually active or interested in becoming sexually active, providers should understand how spina bifida impacts sexual function and options for treatment. OBJECTIVES The objective of this study is to summarize the current literature describing how features of spina bifida impact sexual function in men and women, effective available treatment options for sexual dysfunction, and to identify research gaps. METHODS Searches were conducted in PubMed, CINAHL Complete, PsychInfo, Cochrane Central, Scopus, and Web of Science Core Collection databases using keywords related to spina bifida and sexual function. 34 primary research studies were included. RESULTS Most men (56-96%) can achieve an erection, although it may be insufficient for penetration. Although 50-88% ejaculate, it is often dripping, retrograde, or insensate. Twenty percent to 67% achieve orgasm. Generally, men with lower lesions and intact sacral reflexes have better outcomes, although some men with all levels of lesion report good function. Sildenafil is efficacious at treating erectile dysfunction for most men. The "TO-MAXimize sensation, sexuality, and quality of life" procedure may improve sexual function in selected men with low-level lesions. Female sexual function and treatment is less well understood. Women may experience decreased arousal, difficulties with orgasm, and pain. No treatment has been studied in women. Bowel and bladder incontinence during intercourse appears to be bothersome to men and women. Although both men and women have diminished sexual satisfaction, their sexual desire appears to be least impacted. Present studies are limited by studies' small, heterogeneous populations, the misuse of validated questionnaires in the sexually inactive population, and the lack of a validated questionnaire specific to people with spina bifida. CONCLUSIONS Spina bifida impacts the sexual function of both men and women. Future studies should seek a better understanding of female sexual function and treatment, use validated questionnaires appropriately, and ultimately create a validated sexual function questionnaire specific to this population. Streur CS, Corona L, Smith JE, et al. Sexual Function of Men and Women With Spina Bifida: A Scoping Literature Review. Sex Med Rev 2021;9:244-266.
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27
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Holt LL, Chung YB, Janssen E, Peterson ZD. Female Sexual Satisfaction and Sexual Identity. JOURNAL OF SEX RESEARCH 2021; 58:195-205. [PMID: 32643959 DOI: 10.1080/00224499.2020.1784827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study addressed three goals related to better understanding the factors that contribute to female sexual satisfaction: (a) exploring differences in factors that contribute to perceptions of sexual satisfaction among women with varying sexual identities, (b) evaluating an existing measure of sexual satisfaction among women with diverse sexual identities, and (c) developing potential items for a future expanded measure of the factors contributing to sexual satisfaction. Participants were 996 heterosexual women, 333 bisexual women, and 204 lesbians. They completed an online survey that included a demographic questionnaire, an item measuring sexual satisfaction, an open-ended question about factors contributing to sexual satisfaction, the newly-developed Potential Sexual Satisfaction Factors, and the New Sexual Satisfaction Scale (NSSS). A multinomial regression, an internal consistency analysis, and qualitative analyses were performed to examine the three research questions. Several important differences in factors related to sexual satisfaction were found as a function of sexual identity. In particular, several of the factors that contributed to bisexual women's sexual satisfaction were different than those that contributed to heterosexual and lesbian women's satisfaction. These findings point to the importance of considering sexual identity when researching sexual satisfaction and when providing interventions to improve sexual satisfaction.
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Affiliation(s)
- Laura L Holt
- Counseling Psychology, Indiana University Bloomington
| | - Y Barry Chung
- Counseling Psychology, Indiana University Bloomington
| | - Erick Janssen
- Institute for Family and Sexuality Studies, University of Leuven
| | - Zoë D Peterson
- Kinsey Institute and Department of Counseling and Educational Psychology, Indiana University Bloomington
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28
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A systematic review of the psychosocial impact of fibroids before and after treatment. Am J Obstet Gynecol 2020; 223:674-708.e8. [PMID: 32474012 DOI: 10.1016/j.ajog.2020.05.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/15/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Despite the high prevalence of uterine fibroids, the psychosocial impact of fibroids has not been evaluated across different quality of life indicators and compared with other chronic conditions. Here, we rigorously analyzed available evidence pertaining to the psychosocial burden of uterine fibroids in premenopausal women and compared validated quality of life and symptom scores before and after treatment. DATA SOURCES We searched PubMed, PsycINFO, ClinicalTrials.gov, Embase, and Cochrane Library for publications from January 1990 to January 2020. STUDY ELIGIBILITY CRITERIA We considered English-language publications that evaluated the association between uterine fibroids diagnosed by imaging studies in premenopausal women and quality of life by standardized and validated questionnaires at baseline and after treatment. We used a detailed list of terms related to quality of life, questionnaires, and uterine fibroids to conduct the search. METHODS Three reviewers screened titles and abstracts and then obtained full-text articles for further analysis. The reviewers assessed risk of bias using established Cochrane and Newcastle-Ottawa Scale guidelines. The quality of life scores of premenopausal women with fibroids were reviewed at baseline and compared with those of published quality of life scores in other disease populations in addition to after fibroid treatment. RESULTS A total of 57 studies were included in the review: 18 randomized controlled trials and 39 observational studies. Of note, the 36-Item Short Form Survey and European Quality of Life Five-Dimension Scale questionnaires both indicated a diagnosis of uterine fibroids to have a disability score that was similar to or exceeded (was a greater psychosocial stressor) a diagnosis of heart disease, diabetes mellitus, or breast cancer. Quality of life scores were lower at baseline than after treatment in all instruments measuring these variables in women with uterine fibroids, indicating significantly impaired psychosocial functioning. Uterine fibroids were associated with significant patient-reported health disabilities related to bodily pain, mental health, social functioning, and satisfaction with sex life. CONCLUSION A diagnosis of uterine fibroids was a significant psychosocial stressor among women at baseline and relative to other diseases. Validated quality of life instruments indicated therapeutic success and the improvement of both physical and emotional symptoms after treatment.
