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Montecalvo M, Vegni E, Balestrieri R, Leone D, Borghi L. The elephant in the room: a study on the dialogue about sexuality during Assisted Reproductive Technology visits. J Psychosom Obstet Gynaecol 2024; 45:2372565. [PMID: 38965685 DOI: 10.1080/0167482x.2024.2372565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/22/2024] [Indexed: 07/06/2024] Open
Abstract
Despite ongoing medical advancements in infertility treatment, the significant impact of sexuality on this journey often goes unaddressed. The present research aims to examine sexual conversations during ART visits, including who initiate the conversation and their content.This quali-quantitative study delves into analyzed video-recorded ART visits to explore how "sex" conversations are broached during healthcare interactions. Our findings reveal a strikingly low proportion of utterances related to sexuality, accounting for only 1.3% of the total 14,372 utterances analyzed. Sex utterances were mainly introduced by physicians (72%), while regarding those introduced by the couple, 64% were reported by men. From the qualitative analysis on the utterances emerged three distinct levels of communication about sex: explicit, almost explicit, and implicit. While physicians and males exhibit an almost balanced distribution across the 3 levels, female patients primarily respond to explicit and almost explicit communication initiated by physicians. The low percentage of sexual utterances underscores the rarity of these conversations during ART interactions, despite the clinical field where sexual health should deserve a crucial attention. Opening the door to conversations about sexuality could help to create a safe and supportive space for patients to talk about sex, with a potential impact on well-being and quality of care during the ART process.
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Affiliation(s)
- Michele Montecalvo
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
| | - Elena Vegni
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
| | - Raffaella Balestrieri
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
| | - Daniela Leone
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
| | - Lidia Borghi
- Clinical Psychology, Department of Health Science, University of Milan, Milan, Italy
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan, Italy
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Lehmann RJB, Jahnke S, Bartels R, Butzek J, Molitor A, Schmidt AF. Public Stigmatizing Reactions Toward Nonoffending Pedophilic Individuals Seeking to Relieve Sexual Arousal. JOURNAL OF SEX RESEARCH 2024; 61:1119-1129. [PMID: 37163734 DOI: 10.1080/00224499.2023.2198512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
People with pedophilia (PWP) can deal with their sexual desires by relieving sexual arousal without sexually exploiting children. Study 1 investigated whether public reactions toward nonoffending pedophilic men are affected by their strategies to relieve sexual arousal (nonsexual pictures vs. child sex dolls) or to reduce their sex drive via testosterone lowering medication in legally nonproblematic ways. A sample of German-speaking participants (N = 143) read three vignettes describing PWP using either of these strategies. Participants' (59.4% females) mean age was 39.7 (SD = 15.6). Although no significant difference was detected between the nonsexual pictures and sex dolls conditions on cognitive (except for dangerousness), affective, and behavioral levels, both consistently elicited more stigmatizing reactions than the testosterone-lowering medication condition. To investigate if this effect was driven by disapproving any relief of sexual arousal or the use of actual child stimuli in particular, Study 2 (N = 151) added two conditions with PWP using adult child-like stimuli to relieve sexual arousal: adult-as-schoolgirl porn and adult partner with childlike appearance. Here, Participants' (57.6% females) mean age was 28.0 (SD = 13.3). Results indicate that stigmatization was driven by disapproving the use of child stimuli rather than the relief of sexual arousal in general. Individuals with a sexual interest in children face strong stigmatizing reactions, which are only alleviated when they are described as undergoing treatment lowering sex drive or - to a lesser extent - being able to mate with an adult partner or using porn with adult actors posing as schoolgirls.
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Affiliation(s)
| | - Sara Jahnke
- Department of Health Promotion and Development, University of Bergen
| | | | | | | | - Alexander F Schmidt
- Institute of Psychology, Social & Legal Psychology, Johannes Gutenberg-University of Mainz
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Wright PJ, Herbenick D. Adolescent Pornography Exposure, Condom Use, and the Moderating Role of Parental Sexual Health Communication: Replication in a U.S. Probability Sample. HEALTH COMMUNICATION 2024:1-9. [PMID: 39104215 DOI: 10.1080/10410236.2024.2386215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Following calls for an increase in replication studies in communication science as well as multiple other disciplines, the present study provides a direct replication of a pragmatically and theoretically important investigation of U.S. adolescents' pornography exposure, parent-adolescent sexual health communication, and condomless sex published in this journal. Parent-adolescent sexual health communication has been suggested as a sexual risk-reduction mechanism, but condomless sex among U.S. adolescents is increasing. Simultaneously, pornography remains an extremely popular media genre and condomless sex is the norm in pornographic depictions. The findings of the present study replicated the findings of the original study, with the most notable replicated finding being an interaction between pornography exposure and parent-adolescent sexual health communication on the likelihood of condomless sex. Both in the original and present study, the association between U.S. adolescents' pornography exposure and likelihood of condomless sex decreased as parental-adolescent sexual health communication increased. Results are discussed in terms of the challenges to examining these particular relationships among U.S. youth and the state of replication in the pornography effects literature.
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Barrera E, Baronas JM, Sutherland S, Rohan A, Margolin RE, Boskey ER, Renthal NE. A Multidisciplinary Approach Improves Sexual Health Care for Youth with Duchenne Muscular Dystrophy. J Pediatr 2024; 271:114079. [PMID: 38692562 DOI: 10.1016/j.jpeds.2024.114079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
We sought to determine the prevalence of sexual health counseling in patients with Duchenne muscular dystrophy in a single-institution setting. Keywords related to sexual health and development concerns were documented at least once for 75% of patients across the duration of their care. Integration of sexual health discussions was facilitated by comprehensive multidisciplinary support, particularly with the inclusion of specialists in endocrinology and adolescent medicine.
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Affiliation(s)
- Ellis Barrera
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - John M Baronas
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Sherice Sutherland
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Alyssa Rohan
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Robin E Margolin
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth R Boskey
- Division of Gynecology, Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Nora E Renthal
- Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA.
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Brissette V, Monton O, Demian M, Al Busaidi N, Moon J, Sabboobeh S, Vasilevsky CA, Rajabiyazdi F, Boutros M. Exploring patients' needs and expectations for information on sexual dysfunction after rectal cancer treatment: A qualitative study. Colorectal Dis 2024; 26:1535-1543. [PMID: 38890007 DOI: 10.1111/codi.17048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/25/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024]
Abstract
AIM Sexual dysfunction is an important, and often overlooked, sequela of rectal cancer treatment with significant implications for patients' quality of life. The aim of this study was to explore patients' information needs regarding sexual health after rectal cancer treatment and their experiences accessing information on sexual dysfunction throughout the cancer care continuum. The secondary aim was to explore surgeons' perspectives on patients' information needs and gain insight into their experiences providing information on sexual health following rectal cancer surgery. METHOD A qualitative study was conducted using semistructured interviews with 10 rectal cancer survivors and six colorectal surgeons from a Canadian tertiary care institution. Transcribed interviews were coded independently by two researchers and thematic analysis was performed. RESULTS Analysis of patient interviews revealed that patients had limited knowledge of sexual dysfunction symptoms following rectal cancer treatment and received inadequate information on sexual dysfunction from their treating medical team. Patients expressed the desire to receive information on sexual dysfunction in different formats, especially before the start of treatment. The surgeon interviews revealed that colorectal surgeons faced challenges when informing patients about sexual dysfunction. Surgeons did not routinely provide information on sexual dysfunction to all patients; however, they felt that patients should receive high-quality information on sexual dysfunction, both before and after treatment. CONCLUSION Patients' information needs related to sexual dysfunction after rectal cancer treatment were inadequately met. High-quality informational resources are needed to facilitate communication between patients and physicians and improve patients' understanding of sexual dysfunction.
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Affiliation(s)
- Vincent Brissette
- Department of Medicine (Neurology), University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Monton
- Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marie Demian
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nasra Al Busaidi
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeongyoon Moon
- Department of Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada
| | - Sarah Sabboobeh
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Fateme Rajabiyazdi
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Marylise Boutros
- Department of Surgery, McGill University, Montreal, Quebec, Canada
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
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Anafy A, Cohen S, Matar M, Shouval DS, Shamir R, Weintraub Y. Sexual health in adolescents with inflammatory bowel disease - The paediatric gastroenterologists' point of view. Acta Paediatr 2024; 113:1965-1971. [PMID: 38850099 DOI: 10.1111/apa.17322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/04/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
AIM Although sexual health (SH) impairment and sexually transmitted infections (STI) are occasionally encountered in patients with inflammatory bowel disease (IBD), paediatric gastroenterologists (PedGI) do not often discuss these issues. Literature about SH in the paediatric IBD population is limited. We aimed to assess PedGI knowledge and common practice related to sexual advice and STI workups in patients with IBD. METHODS A questionnaire comprising 25 questions addressing sexual activity in youth, SH, recommendations, and workup for STI in adolescents with IBD was sent to all registered PedGI in Israel. RESULTS Fifty-two physicians completed the questionnaire (27 males,52%). Only 50% correctly predicted the mean age that Israeli youth start practicing sex. Seventy-five per cent responded that providers should discuss sexual activity with their patients, but only 19% do so, most often in response to a patient's query. Ninety six percent answered that they do not have enough knowledge about SH in IBD. Finally, only 2% obtain rectal swabs for STI in patients with refractory proctitis. CONCLUSION Sexual issues and recommendations are not routinely discussed by the majority of PedGI in paediatric IBD clinics. Providers should obtain more knowledge in the field and initiate discussion of these issues with adolescent patients with IBD.
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Affiliation(s)
- Adi Anafy
- Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Tel-Aviv Medical Center, Tel Aviv, Israel
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
| | - Shlomi Cohen
- Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Tel-Aviv Medical Center, Tel Aviv, Israel
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
| | - Manar Matar
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Dror S Shouval
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Raanan Shamir
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Yael Weintraub
- Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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Del Forno S, Raspollini A, Doglioli M, Andreotti A, Spagnolo E, Lenzi J, Borghese G, Raimondo D, Arena A, Rodriguez E, Hernandez A, Govoni F, Seracchioli R. Painful sexual intercourse, quality of life and sexual function in patients with endometriosis: not just deep dyspareunia. Arch Gynecol Obstet 2024:10.1007/s00404-024-07643-7. [PMID: 39052076 DOI: 10.1007/s00404-024-07643-7] [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: 06/21/2024] [Accepted: 07/07/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To evaluate the prevalence of deep and superficial dyspareunia in women with diagnosis of endometriosis. Secondly, to assess the temporal relation between deep and superficial dyspareunia in women reporting both symptoms (concomitant dyspareunia) and the impact on quality of life (QoL) and sexual function. METHODS This is a cross-sectional cohort study that included fertile women with diagnosis of endometriosis. Enrolled subjects reported pain symptoms including dyspareunia and its temporal onset and completed two one-time validated questionnaires regarding sexual function (Female Sexual Function Index) and QoL (International QoL Assessment SF-36). RESULTS Among the 334 enrolled patients, 75.7% (95%) reported dyspareunia. Women were divided into four groups according to the presence and type of dyspareunia: isolated superficial dyspareunia (6.3%), isolated deep dyspareunia (26.0%), concomitant dyspareunia (43.4%) and no dyspareunia (24.3%). Women with concomitant dyspareunia reported higher NRS scores than women with isolated dyspareunia or no dyspareunia (P ≤ 0.001). The majority of women with concomitant dyspareunia (56.6%) reported that deep dyspareunia developed before superficial dyspareunia. Women with concomitant dyspareunia reported worse QoL and worse sexual function than women with isolated dyspareunia or without dyspareunia (P ≤ 0.001). CONCLUSION Dyspareunia is a common symptom in women with endometriosis, with many reporting concomitant deep and superficial dyspareunia. Concomitant dyspareunia can significantly impact sexual function and quality of life (QoL). Therefore, it is crucial to investigate dyspareunia thoroughly and differentiate between its types to tailor effective therapeutic strategies.
