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Zhang X, Zhu Z, Tang G, Xu H. The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis. Int J Impot Res 2024; 36:463-473. [PMID: 37759098 DOI: 10.1038/s41443-023-00767-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
In recent years, numerous epidemiological studies have investigated the prevalence of female sexual dysfunction (FSD) in females with inflammatory bowel disease (IBD). However, a comprehensive systematic review with meta-analysis pooling their findings is lacking. This study aimed to determine the pooled prevalence estimates of FSD and its risk factors among females with IBD based on extensive research in electronic databases (PubMed, Embase, and Web of Science) from inception until April 1, 2023. The overall prevalence of FSD among females with IBD, along with its 95% confidence interval (CI), and subgroup-specific prevalence rates, were summarized. Sources of heterogeneity were identified through subgroup analyses and meta-regression. A total of 13 studies were included in this systematic review and meta-analysis. The pooled global prevalence of FSD among females with IBD was 61.4% (95% CI: 52.8-70.1%). Sensitivity analysis, which involved excluding individual studies, indicated no significant variation in the pooled prevalence, confirming the robustness of our results. Additionally, a significant risk factor for FSD among females with IBD was the quality of life (OR = 0.39, 95% CI: 0.19-0.79). In conclusion, our systematic review and meta-analysis revealed a high prevalence of FSD among females with IBD, which warrants attention from health organizations and clinical practitioners. Importantly, the quality of life was identified as a potential risk factor for FSD in this population. Nonetheless, future prospective cohort studies with a large sample size are warranted to confirm these findings.
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Affiliation(s)
- Xiaolong Zhang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zhirong Zhu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Guiliang Tang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
| | - Huali Xu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
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Calvo Moya M, Mesonero Gismero F, Suarez Ferrer C, Hernández-Camba A, Vásquez Carlón D, García Benasach F, Aguas Peris M, Delgado Oliva FJ, González-Lama Y, Millán Scheiding M, Alonso Sebastián I, Camacho Martel L, Gallardo Arriero V, Echarri Piudo A, Bella Castillo P, Cano Sanz N, Vera Mendoza MI, Serrano Labajos R, Valdivia Martínez A, Pérez Restoy L, Zabana Abdo Y, Mañosa Ciria M, Rodríguez-Moranta F, Barreiro-de Acosta M, Gutiérrez Casbas A. Position statement of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis on sexuality and inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:774-792. [PMID: 38218430 DOI: 10.1016/j.gastrohep.2023.12.013] [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: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
It is widely acknowledged that inflammatory bowel disease (IBD) is associated with a high prevalence of sexual dysfunction (SD). However, there is a notable paucity of specific literature in this field. This lack of information impacts various aspects, including the understanding and comprehensive care of SD in the context of IBD. Furthermore, patients themselves express a lack of necessary attention in this area within the treatment of their disease, thus creating an unmet need in terms of their well-being. The aim of this position statement by the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) is to provide a review on the most relevant aspects and potential areas of improvement in the detection, assessment, and management of SD in patients with IBD and to integrate the approach to sexual health into our clinical practice. Recommendations are established based on available scientific evidence and expert opinion. The development of these recommendations by GETECCU has been carried out through a collaborative multidisciplinary approach involving gastroenterologists, gynecologists, urologists, surgeons, nurses, psychologists, sexologists, and, of course, patients with IBD.
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Affiliation(s)
- Marta Calvo Moya
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
| | - Francisco Mesonero Gismero
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España
| | - Cristina Suarez Ferrer
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación Hospital Universitario La Paz, Madrid, España
| | - Alejandro Hernández-Camba
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| | - Danízar Vásquez Carlón
- Centro de Asistencia a la Reproducción Humana de Canarias (FIVAP), San Cristóbal de la Laguna, Tenerife, España
| | - Fátima García Benasach
- Servicio de Ginecología y Obstetricia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mariam Aguas Peris
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitari i Politécnic La Fe, Valencia, España
| | | | - Yago González-Lama
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mónica Millán Scheiding
- Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari i Politécnic La Fe, Valencia, España
| | - Isabel Alonso Sebastián
- Unidad de Coloproctología, Servicio de Cirugía general y Aparato Digestivo. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Laura Camacho Martel
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Virgen de la Victoria, Málaga, España
| | - Vanesa Gallardo Arriero
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ana Echarri Piudo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - Pablo Bella Castillo
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Noelia Cano Sanz
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario de León, León, España
| | - María Isabel Vera Mendoza
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ruth Serrano Labajos
- Confederación Asociaciones de enfermos de Crohn y Colitis Ulcerosa de España, Madrid, España
| | | | - Lourdes Pérez Restoy
- Sexología, Clínica Bonadea, Granada, España; Neurohábilis Centro de Salud Integral, Granada, Loja y Puerto de Santa María, España
| | - Yamile Zabana Abdo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitari Mútua de Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España
| | - Miriam Mañosa Ciria
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Hospital Universitari Germans Trias i Pujol Badalona, Barcelona, España
| | - Francisco Rodríguez-Moranta
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Manuel Barreiro-de Acosta
- Unidad de Enfermedad Inflamatoria Intestinal, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, España
| | - Ana Gutiérrez Casbas
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital General Universitario Dr. Balmis de Alicante, ISABIAL, Alicante, España
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Mirzaei Damabi N, Begum M, Avery JC, Padhani ZA, Lassi ZS. Unveiling silenced narratives: a scoping review on sexual function challenges in migrant and refugee women. Sex Med Rev 2024; 12:288-298. [PMID: 38462747 DOI: 10.1093/sxmrev/qeae005] [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: 09/19/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being. OBJECTIVES This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field. METHODS We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively. RESULTS Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations. CONCLUSION This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.
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Affiliation(s)
- Negin Mirzaei Damabi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Mumtaz Begum
- Life Course and Intergenerational Health Research Group, Faculty of Health and Medical Science, University of Adelaide, Adelaide 5005, Australia
| | - Jodie C Avery
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zahra Ali Padhani
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
| | - Zohra S Lassi
- Robinson Research Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5006, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5000, Australia
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Kamrul-Hasan A, Hannan MA, Alam MS, Aalpona FTZ, Nagendra L, Selim S, Dutta D. Role of flibanserin in managing hypoactive sexual desire disorder in women: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e38592. [PMID: 38905407 PMCID: PMC11192006 DOI: 10.1097/md.0000000000038592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Flibanserin, approved for the treatment of hypoactive sexual desire disorder (HSDD) in females, has demonstrated diverse therapeutic and adverse effect (AE) prospects in the extant randomized controlled trials (RCTs). This meta-analysis aimed to characterize the outcomes of flibanserin use in these patients comprehensively. METHODS RCTs involving women with HSDD receiving flibanserin in the intervention arm and placebo in the control arm were sought after throughout the electronic databases. The primary outcomes were the changes from baseline in satisfying sexual events (SSE) per month and sexual desire score per month measured using an electronic diary (eDiary). RESULTS From 478 initially screened articles, data from 8 RCTs involving 7906 women with HSDD were analyzed. In premenopausal women, flibanserin 100 mg was superior to placebo in improving the number of SSE per month (mean difference, MD 0.69, 95% CI [0.39, 0.99]), eDiary sexual desire score (MD 1.71, 95% CI [0.43, 2.98]), Female Sexual Function Index (FSFI) desire domain (FSFI-d) score (MD 0.30, 95% CI [0.29, 0.31]), FSFI total score (MD 2.51, 95% CI [1.47, 3.55]), Female Sexual Distress Scale-Revised (FSDS-R) Item 13 score (MD -0.30, 95% CI [-0.31, -0.29]), and FSDS-R total score (MD -3.30, 95% CI [-3.37, -3.23]). Compared to placebo, a higher number of premenopausal women using flibanserin 100 mg achieved improvements in the Patient's Global Impression of Improvement score (OR 1.93, 95% CI [1.58, 2.36], P < .00001) and responded positively at Patient Benefit Evaluation (PBE) (odds ratio, OR 1.76, 95% CI [1.34, 2.31], P < .0001). Postmenopausal women receiving flibanserin 100 mg also benefited in terms of the number of SSE per month, FSFI-d and total scores, FSDS-R Item 13 and total scores, and PBE response. Although flibanserin use was associated with higher risks of dizziness, fatigue, nausea, somnolence, and insomnia, these adverse events were mild in nature; the serious AEs and severe AEs were comparable between the flibanserin and placebo groups. CONCLUSION While flibanserin has demonstrated efficacy in the treatment of HSDD in both pre- and postmenopausal women, its therapeutic advantages may be overshadowed by the higher likelihood of AEs.
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Affiliation(s)
- A.B.M. Kamrul-Hasan
- Department of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh
| | - Mohammad Abdul Hannan
- Department of Endocrinology, North East Medical College and Hospital, Sylhet, Bangladesh
| | - Muhammad Shah Alam
- Department of Medicine, Army Medical College Cumilla, Cumilla, Bangladesh
| | | | - Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Deep Dutta
- Department of Endocrinology, CEDAR Superspeciality Healthcare, Dwarka, New Delhi, India
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Gravholt CH, Andersen NH, Christin-Maitre S, Davis SM, Duijnhouwer A, Gawlik A, Maciel-Guerra AT, Gutmark-Little I, Fleischer K, Hong D, Klein KO, Prakash SK, Shankar RK, Sandberg DE, Sas TCJ, Skakkebæk A, Stochholm K, van der Velden JA, Backeljauw PF. Clinical practice guidelines for the care of girls and women with Turner syndrome. Eur J Endocrinol 2024; 190:G53-G151. [PMID: 38748847 DOI: 10.1093/ejendo/lvae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/19/2024] [Indexed: 06/16/2024]
Abstract
Turner syndrome (TS) affects 50 per 100 000 females. TS affects multiple organs through all stages of life, necessitating multidisciplinary care. This guideline extends previous ones and includes important new advances, within diagnostics and genetics, estrogen treatment, fertility, co-morbidities, and neurocognition and neuropsychology. Exploratory meetings were held in 2021 in Europe and United States culminating with a consensus meeting in Aarhus, Denmark in June 2023. Prior to this, eight groups addressed important areas in TS care: (1) diagnosis and genetics, (2) growth, (3) puberty and estrogen treatment, (4) cardiovascular health, (5) transition, (6) fertility assessment, monitoring, and counselling, (7) health surveillance for comorbidities throughout the lifespan, and (8) neurocognition and its implications for mental health and well-being. Each group produced proposals for the present guidelines, which were meticulously discussed by the entire group. Four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with systematic review of the literature. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with members from the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology, the European Reference Network on Rare Endocrine Conditions, the Society for Endocrinology, and the European Society of Cardiology, Japanese Society for Pediatric Endocrinology, Australia and New Zealand Society for Pediatric Endocrinology and Diabetes, Latin American Society for Pediatric Endocrinology, Arab Society for Pediatric Endocrinology and Diabetes, and the Asia Pacific Pediatric Endocrine Society. Advocacy groups appointed representatives for pre-meeting discussions and the consensus meeting.