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Panzeri M, Ferrucci R, Cozza A, Fontanesi L. Changes in Sexuality and Quality of Couple Relationship During the COVID-19 Lockdown. Front Psychol 2020; 11:565823. [PMID: 33132969 PMCID: PMC7550458 DOI: 10.3389/fpsyg.2020.565823] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/02/2020] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 pandemic is heavily influencing people's general well-being worldwide. Since its outbreak, many studies have explored the population's general psychological well-being, while only a few studies have addressed how the COVID-19 pandemic and the lockdown are affecting sexuality. Sexual health, an important aspect of general well-being, has relevant consequences on people's daily lives. Although it is well known that distress can affect sexuality, and it is possible to speculate that the outbreak's psychological outcomes are affecting the population's sexual life; recent literature does not explore couples' sexuality and their relationship quality during the lockdown. The present preliminary research aimed to understand if the Italian population's sexuality has changed, and if so, how it had changed since the spread of COVID-19, and which variables were influencing couples' relationship quality during the COVID-19 lockdown. A questionnaire reserved especially for cohabiting couples was designed and distributed online from April 11 to May 5, 2020, the 5th and 8th weeks, respectively, after the start of the lockdown. Of the 124 respondents who completed the online survey, 73% were females. Despite the pandemic's psychological consequences, when asked directly, most couples responded that they did not perceive any differences in their sexuality. However, some female participants did report a decrease in pleasure, satisfaction, desire, and arousal. The main reasons behind the changes in sexuality in women, therefore, appear to be worry, lack of privacy, and stress. Even when participants seemed to show high levels of resilience, the negative aspects of lockdown could affect their quality of sexual life. This study needs to be completed using qualitative data from online focus groups that have investigated how sexual life has changed and the main needs of couples. All the same, our results will serve to better address population needs and experiences, and provide ad hoc interventions during this unprecedented time of crisis.
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Affiliation(s)
- Marta Panzeri
- Department of Developmental Psychology and Socialisation, Padua University, Padua, Italy
| | - Roberta Ferrucci
- Aldo Ravelli Center, University of Milan, Milan, Italy
- San Paolo Hospital, Milan, Italy
| | - Angela Cozza
- Department of Developmental Psychology and Socialisation, Padua University, Padua, Italy
| | - Lilybeth Fontanesi
- Department of Psychological Health and Territorial Science, University G. D’Annunzio Chieti-Pescara, Chieti, Italy
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Cope AG, Young RJ, Stewart EA. Non-extirpative Treatments for Uterine Myomas: Measuring Success. J Minim Invasive Gynecol 2020; 28:442-452.e4. [PMID: 32841756 DOI: 10.1016/j.jmig.2020.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To analyze outcomes of nonextirpative treatments for uterine myomas compared with myomectomy. DATA SOURCES A systematic search of the following databases from inception to January 2020 was performed: Ovid Medline, Embase, PubMed, and Cochrane Controlled Register of Trials. METHODS OF STUDY SELECTION Two authors reviewed titles and abstracts for relevance, and full articles were obtained and evaluated for inclusion. Studies were included if they compared nonextirpative interventions for uterine myomas to myomectomy and reported at least one outcome of interest. TABULATION, INTEGRATION, AND RESULTS Of the 2010 articles identified and reviewed, 125 full text articles were reviewed, and 22 were ultimately included in the analysis. Nonextirpative treatments reviewed included uterine artery embolization (UAE; 16 studies, n = 9555 subjects), focused ultrasound (FUS; 4 studies, n = 1516), laparoscopic radiofrequency ablation (RFA; 3 studies, n = 49). UAE, FUS, and laparoscopic RFA groups were compared with patients undergoing myomectomy (n = 34 872, n = 20 677, n = 47 respectively). In comparison with myomectomy, UAE had similar quality of life scores, symptom severity scores, sexual function scores, ovarian function, and miscarriage rates following intervention. There was lower likelihood of conceiving after UAE and a higher rate of reintervention after UAE compared with myomectomy. FUS had similar postprocedure sexual function scores and reintervention rates compared with myomectomy. Laparoscopic RFA had similar quality of life scores, symptom severity scores, sexual function scores, reintervention rates, and pregnancy rates after the procedure compared with myomectomy. CONCLUSION Nonextirpative treatments for uterine myomas have similar outcomes to myomectomy in multiple domains, with most available evidence comparing UAE with myomectomy.
