Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women

The Influence of the COVID-19 Pandemic on the Sexual Lives of Polish Young Adults

Background: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic's impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). Methods: The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. Results: Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. Conclusions: The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences.

A Prospective, Longitudinal Comparison of Sexual Distress Across Relationship Status During the COVID-19 Pandemic

Numerous studies have described declines in sexual well-being during the COVID-19 pandemic, although experiences of sexual distress during this time appear to be mixed. Previous research has relied on cross-sectional methodology and focused on individuals in relationships. Furthermore, little is known about the frequency of "COVID-safe" sexual behaviors, such as online sexual activities. These gaps in the literature were addressed using a prospective, longitudinal online study examining sexual distress, predictors of sexual distress (i.e., perceived stress), and online sexual activities over time in single and partnered individuals. Participants were single (N = 64) and partnered (N = 60) individuals who completed surveys at three timepoints over a 6-month period during the COVID-19 pandemic. Mean age across the two groups was 29 years, and approximately half were women (51.6% and 50%, respectively). Results indicated that single individuals reported significantly higher sexual distress than partnered individuals at Times 1 and 2, but not at Time 3. Sexual distress significantly decreased over time for individuals in the single group but remained stable for partnered individuals. At each timepoint, there was a conditional effect of perceived stress on sexual distress depending on one's relationship status, and the nature of these conditional effects changed throughout the course of the study. Results suggested that single individuals demonstrated improvements in sexual distress over time. Perceived stress is an important predictor of sexual distress but may operate differently depending on relationship status. Results highlight the resiliency of both single and partnered individuals during the COVID-19 pandemic.

Effect of COVID-19 on sexual function and activities among reproductive-age women in Ibadan, South-West Nigeria

Background

Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health.

Aim

To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria.

Methods

This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05.

Outcomes

Respondents were aged 20 to 50 years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers.

Results

An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores.

Clinical Implications

Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction.

Strength and Limitations

Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results.

Conclusion

A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown.

Evaluation of Sexual Function According to Gender and Sexual Orientation during the COVID-19 Pandemic in Turkey: A National Online Survey Study

OBJECTIVE

Coronavirus Diseases-19 (COVID-19) pandemic that has caused the death of thousands of people affected negatively not only people's physical wellbeing but also their mental health. The aim of this study was to evaluate the sexual function, depression, anxiety and stress, and fear of COVID-19 of individuals according to gender and sexual orientation during the COVID-19 pandemic.

METHOD

The questionnaire form included sociodemographic data form, the Arizona Sexual Experiences Scale (ASEX), the Depression, Anxiety and Stress Scale-Short Form (DASS-21), and the Fear of COVID-19 Scale (FCV-19S). The form was distributed on social media platforms.

RESULTS

1593 sexually active participants were included in the study. 47.5% of the participants were females and 52.5% were males. 86.9% of them were heterosexuals and 13.1% were lesbian, gay, and bisexual (LGB) individuals. ASEX, DASS-21 Depression, Anxiety, and Stress, and FCV-19S scores were significantly higher in females than males (p<0.001). When anxiety, depression, stress, and fear of COVID-19 were controlled, level of sexual dysfunction continued to be higher in women. We found that while the ASEX and FCV-19S scores were similar between the heterosexuals and LGBs (respectively p=0.66 and p=0.31), the DASS-21 Depression, Anxiety, and Stress scores were higher in LGBs (p<0.001).

CONCLUSION

Our results reveal the effect of the pandemic period on female sexual functions and the importance of addressing this topic in clinical practice and research.

The Comparison of Patient Characteristics, Therapy Outcome, and Sexual Functions in Vaginismus Patients Prior to and During the COVID-19 Pandemic

Background The objective of this study conducted at one center is to compare the demographic features and female sexual functions of patients treated for vaginismus before the COVID-19 pandemic to those treated for vaginismus during the pandemic. Aim Additionally, the study intends to evaluate the results of vaginismus therapy and assess the post-treatment sexual functioning of women. Methods A retrospective analysis was conducted on the medical records of patients diagnosed with vaginismus who sought treatment between March 2018 and March 2022. The enrolled patients were categorized into two groups: the pre-COVID-19 group and the COVID-19 group. The following data have been collected: age, education level, occupation, and marriage duration. After three months of treatment, the patients were called for a follow-up examination and evaluation of their sexual functions. Outcomes Compared to the pre-COVID-19 group, an increase of 52.51% was observed in the number of patients admitted for treatment in the COVID-19 group. Results The severity of vaginismus in the patients was similar in both groups. There were no statistically significant changes observed in any of the areas of the Female Sexual Function Index (FSFI) scale. Clinical implications According to our findings, there was no significant difference in female sexual functioning between women who had vaginismus treatment during the pandemic and those who underwent pre-pandemic treatment. Strengths and limitations The research sample comprised women who sought medical care at our women's health clinic. Conclusions We believe that vaginismus patients who had previously avoided seeking treatment are now seeking it during the pandemic.

Changes in frequency of urology clinic visits and diagnosis of erectile dysfunction in Germany before and during COVID-19

OBJECTIVES

To explore and analyze [1] the differences in the total number of patients visiting urology practices in Germany, [2] explore and analyze any differences in the number of newly diagnosed erectile dysfunction (ED) patients as well as [3] the number of new drug prescription, before and during the COVID-19 pandemic in Germany (April 2019-March 2020 and April 2020-March 2021).

METHODS

This retrospective cross-sectional study used data from the Disease Analyzer database (IQVIA) and included all patients aged ≥18 years with at least one visit to one of 85 urology practices across Germany. Outcomes were the mean number of patients with [1] new diagnosis of ED and [2] new prescription of drugs for erectile dysfunction per practice, in pandemic (April 2020-March 2021) versus non-pandemic (April 2019-March 2020) time periods. Differences between the periods were assessed using Wilcoxon tests.

RESULTS

In the non-pandemic period, there were 195,895 men, and in the pandemic period, 192,659 men visiting urology practices in Germany. A total of 10,977 men were initially diagnosed with ED in non-pandemic and 12,213 (+11.26%) men in pandemic time periods. Although the differences of new ED diagnoses were not statistically significant, a non-significant increase of new ED diagnoses was observed across all age groups. Also, a non-significant increase in new ED prescription drugs was detected across all age groups.

CONCLUSIONS

Even though less urology practice-visits of men with ED were recorded during the COVID-19 pandemic, an increase of new ED diagnosis was observed across all age groups between April 2020 and March 2021.

Mitigating Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Ameliorating Sexual Function and Psychological Well-Being in Older Men

This study aimed to investigate the prevalence of lower urinary tract symptoms (LUTS) in older men (N= 3056) with benign prostatic hyperplasia (BPH) and its effects on their sexual function and mental health. Descriptive, correlation, and regression analyses were used to explore the relationships between prostate and lower urinary tract health and psychological well-being. Better prostate and lower urinary tract health positively affected psychological well-being, and sexual function also had a positive influence. LUTS have an adverse impact on sexual function and mental health. Early intervention is crucial for mitigating the negative impact of LUTS on the quality of life in older men. Addressing prostate and lower urinary tract health issues through appropriate interventions may improve psychological well-being. Health care professionals must consider the adverse effects of BPH and LUTS on sexual function and mental health, and implement interventions to enhance the overall quality of life in older men.