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Affiliation(s)
- Claus H Gravholt
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
| | - Niels H Andersen
- Department of Cardiology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Sophie Christin-Maitre
- Endocrine and Reproductive Medicine Unit, Center of Rare Endocrine Diseases of Growth and Development (CMERCD), FIRENDO, Endo ERN Hôpital Saint-Antoine, Sorbonne University, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
| | - Shanlee M Davis
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, United States
- eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, CO 80045, United States
| | - Anthonie Duijnhouwer
- Department of Cardiology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Aneta Gawlik
- Departments of Pediatrics and Pediatric Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Andrea T Maciel-Guerra
- Area of Medical Genetics, Department of Translational Medicine, School of Medical Sciences, State University of Campinas, 13083-888 São Paulo, Brazil
| | - Iris Gutmark-Little
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
| | - Kathrin Fleischer
- Department of Reproductive Medicine, Nij Geertgen Center for Fertility, Ripseweg 9, 5424 SM Elsendorp, The Netherlands
| | - David Hong
- Division of Interdisciplinary Brain Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94304, United States
| | - Karen O Klein
- Rady Children's Hospital, University of California, San Diego, CA 92123, United States
| | - Siddharth K Prakash
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
| | - Roopa Kanakatti Shankar
- Division of Endocrinology, Children's National Hospital, The George Washington University School of Medicine, Washington, DC 20010, United States
| | - David E Sandberg
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
- Division of Pediatric Psychology, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-2800, United States
| | - Theo C J Sas
- Department the Pediatric Endocrinology, Sophia Children's Hospital, Rotterdam 3015 CN, The Netherlands
- Department of Pediatrics, Centre for Pediatric and Adult Diabetes Care and Research, Rotterdam 3015 CN, The Netherlands
| | - Anne Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Kirstine Stochholm
- Department of Endocrinology, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Center for Rare Diseases, Department of Pediatrics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Janielle A van der Velden
- Department of Pediatric Endocrinology, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen 6500 HB, The Netherlands
| | - Philippe F Backeljauw
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, United States
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Kelley EL, Kingsberg SA. Sexuality and Infertility. Obstet Gynecol Clin North Am 2024; 51:311-322. [PMID: 38777486 DOI: 10.1016/j.ogc.2024.02.005] [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] [Indexed: 05/25/2024]
Abstract
Infertility diagnoses and treatment can lead to psychological distress and relationship strain. Infertility is commonly associated with disruptions in sexual function and satisfaction among women, in part due to overlapping etiologic factors (eg, comorbid medical conditions). Women and couples with infertility should be screened for sexual problems and provided education on the relationship between infertility and sexuality. Sexual dysfunction in the context of infertility is often best addressed using an interdisciplinary approach. This article provides a summary on the relationship between sexuality and infertility and recommendations for the assessment and management of sexual dysfunction in women with infertility.
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Affiliation(s)
- Erika L Kelley
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Department of Reproductive Biology, Case Western Reserve University, School of Medicine; Department of Urology, Case Western Reserve University, School of Medicine; MacDonald Women's Hospital, Mailstop 5034, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Sheryl A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center; Department of Reproductive Biology, Case Western Reserve University, School of Medicine; Department of Urology, Case Western Reserve University, School of Medicine; MacDonald Women's Hospital, Mailstop 5034, 11100 Euclid Avenue, Cleveland, OH 44106, USA; Department of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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Gollapudi M, Thomas A, Yogarajah A, Ospina D, Daher JC, Rahman A, Santistevan L, Patel RV, Abraham J, Oommen SG, Siddiqui HF. Understanding the Interplay Between Premenstrual Dysphoric Disorder (PMDD) and Female Sexual Dysfunction (FSD). Cureus 2024; 16:e62788. [PMID: 39036127 PMCID: PMC11260262 DOI: 10.7759/cureus.62788] [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: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe variant of premenstrual syndrome (PMS), categorized as a mood disorder due to marked symptoms of depression and anxiety, compounded with severe physical symptoms. Female sexual dysfunction (FSD) can manifest as low libido, difficulty achieving sexual pleasure, and dyspareunia, causing functional and psychological distress. PMDD and FSD are globally prevalent conditions with postulated biological, psychological, and social associations between them. Nevertheless, sexual dysfunction in PMDD is an important aspect of women's health that has been understudied and has notable methodological limitations. In this narrative review, we summarize the existing literature on sexual function in women with PMDD and PMS, specify the distinctions between PMDD and other general symptoms of PMS, highlight the significance of understanding sexual dysfunction in the female population, and outline some available therapeutic options. Studies show that women frequently experience debilitating sexual distress during the premenstrual phase; however, there is an essential need to formulate standardized tools for definite diagnosis. Selective serotonin re-uptake inhibitors (SSRIs) and combined oral contraceptive pills (COCPs) are approved medications for PMDD, while flibanserin and bremelanotide are effective in treating FSD. However, the potential effects of these treatment modalities on the two comorbid conditions render them inconclusive. Awareness of PMDD and FSD among clinicians and society can allow the implementation of targeted interventions to alleviate the suffering of women and enhance their quality of life.
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Affiliation(s)
- Mahati Gollapudi
- Department of Medicine, Saba University School of Medicine, Caribbean, NLD
| | - Angelica Thomas
- Department of Internal Medicine, Anhui Medical University, Hefei, CHN
| | - Angelina Yogarajah
- Department of Family Medicine, Medical University of the Americas, Devens, USA
| | - David Ospina
- Department of Internal Medicine, Universidad de los Andes, Bogotá, COL
| | - Jean C Daher
- Department of Medicine, Lakeland Regional Health, Lakeland, USA
- Department of Medicine, Universidad de Ciencias Médicas Andrés Vesalio Guzman, San José, CRI
| | - Aaliya Rahman
- Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Lucia Santistevan
- Department of Medicine, University of San Martín de Porres, Lima, PER
| | - Ruby V Patel
- Department of Surgery, Hemchandracharya North Gujarat University, Ahmedabad, IND
| | - Jeby Abraham
- Department of General Medicine, Yenepoya Medical College, Mangalore, IND
| | - Sheethal G Oommen
- Department of Psychiatry, University of Medicine and Pharmacy "Gr. T. Popa", Iași, ROU
| | - Humza F Siddiqui
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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8
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Sood R, Mara KC, Vencill JA, Kling JM, Faubion SS. Association of resilience with female sexual dysfunction. Maturitas 2024; 183:107939. [PMID: 38367366 DOI: 10.1016/j.maturitas.2024.107939] [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: 10/09/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES Female sexual dysfunction (FSD), a common concern affecting women of all ages, is often mediated by important psychological factors. Resilience has been shown to correlate with psychological well-being across different groups of people. The aim of this study was to assess if there is an association between resilience and FSD. STUDY DESIGN This cross-sectional study included 4,366 women (mean [SD] age, 51.7 [11]) seen in women's health clinics at 1 of 3 geographic Mayo Clinic locations. Participants completed the Brief Resilience Scale, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale-Revised (FSDS-R). MAIN OUTCOME MEASURES We used univariate and multivariable logistic regression analyses to assess associations between resilience, sexual function, and sexual distress, adjusting for potential confounding variables. RESULTS FSD criteria (FSFI ≤26.55 and FSDS-R ≥ 11) were met by 55.8 % of women. Low, normal, and high levels of resilience were reported by 17.3 %, 57.1 %, and 25.6 % of participants, respectively. The univariate analysis showed that higher resilience was associated with lower sexual distress, lower odds of FSD, and better sexual function. Multivariable analysis adjusted for potential confounders showed that the association persisted and that higher resilience correlated with better sexual function and lower odds of FSD. CONCLUSIONS In this large cross-sectional study, women with higher resilience scores had better sexual function and lower odds of FSD. Additional studies with diverse women are needed to confirm this association and to determine whether women with FSD could benefit from enhancing resilience as a therapeutic strategy.
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Affiliation(s)
- Richa Sood
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America.
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States of America
| | - Jennifer A Vencill
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States of America
| | - Stephanie S Faubion
- Women's Health, Mayo Clinic, Jacksonville, FL, United States of America; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America
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Ospina-Serrano AV, Maximiano C, Cantos B, Torrente M, Mendez M, Sanchez JC, Calvo V, Collazo-Lorduy A, Blanco M, Nuñez B, Triana I, Parejo C, Martinez P, Duma N, Provencio-Pulla M. Sexual dysfunction in patients with cancer, a challenge in oncology practice: results of the CLARIFY project. Clin Transl Oncol 2024; 26:1147-1156. [PMID: 37917247 DOI: 10.1007/s12094-023-03332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) associated with oncological treatment is a common and understudied disorder. Our aim was to characterize SD in a cohort of Spanish patients. METHODS Analytic observational study in patients included in the CLARIFY H2020 project at the Hospital Universitario Puerta de Hierro. Clinical variables and validated measures of sexual function were collected from October 2020 to May 2022. Frequency and quality of sexual activity were assessed. Descriptive, trend associations, and logistic regression analyses were performed. RESULTS A total of 383 patients were included: breast cancer 68.14% (261), lung cancer 26.37% (101), and lymphoma 5.50% (21). Mean age was 56.5 years (range 33-88). 19.58% (75) were men and 80.42% (308) were women. 69% and 31% of men and women, respectively, reported being sexually active. The absolute frequency of overall sexual dissatisfaction was 76% in women and 24% in men. Women with breast cancer were most likely to have severe sexual dysfunction. Those with early disease had resolved complaints after 5 years. In multinomial logistic regression, significant associations were found in women with metastatic breast cancer and severe disorders of arousal (p 0.000), lubrication (p 0.002), orgasm (p 0.000), as well as dissatisfaction with sexual performance (p 0.000) and global sexual dissatisfaction (p 0.000). Women with lung cancer have severe arousal dysfunction (p 0.016) and global sexual dissatisfaction (p 0.044). CONCLUSIONS Our population has a high prevalence of SD, which supports the need to increase awareness of this disorder among the medical oncology team and the importance of including sexual health assessment in oncological patient follow-up.
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Affiliation(s)
- Aylen Vanessa Ospina-Serrano
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España.
| | - Constanza Maximiano
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Blanca Cantos
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Maria Torrente
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Miriam Mendez
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Juan Cristobal Sanchez
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Virginia Calvo
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Ana Collazo-Lorduy
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Mariola Blanco
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Beatriz Nuñez
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Ivan Triana
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Consuelo Parejo
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Paula Martinez
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
| | - Narjust Duma
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Mariano Provencio-Pulla
- Instituto Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, C/Manuel de Falla, 1, 28222, Madrid, Majadahonda, España
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10
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Reiser E, Böttcher B, Ossig C, Schiller J, Tollinger S, Toth B. Female cancer survivors: sexual function, psychological distress, and remaining fertility. J Assist Reprod Genet 2024; 41:1057-1065. [PMID: 38381389 PMCID: PMC11052740 DOI: 10.1007/s10815-024-03051-7] [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: 10/09/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE Improved survivorship in cancer patients leads to new challenging issues including potential impairment of quality of life, sexual function, and fertility. The aim of this study was to assess sexual dysfunction (SD) and psychological distress in female cancer survivors who underwent fertility preservation in the past in comparison to reviewed healthy control data from other published studies. Additionally, our focus was on the difference in SD between women with current desire to get pregnant and already completed family planning. METHODS In this prospective study, 53 female cancer survivors who underwent fertility preservation at time of cancer diagnosis between 2010 and 2020 were invited to a gynecological exam, laboratory assessment, and two questionnaires (Female Sexual Function Index (FSFI) and Hospital anxiety and depression scale (HADS)) in 2022. These scores were compared to results in the literature of healthy controls and depending on anti-Mullerian-hormone (AMH) levels, current desire to have a child, and age. RESULTS After a mean follow-up time of 70 ± 50 months, SD was detected in 60.4% (n = 32) of the 53 included patients. Normal results regarding HADS-D/anxiety and HADS-D/depression were found in 88.7% and 94.3% of patients, respectively. At time of follow-up, 69.9% (n = 40) regained regular menstrual cycles, 52.6% (n = 20) < 40 years showed a diminished ovarian reserve with AMH levels < 1.1 ng/ml and 28.3% (n = 15) suffered from infertility. CONCLUSION Female cancer survivors may be at risk for SD. Cancer patients should be informed about possible sexual dysfunction already at the start of cancer treatment and during follow-up. In addition, contraception needs to be addressed if regular cycles occur as more than two-thirds of the women regained regular menstrual cycles.