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Affiliation(s)
- Adela G Cope
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota (all authors)
| | - Riley J Young
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota (all authors)
| | - Elizabeth A Stewart
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota (all authors).
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Padoa A, McLean L, Morin M, Vandyken C. The Overactive Pelvic Floor (OPF) and Sexual Dysfunction. Part 2: Evaluation and Treatment of Sexual Dysfunction in OPF Patients. Sex Med Rev 2020; 9:76-92. [PMID: 32631813 DOI: 10.1016/j.sxmr.2020.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/30/2020] [Accepted: 04/08/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The assessment of pelvic floor muscle (PFM) overactivity is part of a comprehensive evaluation including a detailed history (medical, gynecological history/antecedent), appraisal of the psychosocial contexts of the patient, as well as a musculoskeletal and a neurological examination. OBJECTIVES The aims of this article are to review (i) the assessment modalities evaluating pelvic floor function in women and men with disorders associated with an overactive pelvic floor (OPF), and (ii) therapeutic approaches to address OPF, with particular emphases on sexual pain and function. METHODS We outline assessment tools that evaluate psychological and cognitive states. We then review the assessment techniques to evaluate PFM involvement including digital palpation, electromyography, manometry, ultrasonography, and dynamometry, including an overview of the indications, efficacy, advantages, and limitations of each instrument. We consider each instrument's utility in research and in clinical settings. We next review the evidence for medical, physiotherapy, and psychological interventions for OPF-related conditions. RESULTS Research using these assessment techniques consistently points to findings of high PFM tone among women and men reporting disorders associated with OPF. While higher levels of evidence are needed, options for medical treatment include diazepam suppositories, botulinum toxin A, and other muscle relaxants. Effective psychological therapies include cognitive behavioral therapy, couple therapy, mindfulness, and educational interventions. Effective physiotherapy approaches include PFM exercise with biofeedback, electrotherapy, manual therapy, and the use of dilators. Multimodal approaches have demonstrated efficacy in reducing pain, normalizing PFM tone, and improving sexual function. Multidisciplinary interventions and an integrative approach to the assessment and management of OPF using a biopsychosocial framework are discussed. CONCLUSION Although the efficacy of various intervention approaches has been demonstrated, further studies are needed to personalize interventions according to a thorough assessment and determine the optimal combination of psychological, physical, and behavioral modalities. Padoa A, McLean, L, Morin M, et al. The Overactive Pelvic Floor (OPF) and Sexual Dysfunction. Part 2: Evaluation and Treatment of Sexual Dysfunction in OPF Patients. Sex Med 2021;9:76-92.
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Affiliation(s)
- Anna Padoa
- Department of Obstetrics and Gynecology, Yitzhak Shamir (formerly Assaf Harofe) Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Linda McLean
- School of Rehabilitation Sciences, Chair in Women's Health Research, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Melanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Research Center of the Centre hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada
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Diseño y validación de la segunda edición del Cuestionario de Función Sexual de la Mujer, FSM-2. Semergen 2020; 46:324-330. [DOI: 10.1016/j.semerg.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/24/2019] [Accepted: 01/22/2020] [Indexed: 11/15/2022]
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Kislev E. Does Marriage Really Improve Sexual Satisfaction? Evidence from the Pairfam Dataset. JOURNAL OF SEX RESEARCH 2020; 57:470-481. [PMID: 31050568 DOI: 10.1080/00224499.2019.1608146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In light of the growing unmarried demographic, this study analyzed the extent and determinants of sexual satisfaction among seven relationship-status groups: married, never married, and those who are divorced/separated, where the latter two groups are further divided into single, living apart together (LAT), and cohabiting. In addition, the study measured the levels of sexual self-esteem, sexual communication, and sex frequency for the different relationship-status groups as predictors of sexual satisfaction. Finally, this study also analyzed sexual satisfaction while accounting for overall life satisfaction. Using the ninth wave of the Pairfam data set and analyzing the responses of 3,207 respondents in total, this study suggests that marriage is not a determinant for sexual satisfaction. In fact, it can even be a negative correlate when married respondents are compared to certain unmarried groups. The only exception is that of unmarried individuals who currently have no partner. Even this situation is shown to be dependent only on less frequent intercourse, not on a lack of sexual self-esteem and sexual communication. These conclusions challenge previous research as well as the explanations of earlier scholars. Several directions for future research are discussed in light of these findings.