(Un)forgotten Sex Lives During the COVID-19 Pandemic: Coping Strategies That Work and the Role of Experience

Available literature points to a worsening trend in sexual functioning, desire, and satisfaction during the pandemic. Nevertheless, virtually no empirical research was conducted on the mechanisms of coping with the pandemic's impacts on sex life. Thus, the purpose of this exploratory study was to examine a variety of coping mechanisms and their perceived usefulness by people who have and have not tried these coping strategies to maintain and enhance their sex lives during the first year of the pandemic. The cross-sectional data were collected using an online survey methodology (N = 420; 66.9% women) and analyzed utilizing exploratory factor analysis, analysis of variance, and multiple regression. The results revealed nine factors/coping mechanisms (based on 59 items/strategies), including goal-setting strategies, risk and experimentation strategies, relational strategies, caution and logistical strategies, creativity and innovation strategies, substances and context-related strategies, online and technology strategies, diversion strategies, and educational strategies. Consistently, across all the specific coping strategies and overall coping mechanisms, people who tried them found them significantly more useful than those who had not tried these coping strategies. Moreover, a higher diversity of tried strategies per coping mechanism consistently and significantly predicted the perceived usefulness of that coping mechanism. These results emphasize the crucial role of experience with coping mechanisms and show that amidst COVID-related adversity and challenges, many people found ways to adapt their sex lives and enjoy silver-lining opportunities. This exploratory study offers promising evidence for potential sexual coping strategies during times of stress that could be informative for clinical practice and education.

Lived sexual experience of health workers on the Iranian frontline of the fight against the COVID-19 pandemic: A qualitative content analysis

BACKGROUND

Lifestyle changes due to the COVID-19 pandemic may affect individuals' sexual lives and probably their sexual function. The present study aimed to explain the sexual lived experiences of health workers on the Iranian frontlines of the fight against the COVID-19 pandemic.

MATERIALS AND METHODS

The present study was qualitative research using the conventional qualitative content analysis method. It was conducted in the city of Ramsar, Iran, in 2022. The data were collected using 12 in-depth personal interviews and a purposive sampling method. Lundman and Granheim's method was used to analyse the data.

RESULTS

The analysis of the data in the first phase of the research led to 60 initial codes, 7 subcategories, 3 main categories (concerns about health risks, sexual dissatisfaction, and sexual facilitators and barriers), and one theme (unhealthy lifestyle due to sexual dissatisfaction).

CONCLUSION

The present study revealed new and different dimensions of the sexual experiences of health workers on the frontlines of the fight against the COVID-19 pandemic [concerns about health risks, sexual dissatisfaction, sexual facilitators, and sexual inhibitors]; these dimensions are based on the Iranian context and culture that can be considered to enhance sexual pleasure and the physical and mental health of health professionals that have an impact on improving patients' and people's health status in society.

Impact of the covid-19 pandemic on mental health and sexuality of female doctors

BACKGROUND

COVID-19 pandemic has changed people's lives around the world due to restrictive measures adopted by governments. The impact of this change on female sexuality needs to be further investigated, particularly between female doctors who are more at risk as they are directly involved with health care services.

METHODS

An online survey has been filled out by female doctors. The questionnaire evaluates sexual function, depression, anxiety, burnout, sociodemographic and professional data, and it was answered during the peak of COVID-19 pandemic in Brazil. The main outcome is female doctors' sexual function during COVID-19 pandemic, which was evaluated by analyzing FSFI questionnaires. The secondary outcome is related to their mental health, assessed via depression, anxiety and burnout questionnaires.

RESULTS

A sample of 388 female doctors filled out the questionnaire. The median age was 34.0 (29.0, 43.0) years old. The total FSFI median score was 23.8 [18.9, 26.8] with desire domain median of 5.0 [3.0, 7.0]. In our sample, 231 (59.5%) women had depression and/or anxiety, out of these, 191 (82.7%) had depression and 192 (83.2%), anxiety. From these samples of doctors with depression and/or anxiety, 183 (79.2%) had sexual dysfunction.

CONCLUSION

This finding suggests that doctors are experiencing a high risk of sexual dysfunction and mental illness during the COVID-19 outbreak. A high index of depression and/or anxiety was shown in the studied population, with almost 80% of them reaching criteria for sexual dysfunction. Working in the frontline is related to worse mental health conditions. Depression and anxiety were found as potential mediators of burnout effect on sexual function.

SARS-CoV-2 infection and female reproductive health: A narrative review

The COVID-19 pandemic has had a profound global impact, affecting people's physical and mental health, and their social and economic circumstances. Mitigation measures have disproportionately affected women. Studies have reported menstrual cycle and psychological disturbance associated with the pandemic. Pregnancy is a risk factor for severe COVID-19 disease. Reports have also demonstrated associations between COVID-19 infection, vaccination and Long COVID syndrome and reproductive health disturbance. However, studies are limited and there may be significant geographical variation. Also there is bias amongst published studies, and menstrual cycle data was not included in COVID-19 and vaccine trials. Longitudinal population based studies are required. In this review we discuss existing data, along with recommendations for further research required in this area. We also discuss a pragmatic approach to women presenting with reproductive health disturbance in the era of the pandemic, encompassing a multi-system assessment of psychological, reproductive health and lifestyle.

Estimation of global rating changes in quality of life and marital satisfaction among reproductive age women in Iran and Afghanistan before and after COVID-19 pandemic

BACKGROUND

Quality of life and marital satisfaction are important components of reproductive-age women's health. This study aimed to compare the quality of life and marital satisfaction in women of reproductive age in Iran and Afghanistan before and after the COVID-19 pandemic.

METHODS

This was a cross-sectional study on a sample of Iranian and Afghan women of reproductive age. To collect the data, the 12-item short-form health survey (SF-12) and the Enrich marital satisfaction scale were used to assess the quality of life and marital satisfaction, respectively. In addition, the Global Rating of Change (GRC) was used in order to evaluate the quality of life and marital satisfaction compared to before the COVID-19 pandemic. Data were evaluated descriptively through statistics including sing t-test, and chi-square, Logistic regression was performed to assess the relationship between outcome variables and independent variables.

RESULTS

In all 599 reproductive-age women (300 Iranian, and 299 Afghan) were studied. After adjusting for demographic variables, no significant difference was observed between the two groups for the physical component (P = 0.05) and mental component summary scores of quality of life (P = 0.166) as measured by the SF-12. The majority of Iranian women reported that their quality of life was worsened compared to before the pandemic (57.2%), while in the Afghan group, a higher percentage declared that it was unchanged (58.9%). The mental component of quality of life had no significant relationship with any of the independent variables including nationality. In contrast, the physical component quality of life had a significant relationship with nationality (P = 0.01). Iranian women had more marital satisfaction than Afghan women (P<0.001) and marital satisfaction had a significant relationship with nationality (P<0.001). Most women in both groups (70% of Iranian and 60% of Afghan women) declared that their marital satisfaction unchanged compared to before the COVID-19 pandemic.

CONCLUSION

The results showed that the quality of life of Iranian and Afghan women of reproductive age was almost the same before and after the pandemic. However, Iranians scored lower on the mental component summary and Afghans reported lower scores on the physical component summary. Marital satisfaction of Afghan women was much lower than that of Iranian women. The findings suggest the need for serious attention by health care authorities. Providing a supportive environment might be considered a primary step towards a better quality of life for these populations.