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Affiliation(s)
- Simona Del Forno
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Arianna Raspollini
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy.
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
| | - Marisol Doglioli
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Anna Andreotti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Emanuela Spagnolo
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giulia Borghese
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Alessandro Arena
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Elena Rodriguez
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Alicia Hernandez
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Francesca Govoni
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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8
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Liberacka-Dwojak M, Wiłkość-Dębczyńska M, Perkowski R. Breaking the silence: the role of sexual communication on quality of life in women with cervical cancer. Support Care Cancer 2024; 32:503. [PMID: 38985342 PMCID: PMC11236959 DOI: 10.1007/s00520-024-08713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/03/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Cervical cancer (CC) and its treatments impact various dimensions of quality of life (QoL), including physical, psychological, and sexual functioning. Sexual health, a crucial QoL aspect, is often compromised, highlighting the necessity for open sexual communication. MATERIALS AND METHODS This study involved 60 women diagnosed with stage IIb-IIIa CC. The 36-Item Short Form Survey (SF-36) was used to measure physical and psychological components of QoL, the Female Sexual Function Index-6 (FSFI-6) to assess its sexual component, and the Sexual Communication Self-Efficacy Scale (SCSES) to diagnose communication confidence. Self-administered questions gauged patient-provider sexual communication. The results include quotes from participants, providing additional insight. RESULTS Sexual communication self-efficacy and patient-provider communication correlated significantly with QoL components. Only 23.33% discussed sexual issues with their doctors. Participants' experiences highlighted the impact of cancer on sexuality and the need for tailored support. DISCUSSION Post-diagnosis psychosexual changes emphasize the importance of communication in renegotiating sexual identity and needs. Effective communication is associated with improved QoL, highlighting the role of healthcare professionals in addressing psychosexual issues. Integrating PLISSIT and BETTER models provides a comprehensive approach to sexual communication in the cancer context. CONCLUSION The study demonstrates the importance of sexual communication self-efficacy in QoL of CC patients and highlights the need for healthcare professionals to include sexual communication education in cancer care.
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Affiliation(s)
| | | | - Radosław Perkowski
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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Yanagida K, Watanabe D, Yoshida T, Mizushima A, Nakagawa T. The Effects of Vibegron Add-on Therapy on Alpha 1-Blocker Therapy for Sexual Function and Overactive Bladder Symptoms in Benign Prostatic Hyperplasia: A Prospective, Open-Label Study. J Clin Med 2024; 13:3940. [PMID: 38999505 PMCID: PMC11242829 DOI: 10.3390/jcm13133940] [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: 06/06/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Background: The effect of combining an α1-adrenergic receptor blocker (α1-blocker) and the β3-adrenoceptor agonist vibegron for treating persistent overactive bladder (OAB) symptoms associated with benign prostatic hyperplasia (BPH) on sexual function remains uncertain. Therefore, we aimed to evaluate the effects of vibegron as an add-on to α1-blocker therapy on both OAB and sexual function. Methods: Forty-three patients with BPH in whom OAB symptoms were inadequately controlled by α1-blocker treatment were included in this prospective open-label study. The OAB Symptom Score (OABSS), International Prostate Symptom Score (IPSS), 15-item International Index of Erectile Function (IIEF-15), and Erection Hardness Score (EHS), as well as the residual urine volume and serum-free testosterone (FT) and C-reactive protein (CRP) levels, were evaluated before and 8 weeks after the daily administration of 50 mg vibegron/α1-blocker combination therapy. Results: Vibegron/α1-blocker combination therapy significantly improved the OABSS (from 6.9 ± 2.6 to 5.1 ± 2.9, p < 0.0001) and IIEF intercourse satisfaction domain (from 1.1 ± 2.3 to 1.9 ± 2.6, p = 0.02). No significant differences were observed for the IPSS, EHS, total IIEF-15 score, residual urine volume, and serum FT and CRP levels. Conclusions: The study findings suggest that vibegron/α1-blocker combination therapy improves OAB and sexual satisfaction.
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Affiliation(s)
- Kazuki Yanagida
- Department of Urology, Koto Hospital, Tokyo 136-0072, Japan; (K.Y.); (T.Y.)
- Department of Urology, Teikyo University School of Medicine, Tokyo 173-8606, Japan;
- Department of Molecular and Cellular Therapeutics, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan;
| | - Daisuke Watanabe
- Department of Urology, Koto Hospital, Tokyo 136-0072, Japan; (K.Y.); (T.Y.)
- Department of Molecular and Cellular Therapeutics, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan;
- Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Takahiro Yoshida
- Department of Urology, Koto Hospital, Tokyo 136-0072, Japan; (K.Y.); (T.Y.)
| | - Akio Mizushima
- Department of Molecular and Cellular Therapeutics, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan;
- Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Tokyo 173-8606, Japan;
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Russell AC, Reid H, Coleman HG, Santin O. Understanding the treatment experiences of adults diagnosed with early-onset colorectal cancer: A qualitative study. Psychooncology 2024; 33:e6367. [PMID: 38937110 DOI: 10.1002/pon.6367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Early-onset colorectal cancer (CRC) incidence in adults aged under 50 is increasing. There is a critical lack of knowledge regarding the challenges faced by early-onset CRC patients and their experiences of treatment. The aim of this study was to explore the lived experiences of individuals receiving treatment for early-onset CRC, and the resulting impact on their lives. METHODS Semi-structured interviews of patients with early-onset CRC in the UK (n = 21) were conducted from August 2021 to March 2022. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS Results identified four key themes: (1) early-onset CRC treatment results in sudden physical, psychological and social impacts in all aspects of life; (2) early-onset CRC patients have unique supportive care needs which are not recognised in current practice; (3) there is a need for tailored information; (4) a lack of support was identified in the areas of mental health, sexual health and fertility. CONCLUSIONS Our study highlights numerous unique issues experienced by the early-onset CRC patient group during treatment. There is a need for change in clinical practice, along with the development of international guidelines and tailored resources for both patients and healthcare professionals, in order to improve care.
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Affiliation(s)
| | - Helen Reid
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Helen G Coleman
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Olinda Santin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Yang F, Ho KY, Yorke J, Wai Lam KK, Liu Q, Guo L, Fai NC, Anthony Liu PY, Yuen J, Belay GM, Mao T, Law K, Ying CS, Chan Chi Fung G, Xu X, Shi H, Wong FKY. Research progress on sexual functioning and associated factors in childhood cancer survivors: a scoping review. EClinicalMedicine 2024; 73:102695. [PMID: 39050584 PMCID: PMC11266477 DOI: 10.1016/j.eclinm.2024.102695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 05/24/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
Background Childhood Cancer Survivors (CCSs) are more likely to report sexual dysfunction than people without cancer history. Sexual functioning encompasses more than just sexual dysfunction. The scarcity of information regarding the status and influencing factors of sexual functioning in CCSs, hampers to devise suitable screening or interventions. This review aims to summarize research progress on sexual functioning and associated factors among CCSs. Methods This review protocol is registered in PROSPERO(CRD42023427939) and performed according to PRISMA guidelines. From inception to November 15, 2023, a comprehensive search was conducted in PubMed, EMBASE, CINAHL, Web of Science, SCOPUS, PsycINFO, CNKI Database, Wanfang of Chinese Database, SinoMed Database and Cochrane Library on sexual functioning and childhood cancer survivors. Inclusion criteria were English or Chinese studies focusing on sexual functioning and related factors of cancer survivors, who diagnosed with cancer before 18 years old, and were adult and disease-free when participating in the study. Studies were excluded if the focus was on adult cancer patients or without age information. Findings 395 records were retrieved, and 22 studies were finally included in this review. Results suggest that CCSs experience a substantial burden of sexual issues, including delayed psychosexual development, low satisfaction, and high prevalence of dysfunction. Underlying factors related to sexual functioning of CCSs were identified, including demographic, cancer treatment-related, psychological, and physiological factors. The historical change in research on sexual functioning was summarized. Interpretation Research on sexual functioning among CCSs is limited. The extent to which cancer and related treatments affect sexual functioning remains largely unknown. The relationships between various factors and mechanisms underlying sexual functioning need to be confirmed by more rigorous studies to enable effective interventions to be developed. Funding None.
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Affiliation(s)
- Funa Yang
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Ka Yan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Janelle Yorke
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | | | - Qi Liu
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Lanwei Guo
- Henan Office for Cancer Control and Research, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan, China
| | - N.G. Chi Fai
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Pak Yin Anthony Liu
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - John Yuen
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | | | - Ting Mao
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Kate Law
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Chiu Sau Ying
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Godfrey Chan Chi Fung
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - Xiaoxia Xu
- Department of Nursing, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan, China
| | - Hongying Shi
- Office of the Dean, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan, China
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Choi UE, Nicholson RC, Grutman AJ, Cohen AJ. Personal genital satisfaction is associated with differences in perception of male and female sexual anatomy and function. J Sex Med 2024; 21:589-595. [PMID: 38721677 DOI: 10.1093/jsxmed/qdae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Prior studies primarily of men correlated low personal genital satisfaction (PGS) with decreased sexual activity; however, the association between PGS and genital anatomy perceptions is unknown, and there is a paucity of studies examining women. AIM We assessed the relationship between genital satisfaction, survey respondent sexual activity, and perceptions of anatomy and function. METHODS A 54-item REDCap survey was distributed to any-gendered volunteers ≥18 years of age through ResearchMatch from January to March 2023. Responses were split into (1) high PGS and (2) low PGS. Analysis was performed using chi-square tests on survey responses and a Mann Whitney U test on median satisfaction level. OUTCOMES Outcomes were genital anatomy perceptions, sexual activity, and respondents' PGS. RESULTS Of the 649 respondents who started the survey, 560 (86.3%) completed it. Median PGS was 7 of 10, forming subgroups of high (≥7 of 10) satisfaction (n = 317 of 560 [56.6%]) and low (<7 of 10) satisfaction (n = 243 of 560 [43.4%]). The mean age was 45.8 ± 16.8 years, and demographics were notable for 72.1% women (n = 404 of 560), 83.2% White (n = 466 of 560), 47.9% married (n = 268 of 560), and 75.5% bachelor's degree holders (n = 423 of 560). Comparing high- and low-PGS groups, more low-PGS respondents felt normal flaccid penis length to be <2 inches (11.1% vs 5.1%; P = .008). High-PGS respondents more often responded that it is normal for women to have orgasms over half the time (20.8% vs 13.2%; P = .0002) or to identify as being sexually active (81.1% vs 71.6%; P = .008). Women were more likely than men to report larger normal testicle sizes as 60.1 to 90 mL (24.5% vs 10.3%; P < .0001), whereas more men felt that normal testicle size was 7 to 15 mL (26.3% vs 11.4%; P < .0001). Orgasm length perceptions also differed: more women felt female orgasm length was 2.6 to 5 seconds (36.6% vs 16.7%; P < .0001), and more men believed female orgasms to be longer, at 7.6 to 10 seconds (29.5% vs 17.3%; P = .002), 10.1 to 12.5 seconds (11.5% vs 5.2%; P = .0008), and >12.5 seconds (12.2% vs 5.7%; P = .009). Respondents' views on their genitalia differed by gender, with women more likely to feel that their genitals are normal compared with men (89.4% vs 75.0%; P < .0001). CLINICAL IMPLICATIONS PGS may be a useful screening tool given its association with sexual activity. STRENGTHS AND LIMITATIONS Our large-scale survey assesses public perceptions of genital anatomy and function. Limitations include a lack of gender nonbinary perceptions. CONCLUSION Gender and PGS interact with perceptions of male anatomy and female sexual activity, and the frequency of sexual activity was higher among high-PGS respondents; however, the direction of these interactions remains unclear and requires future causal analysis.