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Affiliation(s)
- Elyakim Kislev
- The Federmann School of Public Policy and Government, The Hebrew University of Jerusalem
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Affiliation(s)
- Tatiana Sedláková
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Anna Ševčíková
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
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Zheng J, Skiba MA, Bell RJ, Islam RM, Davis SR. The prevalence of sexual dysfunctions and sexually related distress in young women: a cross-sectional survey. Fertil Steril 2020; 113:426-434. [DOI: 10.1016/j.fertnstert.2019.09.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 10/24/2022]
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Blais RK, Livingston WS, Fargo JD. Higher depression severity mediates the association of assault military sexual trauma and sexual function in partnered female service members/veterans. J Affect Disord 2020; 261:238-244. [PMID: 31655379 DOI: 10.1016/j.jad.2019.09.072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/16/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Military sexual trauma (MST), and assault as opposed to harassment-only MST in particular, is associated with lower sexual function among female service members/veterans (SM/Vs). Recent research revealed that higher posttraumatic stress disorder (PTSD) symptom clusters of anhedonia and dysphoric arousal mediated the association of assault MST and sexual function. Such clusters represent the depressive symptoms of PTSD, and theories of sexual function suggest that depression worsens sexual function. The impact of depression on the association of MST and sexual function has yet to be tested. METHOD Using path analysis, the study examined whether depression severity mediated the association of MST and sexual function after accounting for demographics and mediators of PTSD-related anhedonia and dysphoric arousal. Female SM/Vs (N = 697) completed measures of MST (history, severity), depression, PTSD-related anhedonia and dysphoric arousal, sexual function, and a demographic inventory. RESULTS One hundred twenty-two (17.50%) indicated that they did not experience MST, 336 (48.21%) reported that they experienced harassment-only MST, and 239 (34.29%) reported assault MST. Fit indices evidenced strong model fit, χ2(12, N = 697)=18.85, p=.09, CFI=1.00, TLI=0.99, SRMR=0.02, and RMSEA=0.03. The indirect effect of depression severity was significant (p<.001). LIMITATIONS Use of cross-sectional data in a convenience sample of female SM/Vs. CONCLUSIONS Even after accounting for established covariates and mediators of assault MST and sexual function, depression accounted for a significant amount of variance in this association. Treatment of poor sexual function must address depressive symptoms. As medications for depression can exacerbate sexual issues, psychotherapy may be the most effective treatment strategy.
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Pereira-Caldeira NMV, Pereira-Ávila FMV, Almeida-Cruz MCMD, Reinato LAF, Reis RK, Gir E. Instruments for quality of life assessment in individuals with human papillomavirus. Rev Bras Enferm 2019; 72:1363-1369. [PMID: 31531663 DOI: 10.1590/0034-7167-2017-0394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/10/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To identify scientific evidence on quality of life measurement instruments used in individuals with infections caused by human papillomavirus. METHOD This was an integrative review carried out from April 1995 to March 2017 in the LILACS, SciVerse Scopus, ISI Web of Science, CINAHL, and PubMed databases. The controlled descriptors adopted were: Infecções por Papilomavirus; Qualidade de Vida; Papillomavirus Infections; and Quality of Life. RESULTS Of the 416 articles found, 12 were selected. Thirteen different types of instruments to evaluate the quality of life of individuals with human papillomavirus were identified, in that nine were generic and four specific. CONCLUSION Different generic and specific instruments were used to evaluate the quality of life of individuals with human papillomavirus, which means no consensus or preference among the studies was identified. However, a lack of use of specific instruments to evaluate this construct in this population was observed.