The COVID-19 Pandemic Impact on the Psychophysical Health of Post-Menopausal Women: A Cross-Sectional Study

Background and Objectives: The aim of this study was to investigate lifestyle, menopausal symptoms, depression, post-traumatic stress disorder (PTSD) and sleep disorders in post-menopausal women throughout the first wave of the COVID-19 pandemic, including the impact of menopause hormonal therapy (HT). Materials and Methods: Post-menopausal women were given the following questionnaires: socio-demographic characteristics; lifestyle; history of COVID-19; menopause-specific quality of life (MENQOL), the first part of which refers to the pre-pandemic period ("pre COVID-19") and the second refers to the current period ("during COVID-19"); Beck's depression inventory (BDI); the impact of event scale-revised (IES-R); and the Pittsburgh sleep quality index (PSQI). Results: One hundred and twenty-six women completed all questionnaires, with a mean age of 55.5 ± 6.0 years. The mean menopause duration was 5.7 ± 5.6 years. Twenty-four women were taking HT. A significant mean weight gain, a reduction in physical activity (respectively p < 0.001) and worsened quality of romantic relationships (p = 0.001) were reported during the pandemic. Menopausal symptoms did not vary significantly throughout the pandemic; however, women taking menopausal HT had lower physical (p = 0.003) and sexual (p = 0.049) MENQOL domain scores, lower depressive symptoms (p = 0.039) and better romantic relationships (p = 0.008). Conclusions: The COVID-19 pandemic caused reduced physical activity, worsened food habits and weight gain in post-menopausal women. They also reported a high rate of severe-moderate PTSD and a negative influence on their romantic relationships. Menopausal HT seems to be a potential protective factor for sexual and physical status and for symptoms of depression.

Experience of Racial Discrimination was Associated with Psychological Distress and Worsening Sex Life Among Adult Americans During COVID-19

The recent escalation of racism in the U.S. during the COVID-19 pandemic points to the importance of examining the association between experienced racism and sexual health. Based on data from a nationally representative survey conducted in the U.S. in October 2020 (n = 1,915), Chi-square tests and multivariable logistic regressions were estimated to examine the association between experience of racism and changes in sex life during the pandemic. We further performed a causal mediation analysis using the bootstrap technique to assess the mediating role of psychological distress in the observed association between the experience of racism and changes in sex life. Among the respondents, the proportions reporting better, worse, or no change in sex life were, respectively, 15%, 21%, and 64%. Experiencing racial discrimination during COVID-19 was significantly associated with worsening sex life (adjusted odd ratio [AOR] = 1.53; 95% confidence interval [CI] = 1.04, 2.25). Respondents with experienced racism were also more likely to report psychological distress (AOR = 1.68; 95% CI = 1.09, 2.59). About one-third (32.66%) of the observed association between experienced racism and worsening sex life was mediated through psychological distress. Addressing racism and its association with psychological distress has the potential to improve sexual health and reduce related racial and ethnic disparities.

Sexual Coping Mechanisms During the COVID-19 Pandemic and Their Determinants of Use, Usefulness, and Effects on Sex Life

Introduction

The COVID-19 pandemic has taken a toll on many people's sex lives. The ways people cope with these adverse impacts are an urgent area that needs to be recognized by sexual health researchers, practitioners, and policymakers. Thus, this study investigated sexual coping mechanisms during the pandemic while clarifying their determinants of use and usefulness and examining their impacts on the quantity and quality of sex life.

Methods

The cross-sectional data (N = 675) were collected using an online survey methodology in February-May 2021. The data were analyzed with one-sample and independent-samples t-tests, one-way between-subjects ANOVA, and multivariate multiple regression.

Results

This study identified eight sexual coping mechanisms during the pandemic, including creativity and pleasure, diversion, goal-setting, relational, educational, caution and logistical, online and technological, and innovation and experimentation strategies. All the coping mechanisms were used and rated significantly useful, albeit to different degrees. Gender, availability of a sex partner, the existence of children, and age served as determinants of different coping mechanisms' scope of use and degree of usefulness. The coping mechanisms predicted the frequency of sexual activity, sexual desire, and satisfaction with sex life during the pandemic.

Conclusions

This study's results can help scholars and practitioners prevent or mitigate the deterioration of sex life during the pandemics and other crises and stressors. It is essential to train people concerning sexual coping resources and strategies to protect their sexual wellbeing and quality of life.

Policy Implications

Health researchers, practitioners, and policymakers must consider maintaining sexual health as an essential service. Recognizing sexual health, rights, education, and counseling is a prerequisite for appropriate prevention measures during the pandemic. It is vital to ensure the availability of proper resources supporting people's sexual coping processes during and after the pandemic.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

Psychological, Socio-Demographic, and Logistical Factors Associated With Changes in Sex Life After Over a Year Into the COVID-19 Pandemic

This study examined changes in sex life about a year into the COVID-19 pandemic for both partnered and non-partnered individuals and identified the determinants of these changes. The results of an online survey (N = 675) reflect a significant decrease in the frequency of intimate and sexual behaviors and declines in sexual desire, quality, intimacy, diversity, and satisfaction. This study also showed that socio-demographic characteristics, psychological factors, and the logistical impacts of the pandemic explain trends in people's sex lives during the pandemic. This study contributes to understanding the long(er)-term nature, scope, and determinants of changes in sex life during the pandemic.

Evaluation of sexual function and sexual quality of life in women during the COVID-19 Pandemic: the Turkish case

BACKGROUND

Sexual health is an important component of general health.

OBJECTIVE

To evaluate sexual function and sexual quality of life (SQOL) in women during the COVID-19 pandemic.

METHODS

This descriptive, cross-sectional study was conducted in Turkey. Data were collected via a Visual Analog Scale (VAS), Female Sexual Function Index (FSFI), and Sexual Quality of Life-Female (SQOL-F) questionnaire.

RESULTS

The mean FSFI score was 26.91±5.62, and 39.1% of the women had an FSFI score of 26.55 or lower. The mean SQOL-F score was 79.08±20.90. FSFI score was significantly associated with employment status (β=-0.661), partner education (β=1.698), sexual compatibility between partners (β=0.518), sexual satisfaction (β=0.230), fatigue level (β= -0.120), and frequency of sexual intercourse (β=0.160). In addition, SQOL-F score was significantly associated with sexual desire (β=2.625), satisfaction (β=1.338), pain or discomfort (β=1.274), age (β= -0.356), sexual compatibility between partners (β=1.984), and fatigue level (β=-0.981) (p<0.05).

CONCLUSION

Less than half of the women participating in this study had sexual dysfunction, and overall SQOL was moderate to high. These results were associated with some descriptive characteristics of the women and were similar to those reported in pre-pandemic studies conducted in Turkey.

The Effect of Sexual Counseling Based on EX‑PLISSIT Model on Improving the Sexual Function of Married Women with Systemic Lupus Erythematosus: A Randomized Controlled Trial

Systemic Lupus erythematosus (SLE) is a multisystem autoimmune disease. This disease triggers sexual dysfunction due to physiological, cognitive and mental effects. Since sexual function is often ignored in these patients, this study aimed to investigate the effect of sexual counseling based on EX‑PLISSIT model on improving the sexual function of married women with SLE. This clinical trial was conducted on 101 married women suffering from SLE (18-49 years) residing in Tehran. Randomization was performed by random block allocation with six blocks in a rheumatology clinic. A demographic questionnaire, the Depression, Anxiety, Stress Scales-21 Items (DASS-21), and the female sexual function index were used to collect the data. The intervention group received counselling sessions every week while the control group (n = 55) received routine care for the disease. Eight and twelve weeks after completion of counselling sessions, outcomes compared between the intervention and control groups, using independent ttest, paired t-test, repeated measures and Chi-squared test. The scores of sexual function in both groups did not differ significantly before the intervention (p > 0.05). At the first follow-up session, the score of all sexual function domains except sexual pain increased significantly in the intervention group while a significant reduction was observed in all domains of sexual function in the control group (p < 0.05). In the second follow-up, sexual function significantly increased in the intervention group whereas it significantly decreased in the control group (p < 0.05). According to the findings of this study, counseling based on EX-PLISSIT model positively affected the sexual function of women with SLE. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual functions.