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Affiliation(s)
- Una E Choi
- James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD 21224, United States
| | - Ryan C Nicholson
- James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD 21224, United States
| | - Aurora J Grutman
- James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD 21224, United States
| | - Andrew J Cohen
- James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD 21224, United States
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Andreoli G, Rafanelli C, Gremigni P, Hofmann SG, Casu G. Positive sexuality, relationship satisfaction, and health: a network analysis. Front Psychol 2024; 15:1420148. [PMID: 38903470 PMCID: PMC11189356 DOI: 10.3389/fpsyg.2024.1420148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/24/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Positive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions. Methods The present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18-71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women. Results Results indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse. Discussion The findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.
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Affiliation(s)
- Giovanbattista Andreoli
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
| | | | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Stefan G. Hofmann
- Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
| | - Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
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14
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Huțul TD, Karner-Huțuleac A. The Roles of Frequency of Pornography Use, and Moral Incongruence in the Relationship Between Sexual Satisfaction, and Psychological Distress Related to the Use of Pornography: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:329-342. [PMID: 39148923 PMCID: PMC11323863 DOI: 10.1080/19317611.2024.2349592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 08/17/2024]
Abstract
Objective This study aims to examine how the frequency of pornography use mediates between sexual satisfaction and psychological distress related to the use of pornography, moderated by moral incongruence. Method 943 individuals from Romania, aged 18-65 (M = 27.95; SD = 9.29), 70.1% of whom were women, all in romantic relationships. Results The frequency of pornography use mediated the link between sexual satisfaction and psychological distress, with moral incongruence moderating this relationship. Conclusion Moral incongruence plays a crucial role in understanding the dynamics between sexual satisfaction, pornography use, and psychological distress related to the use of pornography.
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Affiliation(s)
- Tudor-Daniel Huțul
- Department of Psychology, Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University of Iași, Iași, Romania
| | - Adina Karner-Huțuleac
- Department of Education Sciences, Faculty of Psychology and Education Sciences, Alexandru Ioan Cuza University of Iași, Iași, Romania
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15
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Wright PJ, Tokunaga RS, Herbenick D. Pornography, identification, alcohol, and condomless sex. THE JOURNAL OF COMMUNICATION 2024; 74:198-211. [PMID: 38841539 PMCID: PMC11149618 DOI: 10.1093/joc/jqae009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/17/2024] [Accepted: 01/27/2024] [Indexed: 06/07/2024]
Abstract
Using national probability data from the 2022 National Survey of Sexual Health and Behavior, the present study evaluated whether moderators of the association between frequency of pornography exposure and condomless sex are consistent with the sexual script acquisition, activation, application model's (3AM) suppositions about the facilitating effects of wishful identification and decreased self-regulation and forethought capacity. Consistent with the 3AM, two-way interaction effect analysis indicated that the strength of the positive association between exposure frequency and condomless sex increased as identification intensified. Inconsistent with the 3AM, two-way interaction effect analysis indicated that the association between exposure frequency and condomless sex was not significantly different among those who had and had not consumed alcohol before their last sexual encounter. However, the three-way interaction between exposure frequency, identification, and alcohol use did suggest a role for each 3AM moderator, as the catalyzing effect of identification was operable among those who had consumed alcohol only.
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Affiliation(s)
- Paul J Wright
- The Media School, Indiana University, Bloomington, IN, USA
| | - Robert S Tokunaga
- Department of Communication, University of Texas at San Antonio, San Antonio, TX, USA
| | - Debby Herbenick
- The Center for Sexual Health Promotion, The School of Public Health at Indiana University, Bloomington, IN, USA
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16
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Prieto LR, Shires DA, Xiong Y. Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men. JOURNAL OF HOMOSEXUALITY 2024:1-18. [PMID: 38776454 DOI: 10.1080/00918369.2024.2353054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.
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Affiliation(s)
- Lucas R Prieto
- Department of Social Work, George Mason University, Fairfax, Virginia, USA
| | - Deirdre A Shires
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Yuan Xiong
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
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17
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Costa D, Ielapi N, Bracale UM, Peluso A, Minici R, Andreucci M, Serra R. Sex and the veins. A cross-sectional analysis on sexual dysfunction in patients with Chronic Venous Disease. Heliyon 2024; 10:e30038. [PMID: 38707288 PMCID: PMC11066625 DOI: 10.1016/j.heliyon.2024.e30038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
Background This study aimed to investigate the presence of sexual dysfunction (SD) in patients with Chronic Venous Disease (CVD) and if CVD treatments may have an impact on SD evolution in these patients. Methods Inclusion criteria were patients of both sexes and genders, with minimum age of 18, with first diagnosis of CVD. Exclusion criteria were presence of known sexual dysfunction of organic origin, arterial system diseases, malignancies and endocrine system diseases. Included patients were administered the ASEX (Arizona Sexual Experience) questionnaire that was administered at the moment of study inclusion (T0), and for patients that resulted affected from sexual dysfunction, were administered also, after CVD treatments at 6 months (T1) and after 12 months (T2). Results A total of 649 patients with CVD were recruited. After the administration of the ASEX questionnaire, 122 patients (18.8 %) resulted affected from SD. Female sex, C3-C6 clinical stages, and the presence of Coronary Artery Disease (CAD), hypertension, and hyperlipidemia were more associated with the presence of SD. SD improved in all patients' population, especially after CVD treatment at T2. Conclusions CVD patients may experience SD, especially in female sex, in more advanced disease stages. SD in CVD patients appears to improve after adequate CVD treatment.
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Affiliation(s)
- Davide Costa
- Department of Law, Economics and Sociology, University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology. University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
| | - Nicola Ielapi
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology. University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185, Rome, Italy
| | | | - Antonio Peluso
- Department of Public Health, University of Naples “Federico II”, 80138, Naples, Italy
| | - Roberto Minici
- Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
| | - Michele Andreucci
- Department of Health Sciences. University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
| | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology. University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
- Department of Medical and Surgical Sciences. University “Magna Graecia” of Catanzaro, 88100, Catanzaro, Italy
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18
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Torkaman P, Meybodi AM, Kheradmand A, Eiliaei S, Ardakani MT. Effect of l-arginine compared to placebo on sexual function in women with major depressive disorder: a randomized controlled trial. BMC Psychiatry 2024; 24:358. [PMID: 38745327 PMCID: PMC11092258 DOI: 10.1186/s12888-024-05781-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND While some evidence suggests that l-arginine may improve sexual function and alleviate depression, it has not been investigated in women with depression to assess both its effects on the depression and sexual function concurrently. METHODS Patients who had received a diagnosis of major depressive disorder, as determined by predetermined inclusion and exclusion criteria, were enrolled in this triple-blind clinical trial. Patients were divided into two groups: group A, received L-arginine 1 gram twice daily, and group B, received a placebo for four weeks. They were evaluated at baseline, after four and eight weeks with the Hamilton Depression Rating Scale (HDRS), and Rosen's questionnaire or Female Sexual Function Index (FSFI). RESULTS A decrease in the severity of depression was observed in all patients, which was determined due to Hamilton's questionnaire (P-value < 0.001). During the time in group A, FSFI increased. Based on the FSFI questionnaire, they had improvement in some domains, including the lubrication index and orgasm index, which significantly changed in the eighth week compared to the baseline (P-value < 0.05). However, these two indicators did not change statistically significantly compared to the placebo group. CONCLUSION L-arginine supplementation can improve sexual function, particularly lubrication and orgasm, and mood in women with depression, with minimal side effects observed. Additional research is necessary to validate these results by examining the effects of higher dosages, extended durations, and larger populations of depressed patients. TRIAL REGISTRATION Iranian Registry of Clinical Trial: IRCT20100127003210N26.
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Affiliation(s)
- Pouria Torkaman
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Mazaheri Meybodi
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shiva Eiliaei
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maria Tavakoli Ardakani
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Solmi M, Lähteenvuo M, Tanskanen A, Corbeil O, Mittendorfer-Rutz E, Correll CU, Tiihonen J, Taipale H. Antipsychotic Use and Risk of Breast Cancer in Women With Severe Mental Illness: Replication of a Nationwide Nested Case-Control Database Study. Schizophr Bull 2024:sbae058. [PMID: 38687213 DOI: 10.1093/schbul/sbae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND HYPOTHESIS Breast cancer is more prevalent in women with severe mental illness than in the general population, and use of prolactin-increasing antipsychotics may be a contributing factor. STUDY DESIGN A nested case-control study was conducted using the Swedish nationwide registers (inpatient/outpatient care, sickness absence, disability pension, prescribed drugs, cancers). All women aged 18-85 years with schizophrenia/schizoaffective/other nonaffective psychotic disorder/bipolar disorder and breast cancer (cases) were matched for age, primary psychiatric diagnosis, and disease duration with five women without cancer (controls). The association between cumulative exposure to prolactin-increasing/prolactin-sparing antipsychotics and breast cancer was analyzed using conditional logistic regression, adjusted for comorbidities and co-medications. STUDY RESULTS Among 132 061 women, 1642 (1.24%) developed breast cancer between 2010 and 2021, at a mean age of 63.3 ± 11.8 years. Compared with 8173 matched controls, the odds of breast cancer increased in women with prior exposure to prolactin-increasing antipsychotics for 1-4 years (adjusted odds ratio [aOR] = 1.20, 95% confidence interval [CI] = 1.03-1.41), and for ≥ 5 years (aOR = 1.47, 95%CI = 1.26-1.71). There were no increased or decreased odds of breast cancer with exposure to prolactin-sparing antipsychotics of either 1-4 years (aOR = 1.17, 95%CI = 0.98-1.40) or ≥5 years (aOR = 0.99, 95%CI = 0.78-1.26). The results were consistent across all sensitivity analyses (ie, according to different age groups, cancer types, and primary psychiatric diagnosis). CONCLUSIONS Although causality remains uncertain, exposure to prolactin-elevating antipsychotics for ≥ 1 year was associated with increased odds of breast cancer in women with severe mental illness. When prescribing antipsychotics, a shared decision-making process should consider individual risk factors for breast cancer.
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Affiliation(s)
- Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- SCIENCES LAB, Department of Mental Health, The Ottawa Hospital, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Antti Tanskanen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Olivier Corbeil
- Faculty of Pharmacy, Université Laval, Quebec, Canada
- Department of Pharmacy, Quebec Mental Health University Institute, Quebec, Canada
| | | | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY
- Department of Psychiatry and Molecular Medicine, Donald and Barbara School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Jari Tiihonen
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Heidi Taipale
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
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Barr A, Moore K, Flegge LG, Atsaphanthong E, Kirby KE, Craner JR. Predictors of sexual satisfaction among patients with chronic pain. FRONTIERS IN PAIN RESEARCH 2024; 5:1375546. [PMID: 38638533 PMCID: PMC11024270 DOI: 10.3389/fpain.2024.1375546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Objectives Sexual satisfaction is an important aspect of quality of life. Chronic pain, depression and anxiety, and relational problems correspond with higher risk for sexual difficulties. Less is known about how risk factors for sexual dysfunction and other problems-such as medical conditions, pain severity, and medication side effects-affect the sexual satisfaction of people with chronic pain. Using a biopsychosocial framework, this study explored factors related to sexual satisfaction among patients presenting for evaluation of chronic pain. Methods Researchers used a hierarchical multiple regression analysis to model potential predictors of sexual satisfaction. Variables analyzed were demographic features, medical history, average pain severity, depressed mood, anxiety, and perceived significant other support. Data collection involved administration of retrospective questionnaires and chart review. The sample included male and female participants (N = 134) presenting for evaluation at a multidisciplinary pain rehabilitation clinic. Results Medical history (i.e., medical conditions, surgical history, and medications) and clinical self-report variables (i.e., pain severity, depressed mood, anxiety, and perceived significant other support) were associated with sexual satisfaction. In this sample, antidepressant use and higher pain severity were unique predictors of lower sexual satisfaction. Married marital status and higher levels of perceived significant other support were predictive of greater sexual satisfaction. Discussion Findings highlight the importance of understanding the unique impact of biopsychosocial variables on the sexual satisfaction of patients presenting for evaluation at a multidisciplinary pain rehabilitation clinic. Further exploration of protective factors that account for sexual satisfaction among individuals with chronic pain may help inform screening, referrals, and treatment.