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Affiliation(s)
| | | | | | | | | | - Elucir Gir
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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Farnam F. The complexities and challenges of sexual dysfunctions diagnosis
in females: A case report. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2019. [DOI: 10.29252/pcnm.9.2.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Banaei M, Azizi M, Moridi A, Dashti S, Yabandeh AP, Roozbeh N. Sexual dysfunction and related factors in pregnancy and postpartum: a systematic review and meta-analysis protocol. Syst Rev 2019; 8:161. [PMID: 31277721 PMCID: PMC6612152 DOI: 10.1186/s13643-019-1079-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 06/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sexual dysfunction refers to a chain of psychiatric, individual, and couple's experiences that manifests itself as a dysfunction in sexual desire, sexual arousal, orgasm, and pain during intercourse. The aim of this systematic review will be to assess the sexual dysfunction and determine the relevant factors to sexual dysfunction during pregnancy and postpartum. METHODS AND ANALYSIS All observational studies, including descriptive, descriptive-analytic, case-control, and cohort studies published between 1990 and 2019, will be included in the study. Review articles, case studies, case reports, letter to editors, pilot studies, and editorial will be excluded from the study. The search will be conducted in the Cochrane Central Register, MEDLINE, Google Scholar, EMBASE, ProQuest, Scopus, WOS, and CINAHL databases. Eligible studies should assess at least one of the sexual dysfunction symptoms in pregnant women or in the first year postpartum. Quality assessment of studies will be performed by two authors independently based on the NOS checklist. This checklist is designed to assess the quality of observational studies. Data will be analyzed using Stata software ver. 11. Considering that the index investigated in the present study will be the level of sexual disorder, standard error will be calculated for each study using binomial distribution. The heterogeneity level will be investigated using Cochran's Q statistic and I2 index in a chi-square test at a significance level of 1.1. Predictable limitations of this study included a small number and unacceptable quality of studies. DISCUSSION This systematic review addresses the factors associated with sexual dysfunction during pregnancy and postpartum. Considering the high prevalence of sexual dysfunction among women, the treatment of this problem has been highly sought after by the World Health Organization in recent years. The results of this study can help discover new strategies by introducing factors affecting women's sexual dysfunction, thereby eliminating or diminishing these factors, and play an important role in improving the quality of life of women during pregnancy and postpartum periods. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018083554.
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Affiliation(s)
- Mojdeh Banaei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Azizi
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azam Moridi
- Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, Bandar Abbas, Iran
| | - Sareh Dashti
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Asiyeh Pormehr Yabandeh
- Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, Bandar Abbas, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, Bandar Abbas, Iran.
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Dy GW, Nolan IT, Hotaling J, Myers JB. Patient reported outcome measures and quality of life assessment in genital gender confirming surgery. Transl Androl Urol 2019; 8:228-240. [PMID: 31380229 DOI: 10.21037/tau.2019.05.04] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Transgender and gender nonbinary (TGNB) individuals may seek genital gender confirming surgery (GCS) as part of their transition. Outcomes of genital GCS may include gender congruence, sexual functioning and satisfaction, urinary symptoms, aesthetic satisfaction, and overall quality of life, among others. Despite a wide number of studies on results of vaginoplasty, metoidioplasty, phalloplasty, and other genital GCS, data regarding patient reported outcomes are limited. To date, there is no patient reported outcome measure (PROM) validated within the TGNB population to assess subjective outcomes of GCS. In this review, we aim to describe existing tools being utilized to report outcomes following GCS, assessing the merits and limitations of each.
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Affiliation(s)
- Geolani W Dy
- Department of Urology, New York University, New York, NY, USA
| | - Ian T Nolan
- School of Medicine, New York University, New York, NY, USA
| | - James Hotaling
- Department of Urology, University of Utah, Salt Lake City, UT, USA
| | - Jeremy B Myers
- Department of Urology, University of Utah, Salt Lake City, UT, USA
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Examining Changes in Sexual Functioning after Cognitive Processing Therapy in a Sample of Women Trauma Survivors. Womens Health Issues 2019; 29:72-79. [DOI: 10.1016/j.whi.2018.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 09/21/2018] [Accepted: 10/08/2018] [Indexed: 01/23/2023]
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Qualls LR, Hartmann K, Paulson JF. Broad Autism Phenotypic Traits and the Relationship to Sexual Orientation and Sexual Behavior. J Autism Dev Disord 2018; 48:3974-3983. [PMID: 29616484 DOI: 10.1007/s10803-018-3556-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Individuals with higher levels of the broad autism phenotype (BAP) have some symptoms of autism spectrum disorder (ASD). Like individuals with ASD, people with higher-BAP may have fewer sexual experiences and may experience more same-sex attraction. This study measured BAP traits, sexual experiences, and sexual orientation in typically developing (TD) individuals to see if patterns of sexual behavior and sexual orientation in higher-BAP resemble those in ASD. Although BAP characteristics did not predict sexual experiences, one BAP measure significantly predicted sexual orientation, β = 0.22, t = 2.72, p = .007, controlling for demographic variables (R2 change = .04, F = 7.41, p = .007), showing individuals with higher-BAP also reported increased same-sex attraction. This finding supports the hypothesis that individuals with higher-BAP resemble ASD individuals in being more likely than TD individuals to experience same-sex attraction.