Effect of Nigella sativa L. seed oil on urinary incontinence and quality of life in menopausal women: A triple-blind randomized controlled trial

Increased urinary incontinence is one of the most common changes during menopause. This study aimed to investigate the effect of Nigella sativa L. seed oil on urinary incontinence and quality of life (QoL) (primary outcomes) and sexual function (secondary outcome) in menopausal women. In this triple-blind randomized controlled trial, 60 women in Tabriz-Iran were equally allocated into two treatment and control groups using block randomization. The women applied 2-3 drops of Nigella sativa L. seed oil or placebo on their stomachs below the novel twice a day for 8 weeks. The data collection instruments were completed at baseline and just after the intervention. After intervention, the mean rank score of mixed urinary incontinence was significantly lower (p = .04) and the mean score of the incontinence-QoL was significantly higher (mean difference 12.63, 95% CI 2.33 to 22.93; p = .017) in the treatment group than the control group. However, there were no significant differences in stress incontinence, urge incontinence, sexual function, and menopause-specific QoL of women between the groups (p > .05). The results indicated the positive effect of the Nigella sativa L. seed oil on mixed incontinence and incontinence-QoL; nevertheless, to make a certain conclusion, further studies are required.

COVID-19 Pandemic and Its Impact on the Quality of Women's Sexual Life: A Systematic Review

The COVID-19 pandemic has had far-reaching effects, including onphysical and mental health and wellbeing. The aim of this study was to investigate the effect of the COVID-19 pandemic on women's health, especially on women's sexual life includingdesire, arousal, orgasm and satisfaction. The initial research in PubMed/Medline, Google Scholar and Scopus yielded 573 articles from Europe (Portugal, Poland, Italy, Greece), America (U.S, Brazil) and Africa (Egypt), of which 14 met the inclusion criteria and were included in the review. Results from the studies suggest that the pandemic negatively affected sexual functioning and satisfaction, while it increased sexual distress, sexual avoidance and solitary sexual approach behaviors. The desire to have children decreased during the pandemic, but so didthe use of contraception. There is conflicting evidence as to whether or not the pandemic has had an impact on sexual desire and frequency among women. However, some major factors associated with sexual life were psychological factors and working status. It is well documented that the pandemic has had a great psychological impact. Therefore, both of these factors are expected to significantly affect women's sexual life.

The Differential Impact of COVID-19 Pandemic on Sexual Behavior of Eligible Couples in Urban and Rural India

Background:

Intimacy during sexual contact with a person with symptomatic or asymptomatic COVID-19 disease carries the risk of its transmission. COVID-19 has been therefore found to adversely impact the sexual behavior in people in various countries. A discussion on sexual health is often tabooed in India, leading to less research evidence from India.

Aim:

We tried to study and compare the impact of COVID-19 pandemic on the sexual behavior of urban- and rural-based eligible couples.

Methods:

Eligible couples were randomly selected from the urban and rural field practice area of a Medical College of West Bengal (India). They were interviewed using a data collection schedule for their sexual practices adopted during the pandemic. Urban vs rural sexual behavior was compared using chi-square test.

Results:

Majority didn’t report any change in sexual desire compared to prepandemic days. However, scope of sexual contact had significantly reduced among urbanites ( P = .036); fear of contracting COVID-19 during sexual intimacy was more among them as well ( P = .047). The rural respondents reported significantly higher desire for parenthood ( P = .018), though their contraceptive behavior was not significantly different from the urban counterparts. Many used means other than sexual intercourse for sexual gratification, which had remained similar to the prepandemic times.

Conclusion:

The sexual behavior of urban and rural participants was found to be significantly different on many fronts, probably due to better COVID-19 awareness among urban residents as well as other prevalent social stigma and restrictions that were less commonly encountered in rural participants.

Mating in Captivity: The Influence of Social Location on Sexual Satisfaction through Phases of the COVID-19 Pandemic

The recent global pandemic provides a natural experiment "intervention" to examine how differing baseline social dynamics such as gender, education, and politics shaped diverging patterns of well-being during rapidly shifting societal conditions. Using married adults from a nationally representative panel study in the United States from August 2019 to August 2021, discontinuous growth curves reveal a large drop in average married sexual satisfaction in both quality and frequency directly following the pandemic onset. Moreover, sexual satisfaction remained largely suppressed for the subsequent 18 months, apart from a brief "optimism blip" in the fall of 2020. Race, age, income, employment, parenthood, education, and political affiliation all appear as meaningful predictors, but these differ across various phases of the pandemic and by gender. These results reveal evidence of lingering changes in subjective sexual well-being as well as patterns of catastrophe risk and resilience moderated by social location factors.

The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China

To investigate the impact and factors of home quarantine life on women's sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people's spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.

Quality of life and sexual function analysis in a group of Italian postmenopausal women after COVID-19 vaccination

AIM

The aim of the study was to evaluate the impact of SARS-CoV-2 vaccination on quality of life, psychological aspect and sexual life in a group of Italian postmenopausal women during the COVID-19 pandemic.

METHODS

The study was a prospective, observational analysis of postmenopausal women before and after the COVID-19 vaccination. The population previously answered different questionnaires, such as the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), the 36-Item Short Form Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Twelve weeks after the end of the vaccine cycle, these women were invited to complete the same questionnaires by e-mail to evaluate if vaccination coverage could positively impact the quality of life of postmenopausal women. The Patient Impression of Global Improvement (PGI-I) after three months of treatment was also calculated.

RESULTS

A total of 114 patients were reported. The median age was 60.96 (52-66) years. Mean sexual intercourses/month increased from 1.28 ± 1.23 to 4.21 ± 1.80 (p = 0.001). The FSFI increased (19.22 ± 3.31 vs 29.24 ± 4.21, p < 0.0001) and the FSDS decreased significantly (20.12 ± 5.23 vs 9.32 ± 5.55, p < 0.0001) 12 weeks after vaccination coverage. The SF-36 increased from 64.23 ± 11.76 to 82.21 ± 10.24 (p < .0001) and the HADS questionnaire improved significantly from 9.3 ± 2.73 to 5.1 ± 1.34 after the COVID-19 vaccine execution (p<.0001).

CONCLUSIONS

The spread of COVID-19 vaccine coverage positively influenced sexual function, quality of life and psychological aspect in postmenopausal women.

Impact of the first wave of the COVID-19 pandemic on birth rates in Europe: a time series analysis in 24 countries

STUDY QUESTION

Did the first wave of the COVID-19 pandemic have an impact on monthly birth rates in Europe?

SUMMARY ANSWER

Using datasets on live births per month in Europe, collected from the Human Fertility Database, we found a -14.1% decline in live births in January 2021 (i.e. 9-10 months after the epidemic peaks and first lockdowns), compared to the average number of live births in January 2018 and 2019.

WHAT IS KNOWN ALREADY

Previous pandemics in the 20th and 21st centuries have been associated with a decline in birth rates 9 months after their peak, and a rebound in births over time. Lockdowns were necessary to control the first wave of the COVID-19 pandemic and may have had an impact on subsequent birth rates.