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Affiliation(s)
- Elisabeth Reiser
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Bettina Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Charlotte Ossig
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Julia Schiller
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Susanne Tollinger
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Bettina Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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11
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Pires LAS, Fosse AM, Ribeiro JGA, Postigo PRM, Manaia JHM, Babinski MA. Stereological comparison of smooth muscle, collagen, and elastic fibers of the clitoris and glans penis in young adults. Morphologie 2024; 108:100721. [PMID: 37897939 DOI: 10.1016/j.morpho.2023.100721] [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: 03/14/2023] [Revised: 05/31/2023] [Accepted: 07/27/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE To compare the collagen, elastic fibers, and smooth muscle content of the clitoris and the glans penis in young adults. MATERIALS AND METHODS The clitoris and the glans penis of six women and six men (mean age 25±3) who died as a result of accidents were excised. The samples were placed under a formaldehyde solution and histologically processed. Masson's trichrome and Weigert's resorcin-fuchsin stain was used to highlight the elastic fibers, smooth muscle, and collagen. Stereological analysis was conducted in 5 random fields of 5 slides for each sample. For statistical analysis, the unpaired t-test was used to compare values between groups, and a value of P<0.05 was considered as significant for all analyses. RESULTS Stereology revealed a mean smooth muscle content of 35.84±6.46% and 31.64±4.74% for the clitoris and glans penis, respectively, while it also revealed collagen content of 26.11±7.41% and 28.44±3.55% and elastic fibers content of 24.12±4.34% and 30.97±6.13% for the clitoris and glans penis, respectively. The statistical analysis showed no significant differences between them. CONCLUSION Regardless of anatomical differences, the volumetric density of collagen, elastic fibers, and smooth muscle were similar for the clitoris and glans penis in young adults, a feature possibly explained by their embryology.
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Affiliation(s)
- L A S Pires
- Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - A M Fosse
- Antonio-Pedro University Hospital, Niterói, Rio de Janeiro, Brazil
| | - J G A Ribeiro
- Antonio-Pedro University Hospital, Niterói, Rio de Janeiro, Brazil
| | - P R M Postigo
- Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - J H M Manaia
- Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - M A Babinski
- Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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12
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Trapani A, Giordani MS, Notari MM. Teaching of sexual medicine and gender issues in medical courses: students' perception. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231075. [PMID: 38198395 PMCID: PMC10768678 DOI: 10.1590/1806-9282.20231075] [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: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION In addition to reproductive purposes, human sexuality and sexual health are matters of great importance in the medical office. Despite this, there is still a deficiency in the training of Brazilian medical students regarding sexual medicine and gender issues. OBJECTIVE The objective of this study was to analyze the perception of fifth- and sixth-year students in relation to the teaching of sexual medicine and gender issues in medical courses. METHODS This is a descriptive and cross-sectional study with students from the last 2 years of medical schools in the State of Santa Catarina (internship classes), through the application of a self-administered, semi-structured online questionnaire. RESULTS A total of 164 students answered the questionnaire, with 83.5% (137/164) saying they had taken classes on sexual medicine and 47% (77/164) saying they had taken classes on gender issues. The participants judged the teaching inadequate in most of the topics addressed, and there was no significant difference between students from public and private schools. Notably, 79.9% (131/164) of the students considered the teaching of sexual medicine insufficient or inadequate, while 87.8% (144/164) considered the teaching of gender issues insufficient or inadequate. CONCLUSION The vast majority of students consider the teaching of sexual medicine and gender issues insufficient and inadequate.
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Affiliation(s)
- Alberto Trapani
- Universidade Federal de Santa Catarina, Universidade do Sul de Santa Catarina, Brazilian Federation of Gynecology and Obstetrics Associations, São José Regional Hospital Dr. Homero de Miranda Gomes, Palhoça Medicine Course
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13
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Jehan M, Azam S, Taimuri MA, Sumbal A, Azhar A, Amir A, Oduoye MO, Zainab A, Ikram A, Ali T. Care for breast cancer survivors in Asian countries: A review of sexual dysfunction. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241237687. [PMID: 38481086 PMCID: PMC10938604 DOI: 10.1177/17455057241237687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/21/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
Breast cancer accounts for one in three new cancer cases in women each year. Despite having a higher survival rate than other cancers, it is associated with various side effects, including anorgasmia, vaginismus, hair loss, and decreased libido. This review aims to explore trends in the incidence of sexual dysfunction in breast cancer survivors, the etiology of sexual dysfunction, and the role of factors such as family history, age, duration of marriage, and depression in predisposing patients. We summarize the limitations of the treatment modalities already used to cater to sexual dysfunction in breast cancer survivors and patients. The authors conducted searches on databases such as PubMed and Google Scholar using relevant search terms: sexual dysfunction, breast cancer, breast cancer survivors, chemotherapy, dyspareunia, vaginismus, and anorgasmia from 1997-2023. The inclusion criteria encompassed all types of articles with abstracts or titles indicating research on sexual dysfunction in breast cancer survivors in Asia. A total of 64 articles were included out of which 10 were systematic reviews and meta-analyses. The literature search yielded results showing high incidence rates of breast cancer in Asia (45.4%), with 31.6%-91.2% of breast cancer survivors likely to experience sexual dysfunction. Regional differences were noted, as female sexual dysfunction occurred in 74.1% of Asian breast cancer women. Further randomized controlled trials should be conducted to assess the effectiveness of treatment modalities. Personalized approaches should be tailored to address beliefs, such as the potential impact of sexual activity on disease recovery. Utilizing a family history of breast cancer as a preemptive tool can help reduce the risk of developing female sexual dysfunction in survivors, and factors such as age and depression should be considered when formulating solutions.
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Affiliation(s)
- Minal Jehan
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Sumran Azam
- Karachi Medical and Dental College, Karachi, Pakistan
| | | | - Anusha Sumbal
- Dow University of Health Sciences, Karachi, Pakistan
| | - Ayesha Azhar
- Dow University of Health Sciences, Karachi, Pakistan
| | - Alina Amir
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Asra Zainab
- Dow University of Health Sciences, Karachi, Pakistan
| | - Areeba Ikram
- Dow University of Health Sciences, Karachi, Pakistan
| | - Tehreem Ali
- Dow University of Health Sciences, Karachi, Pakistan
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14
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Janz C, Timpka J, Rosqvist K, Paul G, Storch A, Odin P. Non-Motor Symptom Management: Insights into Adherence to Treatment Guidelines in Parkinson's Disease Patients. JOURNAL OF PARKINSON'S DISEASE 2024; 14:297-312. [PMID: 38217612 PMCID: PMC10977407 DOI: 10.3233/jpd-230263] [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: 12/13/2023] [Indexed: 01/15/2024]
Abstract
Background Non-motor symptoms (NMS) reduce quality of life in Parkinson's disease (PD) patients, who experience three times more NMS than individuals without PD. While there are international and national NMS treatment guidelines, their implication in clinical practice remains unclear. Objective This study aimed to investigate the adherence to pharmacological NMS treatment guidelines in patients with mild to moderately severe PD. Methods 220 PD patients with ≥1 NMS based on the Non-Motor Symptom Questionnaire and a Hoehn and Yahr stage ≤4 were randomly selected from the Swedish Parkinson registry and screened for inclusion. NMS were evaluated using the International Parkinson and Movement Disorder Society-Non-Motor Rating Scale (MDS-NMS), Parkinson's Disease Sleep Scale 2, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale. Treatment was compared with Swedish national guidelines and international guidelines from the MDS Evidence-Based Medicine Committee. Results Among 165 included patients, the median number of NMS was 14, and in median 7 symptoms were estimated to require treatment. The most common NMS requiring treatment were pain (69%) and urinary problems (56%). Treatment of depression and constipation demonstrated the highest adherence to guidelines (79% and 77%), while dysphagia and excessive daytime sleepiness exhibited the lowest adherence (0% and 4%). On average, only 32% of NMS were treated in accordance with guidelines. Conclusions Adherence to pharmacological guidelines for NMS in patients with mild to severe PD was low. This study highlights the need for improved evaluation and treatment of NMS to enhance symptom management and quality of life among PD patients.
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Affiliation(s)
- Carin Janz
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Jonathan Timpka
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Kristina Rosqvist
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Gesine Paul
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Alexander Storch
- Department of Neurology, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
| | - Per Odin
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
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15
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Ospina Serrano AV. Overview of sexual dysfunction in patients with cancer. Clin Transl Oncol 2023; 25:3369-3377. [PMID: 37633856 DOI: 10.1007/s12094-023-03311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
Among survivor's patients with cancer, sexual dysfunction (SD) is a common treatment-related disturbance that significantly affects their quality of life. The disorder can be a short-term effect, but frequently it can be permanent and patients often do not receive adequate support to overcome the problem. The characteristics of SD may differ depending on the type of neoplasm and oncological treatment. The most common long-term effects are those related to treatment-induced menopause, ablative oncologic surgery, and altered gonadal function. Breast, prostate, and gynecologic cancers are the tumors most commonly associated with disturbances in sexual health, although there is evidence of SD in patients with other types of neoplasms. It is necessary for the healthcare team caring for oncological patients to be aware of the characteristics of sexual dysfunction in this population. This will make it possible to offer patients a comprehensive and personalized approach to improve their quality of life.
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Affiliation(s)
- Aylen Vanessa Ospina Serrano
- Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla 1, 28222, Madrid, Spain.
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16
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Tian X, Ruan X, Du J, Cheng J, Ju R, Mueck AO. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2221736. [PMID: 37302412 DOI: 10.1080/09513590.2023.2221736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18-45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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17
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Ning S, Liu S, Chen X, Wang J. Acupuncture modification treatment for female sexual dysfunction: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2023; 291:29-33. [PMID: 37806029 DOI: 10.1016/j.ejogrb.2023.09.026] [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: 07/03/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Acupuncture has potential in the treatment of female sexual dysfunction (FSD), but its effectiveness needs to be verified. AIM A meta-analysis to provide a summary of studies that had investigated the efficacy of acupuncture as a treatment for FSD. METHODS A systematic screening was conducted on electronic databases such as Pubmed, Embase, Cochrane Library, CNKI, and CBM to select studies that met the criteria before April 2023. We only included those studies assessing women's sexual functioning by the Female Sexual Function Index (FSFI). OUTCOMES By calculating the relative risk (RR) using the standardized mean difference (SMD) and 95% confidence interval (CI), these data were combined to generate a summary of the findings. The pooled results were calculated using a random-effects model. RESULTS A total of 4 studies involving 178 participants were included, and the comprehensive results indicated a significant difference in FSFI scores between the acupuncture group and the control group. In the desire and arousal scale, there was a statistically significant difference between the acupuncture group and the control group. But in the scale of lubrication, orgasm, satisfaction, and pain, there was no statistically significant difference between the two groups. CONCLUSION A comparison of overall FSFI scores, sexual desire, and sexual arousal revealed that acupuncture treatment can improve female sexual dysfunction to some extent. However, in terms of vaginal lubrication, orgasm, sexual satisfaction, and sexual pain, acupuncture treatment did not significantly improve female sexual dysfunction. In the future, it is necessary to include more RCT trials and expand the number of patients analyzed to make the conclusions more reliable.