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Affiliation(s)
- Lydia R Qualls
- Virginia Consortium Program for Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.
| | - Kathrin Hartmann
- Virginia Consortium Program for Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.,Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, 825 Fairfax Ave. Suite 710, Norfolk, VA, 23507, USA
| | - James F Paulson
- Virginia Consortium Program for Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.,Department of Psychology, Old Dominion University, 5115 Hampton Boulevard, Norfolk, VA, 23529, USA
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Tomao F, Di Pinto A, Sassu CM, Bardhi E, Di Donato V, Muzii L, Petrella MC, Peccatori FA, Panici PB. Fertility preservation in ovarian tumours. Ecancermedicalscience 2018; 12:885. [PMID: 30679952 PMCID: PMC6345054 DOI: 10.3332/ecancer.2018.885] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 12/14/2022] Open
Abstract
A considerable number of patients with a cancer diagnosis are of childbearing age and have not satisfied their desire for a family. Despite ovarian cancer (OC) usually occurring in older patients, 3%-14% are diagnosed at a fertile age with the overall 5-year survival rate being 91.2% in women ≤44 years of age when it is found at 1A-B stage. In this scenario, testing the safety and the efficacy of fertility sparing strategies in OC patients is very important overall in terms of quality of life. Unfortunately, the lack of randomised trials to validate conservative approaches does not guarantee the safety of fertility preservation strategies. However, evidence-based data from descriptive series suggest that in selected cases, the preservation of the uterus and at least one part of the ovary does not lead to a high risk of relapse. This conservative surgery helps to maintain organ function, giving patients of childbearing age the possibility to preserve their fertility. We hereby analysed the main evidence from the international literature on this topic in order to highlight the selected criteria for conservative management of OC patients, including healthy BRCA mutations carriers.
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Affiliation(s)
- Federica Tomao
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Di Pinto
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Carolina Maria Sassu
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Erlisa Bardhi
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Violante Di Donato
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Ludovico Muzii
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | | | | | - Pierluigi Benedetti Panici
- Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Carter A, Greene S, Money D, Sanchez M, Webster K, Nicholson V, Brotto LA, Hankins C, Kestler M, Pick N, Salters K, Proulx-Boucher K, O'Brien N, Patterson S, de Pokomandy A, Loutfy M, Kaida A. Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types. JOURNAL OF SEX RESEARCH 2018; 55:1134-1154. [PMID: 29624080 DOI: 10.1080/00224499.2018.1440370] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women's own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women's rights, which are critical to overall well-being.
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Affiliation(s)
- Allison Carter
- a Faculty of Health Sciences , Simon Fraser University
- b Epidemiology and Population Health , British Columbia Centre for Excellence in HIV/AIDS
| | | | - Deborah Money
- d Department of Obstetrics and Gynecology and Department of Medicine, Faculty of Medicine , University of British Columbia
| | | | - Kath Webster
- a Faculty of Health Sciences , Simon Fraser University
| | | | - Lori A Brotto
- f Department of Obstetrics and Gynecology, Faculty of Medicine , University of British Columbia
| | - Catherine Hankins
- g Amsterdam Institute for Global Health and Development, Department of Global Health , University of Amsterdam
- h Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine , McGill University
| | - Mary Kestler
- i Division of Infectious Diseases, Faculty of Medicine , University of British Columbia
| | - Neora Pick
- i Division of Infectious Diseases, Faculty of Medicine , University of British Columbia
- j Oak Tree Clinic , British Columbia Women's Hospital and Health Centre
| | - Kate Salters
- a Faculty of Health Sciences , Simon Fraser University
- b Epidemiology and Population Health , British Columbia Centre for Excellence in HIV/AIDS
| | | | - Nadia O'Brien
- k Chronic Viral Illness Service , McGill University Health Centre
- l Department of Family Medicine , McGill University
| | - Sophie Patterson
- a Faculty of Health Sciences , Simon Fraser University
- m Department of Public Health and Policy , University of Liverpool
| | - Alexandra de Pokomandy
- k Chronic Viral Illness Service , McGill University Health Centre
- o Department of Medicine , University of Toronto
| | - Mona Loutfy
- n Women's College Research Institute , Women's College Hospital
- o Department of Medicine , University of Toronto
| | - Angela Kaida
- a Faculty of Health Sciences , Simon Fraser University