STUDY DESIGN, SIZE, DURATION

Monthly time series data on live births from January 2018 to March 2021 were extracted to provide a time-series analysis of birthrates during and after the first wave of the COVID-19 pandemic in 24 European countries.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We conducted a random-effect generalized least squares regression to assess the seasonality of births from January 2018 to March 2021, and to identify potential differences in monthly live births after the first wave of the COVID-19 pandemic, considering the seasonality of births. To quantify these potential differences, we estimated the variation rate between the monthly live births observed during 2020 and 2021 and the mean of the 2018-2019 monthly live births in Europe. Factors potentially associated with a variation in monthly birth rates were assessed using univariable and multivariable generalized linear regressions.

MAIN RESULTS AND THE ROLE OF CHANCE

When considering the seasonality of births, January 2021 was the only month with a significant difference in live births. A drop of -14.1% was observed compared to the average number of live births in January 2018 and 2019. At the national level, this drop was observed 9-10 months after the epidemic peaks in 13 countries. The duration of lockdowns was the variable that had the stronger association with this decrease, whereas higher incomes per capita could be a factor limiting this decline. A rebound in births compared to the previous years occurred in March 2021 in 13 countries.

LIMITATIONS, REASONS FOR CAUTION

Our data are based on national data, limiting the power in the multivariable models used and the identification of other potential factors contributing to a decrease or an increase in birth rates. In addition, we collected only live births up to April 2021, which precludes the identification of a difference in births seasonality in 2021.

WIDER IMPLICATIONS OF THE FINDINGS

As with previous pandemics, the COVID-19 outbreak was associated with a decline in births 9 months after its first wave. This trend may be associated with the duration of the lockdowns. Although there was a rebound in births in the following months, it does not seem to compensate for this decline.

STUDY FUNDING/COMPETING INTEREST(S)

The authors receive no external funding and have no conflict of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Sexual Health During COVID-19: A Scoping Review

INTRODUCTION

The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures.

OBJECTIVES

The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed.

METHODS

The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach.

RESULTS

Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health.

CONCLUSION

The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.

Changes in Couples' Relationships and Their Differences in Type during the COVID-19 Pandemic in China

PURPOSE

This study explores changes in couples' relationships during the COVID-19 pandemic, and analyzes the differences in the changes across three types: positive communication, criticism/defense, and demand/withdrawal.

METHOD

A total of 600 (567 valid) Chinese respondents participated in this study, and a questionnaire was utilized to determine changes in their overall relationship, verbal and nonverbal communication, emotion, and activities with their spouses.

RESULTS

The average score of items related to positive communication is higher, compared with that of negative communication. Compared with the other two types of relationships, respondents with positive communication scored highest on all items related to positive communication and lowest on all items related to negative communication. Significant differences were noted between the positive communication types and the others.

CONCLUSIONS

Results show that the relationships of couples included in this study have improved during the current pandemic. Therefore, improved consistency in the type of intimacy can lead to improved quality of couples' relationships during the COVID-19 pandemic.

The Impact of the COVID-19 Pandemic and Social Isolation on the Sexual Functioning of Women Who Have Been Treated for Vaginismus

Background: Multiple factors that impact the mental and hormonal condition of the person influence female sexual function. To our knowledge, however, hardly any research has investigated the sexual function during the COVID-19 pandemic for women who were treated for vaginismus.

Aim: The purpose of this research is to examine how sexual function, frequency of sexual activity, and dyspareunia altered in women who had been treated for vaginismus before the pandemic.

Methods: This observational study ultimately included 204 patients with completely treated vaginismus at the Women's Health Clinic . Before and during the pandemic, the following data was collected: age, education level, profession, frequency of sexual activity, Arizona Sexual Experiences Scale (ASEX) scores, Golombok-Rust Inventory of Sexual Satisfaction (GRISS) scores, and Hamilton Depression Rating Scale (HDRS) scores.

Results: Before the pandemic, the mean ASEX score of women in the research group was 12.56±3.41 , and during the pandemic, ASEX average scores of the women significantly increased to 16.88±5.56 . The GRISS total scores were 28.7±10.1 (range, 14-50) following therapy and 23.9±14.8 (8-58) during the pandemic. After therapy, the HDRS score was 9.58±5.53 (1-19) , while it was 15.21±6.43 (5-26) during the pandemic. During the coronavirus disease 2019 (COVID-19) pandemic, mental health declined significantly, indicating a mild state of depression unrelated to vaginismus. During the pandemic, the mean frequency of sexual activity was 2.9±1.4 per week, and the frequency of sexual encounters did not considerably vary.

Clinical Implications: Therapists should examine the pandemic's impacts on all sexual function symptom categories and modify their treatment plans appropriately. The findings indicate that lowering COVID-19-related stress may be especially useful in minimizing the negative impact of COVID-19 on symptoms. We noticed that vaginismus-treated women did not relapse during the pandemic.

Limitations: The study population was comprised of women attending a particular women health clinic. This can place a certain bias on the demography of the patient population.

Conclusion: The present research indicated that the frequency of sexual activity among women treated for vaginismus did not alter, and notwithstanding a rise in stress and depression ratings, the majority of sexual function scores, including pain, improved during the pandemic. Nonetheless, dissatisfaction and anorgasmia subscales deteriorated, while ASEX satisfaction did not improve to the same extent, suggesting deleterious consequences on sexual function.

College Student Experiences Regarding the Impact of the COVID-19 Pandemic on Their Sexual Lives

The COVID 19 pandemic has impacted sexual health in a variety of ways. The purpose of this research was to examine the ways in which college students (attending a university providing primarily online curriculum during fall 2020 and spring 2021 semesters) perceive the pandemic influencing their sexual health and lives. Participants were undergraduate students (N = 66) at a mid-sized Western university recruited during the beginning of the spring 2021 semester. Participants completed an anonymous online survey. A Thematic Analysis of responses to two open-ended questions asking about the impact of the COVID-19 pandemic on their sexual health and lives was conducted. Several important themes were identified during this analysis: (1) Sexual activity and quality, (2) Relationship dynamics, (3) Self-focus, (4) New partners, (5) Sexual healthcare, (6) No change. Findings have implications for promoting sexual health for students during times when the majority of instruction is conducted online.

Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic

The COVID-19 pandemic has affected nearly every area of daily life, including romantic relationships. With the pandemic still ongoing, this study reviewed the existing scholarly literature to document the status of empirical research on how COVID-19 has affected couples during its first year. Studies were identified through searching five databases as well as sources of gray literature. Overall, 42 studies on committed romantic relationships during the first year of the pandemic were identified. The mapping process revealed four main themes: (1) relationship quality; (2) sexuality; (3) couple daily adjustment; and (4) intimate partner violence. The findings suggest that the way romantic relationships were affected by the pandemic depends on a variety of demographic, individual, and couple-level factors. Implications include a call for both the development of evidence-based interventions that consider the current findings and further research to continue exploring the clinical implications of future findings to promote healthy intimate relationships during the ongoing global pandemic.