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Affiliation(s)
- Aex Barr
- Pain Rehabilitation Program, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, United States
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Kayla Moore
- Pain Rehabilitation Program, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, United States
| | - Lindsay G. Flegge
- Pain Rehabilitation Program, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, United States
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Emily Atsaphanthong
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Krissa E. Kirby
- Pain Rehabilitation Program, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, United States
| | - Julia R. Craner
- Pain Rehabilitation Program, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, United States
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
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Valli JL, Shearer K, Zachry AH, Weisser-Pike O, Boughter JD. A Missing Piece of Occupational Therapy Education: Attitudes About Sex. Occup Ther Health Care 2024:1-16. [PMID: 38557162 DOI: 10.1080/07380577.2024.2325069] [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: 07/31/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Abstract
Following a lecture on sexual health and function, occupational therapy students were surveyed regarding their past sex education and their comfort level with the topic of sex. Students indicated a lack of sexual education received from parents/guardians and a prevalence of fear-based education from formal or informal sources. Results reflected a significant increase in students' perceived comfort level with the topic following the lecture from a provider trained and certified in sexual health. As sexuality falls within the domain of occupational therapy, these results suggest a need for comprehensive sex education taught to students by qualified instructors.
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Affiliation(s)
- Jennifer L Valli
- Department of Urology, University of TN Health Science Center, Memphis, TN, USA
| | - Katie Shearer
- School of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anne H Zachry
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Orli Weisser-Pike
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - John D Boughter
- Department of Anatomy & Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA
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22
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Oreg A, Avlagon E, Gitlitz T. Being a Surrogate Partner: The Challenges of Fragile Boundaries. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1403-1414. [PMID: 38448691 PMCID: PMC10954988 DOI: 10.1007/s10508-024-02821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 03/08/2024]
Abstract
Surrogate partner therapy is a type of treatment in which the surrogate partner (SP) works in a triadic setting with a sex therapist and a patient. At the same time, the SP acts as an intimate surrogate partner to the patient. The SP treatment includes a range of therapeutic experiences such as relaxation, intimate communication, sensual and sexual contact, and training for the acquisition of social skills. In the current study, we ask what and how SPs experience, understand, and construct boundaries in their work. We used Winnicott's therapeutic conceptualization of psychotherapy as a mode of playing and Goffman's dramaturgical role theory as the theoretical framework for our exploration. Applying a phenomenological and empathic approach, we analyzed 13 in-depth interviews with Israeli SP. It appears that SP's transitions from one performance to another are dramatic, in that their role requires the involvement of sexual and emotional helping relations with their patients. Moreover, SPs are obliged to have secrecy at all levels and in various relationships in their lives. We uncovered various complexities that SPs experience, such as a lack of clarity about their role, which creates challenges for building their professional and personal identity and affects their family and social relationships.
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Affiliation(s)
- Ayelet Oreg
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, 5290002, Israel.
| | | | - Tamar Gitlitz
- The Bob Shapell School of Social Work, Ramat Aviv, Tel Aviv, Israel
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23
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Nimbi FM, Mesce M, Limoncin E, Renzi A, Galli F. Role of sexuality in women with chronic pain: Results from an Italian cross-sectional study on chronic headache, fibromyalgia, and vulvodynia. Int J Clin Health Psychol 2024; 24:100472. [PMID: 38953047 PMCID: PMC11214997 DOI: 10.1016/j.ijchp.2024.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/20/2024] [Indexed: 07/03/2024] Open
Abstract
Background/objectives To compare sexual functioning, genital pain, and satisfaction among women diagnosed with various Chronic pain (CP) conditions. Additionally, it seeks to explore the role of sexual factors in predicting levels of central sensitization (indicative of CP-related mental and physical distress), physical, and mental quality of life (QoL) for each condition individually. Methods From April 2023 to January 2024, 1006 women categorized into five groups (Chronic Headache - CH; Fibromyalgia - FM, Vulvodynia - VU, Comorbidity group - CO, and Healthy Controls - HC) completed an online protocol. Results All groups reported sexual impairment: VU group exhibited the highest genital pain prevalence (97.93 %), followed by CO (74.29 %) and FM (55.91 %). ANCOVAs indicated lower sexual functioning scores for FM, VU, and CO compared to HC and CH. VU and CO reported lower satisfaction scores than other groups. Genital pain emerged as the primary predictor of central sensitization across all groups except controls. Regarding mental QoL, sexual satisfaction was significant for CH and CO, while genital pain and sexual satisfaction were significant for VU. Conclusion This study emphasizes the importance of integrating genito-pelvic pain assessment and addressing related sexual difficulties in CP diagnostics and care to enhance overall well-being and QoL.
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Affiliation(s)
- Filippo Maria Nimbi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, 00185, Italy
| | - Martina Mesce
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, 00185, Italy
| | - Erika Limoncin
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, 00185, Italy
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, 00185, Italy
| | - Federica Galli
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, Rome, 00185, Italy
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Politis M, Kosidou K, Fors S, Nord M. Sexual health among the oldest old: a population-based study among people aged 85 years and older in Stockholm, Sweden. Sex Med 2024; 12:qfae022. [PMID: 38586251 PMCID: PMC10997412 DOI: 10.1093/sexmed/qfae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/21/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Background Sexual health is an important contributor to the well-being and life satisfaction of people aged ≥85 years, known as the oldest old. However, little is known about sexual health in this population. Aim To examine aspects of sexual health among the oldest old and explore its associations with sociodemographic, health-related, and lifestyle factors. Methods We conducted a population-based cross-sectional study including 183 individuals aged ≥85 years who were residents in Stockholm County, Sweden. Responders (response rate, 63%) were interviewed on a range of health, sociodemographic, and lifestyle parameters, including aspects of sexual health. Participants' responses to the sexual health items were reported as proportions with 95% CIs. Associations were examined with multivariable logistic regression. Outcomes We examined sexual activity, sexual satisfaction, problems related to sexual health, and inquiries on sexual health by a health care provider. Results Twelve percent of participants (95% CI, 8%-17.6%) were sexually active, and 63.9% (95% CI, 56.5%-70.9%) were satisfied with their sexual lives during the past year. A third (35%; 95% CI, 28.4%-42.2%) reported at least a problem related to sexual health. Only 2.2% (95% CI, 0.6%-5.5%) were asked about sexual health by a health care provider, while 8.2% (95% CI, 4.7%-13.2%) identified a need for such an assessment. Yet, 85.2% (95% CI, 79.3%-90.0%) indicated no need for their sexual health to be evaluated by a health care provider. Being partnered was positively associated with sexual activity (adjusted odds ratio, 9.13; 95% CI, 2.53-32.90), whereas having strong social support was positively associated with being satisfied with one's sexual life (adjusted odds ratio, 2.96; 95% CI, 1.53-5.74). Clinical Implications Health care providers should be proactive in assessing the sexual health of the oldest individuals. Strengths and Limitations A representative sample of an underresearched population was used in this study. However, the generalizability of our findings may be restricted due to the small sample. To maintain statistical power from a relatively small sample, we might have lost explanatory power. Given the observational cross-sectional nature of the data, we cannot draw causal inferences based on the observed associations. Conclusions A 10th of participants were sexually active, and the majority were satisfied with their sexual lives. Although many participants reported problems related to sexual health, few expressed the need to discuss sexual health with health care providers. Future studies should explore potential barriers to addressing sexual health and unmet health care needs among the oldest old.
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Affiliation(s)
- Marios Politis
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm SE-104 31, Sweden
| | - Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm SE-104 31, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Stefan Fors
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm SE-104 31, Sweden
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm SE-113 30, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm 114 19, Sweden
| | - Martina Nord
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm SE-104 31, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm 171 77, Sweden
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25
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Adaş M, Çakar M, Gürbüz S, İğde N, Keskin A, Demirkale İ. Sexual Dysfunction in Women After Tibial Fracture: A Retrospective Comparative Study. Med Sci Monit 2024; 30:e944136. [PMID: 38549240 PMCID: PMC10986315 DOI: 10.12659/msm.944136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Tibial fractures, common in adults, are often treated with external or internal fixation methods. While effective, external fixation (EF) can lead to sexual dysfunction (SD), especially in young patients. This study aimed to assess SD in women undergoing EF versus internal fixation for tibial fractures. MATERIAL AND METHODS Sexual function and frequency of monthly sexual intercourse (SI) were evaluated using the Female Sexual Function Index (FSFI) before surgery, with the fixator, after at least 6 months following fixator removal in EF group, and after achieving bone union for at least 3 months in the IF group. RESULTS The EF group consisted of 107 (mean age 28.5 years; 19-40 years) and IF group consisted of 106 patients (mean age 32.1 years; 18-40 years). The duration of EF was an average of 4.7 months (range, 2.5-13 months). FSFI scores were significantly lower in the EF group compared to the IF group (9.33 versus 27.3, P<0.001). Also, there was no significant difference between the FSFI scores before EF and after EF was removed (34.22 versus 33.8, P=0.413). FSFI sub-group scores such as desire, arousal, lubrication, and orgasm were significantly lower in the EF group (P<0.001). The monthly average frequency of SI before surgery and after the removal of EF was 10.2 and 9.1, respectively, while this frequency was 2.56 when EF was present (P<0.001). CONCLUSIONS The quality and frequency of SI in women significantly deteriorate and decrease during the period of extremity fixation following tibial diaphyseal fractures treated with EF, but return to normal after removal.
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Affiliation(s)
- Müjdat Adaş
- Department of Orthopedics and Traumatology, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey
| | - Murat Çakar
- Department of Orthopedics and Traumatology, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey
| | - Serhat Gürbüz
- Department of Orthopedics and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey
| | - Niyazi İğde
- Department of Orthopedics and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Keskin
- Department of Orthopedics and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey
| | - İsmail Demirkale
- Department of Orthopedics and Traumatology, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey
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Hacker EC, Lai LY, Baradaran N, Elaine Allen I, Breyer BN, Copp HL, Hampson LA. Patient Characteristics Associated with Sexual Interest and Activity Among Adults with Spina Bifida. Urology 2024; 185:143-149. [PMID: 38070835 DOI: 10.1016/j.urology.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/31/2023]
Abstract
OBJECTIVE To identify factors associated with sexual interest and activity among adults with spina bifida and to describe the sexual profile of those who were sexually active. Sexual health of adults with spina bifida is often neglected and current knowledge on the topic is limited. METHODS An anonymous web-based survey was advertised and administered between March 2018 and September 2018 and participants 16 years and older with spina bifida were included in this study. Respondents were asked about sexual interest, activity, and function using the validated Patient-Reported Outcomes Measurement Information System Sexual Function Profile. Bivariate and multivariable models with ordinal logistic regression were fitted to evaluate predictors of sexual interest and sexual function. RESULTS Of the 261 respondents with a self-reported diagnosis of spina bifida (mean age of 38.5 years), 73.2% noted at least a little bit of interest in sexual activity. In multivariate analysis, women were less likely to report higher sexual interest than men (odds ratio (OR) = 0.53, 95% CI 0.31-0.92, P = .03) whereas those with higher physical functioning were more likely to have higher sexual interest (OR = 1.04, confidence interval (CI) 1.01-1.07, P = .03). Just less than half of respondents (46.4%) were sexually active in the past 30 days, and those with a ventriculoperitoneal shunt were less likely to engage in sexual activity compared to those without (OR = 0.36, 95% CI 0.19-0.68; P <.01). CONCLUSION The mismatch between sexual interest and sexual activity highlights the importance of exploring issues related to sexual health when counseling adult patients with spina bifida.