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Patient-Reported Outcome Measures Used in Gender Confirmation Surgery: A Systematic Review. Plast Reconstr Surg 2018; 141:1026-1039. [PMID: 29595738 DOI: 10.1097/prs.0000000000004254] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The usefulness of patient-reported outcome measures is emphasized along with the development of patient-centered care. When implementing patient-reported outcome measures, evidence of the instrument's validity, reliability, and responsiveness in the target population is necessary to secure accurate reporting of the patient's experience. The aim of this study was to identify the literature in which structured patient-reported outcome measures have been used to evaluate the results of gender confirmation surgery, and to systematically evaluate the validity of these instruments. METHODS A systematic review of the current literature was performed to identify structured patient-reported outcome measures used to evaluate the outcome of gender confirmation surgery. The identified instruments' validity in the transgender population was assessed for adherence to international guidelines for development and validation of health outcomes instruments. RESULTS A total of 110 instruments were identified: 64 ad hoc; six generic; 24 evaluating psychiatric, social, or psychosocial aspects; nine evaluating function but only valid in other patient groups; five ad hoc with some formal development/validation; and two specific for gender dysphoria. CONCLUSIONS There is a lack of patient-reported outcome measures that are valid for the transgender population and concurrently sensitive enough to evaluate gender confirmation surgery without the influence of other gender confirming interventions. Basing research on instruments without confirmed validity decreases the validity of the study itself; thus, previous research using patient-reported outcome measures to evaluate gender confirmation surgery can be considered to have a low level of evidence. To obtain valid patient-reported outcome measures, specific for evaluating the results of gender confirmation surgery, development of new instruments or adaptation of existing instruments is needed.
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Bird ER, Seehuus M, Heiman JR, Davis KC, Norris J, George WH. Sexual vs. Nonsexual Currently Most Upsetting Trauma: A Fresh Look at Attenuation of Sexual Response, Alcohol Intoxication, and Post-Traumatic Stress. JOURNAL OF SEX RESEARCH 2018; 55:915-926. [PMID: 29023137 PMCID: PMC6195219 DOI: 10.1080/00224499.2017.1380159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined the dependence of sexual response (vaginal pulse amplitude [VPA] and subjective sexual arousal) on alcohol intoxication (.10% breath alcohol concentration [BrAC] versus no alcohol) and the nature of a woman's currently most upsetting traumatic event (C-MUTE), whether it was sexual (e.g., rape) or nonsexual (e.g., combat). Self-reported sexual outcomes were also compared by C-MUTE type. A total of 117 women completed background measures and either drank alcoholic or nonalcoholic beverages. They were shown erotic films and their VPA was assessed. A two (sexual versus nonsexual C-MUTE) by two (.10% BrAC versus no alcohol) analysis of variance (ANOVA) showed that, controlling for post-traumatic stress (PTS) symptoms, women with a sexual C-MUTE showed lower percent VPA change than women with a nonsexual C-MUTE. No significant effects were found for subjective sexual arousal. A multivariate analysis of variance (MANOVA) showed that women with a sexual C-MUTE reported more frequent anxiety and inhibition during partnered sex and more frequent lack of vaginal lubrication versus women with a nonsexual C-MUTE. There was no significant interaction between C-MUTE and alcohol intoxication. Whether a woman is currently upset by past sexual victimization may influence current sexual difficulties. Attenuated VPA may be attributable to the sexual nature of a C-MUTE as opposed to general trauma exposure.
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Affiliation(s)
| | | | - Julia R Heiman
- c Psychological and Brain Sciences , Indiana University
- d The Kinsey Institute , Indiana University
| | | | - Jeanette Norris
- f Alcohol and Drug Abuse Institute , University of Washington
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McCloskey H, Kaviani A, Pande R, Boone T, Khavari R. A cross-sectional study of sexual function and fertility status in adults with congenital genitourinary abnormalities in a U.S. tertiary care centre. Can Urol Assoc J 2018; 13:E31-E65. [PMID: 30169148 DOI: 10.5489/cuaj.5374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to evaluate sexual function, sexual knowledge, and fertility status in adult patients with congenital genitourinary abnormalities (CGUA). METHODS Adult patients with CGUA who were referred to a single transitional urology clinic between 2014 and 2017 were prospectively recruited to participate in the study. Questionnaires about general demographics, bowel and bladder continence, fertility, and sexuality were gathered. Validated questionnaires, including the Sexual Health Inventory for Men (SHIM) and Brief Index of Sexual Functioning for Women (BISF-W), were also collected. RESULTS A total of 167 adults with CGUA were referred to our clinic within the defined time frame. Sixty patients (25 males, 35 females) with a mean age of 25.4 years (range 18-75) met inclusion criteria and responded to questionnaires pertaining to sexuality and fertility. Forty-five (75%) responded to the fertility questionnaire; 26 (58%) had never heard of assisted reproductive technologies, and only one had received prior fertility counselling. Fifty-eight participants (97%) responded to the sexuality questionnaire; 21 (36%) reported a history of sexual activity, with 12 (21%) being currently sexually active. Twenty (34%) wanted to learn more about sexuality and/or fertility. The SHIM response rate was 44%, and only three females (9%) completed the BISF-W in its entirety. CONCLUSIONS Adults with CGUA desire more sexuality and fertility education, yet they are uncomfortable completing current questionnaires. Our sexuality and fertility questionnaires are too challenging for this patient population to complete despite assistance. Thus, modifications are urgently needed. Additionally, medical providers should discuss sexual and reproductive health with these patients earlier and in more detail.