Female sexual function before and during the severe acute respiratory syndrome coronavirus-2 pandemic: a systematic review and Meta-analysis of longitudinal studies

PurposeTo compare the female sexual function before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Female Sexual Function Index (FSFI).MethodsRelevant studies were retrieved by online databases and manual searching reporting FSFI scores before and during the SARS-CoV-2 pandemic. The methodological quality of reviewed articles was evaluated using the Newcastle-Ottawa Scale, and heterogeneity with the I² statistic. The standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were calculated by random-effect meta-analyses.ResultsFour studies met the inclusion criteria reporting 1002 sexually active non-pregnant women comparing results of the 19-item FSFI. The meta-analysis of the overall FSFI score showed an SMD (95% CI) of -1.16 (-1.97 to -0.35), comparing the pandemic with the pre-pandemic scores. In addition, SMD scores for the FSFI domains were also significantly lower during the pandemic for arousal -0.80 (-1.13 to -0.48), orgasm -0.66 (-1.07 to -0.25), satisfaction -0.59 (-0.97 to -0.22), and pain -0.35 (-0.54 to -0.16), whereas there were not significant differences for desire and lubrication domains. There was a low risk of bias and the sensitivity analysis suggests that results are robust.ConclusionThe available studies showed a lower overall FSFI score during the pandemic, suggesting an increased risk of female sexual dysfunction compared to prepandemic results. Also, there were increased risks of sexual arousal, orgasm, satisfaction, and pain disorders. However, there were no alterations in the desire and the lubrication domains. Limitations are related to the heterogeneity populations, and pandemic confounding and aggravating factors.

Women's sexual function before and during COVID-19 pandemic: A systematic review and meta-analysis

Background

To systematically review and summarize the available literature regarding the women's sexual function during COVID‐19 pandemic and compare it to pre‐pandemic period.

Methods

We searched PubMed and Embase from the inception of the databases until 15th April 2021. Data regarding the sexual function, measured by female sexual function index (FSFI), of adult sexually active women were extracted from the eligible studies and compared between the before and during the COVID‐19 pandemic. The secondary outcome was the frequency of intercourse during pandemic time. The random‐effect model was used to pool the mean differences and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the I² value.

Results

Our search resulted in a sample of six eligible studies, which involved 1114 female participants. The total FSFI score among study participants during pandemic was 22.93 (95% CI: 19.26–26.59), which indicated a significant decrease in sexual function of women during pandemic as compared to pre‐pandemic time (mean difference = −3.80, 95% CI: −6.48 to −1.12, p = 0.005, I² = 96%). We also conducted a meta‐analysis of individual FSFI domains. During pandemic, women had problems with arousal (p < 0.0001), orgasm (p = 0.0008), satisfaction (p = 0.0009), and pain (p = 0.009). No significant difference in frequency of intercourse was observed between pre‐ and during pandemic (p = 0.80). Furthermore, no significant publication bias was present among included studies.

Conclusion

Overall, there was a significant decrease in sexual function of sexually active adult women during COVID‐19 pandemic. The most affected areas of sexual function were arousal, orgasm, pain, and satisfaction. Physicians must be aware of COVID‐19 impact on sexual life of women and provide proper counseling.

Is There a Direct Link between Sexual Satisfaction and Restrictions during the Second Wave of the COVID-19 Pandemic?

Background: Research suggested that the COVID-19 pandemic-related restrictions decreased sexual function and satisfaction. The present study examines the direct relationship between sexual satisfaction and restrictions during the second wave of the COVID-19 pandemic. Methods: A cross-sectional study was performed in Poland between 3 September 2020 and 18 January 2021. A convenience sample of 1364 adults, aged 18–67 (M = 25.13, SD = 6.45), among whom 62.39% were women, and 23.17% were single, completed anonymous web-based survey. The Sexual Satisfaction Questionnaire (SSQ) and Stringency Index (IS) were used to assess sexual satisfaction and the level of restrictions during the pandemic, respectively. Results: No direct association was found between sexual satisfaction and the level of restrictions during the lockdown. Sexual satisfaction was significantly worse among single participants than those living in a couple. No gender differences were found in sexual satisfaction. Conclusions: Future studies should examine an indirect association between sexual satisfaction and restrictions during the pandemic via stress and anxiety. Single relationship status should be considered a risk factor for sexual satisfaction, so single individuals should be a target group for prevention programs during the pandemic.

Sexual satisfaction and sexual behaviors during the COVID-19 pandemic: results from the International Sexual Health And REproductive (I-SHARE) health survey in Luxembourg

AIM

To identify the impact of COVID-19 measures on sexual behaviors and sexual satisfaction in Luxembourg residents.

METHODS

We conducted a cross-sectional online survey of adults (> 18 years of age) residing in Luxembourg, while COVID-19 restrictions were in place. The survey was available from January 15 to February 12, 2021 in four languages (French, German, English and Portuguese). Survey questions focused on masturbation, cuddling, condom use, sex frequency, sexting, cybersex, watching porn, and sexual satisfaction.

RESULTS

557 volunteers completed the survey (35.5% men, 64.3% women). Sexual satisfaction and sexual problems variables were assessed on 4-point Likert scales (0 = not at all/never to 3 = very/often). Sexual problems increased during the COVID-19 measures while sexual satisfaction decreased compared to before the introduction of COVID-19 restrictions (assessed retrospectively). Factors associated with increased odds of sexual satisfaction included having a steady relationship before COVID-19 restrictions, engaging in sexting, reporting good mental health and not altering alcohol intake.

CONCLUSIONS

The context of the COVID-19 pandemic and the measures implemented in Luxembourg affected sexual behaviors and sexual satisfaction. Sexual and reproductive health care centers and health professionals in general should take these results into consideration when providing care. Recommendations on the importance of sexual health for general wellbeing and behaviors associated with sexual satisfaction should be offered and possibilities to experience sexuality while reducing contamination risks be discussed.

Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population

BACKGROUND

Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant.

AIM

We investigated the longitudinal changes in sexual function during social restrictions for COVID-19 pandemic in Italy.

METHODS

A web-based survey was administered to Italian citizens of legal age via social networks. The Beck Depression Inventory Primary Care, the General Health Survey, Female Sexual Function Index, International Index of Erectile Function, UCLA Loneliness Scale-version 3 questionnaires were used to test mental, physical and sexual well-being. The questionnaires were administered at the beginning of the lockdown (T0), 15 days from the first assessment (T1) and 1 month after the end of the restrictions in 2020 (T2).

OUTCOMES

Descriptive statistics and multiple regression analysis were applied to investigate changes in sexual function over and at the end of social restrictions.

RESULTS

Data were available for 2543 people (47.2% of men; 43.4% women; 9.4% undefined). Mean age was 48.3 ± 15.1 years for males and 43.9 ± 13.4 for females. Overall, 2.6% reported depressive symptoms according to Beck Depression Inventory Primary Care, 7.4% reported a high level of UCLA loneliness and 19.4% low levels of general mental health. Mild to severe erectile dysfunction was reported by 59.1% of men at T0, while 68.4% of women reported sexual dysfunction. Sexual function levels remain generally unchanged at further follow-up over the social restriction time period (T1), although those who were sexually active at baseline showed a decrease in sexual function scores. At T2, there was an overall improvement in sexual function scores with a rate of severe erectile dysfunction decreasing from 37.1% to 24.1% from T0 to T2 among males and a significant decrease of female sexual dysfunction from 68.4% to 51.2%.

CLINICAL IMPLICATIONS

Young individuals and those with good mental and physical health were more likely to improve sexual function at the end of social restrictions.

STRENGTHS & LIMITATIONS

Valid and reliable questionnaires and longitudinal approach design represent strengths; a large but convenient sample and lack of pre-pandemic baseline data represent limits.