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Affiliation(s)
- Emily C Hacker
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Lillian Y Lai
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Nima Baradaran
- Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - I Elaine Allen
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Hillary L Copp
- Department of Urology, University of California San Francisco, San Francisco, CA
| | - Lindsay A Hampson
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Surgery, San Francisco Veterans Affairs Medical Center, San Francisco, CA.
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27
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Stevens EB, Wolfman W, Hernandez-Galan L, Shea AK. The association of depressive symptoms and female sexual functioning in the menopause transition: a cross-sectional study. Menopause 2024; 31:186-193. [PMID: 38350036 DOI: 10.1097/gme.0000000000002309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
OBJECTIVE Sexual dysfunction is very common among middle-aged females. Several factors are considered to influence sexual functioning, including reproductive aging and associated physiological changes as well as life stressors, mental health, and other socioeconomic influences. The objectives of this study are to evaluate the effect of current depressive symptoms on sexual functioning during menopause and to further analyze whether socioeconomic status, age, and antidepressant usage impact this association. METHODS Perimenopausal and postmenopausal women aged 40 to 65 years seeking treatment from a specialized menopause clinic completed a self-report survey with the main outcome measure being the 19-item Female Sexual Function Index quantifying sexual dysfunction. We used the 10-item Center for Epidemiological Studies Depression Scale to estimate a major depressive episode. Statistical analyses were completed to assess the potential associations of socioeconomic factors, age, and antidepressant usage. RESULTS Of the 269 participants, 61.3% met criteria for a major depressive episode and 67.0% had low sexual function. As predicted, women currently experiencing depressive symptoms had a greater risk of low sexual function during perimenopause and postmenopause. Antidepressant usage, low household income, being postmenopausal, and age also predicted low sexual function. CONCLUSIONS Among perimenopausal and postmenopausal women, current depressive symptoms were associated with low sexual function. A biopsychosocial approach should be considered when exploring effective treatment strategies for sexual concerns among midlife women.
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Affiliation(s)
- Emily B Stevens
- From the Research Institute, St Joseph's Healthcare, Hamilton, Canada
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28
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Krebill C, Crozier J, Kalliainen LK. Patient-Provider Communication on Concerns Related to Sexuality Following Upper Extremity Surgery. Hand (N Y) 2024; 19:300-305. [PMID: 35815655 PMCID: PMC10953517 DOI: 10.1177/15589447221107698] [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] [Indexed: 02/10/2023]
Abstract
BACKGROUND Sexuality and sexual health are important components of overall quality of life that can be affected by injuries, operations, and disease processes. Much of the research into health-related sexuality has been devoted to patients with spinal cord injuries and urogenital disease processes. There is very little research on the relationship of upper extremity injuries and their impact on a patient's sex life. The purposes of this study are to assess the proportion of patients who experience sexual limitation following upper extremity surgery and to assess the frequency of discussions regarding their sexual function with their surgeons. METHODS This was a prospective study of a cohort of patients who had hand, shoulder, or arm surgery more than 6 weeks prior to study recruitment. Patients were approached during a follow-up visit with their hand surgeon and were provided with an deidentified survey that focused on upper extremity function, impact of upper extremity injury or surgery on sexual satisfaction, and patient-physician communication surrounding the topic. RESULTS Of the patients surveyed, 11 (39%) reported that their upper extremity injury frequently negatively affected their sexual satisfaction. In addition, 9 patients (35%) reported that they wanted their surgeon to initiate discussion about recovery from surgery and its impact on sexual activity. CONCLUSIONS Upper extremity injuries may negatively affect sexual well-being. Many people want their physician to discuss this with them. Additional research is necessary to qualitatively assess what interventions may be useful for this population as well as how to integrate these discussions into hand surgery clinic visits.
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Affiliation(s)
- Cicely Krebill
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Joseph Crozier
- Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, USA
| | - Loree K. Kalliainen
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, USA
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29
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Goudman L, van Schaik D, Jager T, Moens M, Scheerlinck T. Discussing sexual health with patients eligible for spine surgery: An online survey in spine surgeon and pain physicians. BRAIN & SPINE 2024; 4:102776. [PMID: 38465281 PMCID: PMC10924173 DOI: 10.1016/j.bas.2024.102776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
Introduction Spinal pain syndromes have a severe impact on the patient's sex life, contributing to a decrease in sexual function and sexual satisfaction. Despite the importance of sexual health on mental and physical wellbeing, sexual health is rarely discussed during consultations. Research question The aim of this study is to explore to what extent influencing factors can alter the discussion about sexual health during consultations. More specifically, we will evaluate the influence of healthcare profession, sex of the patient and the surgical approach that is proposed. Material and methods An online survey was sent to neurosurgeons, pain physicians and orthopedists in Belgium and The Netherlands in April 2019. Participants were asked about; counseling routine, knowledge, and opinion on sexual health. Answers were scored on a 5-point Likert scale. Independence between the response levels and type of surgery as well as profession were tested. Results In total, 350 respondents were approached of whom 57 completed the survey. The majority of respondents (61.4%) indicated that they rarely or never discussed sexual disturbances. Profession and type of surgery had an influence on discussing erectile dysfunction, retrograde ejaculation, and alterations in orgasms. Thirty-five percent of healthcare providers considered it the patient's responsibility to bring up the subject of sexual health. Discussion and conclusion Sexual health is rarely addressed by healthcare providers during spinal care. Profession as well as type of surgery seems to play a role on whether sexual health is discussed during consultations.
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Affiliation(s)
- Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Research Foundation—Flanders (FWO), 1090, Brussels, Belgium
| | - David van Schaik
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Tjeerd Jager
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Thierry Scheerlinck
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
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30
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Baszak-Radomańska E, Wańczyk-Baszak J, Paszkowski T. Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women. Front Med (Lausanne) 2024; 11:1289418. [PMID: 38449880 PMCID: PMC10916695 DOI: 10.3389/fmed.2024.1289418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools, such as patient-reported outcomes (PROs) and pelvic floor examination, to improve women's sexual wellbeing and to identify predictors of poor quality of sexual life during the well-woman annual visit. Methods A cross-sectional study was designed to examine 300 healthy women to determine whether the sexual quality of life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (the vulva, anus, muscles, and periurethral (VAMP) protocol) of asymptomatic women during the annual bimanual examination (BME) help differentiate patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterion. Results The majority of subjects experienced high sexual wellbeing (82.0% with SQOL score of ≥84), with a mean of 85.7 points. SQOL scores were lower for psychiatric disorders or symptoms (37.0% of subjects), although they did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, and rectal, bowel, or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33.0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity), although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence, and was unrelated to the SQOL score (p = 0.151). Conclusion Women's sexual health is a global health priority. Finding a way to start a discussion with an asymptomatic patient is crucial to increasing patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual wellbeing direct the discussion mainly toward the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked. Gynecological consultation should resolve concerns, identify the problem, and refer for professional sexual care if still needed.
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Affiliation(s)
| | - Jadwiga Wańczyk-Baszak
- Terpa Clinic, OB/GYN Department, Lublin, Poland
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Paszkowski
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
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31
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Cherven BO, Demedis J, Frederick NN. Sexual Health in Adolescents and Young Adults With Cancer. J Clin Oncol 2024; 42:717-724. [PMID: 37856773 DOI: 10.1200/jco.23.01390] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 10/21/2023] Open
Abstract
Sexual health (SH), an integral aspect of overall health and quality of life, can be negatively affected by cancer and cancer treatment. SH is influenced by biological, psychological, social, and cultural factors, and, for adolescents and young adults (AYAs), developmental factors. The AYA population (age 15-39 years) is diverse in terms of psychosexual development, interpersonal relationships, and varying levels of independence, resulting in unique SH needs for this population. AYAs with cancer are particularly vulnerable to unmet SH needs related to contraception and infection prevention, sexual function, body image, and romantic/sexual relationships. Sexual dysfunction during and after cancer treatment is reported by 30%-100% of AYA cancer survivors. Clinical guidelines recommend discussing SH and screening for dysfunction but currently lack specifics regarding psychosexual interventions and strategies for incorporating screening into clinical care. Research and clinical priorities include improved provider-AYA communication regarding SH, standardization of SH measures and screening tools, infrastructure to support the SH needs of AYAs across pediatric and adult clinical environments, and engagement of sexual and gender minority AYAs in research. As the field of SH in cancer evolves, interventions need to be tailored to the developmental needs that are unique to AYAs and address the multidimensional aspects of SH.
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Affiliation(s)
- Brooke O Cherven
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA
- Emory University School of Medicine, Atlanta, GA
| | - Jenna Demedis
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO
- Division of Hematology/Oncology/BMT, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Natasha N Frederick
- Center for Cancer & Blood Disorders, Connecticut Children's, Hartford, CT
- Division of Hematology and Oncology, Department of Pediatrics, University of Connecticut School of Medicine, Mansfield, CT
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32
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Kuiper ST, Zweers D, Suelmann BBM, Meijer RP, Vervoort SCJM. Perspectives and Concerns on Late Effects Regarding Sexuality among Adolescents and Young Adults Treated for Testicular Germ Cell Tumor: The PRICELESS-Study-A Qualitative Study. Cancers (Basel) 2024; 16:715. [PMID: 38398106 PMCID: PMC10886665 DOI: 10.3390/cancers16040715] [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: 12/14/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to explore perspectives and concerns regarding sexuality among adolescents and young adults (AYAs) possibly experiencing late effects after testicular germ cell tumor (TGCT) treatment. A qualitative study was performed in which semi-structured interviews were held with thirteen AYAs from a center of expertise for TGCT in the Netherlands. Data were analyzed using Braun and Clark's thematic analysis method. Seven interacting and interconnected themes were found: desire to have children, rediscovering sexuality, insecurity about sexual performance, acceptance of physical change, loss of masculinity, burden on relationship, and openness in discussing sexuality. Concerns about the desire to have children seem to play a significant role. In conclusion, TGCT patients face multiple changes (physical, emotional, relational, and sexual), followed by a difficult period of acceptance, after which a new phase of rediscovering sexuality appeared. These findings can help to make healthcare professionals aware of the underlying mechanisms and concerns about sexuality. Furthermore, insights can help to develop sexuality-themed items for a broader monitoring tool to structurally assess the late effects to support discussing sexuality.