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Affiliation(s)
| | - Aaron Kaviani
- Houston Methodist Hospital, Houston, TX, United States
| | - Rashmi Pande
- Houston Methodist Hospital, Houston, TX, United States
| | - Timothy Boone
- Houston Methodist Hospital, Houston, TX, United States
| | - Rose Khavari
- Houston Methodist Hospital, Houston, TX, United States
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Mollaioli D, Di Sante S, Limoncin E, Ciocca G, Gravina GL, Maseroli E, Fanni E, Vignozzi L, Maggi M, Lenzi A, Jannini EA. Validation of a Visual Analogue Scale to measure the subjective perception of orgasmic intensity in females: The Orgasmometer-F. PLoS One 2018; 13:e0202076. [PMID: 30157203 PMCID: PMC6114295 DOI: 10.1371/journal.pone.0202076] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/29/2018] [Indexed: 12/11/2022] Open
Abstract
The female orgasm represents one of the most complex functions in the field of human sexuality. The conjunction of the anatomical, physiological, psycho-relational and socio-cultural components contributes to make the female orgasm still partly unclear. The female orgasmic experience, its correlates and the relation with sexual desire, arousal and lubrication as predictors are highly debated in scientific community. In this context, little is known about the impact of female sexual dysfunction (SD) on sexual pleasure expressed by subjective orgasmic intensity, and there are no suitable psychometric tools suited to investigate this dimension. Thus, we validate, in female subjects, a Visual Analogue Scale (VAS) that we named Orgasmometer-F, to verify if SD is accompanied by a lower perceived orgasmic intensity. A total of 526 women, recruited through a web-based platform and from sexological outpatient clinic, were enrolled in the study. They were divided into, on the basis of the Female Sexual Function Index (FSFI) score in two groups: 1) 112women suffering from SD, (SD Group); and 2) 414 sexually healthy women (Control Group). The participants were requested to fill out the Orgasmometer-F, recording orgasmic intensity on a Likert scale from 0 (absence of orgasmic intensity) to 10 (maximum orgasmic intensity experienced). Women with SD experienced significantly lower orgasmic intensity than controls, as measured by the Orgasmometer-F (p < 0.0001). Interestingly, masturbatory frequency was positively correlated with orgasmic intensity, as were the lubrication, orgasm and sexual satisfaction domains of the FSFI. The Orgasmometer-F was well understood, had a good test-retest reliability (ICC = 0.93) and a high AUC in differentiating between women with and without sexual dysfunction (AUC = 0.9; p < 0.0001). The ROC curve analysis showed that a cut-off <5 had 86.5% sensitivity (95% CI 82,8–89,6), 80.4% specificity (95% CI 71.8–87.3), 75.4% positive predictive value (PPV) and 89.5% negative predictive value (NPV). In conclusion, the Orgasmometer-F, a new psychometrically sound tool for measuring orgasmic intensity in female population, demonstrated that SD impair orgasmic intensity.
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Affiliation(s)
- Daniele Mollaioli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Stefania Di Sante
- Division of Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Erika Limoncin
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Luca Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Elisa Maseroli
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Egidia Fanni
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Andrea Lenzi
- Division of Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Emmanuele A. Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- * E-mail:
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Assessment of Sexual Desire for Clinical Trials of Women With Hypoactive Sexual Desire Disorder: Measures, Desire-Related Behavior, and Assessment of Clinical Significance. Sex Med Rev 2018; 6:367-383. [DOI: 10.1016/j.sxmr.2017.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/22/2017] [Accepted: 11/26/2017] [Indexed: 01/11/2023]
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