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Affiliation(s)
- Shuangcheng Ning
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China; Department of Pharmacy, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China.
| | - Shasha Liu
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China; Department of Pharmacy, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China.
| | - Xiangyu Chen
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China; Department of Pathology, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China.
| | - Jin Wang
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China; Department of Pharmacy, Changsha Hospital for Maternal & Child Care Affiliated to Hunan Normal University, Changsha, China.
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18
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Zhu L, Song B, Han YS, Xu Y, Xun-Wang, Xue BC, Han YZ, Yang RM. Sexual dysfunction in Wilson disease: Prevalence and influencing factors. J Clin Neurosci 2023; 118:117-122. [PMID: 37922727 DOI: 10.1016/j.jocn.2023.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
Wilson disease is a rare neurogenetic disorder that receives significant attention due to its manifestations, such as jaundice, cirrhosis, tremor, dystonia, and others. However, the impact of Wilson disease on sexual function has been overlooked. In this study, we aimed to investigate current status of sexual dysfunction in Wilson disease. In this study, we investigated the sexual function status and possible influencing factors of 245 Wilson disease patients by questionnaire. Our study identified sexual dysfunction as a prevalent issue in Wilson disease patients, with an overall prevalence of 49.0 %, of which 33.9 % in males and 63.7 % in females, both higher than the prevalence of sexual dysfunction in the normal Chinese population. Compared with non-sexual dysfunction patients, sexual dysfunction was more common in the older age group, females, less educated, rural residence, no occupation, lower income, taking sedatives/antipsychotics, and high SIS scores (P < 0.05). Our binary logistic regression analysis revealed that older age (OR: 1.103, 95 %CI: 1.058-1.151, P < 0.001), being female (OR: 5.900,95 %CI: 2.966-11.736, P < 0.001), and the use of antipsychotics or sedatives (OR: 3.277,95 %CI: 1.065-10.077, P < 0.05) were all positively linked with an increased risk of sexual dysfunction. Despite the well-known symptoms of Wilson disease, sexual dysfunction is also a frequent issue in Wilson disease patients, necessitating further attention.
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Affiliation(s)
- Ling Zhu
- Department of Graduate, Anhui University of Chinese Medicine, Hefei 230011, China; Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Bin Song
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Yong-Sheng Han
- Department of Graduate, Anhui University of Chinese Medicine, Hefei 230011, China; Wannan Medical College, Wuhu 241002, China; The Third Clinical College of Anhui University of Chinese Medicine.
| | - Yin Xu
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Xun-Wang
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Ben-Chun Xue
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Yong-Zhu Han
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Ren-Min Yang
- Department of Neurology, Affiliated Hospital of Institute of Neurology, Anhui University of Chinese Medicine, Hefei 230012, China.
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19
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Bilen H, Dayanan R, Ciftel E, Bilen A, Ciftel S, Mercantepe F, Capoglu I. Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients? Int J Gen Med 2023; 16:5147-5156. [PMID: 37954658 PMCID: PMC10638931 DOI: 10.2147/ijgm.s441833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.
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Affiliation(s)
- Habib Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ramazan Dayanan
- Department of Endocrinology and Metabolism, Batman Training and Research Hospital, Batman, Turkey
| | - Enver Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Arzu Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Serpil Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Filiz Mercantepe
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ilyas Capoglu
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
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20
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Mollà-Casanova S, Muñoz-Gómez E, Sempere-Rubio N, Inglés M, Aguilar-Rodríguez M, Moreno-Cervera N, Serra-Añó P. Fibromyalgia syndrome is associated with sexual dysfunction regardless of physical activity status: a cross-sectional study. J Sex Med 2023; 20:1285-1291. [PMID: 37740987 DOI: 10.1093/jsxmed/qdad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a rheumatic disorder that has been observed to affect self-perception of sexuality. AIM The study aims to assess sexual dysfunction (SD), establish possible associations with SD levels, and evaluate the impact of physical activity (PA) levels on SD in Spanish women with FMS as compared with healthy control women. METHODS The study was cross-sectional. A total of 170 women voluntarily agreed to participate between September 2019 and February 2020: 88 in the FMS group and 82 in the control group. OUTCOMES The main outcome measures were SD, as assessed through the Female Sexual Function Index (FSFI), and PA levels, as assessed with a structured interview. RESULTS There were significant differences in every domain and total SD score between the FMS and control groups (P < .05). In addition, we obtained a moderate significant direct association (χ2[1] = 37.071, P < .05, phi = 0.467) when exploring the associations between FMS and risk of SD. Results showed statistically significant differences between the FMS group and the control group when PA levels were not reached in the desire, pain, and total scores of the FSFI (P < .05). When the PA levels were reached, between-group differences were found in all domains, as well as in the total score of the FSFI (P < .05). CLINICAL IMPLICATIONS Sexual function should be evaluated in women with FMS, while future treatments should address this clinical area with the aim of managing SD in this population. STRENGTHS AND LIMITATIONS The main limitation is that the outcome measures were self-reported. CONCLUSION We found a high prevalence of SD in Spanish women with FMS, with an impact on aspects such as desire, arousal, lubrication, orgasm, satisfaction, and pain during sexual intercourse. In addition, there is a moderate direct association between FMS and SD. Ultimately, the results showed that, irrespective of PA, women with FMS reported increased SD.
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Affiliation(s)
- Sara Mollà-Casanova
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Elena Muñoz-Gómez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Núria Sempere-Rubio
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Inglés
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Marta Aguilar-Rodríguez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Noelia Moreno-Cervera
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
| | - Pilar Serra-Añó
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia 46010, Spain
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21
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Fernández Rísquez AC, Carballo García A, Hijona Elósegui JJ, Mendoza Ladrón de Guevara N, Presa Lorite JC. Sexuality in Postmenopausal Women with Genital Prolapse. J Clin Med 2023; 12:6290. [PMID: 37834934 PMCID: PMC10573593 DOI: 10.3390/jcm12196290] [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: 07/01/2023] [Revised: 08/31/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND One of the most common complaints among menopausal women concerns changes in sexual function. This is attributed to various factors, including anatomical defects in the genital tract, with pelvic organ prolapse (POP) being one of the most prevalent problems affecting women during this stage of their lives. Additionally, symptoms resulting from gonadal hypofunction can also contribute to the development of sexual dysfunction during menopause. This research aimed to explore the way in which postmenopausal patients with POP experienced their sexuality in our setting. METHODS To achieve the proposed objective, we conducted a descriptive, cross-sectional study involving a total of 133 postmenopausal women with POP. RESULTS The results of our series are consistent with the scarce literature available in our setting and suggest a high rate of sexual dysfunction in postmenopausal patients with POP. CONCLUSIONS We can conclude that POP is associated with the presence of female sexual dysfunction.
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Affiliation(s)
- Ana Cristina Fernández Rísquez
- Obstetrics and Gynecology Department, University Hospital of Jaén, CP 23007 Jaén, Spain; (A.C.F.R.); (J.J.H.E.); (J.C.P.L.)
| | - Antonio Carballo García
- Obstetrics and Gynecology Department, University Hospital of Jaén, CP 23007 Jaén, Spain; (A.C.F.R.); (J.J.H.E.); (J.C.P.L.)
| | - Jesús Joaquín Hijona Elósegui
- Obstetrics and Gynecology Department, University Hospital of Jaén, CP 23007 Jaén, Spain; (A.C.F.R.); (J.J.H.E.); (J.C.P.L.)
| | | | - Jesús Carlos Presa Lorite
- Obstetrics and Gynecology Department, University Hospital of Jaén, CP 23007 Jaén, Spain; (A.C.F.R.); (J.J.H.E.); (J.C.P.L.)
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22
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Yılmaz R, Karpuz S, Akdere E, Yılmaz H. Evaluation of sexual dysfunction in females with neck and upper back myofascial pain syndrome: a cross-sectional study. Rheumatol Int 2023; 43:1723-1732. [PMID: 37294458 DOI: 10.1007/s00296-023-05359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
Myofascial pain syndrome (MPS) is a prevalent chronic musculoskeletal pain disorder that is frequently encountered in clinical practice and can cause sexual dysfunction in women. While there have been studies examining sexual function in various painful rheumatic conditions, particularly fibromyalgia, no studies have been conducted specifically on primary MPS. In this context, we aimed to investigate the frequency of sexual intercourse and the factors associated with it in women diagnosed with MPS. The study was designed as a cross-sectional study at a tertiary rehabilitation center between May 2022 and April 2023. Forty-five consecutive sexually active women (mean age: 38.1 ± 6.8 years) diagnosed with primary MPS were included in the study. They were compared to 45 healthy women of similar ages. The participants were interviewed regarding their weekly frequency of sexual intercourse and the importance of sexual life. Also, the Beck Depression Inventory (BDI) and the Visual Analog Scale (VAS) were assessed. The importance of sexual life score (p = 0.008), BDI (p < 0.001), VAS pain (p < 0.001), and VAS fatigue (p < 0.001) values were found to be lower in the patient group compared to the control group. The frequency of sexual intercourse was lower in the patient group, although this difference did not reach statistical significance (p = 0.083). In patients with a higher BDI score (≥ 17), the number of sexual intercourse was lower (p = 0.044), and the severity of fatigue was higher (p = 0.013). Significant associations were observed in MPS patients between the weekly frequency of sexual intercourse and VAS pain, VAS fatigue, BDI, and the importance of the sexual life score. A positive correlation was observed between the number of weekly sexual intercourses and the importance of the sexual life score (r = 0.577, p < 0.001), and negative correlations were found between BDI (r = - 0.478, p < 0.001), VAS pain (r = - 0.409, p < 0.001), and VAS fatigue (r = - 0.439, p < 0.001). Patients with MPS should be assessed for depressive mood and fatigue, as these factors may contribute to sexual dysfunction. These results may also emphasize the importance of adopting a multidisciplinary approach in the management of MPS patients with concurrent sexual dysfunction. Clinicaltrials.gov identifier: NCT05727566.
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Affiliation(s)
- Ramazan Yılmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey.
| | - Savaş Karpuz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Emine Akdere
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Halim Yılmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey
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Ågmo A, Laan E. The Sexual Incentive Motivation Model and Its Clinical Applications. JOURNAL OF SEX RESEARCH 2023; 60:969-988. [PMID: 36378887 DOI: 10.1080/00224499.2022.2134978] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual motivation (desire) requires the simultaneous presence of an active central motive state and a stimulus with sexual significance. Once activated, sexual motivation leads to visceral responses and approach behaviors directed toward the emitter of the sexual stimulus. In humans, such behaviors follow cognitive evaluation of the context, including predictions of the approached individual's response. After successful approach and establishment of physical contact, manifest sexual activities may be initiated. Sexual interaction is associated with and followed by a state of positive affect in most animals, whereas aversive consequences may be experienced by humans. The affective reactions may become associated with stimuli present during sexual interaction, and these stimuli may thereby alter their incentive properties. Here we show how the incentive motivation model can be used to explain the origins and possible treatments of sexual dysfunctions, notably disorders of desire. We propose that associations formed between negative outcomes of sexual interaction and the salient stimuli, for example, the partner, underlies hypoactive desire disorder. Highly positive outcomes of sexual interaction enhance the incentive value of the stimuli present, and eventually lead to hyperactive sexual desire. Treatments aim to alter the impact of sexual incentives, mainly by modifying cognitive processes.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam
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24
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Martínez Vázquez S, Hernández Martínez A, Peinado Molina RA, Martínez Galiano JM. Association between sexual function in women and sleep quality. Front Med (Lausanne) 2023; 10:1196540. [PMID: 37636576 PMCID: PMC10457145 DOI: 10.3389/fmed.2023.1196540] [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: 03/29/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Objective To determine the relationship between sexual dysfunction and sleep disorders. Methods Observational study was conducted in 2021 and 2022 including 975 Spanish women over 18 years of age. The Women's Sexual Function Questionnaire (FSM-12) was used as a source of information, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A bivariate and multivariate analysis was performed using binary logistic regression, adjusting for confounding variables. Crude (OR) and adjusted (aOR) odds ratios were estimated with their respective 95% confidence intervals (CI). Results Around 29.2% (285) of the women presented some type of sexual dysfunction, and 73.4% (716) showed sleep disturbance with scores ≥5 on the PSQI scale. The mean score on the PSQI was 8.23 points (SD = 3.93). All the dimensions of the sexual function scale were statistically related to sleep disturbance (p ≤ 0.05), except for sexual activity and the reasons for sexual activity not having penetration. In the multivariable analysis, women with sexual dysfunction presented an aOR of sleep disturbance of 1.88 (95% CI: 1.29-2.76) compared to women without dysfunction. Conclusion Global sexual dysfunction and almost all the dimensions that make up sexual function are related to changes in sleep quality.