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Affiliation(s)
- Stefan T. Kuiper
- Julius Center for Health Sciences and Primary Care, General Practice & Nursing Science, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Daniëlle Zweers
- Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (D.Z.); (B.B.M.S.)
| | - Britt B. M. Suelmann
- Medical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (D.Z.); (B.B.M.S.)
| | - Richard P. Meijer
- Oncological Urology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Sigrid C. J. M. Vervoort
- Julius Center for Health Sciences and Primary Care, General Practice & Nursing Science, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
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Letkiewicz AM, Li LY, Hoffman LMK, Lieberman L, Hsu KJ, Shankman SA. Cognitive inflexibility and heightened error monitoring are related to lower sexual functioning. Int J Psychophysiol 2024; 196:112281. [PMID: 38104774 PMCID: PMC10843768 DOI: 10.1016/j.ijpsycho.2023.112281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Sexual functioning is an important predictor of well-being and relationship satisfaction. Previous research indicates that several aspects of cognitive function are related to sex-related behaviors and functioning among individuals with sex-related disorders, neurological disorders, and in older adults; however, this has been relatively underexamined in younger populations. To examine this, the present study assessed whether behavioral and/or neurophysiological measures of cognitive function are associated with sexual functioning in a community sample of young 489 adults (64 % female) ages 18-30. Cognitive flexibility (n = 460) and inhibition (n = 466) were measured using neuropsychological assessment (D-KEFS), and conflict monitoring and error monitoring were measured by event-related potentials (conflict N2: n = 394; error-related negativity: n = 389). After separately testing relations between the different measures of cognitive function and sexual functioning, we assessed whether results (1) remained after covarying for externalizing and internalizing dimensions (PID-5; n = 489) or (2) varied by gender. Finally, we tested whether any aspects of cognitive function were unique predictors of sexual functioning. Cognitive flexibility and error monitoring (i.e., error-related negativity) were both significantly related to sexual functioning among males and females, such that poorer cognitive flexibility and heightened error monitoring were related to lower sexual functioning. No significant effects emerged for inhibition or conflict monitoring. In a multiple regression model, cognitive flexibility and error monitoring each accounted for a unique portion of variance in sexual functioning beyond other aspects of cognitive function and psychopathology-related traits. Results suggest that cognitive function is a meaningful correlate of sexual functioning in young adulthood, which should be considered further in future research.
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Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Lija M K Hoffman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Lynne Lieberman
- Northwell Health, Center for Traumatic Stress, Resilience, and Recovery, Glen Oaks, NY, USA
| | - Kevin J Hsu
- Department of Psychological and Social Sciences, Pennsylvania State University, Abington, PA, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, Northwestern University, Chicago, IL, USA
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Thompson AE, Record JM, Miller R, Bjorback H. Rose Colored Glasses: An Exploration of the Relationship between Sexual Nostalgia and Sexual Satisfaction. JOURNAL OF SEX RESEARCH 2024; 61:274-284. [PMID: 36787123 DOI: 10.1080/00224499.2023.2175769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Sexual satisfaction contributes significantly to one's quality of life and offers a variety of mental and physical health benefits. Consequently, numerous studies have examined ways to improve sexual satisfaction. However, no research has investigated how sexual nostalgia (i.e., "the sentimental longing for or wistful reflection on past sexual memories," p. 1539) with one's current partner impacts sexual satisfaction. Thus, this program of research was designed to develop the Sexual Nostalgia Inventory, assess the relationship between sexual nostalgia and sexual satisfaction, and to examine the moderating role of romantic attachment. The results of Study One (N = 227) indicated that the content of sexual memories can be conceptualized into one factor. The results from Study Two (N = 619) revealed that sexual nostalgia was positively related to sexual satisfaction and that romantic attachment moderated these relationships. In particular, the positive association between sexual nostalgia and satisfaction was greatest for those insecurely attached (i.e., those high in anxious and avoidant attachment). These findings have important implications for researchers looking to establish the causal link between nostalgia and satisfaction and clinicians working with couples experiencing low sexual desire and/or unmet sexual needs.
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Affiliation(s)
- Ashley E Thompson
- Department of Psychology, University of Minnesota Duluth, Duluth, Minnesota, USA
| | - Julia M Record
- Department of Psychology, University of Minnesota Duluth, Duluth, Minnesota, USA
| | - Rachel Miller
- Department of Psychology, University of Minnesota Duluth, Duluth, Minnesota, USA
| | - Harrison Bjorback
- Department of Psychology, University of Minnesota Duluth, Duluth, Minnesota, USA
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Hafez SH, Alwesabi SAM, Sagiron EI, Alwadei HSA, Abdalla AMO, ِAbdulrahman EEH, Elfaki NK, Mohamed NA, Alshahrani MA, Alshehri AA, Alzahrani MJ, Idris AM, Elsehrawey MG, El-Nablaway M, Ibrahim AM. Consumption of aphrodisiac drugs without prescription among men in Saudi Arabia: cross-sectional study. Saudi Pharm J 2024; 32:101955. [PMID: 38292406 PMCID: PMC10825545 DOI: 10.1016/j.jsps.2024.101955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
Background: The prevalence and patterns of aphrodisiac drug consumption without prescription among men in Saudi Arabia remain underexplored, with limited empirical evidence available. Given the potential health implications and societal considerations, a comprehensive investigation is warranted. Aim: Assess the Prevalence, pattern of use and the associated factors of Aphrodisiac drugs consumption without prescription among men at Najran City, Saudi Arabia. Methods: Employing a cross-sectional descriptive study, 500 participants were included through convenience sampling. The utilized questionnaires covered a range of data, including socio-demographic information, patterns of aphrodisiac use, knowledge about aphrodisiacs, lifestyle details, a sexual health inventory for men, and a perceived stress level scale. Results: The study reveals a significant prevalence of unsanctioned aphrodisiac drug use (31%) among men in Najran City, Saudi Arabia, with a majority (79.3%) consuming these substances four times monthly. Associated disparities in knowledge, lifestyle, stress, and sexual function underscore the urgent need for policy interventions and tailored health education initiatives for this demographic. Conclusion: Approximately one-third of the sampled population engaged in the unsanctioned use of aphrodisiac drugs, with the majority utilizing them four times monthly. Tablets emerged as the most prevalent form of consumption. Commonly cited motives and justifications included peer influence and the perceived safety of aphrodisiacs. Influential factors encompassed levels of knowledge, lifestyle, stress levels, erectile function, age, education, and the number of wives. Recommendations: Urgent policy interventions are warranted to regulate the acquisition and distribution of aphrodisiacs. Tailored health education initiatives should be implemented for married and prospective married men.
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Affiliation(s)
- Sameer Hamdy Hafez
- Community Health Nursing, Beni-Suef University, Faculty of Nursing, Egypt
- Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Elwaleed Idris Sagiron
- Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | | | | | - Nahid Khalil Elfaki
- Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Noha Ahmed Mohamed
- Community Health Nursing, Beni-Suef University, Faculty of Nursing, Egypt
| | - Mohammed Abdulrahman Alshahrani
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, P.O. Box 1988, Najran 61441, Saudi Arabia
| | - Ahmad A. Alshehri
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, P.O. Box 1988, Najran 61441, Saudi Arabia
| | - Mohammed Jamaan Alzahrani
- Departments of Pediatrics, College of Medicine, Najran University, Najran P.O. Box 1988, Saudi Arabia
| | - Amna Mohammed Idris
- Critical Care Nursing, Department of Medical Surgical Nursing, Najran University, Saudi Arabia
| | - Mohamed Gamal Elsehrawey
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Department of Nursing Administration, Faculty of Nursing, Port Said University, Egypt
| | - Mohammad El-Nablaway
- Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Diriyah, 13713, Riyadh, Saudi Arabia
| | - Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
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Cabo JJ, Kaufman MR, Johnsen NV. Impact of sexual function domains on sexual satisfaction and quality of life: Importance across the age spectrum. Andrology 2024. [PMID: 38226963 DOI: 10.1111/andr.13594] [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: 04/08/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Sexual satisfaction is an important component of global quality life for many adult men. Substantial gaps exist in our appreciation of how age mediates sexual satisfaction in the context of functional sexual measures. We sought to evaluate modifiable factors associated with overall sexual satisfaction and health-related quality of life (HRQoL) in a large, age-stratified community-based sample of adult men. METHODS A sample of adult males registered with the online research service ResearchMatch completed a 75-item online questionnaire in this cross-sectional study. Queries included demographics, general health data, and validated sexual health measures including International Index of Erectile Function-5 (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT). Multivariable regression was performed to assess associations with self-reported sexual satisfaction (defined by "moderately satisfied" or "very satisfied" on the 5-level Likert scale) and overall HRQoL (as measured by the EQ-5D-visual analog scale (VAS) stratified by age. RESULTS One thousand thirty-three men completed the survey and were stratified by age cohorts. IIEF-5 and PEDT scores were higher in younger cohorts. On multivariable regression analysis, higher IIEF-5, lower PEDT, better overall health-related quality of life, and the presence of a sexual partner within the last month were associated with an increased likelihood of overall sexual satisfaction. When stratified by age cohort, higher IIEF-5 scores were consistently positively associated with sexual satisfaction (Odds Ratio (OR) 1.18, 95% CI 1.15-1.22, P < 0.001), as well as independently associated with improved overall HRQoL by EQ-5D-VAS (β = 0.71, Standard Error (SE) = 0.08, P < 0.001). CONCLUSIONS The erectile function was independently associated with sexual satisfaction and quality of life across all age strata and predictive of both sexual satisfaction and global HRQoL. Low overall rates of sexual satisfaction across cohorts highlight the critical importance of evaluation and treatment of sexual health, regardless of age.
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Affiliation(s)
- Jackson J Cabo
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melissa R Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Niels V Johnsen
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Aşcı Ö, Bal MD, Koçoğlu F. The Impact of Childhood Sexual Abuse on Adult Female Sexual Function and Sexual Distress: A Systematic Review and Meta- Analysis. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:63-74. [PMID: 38556938 PMCID: PMC11003369 DOI: 10.5080/u26991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 08/22/2022] [Indexed: 04/02/2024]
Abstract
OBJECTIVE In this study, it was aimed to examine the impacts of exposure to childhood sexual abuse (CSA) on women's sexual function and sexual distress. METHOD In this systematic review and meta-analysis study, eight international (EBSCO, Psyc-Info, Proquest, PubMed, Science Direct, Scopus, Ovid, Web of Science) and two national electronic databases (Dergipark and Thesis Database of the Turkish Council of Higher Education) were searched. Studies reporting outcomes of sexual function and sexual distress in women with and without a history of CSA were included. The data were synthesized by meta-analysis and narrative methods. RESULTS Two dissertations and five research articles published between 2010 and 2021 were included in the study. In some studies that were not included in the meta-analysis, it was reported that there was no difference in the prevalence of sexual dysfunction, and sexual satisfaction in women with and without a history of CSA. Meta-analysis results demonstrated lower sexual function (sexual arousal, MD: -0.83, p<0.001; sexual desire, MD: -0.55, p<0.001; lubrication, MD: -0.78, p<0.01; pain, MD: -0.52, p<0.001) and more sexual distress (SMD: -0.79, p<0.05) in women with CSA history. CONCLUSION This study showed that CSA negatively affects female sexual function and increases sexual distress. Healthcare professionals should be aware that women with a CSA history may have worse sexual functions and more sexual distress. More research is needed on the role of CSA in the etiology of sexual function problems and its possible mechanisms of action.
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Affiliation(s)
- Özlem Aşcı
- Assoc. Prof., Niğde Ömer Halisdemir University, Niğde Zübeyde Hanım Faculty of Health Sciences, Division of Midwifery, Niğde
| | - Meltem Demirgöz Bal
- Prof., Marmara University, Health Sciences Faculty, Midwifery Department, İstanbul
| | - Ferdane Koçoğlu
- Assis. Prof., Niğde Ömer Halisdemir University, Zübeyde Hanım Faculty of Health Sciences, Department of Public Health Nursing, Niğde, Turkey
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Busby DM, Leonhardt ND, Hanna-Walker V, Leavitt CE. Is the association of sexual quality with relationship satisfaction really stronger when the sexual relationship is functioning poorly? JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:233-255. [PMID: 38044553 DOI: 10.1111/jmft.12683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 09/08/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
The purpose of this article is to bring empirical evidence to the oft-quoted assumption that sexual quality has a stronger association with the overall relationship when sexuality is dysfunctional as compared to when it is optimal. Using three national samples to analyze a structural equation model, the results verified this assumption with some adaptations. There was an interaction between the association of sexual quality and the overall relationship depending on how sexually satisfied couples were in the sexuality area. However, it was when sexuality was only moderately satisfying rather than at high or low levels that it had the strongest associations with relationship satisfaction. Also, female sexual quality had a significant association with both partner's relationship satisfaction whereas male's sexual quality only had actor effects. Additionally, the sexual relationship had a stronger association with relationship satisfaction and dissatisfaction for couples who reported both low levels of sexual satisfaction and dissatisfaction.