CONCLUSION

Social restrictions due to COVID-19 pandemic led to an increase in sexual dysfunctions in both genders. However, these conditions appeared temporary since an overall improvement was observed at the end of lockdown and especially in younger individuals with higher psycho-physical well-being. Vedovo F, Capogrosso P, Di Blas L, et al. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022;19:923-932.

Effects of the COVID-19 Pandemic on LGBTQ+'s Sexual Behaviors in Turkey: "Everything about Sex Had Become A Black Box"

The COVID-19 pandemic has forced changes in the behavior patterns of many population groups due to restrictive measures all over the world. In this study, qualitative research method based on a phenomenological approach was used to determine the changes in the sexual behavior of a group of LGBTQ+ people living in Turkey. The COVID-19 pandemic has culminated in changes in the sexual life of LGBTQ+s. It has been determined that feelings such as the need of emotional support, loneliness, devaluation and helplessness were experienced, and quarantine and curfew restrictions were effective on sexuality and sexual behaviors. In addition, it has been determined that LGBTQ+s have changed in the standards of determining partners during the pandemic process. The use of sex toys has increased, the sensitivity toward self-care and hygiene rules has increased, the tendency to have sexual fantasies has changed, the sexual behavior of people in their social environment has changed, and the disruptions in health services have posed negative effects. It is recommended to carry out studies focusing on the sexual behavior of LGBTQ+s and to develop counseling services regarding the sexual behaviors of LGBTQ+s and the situations that occur in their sexual lives.

The sexual experience of Italian adults during the COVID-19 lockdown

From March 11 to April 26, 2020, the Italian government imposed a nationwide COVID-19 lockdown, a quarantine that resulted in significant restrictions on the movement and social contacts of the population, with a view to limiting the pandemic outbreak. The quarantine forced people to experience distorted social distance in two contrasting ways. For some people, it resulted in social distancing and isolation, for example by separating noncohabiting couples into different dwellings. For others, however, quarantine increased and imposed social closeness, forcing couples and families into constant, daily, and prolonged cohabitation. The aim of this study was to investigate the sexual health and behaviors of Italian adults during the lockdown period using a multimethod research. An open- and a closed-ended e-questionnaire were administered immediately after the end of the lockdown. A total of 465 Italian adults completed the digital questionnaire (female = 78.7%). Participants recognized their lived sexual experience with generally positive characteristics (related to openness, unproblematic relationship with the body, and awareness and self-reflection about one's sexuality), while negative thoughts such as worry and pain were quite scarce. Participants with a disability (5.6%) showed a marked inversion compared to the mean of respondents, recognizing themselves mainly in negative thoughts related to low self-esteem, inadequacy, and feelings of suffering, yet reporting a higher than mean level of arousal. In the qualitative analysis, the Frequency-Inverse Document Frequency (TF-IDF) index was computed to measure the salience of the word used by participants to respond to the open-ended five questions. It revealed a generally depressed emotional experience associated with the experience of lockdown, both in terms of desire, which seemed to be shifted more to the level of imagination and fantasies, and the actual possibility of experiencing sexual activity as usual. Nevertheless, the participants emphasized an opening to new possibilities in terms of expressing sexuality, accompanied by a rediscovery of the value of tenderness and affectivity as well as a clearer awareness of their sexual life, needs, and desires.

"Sex Seems Less Important When You Are Worried About a Deadly Virus." A Content Analysis of Reported Reasons for Changes in Sexual Behavior and Satisfaction During the COVID-19 Pandemic

The purpose of this study is to assess how the COVID-19 pandemic impacted various sexual behaviors and levels of sexual and relationship satisfaction by performing a content analysis of participants' (N = 1051 American adults) responses to open-ended survey questions. Results revealed a variety of impacts that increased, decreased, or otherwise qualitatively changed sexual behavior and satisfaction. Major themes included emotions and mental health, changes in routines, social distancing and fears related to COVID-19, and changes in romantic relationships. These findings are contextualized within the emerging quantitative research on COVID-19 and sexuality, and areas for future research based on these findings are discussed.

Interaction between the impact of the Coronavirus disease 2019 pandemic and demographic characteristics on sexual/erectile dysfunction in Latin America: cross-sectional study

Aim:

Our objective was to investigate whether there is an interaction between the COVID-19 pandemic, demographic characteristics and erectile/sexual (E/S) function in individuals from Latin America.

Materials and Methods:

Cross-sectional study which included Latin American individuals over 18 years old, recruited through social media and interviewed between July and August 2020 by online surveys (Google Forms) in Portuguese and Spanish languages. The E/S function was evaluated through the following questionnaires: Simplified International Index of Erectile Function (IIEF-5) and Female Sexual Function Index (FSFI); while post-traumatic stress disorder (PTSD) triggered by the COVID-19 pandemic was assessed through the Impact of Event Scale Revised (IES-R). The data was analyzed by T Student, bivariate and multivariate logistic regression, with significance determined by the Wald test (p<0.05), using the R software v4.0.

Results:

Out of the 2016 individuals that responded to the survey, 1986 were included and 743 of them presented E/S dysfunction. PTSD occurrence was greater among people with E/S dysfunction when compared to those without E/S dysfunction, in the total score (males: IES-R=26.54[±19.17] and females: IES-R=35.92[±19.25]) and also in the three domains. It was found that those who do not live with a partner were 74% more likely to have E/S dysfunction, but living with a partner during the pandemic had a greater impact on E/S function.

Conclusion:

A negative interaction between the impact of the COVID-19 pandemic and erectile/sexual function of the Latin American population was observed, with greater implications among the individuals who live with their partners.

Severe COVID-19 has Low Testosterone, Estrogen Levels, and Impaired Sexuality

For assessing whether women with and without COVID-19 differed with regard to female genital self-image, sexual function and hormonal profile. Female genital self-image being assessed with the female genital self-image scale (FGSIS) and Female Sexual Function Index (FSFI) and laboratory investigations. The study had revealed significant differences in all domains of the FSFI except pain between the cases and the controls. The study had demonstrated significant differences in all domains of the FGSIS between the cases and the controls. The study had shown significant decline in the post-COVID-19 serum levels of total testosterone (TT), free testosterone (FT) and estradiol (E) between the two groups (P < 0.05). Positive correlations between serum TT, FT, E and FGSIS domains and total score of FGSIS in the cases were observed.

A factor not to be ignored in post-COVID-19 erectile dysfunction; psychological effect, a prospective study

It was aimed to show the effect of anxiety and depression on erectile dysfunction seen after coronavirus disease‐2019 (COVID‐19). Between March and July 2021, the participants completed the International Index of Erectile Function, Beck Depression Inventory and Generalised Anxiety Disorder 7 forms at the beginning and after the 1st month of the disease. We investigated the psychological impact of COVID‐19 on the development of erectile dysfunction. The mean age of 156 male patients in the study was 54.74 ± 8.01 years. It was determined that the mean International Index of Erectile Function scores of the patients before COVID‐19 were 73.42 ± 3.43 and decreased to 68.28 ± 12.86 after COVID‐19 (p < .01). The patients’ erectile function scores were significantly lower after COVID‐19 (29.45 ± 1.23, 27.69 ± 4.33, p < .01, respectively). Their Beck Depression Inventory scores were statistically significantly higher after COVID‐19 (1.69 ± 2.56, 2.22 ± 2.79, p < .01, respectively). Their Generalised Anxiety Disorder 7 scores were also statistically significantly higher after COVID‐19 (4.69 ± 1.63 6.56 ± 2.40, p < .01, respectively). A negative correlation was found between the increase in the Beck Depression Inventory score during the pandemic process and the decrease in the International Index of Erectile Function score (r = −0.356, p = <.001). A negative correlation was also found between the increase in the Generalised Anxiety Disorder 7 score and the decrease in the International Index of Erectile Function score (r = −0.200, p = .012). One of the main factors post‐COVID‐19 erectile dysfunction is anxiety and depression due to the disease.