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Affiliation(s)
| | | | | | - Juan Miguel Martínez Galiano
- Department of Nursing, University of Jaén, Jaén, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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25
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Fernández-Pérez P, Leirós-Rodríguez R, Marqués-Sánchez MP, Martínez-Fernández MC, de Carvalho FO, Maciel LYS. Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis. BMC Womens Health 2023; 23:387. [PMID: 37482613 PMCID: PMC10364425 DOI: 10.1186/s12905-023-02532-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/08/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. OBJECTIVES The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. DESIGN A systematic review and meta-analysis was conducted. METHOD Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. RESULTS Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. CONCLUSIONS Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. PROSPERO REGISTRATION CRD42021236155.
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Affiliation(s)
- Paula Fernández-Pérez
- Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Mª Pilar Marqués-Sánchez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | | | | | - Leonardo Y. S. Maciel
- Physical Therapy Department of Lagarto, Universidade Federal de Sergipe, Gov. Marcelo Déda Ave, São José, Lagarto 49400-000 Brazil
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure (CIAFEL), University of Porto, R. Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
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26
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Erdem İH, Ustabaşıoğlu F. Evaluation of sexual function and depression in female patients with fibromyalgia. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230180. [PMID: 37466600 DOI: 10.1590/1806-9282.20230180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Fibromyalgia is one of the most important problems, especially for women. Studies point to disorders in the sexual functions of fibromyalgia patients that reduce their quality of life. The aim of this study was to investigate sexual dysfunction and its relationship with disease severity and depression in women with fibromyalgia. METHODS This study included 98 female patients diagnosed with fibromyalgia and 54 healthy women. The Female Sexual Function Index was used to assess sexual dysfunction. Fibromyalgia disease severity was measured with the Fibromyalgia Impact Questionnaire. Hamilton Depression Scale was filled in to evaluate the depression status of the patients. RESULTS According to the female sexual function index data, female sexual dysfunction was found in 78 (79.6%) patients with fibromyalgia and only in 12 (22.2%) controls. When the female sexual function index scores of fibromyalgia patients with and without depression were compared, patients with additional depression had lower female sexual function index scores, and this difference was statistically significant (p=0.002). In the correlation analysis, the female sexual function index score showed a significant negative correlation with the hamilton depression scale (rho=-0.235, p=0.020) and fibromyalgia impact questionnaire (rho=-0.215, p=0.033) scores. CONCLUSION This study highlights the high prevalence of sexual dysfunction in female fibromyalgia patients and the significant correlation between sexual dysfunction and both disease severity and depression.
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Affiliation(s)
- İbrahim Halil Erdem
- Basaksehir Cam Sakura City Hospital, Department of Physical Medicine and Rehabilitation - Istanbul, Turkey
| | - Fatma Ustabaşıoğlu
- Edirne Sultan 1. Murat State Hospital, Department of Physical Medicine and Rehabilitation - Edirne, Turkey
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27
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Pavarini N, Valadares ALR, Varella GM, Brito LGO, Juliato CRT, Costa-Paiva L. Sexual function after energy-based treatments of women with urinary incontinence. A systematic review and meta-analysis. Int Urogynecol J 2023; 34:1139-1152. [PMID: 36680596 DOI: 10.1007/s00192-022-05419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/17/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) affects approximately 50% of adult women worldwide and is associated with declining sexual function (SF). Energy-based devices emerged as a minimally invasive alternative treatment. Nevertheless, their effect on sexuality is uncertain. We hypothesize that the UI energy treatment can lead to sexual function improvement. METHODS A search was performed in PubMed, Cochrane Library, Web of Science, Embase, and Scopus for randomized clinical trials (RCTs) and nonrandomized studies of intervention, which treated incontinent women using energy, with UI and sexual function (SF) as outcomes. Severe comorbidities, pelvic organ prolapse (POP)> grade 2, and use of medication to treat UI or that affects SF were excluded. Quality assessment and meta-analysis were performed. RESULTS From 322 articles, 11 RCTs were included for qualitative analysis. UI symptoms improved in all studies. Regarding SF, RCT with premenopausal women showed improvement in SF in the Er:Yag group (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 and Female Sexual Function Index). A prospective study showed improvement in SF independent of the grade of SUI. RF showed benefits for SF but was not superior to pelvic floor muscle training. One nonrandomized study of intervention with a High-Intensity Focused Electromagnetic Field showed significant improvement of SF in the Golombok Rust Inventory of Sexual Satisfaction total score, a decline in pain and dissatisfaction domains. Meta-analysis with 4 RCTs and 2 nonrandomized studies found no difference between groups (0.26 (95% CI -0.67 to 1.20, and -0.74 (95% CI -3.78 to 2.30) respectively). CONCLUSIONS This meta-analysis did not confirm that energy equipment improved the SF of women with UI.
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Affiliation(s)
- Nádia Pavarini
- School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ana L R Valadares
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil.
| | - Glaucia M Varella
- School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
| | - Luiz G O Brito
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil
| | - Cássia R T Juliato
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil
| | - Lúcia Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Rua Alexander Fleming, 101, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil
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28
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Pires LAS, Babinski MSD, Fonseca Junior A, Manaia JHM, Babinski MA. Aging effects in the extracellular matrix of the clitoris: A scanning electron microscopic analysis. Morphologie 2023; 107:259-263. [PMID: 36707352 DOI: 10.1016/j.morpho.2023.01.001] [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: 10/18/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE OF THE STUDY The present work aims to observe the clitoris' extracellular matrix in young and old women with a scanning electron microscope. MATERIALS AND METHODS After approval of the local research ethics committee, samples of the clitoris body were obtained from cadavers of women between 20 and 40 old (G1) and from cadavers over the age of 60 (G2). The samples were decellularized with NaOH to maintain the extracellular matrix framework, submitted to silver sputter coating, and observed under a scanning electron microscope. RESULTS The mean age of the cadavers in G1 was 28 years old and 75±6 years old in G2. The groups were composed of 10 cadavers each. It was observed that the collagen was arranged in a disorganized fashion in the samples from the G2 in several regions. There was also a decrease in elastic fibers that anchored the collagen in these samples. The concentration of collagen showed an increase in the older samples in comparison to the G1 samples. Conclusions Female sexual dysfunction is a condition prevalent in a significantly large portion of women and it is more common in elderly women. It is known that the tumescence mechanism requires integrity of the extracellular matrix. The changes observed herein may alter the function of the organ and are similar to observations in studies of men with erectile dysfunction. CONCLUSION Female sexual dysfunction is a condition prevalent in a significantly large portion of women and it is more common in elderly women. It is known that the tumescence mechanism requires integrity of the extracellular matrix. The changes observed herein may alter the function of the organ and are similar to observations in studies of men with erectile dysfunction. .
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Affiliation(s)
- Lucas Alves Sarmento Pires
- Experimental Morphology Laboratory, Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - Monique Silva Dias Babinski
- Experimental Morphology Laboratory, Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Albino Fonseca Junior
- Experimental Morphology Laboratory, Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Jorge Henrique Martins Manaia
- Experimental Morphology Laboratory, Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Marcio Antonio Babinski
- Experimental Morphology Laboratory, Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Dilixiati D, Kadier K, Laihaiti D, Lu JD, Rezhake R, Azhati B, Rexiati M. The relationship between sleep disorders, quality, and duration and sexual dysfunction: a systematic review and meta-analysis. J Sex Med 2023:7143630. [PMID: 37186140 DOI: 10.1093/jsxmed/qdad054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The associations between sexual dysfunction (SD) and sleep disorders, sleep quality, and sleep duration remain unclear. AIM To assess the relationship between sleep and SD through a literature review and meta-analysis. METHODS The PubMed, Scopus, Embase, Ovid MEDLINE, and Cochrane Library databases were systematically searched from inception to November 10, 2022. OUTCOMES Pooled relative risks and 95% CIs were used to examine the association of sleep disorders with SD in longitudinal studies. Pooled odds ratios (ORs) and 95% CIs were used to examine the associations between SD and sleep disorders, sleep quality, and sleep duration in cross-sectional studies. RESULTS Forty-three articles, including 11 longitudinal studies and 32 cross-sectional studies, were included in the quantitative analysis. The pooled relative risk of SD in patients with sleep disorders was 1.97 in longitudinal studies (95% CI, 1.46-2.67, P < .001; heterogeneity: I2 = 95.0%, P < .001), while the pooled OR of SD in patients with sleep disorders was 2.05 in cross-sectional studies (95% CI, 1.76-2.39, P < .001; heterogeneity: I2 = 91.4%, P < .001). When compared with controls, subjects with poor sleep quality had a 1.49-fold increased risk of SD (OR, 1.49; 95% CI, 1.31-1.71, P < .001; heterogeneity: I2 = 73.4%, P < .001). In addition, short sleep duration was associated with the risk of SD (OR, 1.14; 95% CI, 1.06-1.22, P < .001; heterogeneity: I2 = 0.0%, P = .849). CLINICAL IMPLICATIONS The risk of SD is significantly increased in patients with sleep disorders and poor sleep quality, indicating that clinicians should monitor sleep among patients with SD. STRENGTHS AND LIMITATIONS This study is the most comprehensive meta-analysis of the association between sleep and SD to date. However, different sleep disorders may have varying associations with sleep duration and sleep quality; thus, we could not identify the independent effects across the studies. CONCLUSION Our systematic review and meta-analysis results suggest that sleep disorders, especially obstructive sleep apnea, increase the risk of SD in men and women. Poor sleep quality is significantly associated with SD. Short sleep duration is associated with an increased risk of SD.