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Affiliation(s)
- Dean M Busby
- School of Family Life, Brigham Young University, Provo, Utah, USA
| | | | - Veronica Hanna-Walker
- Department of Human Development and Familiy Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Chelom E Leavitt
- School of Family Life, Brigham Young University, Provo, Utah, USA
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Wu C, Choi EPH, Chau PH, Štulhofer A. Adaptation and validation of the Chinese version of the New Sexual Satisfaction Scale-Short Form in a sample of Chinese women. Sex Med 2023; 11:qfad065. [PMID: 38162254 PMCID: PMC10756855 DOI: 10.1093/sexmed/qfad065] [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: 07/14/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 01/03/2024] Open
Abstract
Background Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women. Aim This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale-Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities. Methods The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey. Outcomes The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life-Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure's validity. Results A total of 336 Chinese women were recruited, with an average age of 26.82 years (SD, 6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women. Clinical Translation The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys. Strengths and Limitations This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men. Conclusion The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women.
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Affiliation(s)
- Chanchan Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, 10000, Croatia
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Almuqahwi A, Alabdrabulridha H, Aljumaiah RM, Alfaifi AJ, Alnaim MF, Alfaifi IA, Alsaleh NA, Abdullah Alsalem N, Alsuwaylih F, Ahmed Ali Almana A, Altaweel FI, Alsalman SM, AlAli Y. A Systematic Review on the Relationship Between Physical Activity and Sexual Function in Adults. Cureus 2023; 15:e51307. [PMID: 38288234 PMCID: PMC10823211 DOI: 10.7759/cureus.51307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Sexual function is a vital component of overall well-being and quality of life. Physical activity is known to have a profound influence on various aspects of health, but its impact on sexual function in the general population remains an under-explored area. This systematic review seeks to thoroughly examine existing evidence, aiming to establish the correlation between physical activity and sexual function in both male and female adults. We conducted a comprehensive search of electronic databases and relevant sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were those that investigated the effects of physical activity on sexual function using the International Index of Erectile Dysfunction (IIEF-5) questionnaire and the Female Sexual Function Index (FSFI). Quality assessment was performed on the included studies, and the findings were synthesized through qualitative analysis. The review identified 12 randomized controlled trials, primarily focusing on males, with interventions ranging from home-based walking to structured exercise training. Only two studies were conducted among females. The most recommended exercise was aerobic exercise. Consistent aerobic exercise proves to be a hopeful and efficient non-drug intervention for enhancing erectile function in men. However, when considering the effects of physical exercise programs on sexual function and the quality of sexual life of females, the results present challenges in drawing clear conclusions. Health policymakers play an important role in providing guidelines and recommendations to healthcare professionals, encouraging them to prescribe exercise as a preferable alternative to pharmacological treatments for enhancing sexual functions in both men and women.
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Affiliation(s)
| | | | | | | | - Muna F Alnaim
- Plastic and Reconstructive Surgery, King Faisal University, Hofuf, SAU
| | | | | | | | | | | | | | | | - Yaqin AlAli
- Internal Medicine, King Faisal University, Hofuf, SAU
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Ventura-Aquino E, Ågmo A. The elusive concept of sexual motivation: can it be anchored in the nervous system? Front Neurosci 2023; 17:1285810. [PMID: 38046659 PMCID: PMC10691110 DOI: 10.3389/fnins.2023.1285810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Sexual motivation is an abstract concept referring to the mechanisms determining the responsivity to sexually relevant stimuli. This responsivity determines the likelihood of producing a sexual response and the intensity of that response. Both responsivity to stimuli and the likelihood of making a response as well as the intensity of response are characteristics of an individual. Therefore, we need to assume that the concept of sexual motivation materializes in physiological mechanisms within the individual. The aim of the present communication is to analyze the requisites for the endeavor to materialize sexual motivation. The first requisite is to provide an operational definition, making the concept quantifiable. We show that parameters of copulatory behavior are inappropriate. We argue that the intensity of sexual approach behaviors provides the best estimate of sexual motivation in non-human animals, whereas the magnitude of genital responses is an exquisite indicator of human sexual motivation. Having assured how to quantify sexual motivation, we can then proceed to the search for physiological or neurobiological underpinnings. In fact, sexual motivation only manifests itself in animals exposed to appropriate amounts of gonadal hormones. In female rats, the estrogen receptor α in the ventrolateral part of the ventromedial nucleus of the hypothalamus is necessary for the expression of sexual approach behaviors. In male rats, androgen receptors within the medial preoptic area are crucial. Thus, in rats sexual motivation can be localized to specific brain structures, and even to specific cells within these structures. In humans, it is not even known if sexual motivation is materialized in the brain or in peripheral structures. Substantial efforts have been made to determine the relationship between the activity of neurotransmitters and the intensity of sexual motivation, particularly in rodents. The results of this effort have been meager. Likewise, efforts of finding drugs to stimulate sexual motivation, particularly in women complaining of low sexual desire, have produced dismal results. In sum, it appears that the abstract concept of sexual motivation can be reliably quantified, and the neurobiological bases can be described in non-human animals. In humans, objective quantification is feasible, but the neurobiological substrate remains enigmatic.
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Affiliation(s)
- Elisa Ventura-Aquino
- Escuela Nacional de Estudios Superiores, Unidad Juriquilla, UNAM, Juriquilla, Mexico
| | - Anders Ågmo
- Department of Psychology, University of Tromsø, Tromsø, Norway
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Wright PJ, Tokunaga RS, Herbenick D. Model Specification in Media Effects Research. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3181-3188. [PMID: 37814100 PMCID: PMC11167628 DOI: 10.1007/s10508-023-02714-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Paul J Wright
- Communication Science Unit, The Media School, Indiana University, 601 East Kirkwood Avenue, Bloomington, IN, 47405, USA.
| | - Robert S Tokunaga
- Department of Communication, University of Texas, San Antonio, TX, USA
| | - Debby Herbenick
- The Center for Sexual Health Promotion, The School of Public Health at Indiana University, Bloomington, IN, USA
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Kahn M, Barnett N, Gradisar M. Let's Talk about Sleep Baby: Sexual Activity Postpartum and Its Links with Room Sharing, Parent Sleep, and Objectively Measured Infant Sleep and Parent Nighttime Crib Visits. JOURNAL OF SEX RESEARCH 2023; 60:1247-1258. [PMID: 35763039 DOI: 10.1080/00224499.2022.2092050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The postpartum period may pose a considerable challenge for both parent sleep and sexual activity. This study assessed the links between partnered sexual frequency and satisfaction postpartum and parent sleep, infant sleep, parent nighttime caregiving, and parent-infant room sharing. Participants were 897 parents of infants aged 1-18-months (M = 8.8 ± 4.3, 49% girls). Parents completed an online survey about their sexual frequency and satisfaction, sleep, relationship satisfaction, depression, and demographic characteristics. Infant sleep and parent nighttime crib visits were measured objectively using auto-videosomnography during 2-weeks, with 8,460 nights assessed. Results indicated that the frequency of partnered sexual activity was 3.8 ± 4.2 times per month. Frequency of sexual activity increased with infant age, yet increases beyond the first 6 months postpartum were non-significant. Adjusted GEE modeling revealed that more parent nighttime crib visits were significantly associated with lower sexual frequency, regardless of infant age. Other parent and infant sleep-related factors were not significantly linked with sexual frequency in adjusted models. Moreover, sexual satisfaction was not associated with parent nighttime caregiving, parent or infant sleep, or parent-infant sleeping arrangements in adjusted models, suggesting that it may not be susceptible to the effects of disrupted sleep in the postpartum period. These findings suggest that it is not infant or parent sleep disruption per se, but rather parent nighttime engagement with the infant that is associated with parent sexual activity frequency. Longitudinal investigations are warranted to examine the directional pathways of these links.
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Affiliation(s)
- Michal Kahn
- College of Education, Psychology and Social Work, Flinders University
| | | | - Michael Gradisar
- College of Education, Psychology and Social Work, Flinders University
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Caloudas AB, Amspoker AB, Stanley M, Boykin D, Arredondo K, Walder A, Hogan J, Lindsay JA. Prevalence of sexual desire and arousal difficulties among women veterans: A retrospective cohort design. Psychol Serv 2023; 20:780-788. [PMID: 36534427 PMCID: PMC10277319 DOI: 10.1037/ser0000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Low sexual desire and arousal are associated with several negative health outcomes, including reduced quality of life, depression, anxiety, and relationship discord. Although women veterans have high rates of risk factors for sexual dysfunctions (e.g., elevated rates of trauma, depression, anxiety), research on their sexual functioning is lacking. Using a retrospective cohort design, we examined the prevalence of documented sexual desire and arousal disorder diagnoses or symptoms, using International Classification of Diseases, 10th Revision codes, among 790,726 women veterans receiving care in the Veterans Health Administration (VHA). In fiscal year 2020, these symptoms and disorders were documented for only 0.19% (n = 1,494) of women veterans receiving care and symptoms of low sexual desire were documented more frequently than formal desire and arousal diagnoses. Most women veterans with desire and arousal problems were married (53.88%), and most (52.28%) were prescribed antidepressants. Mental health (MH) treatment for desire and arousal difficulties was commonly delivered in person (as compared to telephone or telehealth). Psychologists primarily treated desire and arousal concerns, providing an average of 2.81 MH encounters (SD = 7.53) compared to an average of 1.62 (SD = 5.25) MH encounters by social workers and 1.22 (SD = 2.53) by psychiatrists. Problems with low sexual desire and arousal are likely underassessed and undertreated within the VHA. Better assessment of women veterans' low desire and arousal is warranted to improve their well-being and quality of life. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Alexandra B. Caloudas
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Amber B. Amspoker
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Melinda Stanley
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
| | - Derrecka Boykin
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Kelley Arredondo
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
| | - Annette Walder
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Department of Medicine, Baylor College of Medicine,
Houston, TX
| | - Julianna Hogan
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
| | - Jan A. Lindsay
- Houston VA HSR&D Center for Innovations in Quality,
Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine, Houston, TX
- VA South Central Mental Illness Research, Education and
Clinical Center, a virtual center
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Capezzuoli T, Maseroli E, Barra F, Vannuccini S, Vignozzi L, De Mitri P, Baggio S, Ceccaroni M, Petraglia F. Endometriosis and sexual disorders: the effect of surgical and medical treatment, a multicentre cross-sectional study. F1000Res 2023; 12:1424. [PMID: 39006305 PMCID: PMC11240085 DOI: 10.12688/f1000research.141537.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 07/16/2024] Open
Abstract
Background Sexual health is a major concern in women with endometriosis, however only a few controlled studies have examined this with validated instruments. The effect of hormonal treatments on sexual function in endometriosis is also an underrated topic. The aim of this study was to investigate sexual function of patients with endometriosis by a specific tool to better evaluate their sexual function (including different domains), and the influence of hormonal treatment or surgery on these parameters. Methods An observational, cross-sectional, multicentre study was conducted in a group (n=194) of sexually active, women aged 25-45 years old, with surgical or ultrasonographic diagnosis of endometriosis, referred to the Endometriosis Center of Careggi University Hospital or Negrar di Valpolicella. Sexual function was assessed by administering the Female Sexual Function Index (FSFI), which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction and pain. FSFI scores were compared to those of a control group (n=58) and according to the treatment received by patients with endometriosis. Results Ovarian endometriosis was present in 50 patients (25.8%), deep infiltrating endometriosis in 65 patients (33.5%) and both in 79 patients (40.7%). Adenomyosis coexisted in 102 patients (52.6%). Women with endometriosis reported a mean total FSFI score of 18.3 [4.2-25.8] (< 26.55), indicating female sexual dysfunction (FSD) in all patients. At multivariate analysis, after adjusting for confounders (BMI and hormonal therapy), women with endometriosis presented significantly lower scores than controls in all the FSFI (p<0.001). Patients with endometriosis under hormonal treatments (n=124; 64%), regardless of the type, had significantly lower scores in all FSFI subscales and total score, even after adjusting for confounders-age, BMI and history of surgery. Conclusions Patients with endometriosis are at risk for FSD, encompassing not only dyspareunia, but all domains of sexual function. Hormonal treatments do not result in improvement in sexual symptoms.