Investigation of the Relationships among Self-Efficacy, Stress, and Dyspareunia during the COVID-19 Pandemic

This study examined whether low self-efficacy and heightened perceived stress were associated with dyspareunia at two timepoints during COVID-19. Sixty-two participants (31 with and 31 without dyspareunia) completed a longitudinal online survey. Self-efficacy declined during the pandemic, and individuals with dyspareunia reported lower self-efficacy compared to those without dyspareunia. Although stress was greater for those with dyspareunia, both groups reported stress reductions over time. Lower stress was associated with increases in self-efficacy. This study is the first to examine longitudinal trends of dyspareunia during the COVID-19 pandemic and illuminates psychological factors that may influence the experience of dyspareunia.

The Relationship Between Fear of COVID-19, Quality of Sexual Life, and Sexual Satisfaction of Women in Turkey

Objectives: The study investigated the relationship between fear of COVID-19, quality of sexual life, and sexual satisfaction of women in Turkey. Methods: This cross-sectional study was conducted between November 26, 2020, and January 26, 2021. The sample consisted of 811 women. Data were collected using the Fear of COVID-19 Scale, the Sexual Quality of Life-Female Scale, and the Pre-Pandemic Sexual Satisfaction and During Pandemic Sexual Satisfaction scores. Results: There was a negative correlation between the Fear of COVID-19 Scale and the Sexual Quality of Life-Female Scale and the During Pandemic Sexual Satisfaction scores. The Fear of COVID-19 Scale scores accounted for 86% of the total variance in the Sexual Quality of Life scores and 5% of the total variance in the During Pandemic Sexual Satisfaction Scores. Conclusion: Sexual problems due to the fear of COVID-19 adversely affect women's sexual quality of life. Healthcare professionals should address the fear of COVID-19 and related sexual issues during the pandemic.

Impact of "COVID-19" Lockdown on Male Sexual Behavior in Egyptian Sample

Objective

To assess the changes in the sexual behavior of Egyptian married men during the COVID-19 lockdown period.

Methods

In a cross-sectional study, the sexual behavior of 164 Egyptian married men was examined through an online questionnaire, designed by the authors, and uploaded to strictly male social media groups using Google Forms. The questionnaire included demographic and clinical variables about age, stress level about COVID-19, fear of infection during sexual relations and also compared sexual behavior before the COVID-19 lockdown.

Results

39.17% of the sample reported decrease in sexual desire, 28.05% reported decrease in sexual frequency, 17.68% reported decrease in sexual satisfaction and 22% reported fear of infection with COVID-19 during sexual relations. Severe stress about COVID-19, increased rate of marital conflicts and fear of infection with COVID-19 during sexual relations were significantly associated with decreased sexual desire, frequency and satisfaction.

Conclusions

This study demonstrated severe stress about COVID-19, increased rate of marital conflict and fear of infection with COVID-19 during sexual activity, all of which were significantly associated with decreased levels of sexual desire, frequency and satisfaction respectively among married Egyptian men during the COVID-19 lockdown period. Promoting education to manage stress, decreasing marital conflicts and the correction of the mistaken belief that COVID-19 is a sexually transmitted disease is highly important to promote healthy sexual relations during the COVID-19 pandemic and lockdown period.

Digital Therapeutic Device for Urinary Incontinence: A Randomized Controlled Trial

To evaluate whether pelvic floor muscle training using a motion-based digital intravaginal device is more effective than home pelvic floor muscle training for treatment of stress or stress-predominant mixed urinary incontinence (UI).

The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021

The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.

The Impact of the SARS-CoV-2 Pandemic on Reproduction, Sexual Function and Behaviors: A Review of the Main Trends and Findings

Objective: This review sought to describe the main trends and findings on the SARS-CoV-2 and the pandemic's effect on reproduction (i.e., effects on fertility, reproductive tissue, pregnancy, vertical and sexual transmission) and sexual function and behaviors. Methods: A review was conducted on studies assessing these variables through the Scopus and PubMed databases between the years 2019-2021. Results: Results showed SARS-CoV-2 pandemic and social distancing measures have affected-and in some cases not-different aspects of people's reproductive function, sexual function and behaviors. Conclusions: Suggestions are offered for researchers and professionals focused on future research and clinical practice.

The Impact of COVID-19 Pandemic on Female Sexual Function

Introduction: The outbreak of the COVID-19 pandemic affected many aspects of life involving sexual functioning. Methods: This prospective, noninterventional, observational research was performed from July 2020 to August 2020, involving a total of 644 patients. Female sexual function index (FSFI) scores of those women were compared in relation to results of our research from April 2020. Questionnaires were collected concerning socio-demographic characteristics of patients as well as the impact of the COVID-19 pandemic on their lives. Results: Every domain significantly decreased in the first month of the lockdown. Before the pandemic, the total FSFI was reported at 30.1 ± 4.4, while in the first month of the pandemic it was at 25.8 ± 9.7 (p < 0.001). The lowest FSFI score was reported by women who lived in average conditions. There was a statistically significant increase in the overall FSFI score in the fifth month of the pandemic (27.5 ± 6.8) when compared to the FSFI score in the first month of the pandemic (25.8 ± 9.7). The scores in arousal, lubrication, orgasm and pain were reported as higher (respectively p < 0.001, p < 0.001, p < 0.001, p < 0.05), while desire was reported lower (p < 0.001). The satisfaction score remained almost the same (p < 0.05). Conclusions: Our study indicates a significant decrease in FSFI scores across all domains. There are still many questions whether the statue from the vaccinated person or convalescents affects the sense of security and, thus, increases sexual satisfaction.

Quality of Life of the Elderly during the COVID-19 Pandemic in Asian Countries: A Cross-Sectional Study across Six Countries

Background: Few studies have explored the determinants of health-related quality of life (HRQoL) in the elderly during the COVID-19 pandemic. Identifying these factors may help implement appropriate policies to enhance HRQoL in the elderly. Therefore, we aimed to identify the predictors of physical and mental component summary (PCS and MCS) scores of HRQoL in selected six low- and middle-income Asian countries. Methods: We conducted an online survey of older people aged ≥55 years in six countries: Bangladesh, Iran, Iraq, Malaysia, Palestine, and Sri Lanka. The Stark QoL questionnaire was used to measure the PCS and MCS scores. Univariate and multiple variable analyses after adjusting for confounders were performed to identify the possible predictors of PCS and MCS. Results: A total of 1644 older people (69.1 ± 7.8 years, range 55−97 years, Female: 50.9%) responded to the survey. We documented age, country of residence, marital status, number of male children, current employment status, and health insurance, ability to pay household bills, frequency of family members visits and receiving support during COVID-19 pandemic predicted both PCS and MCS. However, gender, residence, and number of female children were associated with PCS only (all p < 0.05). Conclusion: Socio-demographic factors such as age, country of residence, marital status, number of male children, current employment status, health insurance, ability to pay household bills, frequency of family members visiting family members, and receiving support during the COVID-19 pandemic affecting both physical and mental quality of life. These results can guide formulating health care planning policies to enhance QoL during COVID-19 and future pandemics in the elderly.