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Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Duolikun Laihaiti
- Department of Joint Surgery, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Changji 831199, China
| | - Jian-De Lu
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Remila Rezhake
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830017, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
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Chen K, Bhattacharjee S, Seidel H, Dillman DB, Strelzow JA. Association of Pelvic Trauma With Rates of Cesarean Section, Sexual Dysfunction, and Genitourinary Dysfunction in a National Database. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202304000-00006. [PMID: 37036931 PMCID: PMC10090791 DOI: 10.5435/jaaosglobal-d-22-00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/31/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Pelvic fractures are severe injuries that can drastically affect a woman's quality of life through sexual dysfunction (SD), genitourinary dysfunction (GD), and increasing the potential need for future cesarean section (C-section). Limited research has captured long-term outcomes after pelvic fractures in women of childbearing age. This study aimed to determine the association between pelvic fractures and rates of C-section, SD, and GD. METHODS All women of childbearing age who sustained a pelvic fracture were identified in a national insurance database. A comparison group of patients with lower extremity long-bone fractures was selected. Patients who gave birth after injury were additionally identified. A minimum of 5 years of follow-up was required for inclusion. Rates of C-section, SD, and GD were compared between cohorts. Multivariate logistic regression analysis was conducted with the inclusion of diabetes, tobacco, hypertension, obesity, and advanced maternal age. RESULTS A total of 6,174 patients with pelvic fracture and 27,154 control fracture patients were identified. 434 patients with pelvic fracture (7.0%) and 1,258 control fracture patients (4.6%) gave birth after fracture. Patients with pelvic fracture had a significantly higher rate of C-section (50.0% versus 38.8%, P < 0.001), SD diagnosis (10.9% versus 8.8%, P < 0.001), and urinary retention diagnosis (3.5% versus 2.8%, P < 0.001). No significant difference in global GD diagnosis was identified. Multivariate analyses showed that pelvic fracture was associated with C-section (odds ratio [OR]: 1.78; 95% confidence interval [95% CI]: 1.42 to 2.23, P < 0.001), SD diagnosis (OR: 1.23; 95% CI: 1.12 to 1.35, P < 0.001), and urinary retention diagnosis (OR: 1.35; 95% CI: 1.15 to 1.57, P < 0.001). DISCUSSION Pelvic fractures confer an intrinsic level of risk of C-section, SD, and urinary retention that is elevated beyond what would be expected from a traumatic lower extremity injury alone. Treating orthopaedic surgeons should actively counsel women regarding increased risks, openly discuss postinjury sequelae, and coordinate interspecialty care beyond initial treatment of acute trauma.
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Affiliation(s)
- Kevin Chen
- From the Pritzker School of Medicine at the University of Chicago, Chicago, IL (Mr. Chen, Dr. Bhattacharjee, and Mr. Seidel); and the Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago Medicine, Chicago, IL (Dr. Dillman and Dr. Strelzow)
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Liu XR, Tong Y, Li ZW, Liu F, Liu XY, Zhang W, Peng D. Do colorectal cancer patients with a postoperative stoma have sexual problems? A pooling up analysis of 2566 patients. Int J Colorectal Dis 2023; 38:79. [PMID: 36961570 DOI: 10.1007/s00384-023-04372-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 03/25/2023]
Abstract
PURPOSE This study aimed to evaluate the effect of the stoma on sexual function in colorectal cancer patients. METHODS Search strategy was conducted in four databases including PubMed, Embase, the Cochrane Library, and Medline on Nov 20, 2022. After that, the quality of eligible studies was assessed by the Newcastle Ottawa Scale (NOS) and the Agency for Healthcare Research Quality (AHRQ). In order to evaluate the sexual function between the stoma group and the non-stoma group, mean values and standard deviation were pooled for scores in questionnaires, and odds ratio and 95% confidence intervals were pooled for self-designed problems. Results were shown in forest plots; Egger's test and the trim and fill analysis were used for assessing the publication bias. All the data analyses above were performed by STATA 16.0 software. RESULTS Six cohort studies and three cross-sectional studies were included for this pooling up analysis. As for the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C38), male patients with stomas had more sexual problems (mean differences = 0.32, 95% confidence intervals = 0.01 to 0.63, I2 = 67.80%, P = 0.05); however, other indicators including sexual functioning, sexual enjoyment, and female sexual problems had little difference between the two groups. As for other questionnaires and problems, stoma did not have an impact on sexual function. CONCLUSION The stoma after surgery was not significantly associated with the sexual function of female patients with colorectal cancer and was associated with worse scores on only sexual problems for males.
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Affiliation(s)
- Xu-Rui Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yue Tong
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zi-Wei Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Fei Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao-Yu Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Kaplan T, Feldman T, Healey B, Behn M, Glanz B, Chitnis T. Sexual Problems in MS: Sex Differences and Their Impact on Quality of Life. Mult Scler Relat Disord 2023; 74:104672. [PMID: 37031553 DOI: 10.1016/j.msard.2023.104672] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/04/2023] [Accepted: 03/25/2023] [Indexed: 03/28/2023]
Abstract
BACKGROUND Low sexual function and satisfaction are common problems among people with multiple sclerosis (PwMS), but the literature on which patient variables are associated with these issues is inconsistent. OBJECTIVE To investigate the associations between sexual function and satisfaction in PwMS with clinical, demographic, and patient-reported quality of life (QOL) measures and determine if sex differences exist. METHODS This analysis includes PwMS enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB), who completed patient-reported outcome measures: Multiple Sclerosis Quality of Life-54 (MSQOL-54), Modified Fatigue Impact Scale (MFIS), and Center for Epidemiologic Studies Depression Scale (CES-D). Regression models were used to analyze associations between patient variables and function and satisfaction. Results were stratified by sex. Cross-sectional and longitudinal data were used. RESULTS 702 PwMS (526 females,176 males, mean age 42.2 +/-11.1, median EDSS 1.5) were included in the cross-sectional analysis. Data from 341 PwMS were used in the three-year longitudinal analysis. Increasing age, disease duration, and disability were associated with reduced sexual function and satisfaction to the same degree in males and females. However, sex differences existed in the strength of associations with QOL variables. There was no significant longitudinal change in females or males. CONCLUSIONS Age and disease duration were associated with reduced sexual function and satisfaction in males and females. In females, function was significantly associated with disability and satisfaction with fatigue. Males had stronger associations with sexual function in domains related to emotional well-being, health perceptions, and overall QOL. Males had stronger associations with satisfaction in emotional and social functioning and physical health domains. These findings can help better understand the multidimensional problems of sexual function and satisfaction in PwMS and better guide patient care.
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Agrawal P, Singh SM, Kohn J, Kohn TP, Clifton M. Sleep Disorders Are Associated with Female Sexual Desire and Genital Response - A U.S. Claims Database Analysis. Urology 2023; 172:79-83. [PMID: 36455681 DOI: 10.1016/j.urology.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the association of common sleep disorders with female sexual dysfunction. MATERIALS AND METHODS We conducted a cross-sectional analysis using the TriNetX Diamond Network. Adult women diagnosed with insomnia, obstructive sleep apnea, or circadian rhythm sleep disorder were assessed to determine the association with female sexual dysfunction, hypoactive sexual desire disorder, female orgasmic disorder, and female sexual arousal disorder. A propensity-score matched control cohort for age, race, ethnicity, tobacco use, outpatient service utilization, obesity, hyperlipidemia, diabetes mellitus, hypertensive disease, ischemic heart disease, and surgical procedures on the female genital system was generated, excluding those with any sleep disorders, sleep deprivation, or morbid obesity with alveolar hypoventilation. All cohorts excluded those with any antidepressant or antipsychotic prescriptions. RESULTS Our query yielded 1,317,491 women diagnosed with sleep apnea, 1,538,567 with insomnia, and 58,902 with circadian rhythm sleep disorder. Women with sleep apnea and insomnia had higher odds of hypoactive sexual desire disorder, female sexual arousal disorder, and female orgasmic disorder compared to matched controls. Women with sleep apnea, insomnia, or circadian rhythm sleep disorder all had a significantly higher odds of female sexual dysfunction compared to matched controls. CONCLUSION In this large cross-sectional analysis, sleep disorders were strongly associated with female sexual dysfunction. It is thus crucial for providers to screen for poor sleep when conducting a thorough evaluation for sexual dysfunction in women to diagnose highly prevalent sleep disorders and improve overall health.
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Affiliation(s)
| | - Sajya M Singh
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jaden Kohn
- The Johns Hopkins Department of Gynecology and Obstetrics, Baltimore, MD
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD.
| | - Marisa Clifton
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD
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Erdős C, Kelemen O, Pócs D, Horváth E, Dudás N, Papp A, Paulik E. Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary. J Clin Med 2023; 12:jcm12031112. [PMID: 36769759 PMCID: PMC9918233 DOI: 10.3390/jcm12031112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Female sexual dysfunction (FSD) has a negative impact on women's quality of life, self-esteem, and physical health. The aim of the present study was to explore the prevalence and the factors associated with FSD using an online questionnaire. A cross-sectional survey was conducted among young adults (18-35 years old) in Hungary using the DSM-5 criteria. The participants (n = 5942) were divided into three major groups: FSD (20.3%), an intermediate group (43.9%), and a control group (35.6%). Most of the women showing FSD were affected with female orgasmic disorder (9.2%) and genito-pelvic pain/penetration disorder (4.6%), while female sexual interest/arousal disorder was found in altogether 100 women (1.7%); 4.8% of women were affected by more than one definite disorder. The occurrence of female sexual dysfunction was related to the women's previous sexual history (first sexual experience, sexual education, early encounter with pornographic content, and sexual abuse), their self-satisfaction (with their own body, genitalia, and sexual attraction), and their sexual orientation. Sexual dysfunction showed a strong association with abuse, sexually transmitted diseases, and self-esteem. The present study identified the relationship between sexual dysfunctions and other health conditions, which can be the basis for some form of screening and early assistance programs for FSD.
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Affiliation(s)
- Csaba Erdős
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
| | - Oguz Kelemen
- Department of Behavioural Sciences, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
- Correspondence: ; Tel.: +36-62-42-0530; Fax: +36-62-54-5968
| | - Dávid Pócs
- Department of Behavioural Sciences, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
| | - Edina Horváth
- Family Medicine Department, University of Szeged, 6725 Szeged, Hungary
| | - Nóra Dudás
- Department of Psychiatry, Ödön Jávorszky Hospital, 2600 Vác, Hungary
| | - András Papp
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
| | - Edit Paulik
- Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
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Yuan D, Zhang XH, Pan J, Zhang YA, Li ZA, Li XL. Predictors of female sexual problems in Shanxi, China: a population-based cross-sectional epidemiologic survey. Sex Med 2023; 11:qfac005. [PMID: 37007848 PMCID: PMC10065183 DOI: 10.1093/sexmed/qfac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Abstract
Background
Large studies on female sexual function have been conducted globally. Nonetheless, whether the state of female sexual function in China is significantly different from that in the rest of the world is largely unknown.
Aim
In this study, we aimed to investigate the associated risk factors for sexual problems in women in Shanxi, China, by conducting a population-based cross-sectional epidemiological survey.
Methods
Using the Chinese version of the Female Sexual Function Index (CV-FSFI), we surveyed women aged 20-70 years to diagnose the sexual problems. We used multiple linear regression models to estimate the risk factors for sexual problems.
Outcomes
We used the CV-FSFI for investigating the female sexual function.
Results
Our results included 6720 women, of whom 1205 were the sexually inactive and 5515 were sexually active. The mean FSFI score for sexually active women was 25.38 ± 4.20 (99% CI 25.27-25.49). Negative numerical coefficients were found for model predictors of age (B = −0.134, P < 0.001), postmenopausal status (B = −2.250, P < 0.001), chronic diseases (B = −0.512, P < 0.001), and gynecologic diseases (B = −0.767, P < 0.001). In contrast, positive numerical coefficients were found for education (B = 0.466, P < 0.001) and cesarean section (B = 0.312, P = 0.009).
Clinical Implications
It is important to pay attention to the sexual health of women and explore the factors influencing the sexual problems of women in China.
Strengths and Limitations
The present study is to our knowledge the first to evaluate the sexual function of women in Shanxi, China. Answers to questions asked in the CV-FSFI survey may be somewhat subjective, and thus additional tools and documentation are probably needed for accurate assessment.