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Affiliation(s)
- Tommaso Capezzuoli
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Fabio Barra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Liguria, Italy
- Unit of Obstetrics and Gynecology, P.O. "Ospedale del Tigullio"- ASL4, Genoa, Italy
| | - Silvia Vannuccini
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Tuscany, Italy
| | - Paola De Mitri
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Silvia Baggio
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
| | - Felice Petraglia
- Department of Experimental, Clinical and Biomedical Sciences, Division of Obstetrics and Gynecology, Careggi University Hospital, University of Florence, Florence, Tuscany, Italy
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Smedsland SK, Vandraas KF, Falk RS, Horn J, Reidunsdatter RJ, Kiserud CE, Dahl AA, Brekke M, Reinertsen KV. Sexual health in long-term breast cancer survivors: a comparison with female population controls from the HUNT study. Breast Cancer Res Treat 2023; 201:479-488. [PMID: 37490170 PMCID: PMC10460729 DOI: 10.1007/s10549-023-07021-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/22/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Sexual health is an important aspect of quality of life. Knowledge concerning sexual health in long-term breast cancer survivors (BCSs) is limited. This study compared sexual health in BCSs 8 years after diagnosis with similarly aged controls and examined the impact of menopausal status at diagnosis and systemic breast cancer treatments on sexual health. METHODS Women aged 20-65 years when diagnosed with stage I-III breast cancer in 2011-2012 were identified by the Cancer Registry of Norway (n = 2803) and invited to participate in a nationwide survey. Controls were women from the Trøndelag Health Study (HUNT4). Sexual functioning and sexual enjoyment were measured by the EORTC QLQ-BR23 subscales scored from 0 to 100, and sexual discomfort by the Sexual Activity Questionnaire scored from 0 to 6. Linear regression analyses with adjustments for sociodemographic and health-related variables were performed to compare groups. Differences of ≥ 10% of range score were considered clinically significant. RESULTS The study samples consisted of 1241 BCSs and 17,751 controls. Sexual enjoyment was poorer (B - 13.1, 95%CI - 15.0, - 11.2) and discomfort higher (B 0.9, 95%CI 0.8, 1.0) among BCSs compared to controls, and larger differences were evident between premenopausal BCSs and controls (B - 17.3, 95%CI - 19.6, - 14.9 and B 1.2, 95%CI 1.0, 1.3, respectively). BCSs treated with both endocrine- and chemotherapy had lower sexual functioning (B - 11.9, 95%CI - 13.8, - 10.1), poorer sexual enjoyment (B - 18.1, 95%CI - 20.7, - 15.5), and more sexual discomfort (B 1.4, 95% 1.3, 1.6) than controls. CONCLUSION Sexual health impairments are more common in BCSs 8 years after diagnosis compared to similar aged population controls. During follow-up, attention to such impairments, especially among women diagnosed at premenopausal age and treated with heavy systemic treatment, is warranted.
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Affiliation(s)
- Solveig K Smedsland
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Kathrine F Vandraas
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway
| | - Ragnhild S Falk
- Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Julie Horn
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Randi J Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway
| | - Alv A Dahl
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway
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Pasha H, Khalajinia Z, Yadollahpour MH, Gholinia H. Sexual Function, Religion, Existential Well-being and Mental Health among Iranian Married Women of Reproductive Age. JOURNAL OF RELIGION AND HEALTH 2023; 62:3399-3413. [PMID: 37226017 DOI: 10.1007/s10943-023-01835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
The present study investigates the relationship between sexuality and spirituality with mental health among Iranian married women of reproductive age. It was a cross-sectional, correlational study with a sample size of 120 Iranian married women in 2022. Goldberg general health, Female Sexual Function Index, and Paloutzian and Ellison spiritual health questionnaires were used to collect data. The level of spiritual health scale (SWBS) in more than half of the married women was high (50.8%) and 49.2% at the average level. Sexual dysfunction was reported at 43.3%. Sexual function, religious and existential well-being was predictors of mental health and its dimensions. The risk of sexual dysfunction was 3.33-fold higher in people who had an unfavorable level of SWBS (β = 3.33, CI: 1.558-7.099, P = 0.002) compared to those who had a favorable level of SWBS. Therefore, adhering to sexual health and relying on spirituality are emphasized in preventing mental health problems.
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Affiliation(s)
- Hajar Pasha
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Population, Family and Spiritual Research Core, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Zohreh Khalajinia
- Department of Midwifery, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
| | - Mohammad Hadi Yadollahpour
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Population, Family and Spiritual Research Core, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Hemmat Gholinia
- Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
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Li Y, Liu M, Sun Y, Guo D, Li M. Sexual health problems of patients with cancer: A bibliometrics study and visualization analysis via CiteSpace. Heliyon 2023; 9:e20856. [PMID: 37876432 PMCID: PMC10590793 DOI: 10.1016/j.heliyon.2023.e20856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose This study aimed to conduct a bibliometric analysis of the data acquired and clarified the current research status of sexual health problems in patients with cancer, to provide a comprehensive visual perspective suitable as a reference for subsequent research. Methods We searched the Web of Science Core Collection (WoSCC) up to April 30, 2023 to identify studies associated with sexual health problems in patients with cancer. CiteSpace was used to create visualization networks for countries, institutions, authors, and journals. Results A total of 3183 publications related to sexual health problems in patients with cancer were collected from the WoSCC. In terms of volume, the USA (1259 papers) was the leading country, the Memorial Sloan Kettering Cancer Center (119 papers) was the leading institution, and Carter (39 papers) was the author with the most publications. The top-cited references and keywords were related to quality of life. The top five clusters of reference cocitation were 'brachytherapy', 'prostate cancer', 'radical prostatectomy', 'hypogonadism', and 'breast cancer'. Meanwhile, the top five clusters of keyword cocitation were 'breast cancer', 'prostate cancer', 'rectal cancer', 'testicular cancer', and 'sexual function'. The analysis of the top 25 references and keywords with the strongest citation bursts of published papers on sexual health problems in patients with cancer to reveal the research hotspots and trends. Conclusions Research on sexual health among patients with cancer is constantly developing. The current research focuses on the impact of different treatment options for sexual health and quality of life of patients with breast, rectal, and genitourinary neoplasms. Exploring the long-term changing regularities of sexual function among cancer survivors and formulating sexual health interventions toward patient-reported outcomes and needs are key research directions.
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Affiliation(s)
- Ying Li
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, 300060, China
| | - Mingyue Liu
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, 300060, China
| | - Yanxia Sun
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, 300060, China
| | - Dandan Guo
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, 300060, China
| | - Min Li
- Department of Gynecological Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Centre for Cancer, Tianjin, 300060, China
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Shahmoradi N, Davarinejad O, Brühl AB, Brand S. Effects of Aphrodite (an Herbal Compound) on SSRI-Induced Sexual Dysfunctions and Depression in Females with Major Depressive Disorder: Findings from a Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1663. [PMID: 37763782 PMCID: PMC10538161 DOI: 10.3390/medicina59091663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Almost by default, people with major depression disorder (MDD) also report sexual health issues. This holds even more true when sexual dysfunctions are SSRI-induced. Herbal compounds may have the power to counterbalance such sexual dysfunctions, though research is still scarce. Therefore, we assessed females with diagnosed MDD treated with a standard SSRI (sertraline) and reporting SSRI-induced sexual dysfunctions, and we asked whether compared to placebo, Aphrodite (a blend of ginger, saffron, cinnamon, thistle, and Tribulus terrestris) may favorably impact on sexual dysfunctions, and on symptoms of depression, anxiety, and sleep disturbances. Materials and Methods: A total of 41 females (mean age: 35.05 years) with diagnosed MDD, treated with sertraline (a standard SSRI) at therapeutic dosages, and reporting SSRI-induced sexual dysfunction, were randomly assigned either to Aphrodite or to the placebo condition. At baseline and four and eight weeks later (study end), participants completed a series of self-rating questionnaires covering symptoms of sexual dysfunction, depression, anxiety, and sleep complaints. Results: Symptoms of sexual dysfunction, depression, and anxiety decreased over time, but more so in the Aphrodite condition, compared to the placebo condition (significant p-values and large effect sizes). Over time, sleep disturbances decreased irrespective of the study condition. Conclusions: The pattern of results suggests that compared to placebo, Aphrodite appeared to improve symptoms of sexual dysfunction, depression, and anxiety among females with diagnosed MDD and SSRI-induced sexual dysfunction. Further and similar studies should investigate the underlying psychophysiological mechanisms.
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Affiliation(s)
- Nasrin Shahmoradi
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
| | - Omran Davarinejad
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
| | - Annette Beatrix Brühl
- Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran; (O.D.); (A.B.B.)
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1417466191, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714673159, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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50
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Humbert M, Lequesne J, Licaj I, Bon-Mardion N, Bouhnik AD, Huyghe E, Dugue J, Babin E, Rhamati L. Sexual health at 5 years after diagnosis of head and neck cancer. Support Care Cancer 2023; 31:535. [PMID: 37615815 DOI: 10.1007/s00520-023-07949-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE Sexual health (SH) is an emerging concern in the assessment of quality of life in patients surviving head and neck cancer (HNC). Using data from the French National Prospective VICAN Survey, this study aimed to assess SH deterioration five years after HNC diagnosis and related factors. METHODS Using univariate and multivariate analyses were performed in the 241 HNC survivors. We studied the factors associated between the sexuality and intimate life of these patients with demographic and medical data from the national epidemiological survey VICAN 5. RESULTS Sexuality and body image were altered in 78.8% for men and 79.2% for women. This alteration in sexual quality of life affects both men and women. Dissatisfaction with the frequency of sexual intercourse was associated with being treated with radiotherapy (p=0.024), as well as decrease of sexual desire in patients treated with chemotherapy (p=0.044). Fatigue (p=0.002), impaired physical health (p=0.049), and high disease stage (p=0.001) remained significantly associated, after multivariate analysis, with decreased sexual desire. Among these 3 factors negatively influencing sexual quality of life, two are treatable with appropriate management. CONCLUSION Five years after the diagnosis of HNC, a decrease in sexuality and body image are frequent and significantly impact the quality of life of survivors. These observations imply an adaptation of the management of the professionals involved.
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Affiliation(s)
- M Humbert
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France.
- INSERM 1086 ANTICIPE, Caen University, Caen, France.
| | - J Lequesne
- Clinical Research Department, Centre François Baclesse, Caen, France
| | - I Licaj
- Clinical Research Department, Centre François Baclesse, Caen, France
- Department of Community Medicine, The UiT Arctic University of Norway, Tromsø, Norway
| | - N Bon-Mardion
- Department of Otorhinolaryngology Head and Neck Surgery, Mathilde Clinic, 76100, Rouen, France
| | - A D Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Aix Marseille Univ, Inserm, IRD, Marseille, France
| | - E Huyghe
- Department of Urology, 36760 University of Toulouse, Toulouse, France
| | - J Dugue
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - E Babin
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
- INSERM 1086 ANTICIPE, Caen University, Caen, France
| | - L Rhamati
- Department of Otorhinolaryngology Head and Neck Surgery, Hopital du Pays Salonais, 13300, Salon de Provence, France
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