Conclusion
Similarly to other worldwide studies, our study found that increasing age, postmenopausal status, chronic diseases, and gynecological diseases were risk factors for sexual problems, whereas high education levels and cesarean section childbirth were protective factors for sexual problems.
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Affiliation(s)
- Duo Yuan
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University , Taiyuan, China
| | - Xian-hui Zhang
- Department of Internal Medicine, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Jie Pan
- Department of Pathology, Stanford University School of Medicine , CA, 94305 , United States
| | - Ying-an Zhang
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Zhao-ai Li
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Xiao-li Li
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
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Cipriani S, Alfaroli C, Maseroli E, Vignozzi L. An evaluation of bremelanotide injection for the treatment of hypoactive sexual desire disorder. Expert Opin Pharmacother 2023; 24:15-21. [PMID: 36242769 DOI: 10.1080/14656566.2022.2132144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Female sexual response implies a deep intertwining between psychosocial and neurobiological mediators. Regulation of central melanocortin signaling may enhance sexual desire. In premenopausal women with hypoactive sexual desire disorder (HSDD), melanocortin receptor agonist bremelanotide (Vyleesi) has been hypothesized to trigger excitatory brain pathways. AREAS COVERED Hereby we summarize bremelanotide's proposed mechanism of action, pharmacokinetics, efficacy and safety data derived from clinical trials. A literature search of peer-reviewed publications on the current evidence on the pharmacotherapy with bremelanotide was performed using the PubMed database. EXPERT OPINION Bremelanotide appears to be moderately safe and well-tolerated; the most common adverse reaction is nausea (40%). Although data from clinical trials demonstrated a significant change in validated questionnaires, the overall clinical benefit appears to be modest. However, these results should be interpreted in the light of the dramatic challenges in conducting well-designed clinical trials for female sexual dysfunction, due to the significant placebo effect of pharmacotherapy, and the frequent use of outcome measures that are likely to be highly susceptible to expectation biases, such as long periods of recall of sexual and emotional response.
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Affiliation(s)
- Sarah Cipriani
- Department of Experimental Clinical and Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Chiara Alfaroli
- Department of Experimental Clinical and Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental Clinical and Biomedical Sciences Mario Serio, University of Florence, Florence, Italy.,Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
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Sexuality after breast cancer, how to provide a global and contemporary approach. Bull Cancer 2023; 110:113-128. [PMID: 36336478 DOI: 10.1016/j.bulcan.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Patients' sexuality is one of the major and most neglected impact of breast cancer (BC) and its treatment. Even though research is ongoing on the subject, sexuality issues are rarely taken into account and efficiently dealt with in clinical practice. The objective is to review the impact of BC and its treatment on modern women sexuality. In the literature, a heterogeneous level of advancement is notable in the different publishing countries depending on the cultural background; some countries simply do not publish on the matter, others mainly discuss the male partners and practicians experience, and lastly, the most progressive countries have moved up to studying niches of patients such as sexual and gender minorities. A multidisciplinary approach, including pharmacologic and nonpharmacologic management, appears most efficient. There is a need for greater inclusion of partners and for providing a specific training to first-line health care providers. This review provides a general contemporary worldwide overview of the state of the art in sexuality issues in BC patients and survivors.
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Li G, Yu P, Zhang F, Xu Y, Zhou G, Zhan X, Gao Y, Du X, Liu H, He R. The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China. Sci Rep 2022; 12:19421. [PMID: 36371533 PMCID: PMC9653494 DOI: 10.1038/s41598-022-23974-4] [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: 04/12/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Guangyong Li
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Puguang Yu
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Fen Zhang
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yanlong Xu
- grid.8547.e0000 0001 0125 2443Jinshan Hospital of Fudan University, Fudan University, Shanghai, 201500 China
| | - Gaiyan Zhou
- grid.89957.3a0000 0000 9255 8984The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Xuekang Zhan
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yu Gao
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Xiaoli Du
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Hetao Liu
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
| | - Rui He
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
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Silva Esteves de Hollanda G, Pereira Nogueira W, Iansã de Lima Barroso B, de Lima Brito Magalhães R, Moreira Freire ME, de Oliveira E Silva AC. Quality of sexual life of riparian women: Analysis of sexual practices and attitudes. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:405-412. [PMID: 35598872 DOI: 10.1016/j.enfcle.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To analyse the sexual practices, attitudes, and sexual quality of life of Riparian woman and associated factors. METHOD A cross-sectional analytical study conducted among Riparian women using the Study of Sexual Behaviour (SSB) questionnaire. A bivariate analysis and binary logistic regressions were performed to identify factors associated with sexual quality of life. RESULTS A total of 138 women participated in the study (n = 138). Of the women, 34.1% and 33.3% reported pain and loss of interest during or after sex, respectively. In terms of practices during sex, women reported kissing (85.5%), cuddling (89.1%), mutual masturbation (37.2%), oral sex (34.8%), and anal sex (23.9%). However, the majority reported not using condoms during sex (63.0%). In terms of sexual quality of life, 39.9% of the women rated it as good. Higher education and early sexual initiation increase the chances of a "good" sexual quality of life. CONCLUSION Because Riparian women engage in some risky sexual behaviours, such as not using condoms, educational strategies on the prevention of sexually transmitted infections should be reinforced and incorporated in this population. This may help improve these women's sexual quality of life.
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Affiliation(s)
| | - Wynne Pereira Nogueira
- Programa de postgrado en Enfermería, Federal University of Paraíba, João Pessoa, Paraiba, Brasil
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Sood R, Kuhle CL, Thielen JM, Kapoor E, Vencill JA, Mara KC, Faubion SS. Association of mindfulness with female sexual dysfunction. Maturitas 2022; 161:27-32. [PMID: 35688491 DOI: 10.1016/j.maturitas.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Female sexual dysfunction (FSD) affects women of all ages. It is often a multifactorial problem with a strong psychosocial component. Mindfulness may help alleviate FSD with nonjudgmental, present-moment awareness and decreased emotional reactivity. The goal of this study was to assess the association between dispositional or trait mindfulness and FSD. STUDY DESIGN In this cross-sectional study at a tertiary care women's health clinic, 1718 cisgender women (mean age, 51.9 years) completed the Mindfulness Attention Awareness Scale (MAAS), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale-Revised (FSDS-R). MAIN OUTCOME MEASURES Regression analysis was used to test the associations of mindfulness, sexual function, and sexual distress with univariate and multivariable analyses, adjusting for potential confounders. RESULTS Within the sample, 57% of women met FSD criteria (FSFI scores ≤26.55 and FSDS-R ≥ 11). On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD. This association persisted on multivariable analysis after adjusting for potential confounders. CONCLUSIONS Higher trait mindfulness was associated with better sexual function, lower sexual distress, and lower likelihood of FSD. Further studies are needed to assess the role of mindfulness in mitigating FSD.
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Affiliation(s)
- Richa Sood
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States.
| | - Carol L Kuhle
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States
| | - Jacqueline M Thielen
- Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Ekta Kapoor
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, United States; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States; Women's Health Research Center, Mayo Clinic, Rochester, MN, United States
| | - Jennifer A Vencill
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States; Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States
| | - Stephanie S Faubion
- Mayo Clinic Women's Health, Mayo Clinic, Rochester, MN, United States; Women's Health Research Center, Mayo Clinic, Rochester, MN, United States; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
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41
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Kremska A, Wróbel R, Zych B. Prevalence of sexual dysfunctions in women in their early and middle adulthood from the Pokarpackie Voivodeship. MEDICAL SCIENCE PULSE 2022. [DOI: 10.5604/01.3001.0015.8855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Sexual dysfunctions are disorders related to the physiology of sexual responses. Aim of the study: Our study aimed to assess the prevalence of sexual dysfunctions in women in their early and middle adulthood. Material and methods: The early adulthood group consisted of 125 women aged 20–30, and out of these 100 questionnaires qualified for the final analysis. The middle adulthood group consisted of 275 women aged 45–55 in which 200 complete questionnaires were analyzed. The study was conducted in 2016 using a diagnostic survey method and the author's own survey questionnaire, the Mell-Krat Scale for Women and the Female Sexual Function Index (PL-FSFI). Results: Only 38.0% of respondents from the early adulthood group and 25.0% from the middle-adult group interviewed with a gynecologist about their sex life, possible disorders, and problems. Additionally, only 1.0% of women in the middle adulthood group benefited from the advice of a sexologist. According to the interpretation of the Mell-Krat scale, 41.0% of respondents in the early adulthood group and 76.0% of women in the middle adulthood group had a suboptimal score. These results indicate the possibility of sexual response disorders. All women in the early adulthood group and middle adulthood group scored below normal on the PL-FSFI scale indicating that the respondents are at risk for sexual disorders. Conclusions: According to the PL-FSFI scale, all women in the study may be at risk of sexual disorders. According to the Mell-Krat scale, as many as ¾ of women might suffer from sexual response disorders or are at risk of sexual disorders. Taking into account the significance of a sex life, it is necessary to take action to provide women with professional medical and psychological help to improve their intimacy sphere of life.
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Affiliation(s)
- Anna Kremska
- Obstetrics and Gynaecology Health Care Centre, Institute of Health Sciences, University of Rzeszow, Poland
| | - Romana Wróbel
- Obstetrics and Gynaecology Health Care Centre, Institute of Health Sciences, University of Rzeszow, Poland
| | - Barbara Zych
- 1. Obstetrics and Gynaecology Health Care Centre, Institute of Health Sciences, University of Rzeszow, Poland
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Silva Esteves de Hollanda G, Pereira Nogueira W, Iansã de Lima Barroso B, de Lima Brito Magalhães R, Moreira Freire ME, de Oliveira e Silva AC. Calidad de vida sexual de las mujeres ribereñas: análisis de las prácticas y actitudes sexuales. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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FSFI score and timing of tubal ligation in patients: preliminary results of an online survey. Arch Gynecol Obstet 2022; 306:795-800. [PMID: 35397718 PMCID: PMC9411076 DOI: 10.1007/s00404-022-06547-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/21/2022] [Indexed: 11/02/2022]
Abstract
Abstract
Introduction
Tubal ligation is the most common contraceptive method worldwide. Apart from a very low pearl index and anxiety relief, other benefits are not commonly recognised. In young patients, there is the post-operative risk of regretting the decision with the need for In-Vitro-Fertilisation or refertilising surgery. Positive side effects have not been widely published. In our study we investigated the change in the female sexual function index score after tubal ligation.
Material and method
In this survey the FSFI score of participants around the time of the tubal ligation was compared with the FSFI score of intermediate and long-term time distance to the ligation.
Results
The data indicate an increase in younger women seeking information on permanent contraception and whilst the FSFI score of the early group indicates a risk of female sexual dysfunction, the intermediate and long-term FSFI scores are comparable to published control groups.
Discussion
Besides the obvious benefit of a low pearl index, tubal ligation may contribute to reduce the risk of female sexual dysfunction in the mid and long term. Informed consent is essential for the surgeon and patient to weigh up the risks and benefits individually including possible future perspectives on family planning.
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44
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Liao X, Zhao S, Yin J, Liu L, Liang J, Jiang Y, Yu N, Fan R, Zhong C. Sexual Dysfunction in Patients with Chronic Hepatitis B: Prevalence and Risk Factors. J Sex Med 2022; 19:207-215. [PMID: 34969615 DOI: 10.1016/j.jsxm.2021.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) is an increasingly serious global problem that has adverse effects on the physical and mental health of patients. AIM This study aimed to investigate the prevalence of SD and its related factors in patients with chronic hepatitis B (CHB). METHODS A total of 673 outpatients with CHB from October 2019 to December 2020 were included in the analysis. Demographic and clinical information was collected at enrolment. The Arizona Sexual Experiences Scale was used to evaluate SD. OUTCOMES The primary outcome measure was the prevalence of SD in CHB patients and its associated factors. Secondary outcomes were the corresponding scores in five domains of ASEX: drive, arousal, lubrication and/or erection, orgasm and satisfaction from orgasm. RESULTS The average age of patients was 47.0 years, with 85.6% male and 88.1% with cirrhosis. The SD prevalence was 25.4% and was increased with the decrease in liver function reserve (Child-Pugh A vs Child-Pugh B: 24.6% vs 44.8%, P = .016), the progression of liver fibrosis (FIB-4 < 1.45, 1.45-3.25, and > 3.25: 21.3%, 26.5%, and 34.4%, respectively; P < .001), and the aggravation of depression (without, mild, and moderate to severe: 18.1%, 33.6%, and 34.2%, respectively; P < .001). In multivariate analysis, SD was independently correlated with female sex (OR: 5.627, 95% CI: 3.501 - 9.044, P < .001), liver fibrosis (OR: 1.730, 95% CI: 1.054 - 2.842, P = .030), depression (OR: 2.290, 95% CI: 1.564 - 3.354, P < .001), and frequent diarrhea and/or upper respiratory tract infection/urinary system infection (OR: 2.162, 95% CI: 1.313-3.560, P = .002). CLINICAL IMPLICATIONS This study revealed the current situation of SD in CHB patients in China, and appealed to clinicians to pay attention to the physical and mental health of the CHB patients. STRENGTHS AND LIMITATIONS This study has a large sample size and detailed demographic and clinical data. It evaluated the relationship between SD and liver function reserve and liver fibrosis degree, and compared gender differences of SD. However, this study is a cross-sectional study design and does not include healthy controls. The effects of conflicts between the couple, SD in a partner, antidepressants and hormone changes on SD were not analyzed. CONCLUSION SD in CHB patients was highly prevalent, and its prevalence increased significantly with the deterioration of liver function reserve, liver fibrosis and depression. Additional longitudinal studies are needed to further explore its causality. Xingmei L, Siru Z, Junhua Y, et al. Sexual Dysfunction in Patients with Chronic Hepatitis B: Prevalence and Risk Factors. J Sex Med 2022;19:207-215.
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Affiliation(s)
- Xingmei Liao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Siru Zhao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Junhua Yin
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Li Liu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Jinlin Liang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Yiyue Jiang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Ning Yu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China
| | - Rong Fan
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
| | - Chunxiu Zhong
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangzhou, China.
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Vranješ IM, Školka I, Jakab J, Krajina I, Krajina V, Šantić A, Zibar L. Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study. Int Urol Nephrol 2022; 54:2037-2046. [DOI: 10.1007/s11255-021-03095-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
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46
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Lozano-Lozano M, Rodenas-Herranz T, Ruiz-Villaverde R. Sexual Dysfunction and Atopic Dermatitis: A Systematic Review. Life (Basel) 2021; 11:life11121314. [PMID: 34947845 PMCID: PMC8708093 DOI: 10.3390/life11121314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin whose main symptom is pruritus and may affect all age ranges. Regarding the prevalence, it has been estimated at around 10% of the world population. Many concomitant diseases have been associated with AD, but the causal relationship between AD and psychological impairment has not been clearly established. Scientific literature studying the probable association between male or female sexual dysfunction and dermatological pathology is limited, even more so in AD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the Cochrane Collaboration methodology for systematic reviews. All relevant articles in English were identified through a search from inception to 10 December 2020, including the following databases: Medline (via PubMed), Scopus, Web of Science Core Collection, and SciELO. The results of the search were compiled using the COVIDENCE software for systematic reviews. The methodological quality of the included studies was done using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” and the “Quality Assessment of Case-Control Studies” developed by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH). Our search yielded potentially relevant studies. Five studies that evaluated the prevalence of sexual dysfunction in atopic dermatitis were retrieved after applying the selection criteria. The present systematic review achieved data from 8088 patients with atopic dermatitis from four articles. Sample sizes for atopic dermatitis patients ranged from 266 to 3997. We identified one cohort study with four years of follow-up, three studies with a cross-sectional design, and one case-control study. Three studies reported data disaggregated by the severity of atopic dermatitis. Two studies included healthy controls with a total sample size of 1,747,755 subjects. Two studies compared data with other dermatological conditions such as psoriasis. In conclusion, we can establish that unlike other psychological comorbidities such as anxiety and depression, sexual dysfunction is a field scarcely explored in the literature. This sexual dysfunction focuses on the male sex in large population studies and in clinical diagnoses without exploring it through specific and validated questionnaires in this regard. Further studies focused on both genders are needed. It is important to correlate this sexual dysfunction with the severity of the disease, previous treatments, and cardiovascular comorbidities.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Correspondence:
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, 18011 Granada, Spain;
- Psychiatry Service, Hospital Clínico San Cecilio, 18016 Granada, Spain
- CTS-549 Research Group, Institute of Neuroscience, University of Granada, 18016 Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18011 Granada, Spain
- Sport and Health Joint University Institute (iMUDS), University of Granada, 18011 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18011 Granada, Spain
| | - Teresa Rodenas-Herranz
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain; (I.L.-L.); (T.R.-H.); (R.R.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
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Bostani Khalesi Z, Pouralizadeh M, Maroufizadeh S. Sexual function and sexual quality of life in relation to the COVID-19 pandemic in Iranian couples. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.2007234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Moluk Pouralizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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48
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Tuncer M, Oskay ÜY. Sexual Counseling with the PLISSIT Model: A Systematic Review. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:309-318. [PMID: 34789082 DOI: 10.1080/0092623x.2021.1998270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A systematic review was conducted to use recent and relevant literature resources in examining the sexual counseling with the PLISSIT model. Electronic literature search was conducted on Medline, Science Direct, Google Scholar, and PubMed between January 1, 2011, and March 1, 2021. 14 studies were included in the systematic review. The mostly used study design was randomized controlled trial. It was determined that PLISSIT model on sexual counseling is an effective, simple, useful, and cost-effective counseling method.
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Affiliation(s)
- Merve Tuncer
- Faculty of Health Science, Department of Woman Health and Diseases Nursing, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ümran Yeşiltepe Oskay
- Faculty of Nursing, Department of Woman Health and Diseases Nursing, Istanbul University Cerrahpasa Florence Nightingale, Istanbul, Turkey
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49
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Monteiro MN, Micussi MTABC, Cruz VTD, Oliveira MCD, Medeiros KS, Sarmento ACA, Gonçalves AK. Pelvic floor muscle training program for women in the puerperal period: clinical progress after intervention. Rev Assoc Med Bras (1992) 2021; 67:851-856. [PMID: 34709329 DOI: 10.1590/1806-9282.20210164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/21/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the sexual function of women in the puerperal period after a postpartum pelvic floor musculature training program. We also sought to evaluate correlations between sexual dysfunction in the women and their delivery type and compare the frequency of sexual dysfunction and the quality of resumed sexual function following vaginal and cesarean deliveries. METHODS This clinical study included an intervention, carried out between July and December 2019, in which data were collected about 28 rooming-in women at a Maternity School. Data were divided into vaginal delivery and cesarean delivery. Sexual function was evaluated by the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Short Form to assess the Incontinence Urinary and qualifies urinary loss. The intervention consisted of a muscle training exercise program. ANOVA tests were used to establish differences between groups. RESULTS There was an improvement in all outcomes, but there was no time versus group interaction. Improvement in sexual function was observed (p<0.001), the impact of urinary incontinence on quality of life (p<0.001), and pressure of the muscles of pelvic floor muscles (p<0.001) over time. There was no time versus group interaction for sexual function (p=0.87), the impact of urinary incontinence on quality of life (p=0.88), and pressure of the pelvic floor muscles (p=0.66). CONCLUSIONS Pelvic floor muscle exercise programs seem to be a very promising strategy concerning improving sexual activity among puerperal patients.
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Affiliation(s)
- Michelly Nóbrega Monteiro
- Universidade Federal do Rio do Grande do Norte, Health Sciences Postgraduate Program - Natal (RN), Brazil
| | | | | | | | - Kleyton Santos Medeiros
- Universidade Federal do Rio do Grande do Norte, Health Sciences Postgraduate Program - Natal (RN), Brazil
| | | | - Ana Katherine Gonçalves
- Universidade Federal do Rio do Grande do Norte, Health Sciences Postgraduate Program - Natal (RN), Brazil.,Univesidade Federal do Rio Grande do Norte, Department of Obstetrics and Gynaecology - Natal (RN), Brazil
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50
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Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Ruiz-Villaverde R, Lozano-Lozano M. Sexual dysfunction in a cohort of patients with moderate-to-severe atopic dermatitis. Influence of dupilumab treatment. Int J Dermatol 2021; 61:607-610. [PMID: 34633064 DOI: 10.1111/ijd.15938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/05/2021] [Accepted: 09/20/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Atopic dermatitis is a systemic and immune-mediated dermatological disease that comprises a wide group of physiological and psychological comorbidities. Within the latter, the evaluation of anxiety and depression has been the subject of numerous studies, but sexual dysfunction (SD) is a fact that is rarely addressed in the literature. The objective of the present study is to assess the prevalence of SD in a cohort of patients with moderate-to-severe atopic dermatitis (AD) and to establish the possible impact of dupilumab therapy on it. MATERIAL AND METHODS A cross-sectional study was performed. Recruited patients had been diagnosed with moderate-to-severe AD at the Dermatology Unit of the Hospital Universitario San Cecilio, Granada, Spain, from July 1, 2019, through June 30, 2020. They were followed up for a 6-month period during which the impact of dupilumab treatment was measured. The main variable under study, sexual dysfunction, was evaluated differently according to gender. Regarding the male patients, the International Index Erectile Function (IIEF-5) was applied, whereas for female patients, the questionnaire "Female Sexual Function Index" was used. RESULTS Our study included 31 patients, 18 men and 13 women. Men's mean age was 35 +/- 14.55 years, while that of women was 33 +/- 10.46 years. Seventy-nine percent of patients in our series (n = 22) had SD compared to 29% (n = 9) who did not. A total of 66.9% of males and 76.9% (n = 10) of females sampled, suffered from SD. Six months after initiation of treatment, none of the patient had stopped it due to efficacy or safety issues. All severity indices (SCORAD, EASI, VAS pruritus, and DLQI) had significantly improved by more than 50% from baseline. The improvement in the sexual dysfunction index had improved by four points, both in the male and female patients. DISCUSSION Many large population studies on SD in patients with moderate-to-severe atopic AD only focus on male gender and clinical diagnoses, rather than specific and validated questionnaires. Dupilumab treatment in patients with moderate-to-severe AD has shown a positive impact on the levels of SD in both male and female populations. Further studies focused on populations with mild atopic AD and with larger sample sizes are required to corroborate these preliminary results.
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Affiliation(s)
- Laura Linares-Gonzalez
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Ignacio Lozano-Lozano
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Luis Gutierrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain.,CTS-549 Research Group, Institute of Neuroscience, Granada, Spain
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain
| | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,Department of Physical Therapy, Faculty of Health Sciences, and University of Granada, Sport and Health Joint University Institute (iMUDS), Granada, Spain.,''Cuídate'' Support Unit for Oncological Patients (UAPO-Cuídate), Granada, Spain
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