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Caira-Chuquineyra B, Fernandez-Guzmán D, Garayar-Peceros H, Benites-Zapata VA, Pérez-López FR, Blümel JE, Mezones-Holguín E. Efficacy and safety of visnadine in the treatment of symptoms of sexual dysfunction in heterosexual women: a systematic review of randomized clinical trials. Gynecol Endocrinol 2024; 40:2328619. [PMID: 38528806 DOI: 10.1080/09513590.2024.2328619] [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: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women. METHODS We conducted a systematic review of randomized clinical trials (RCTs) with a primary search without language restriction in PubMed/Medline, Scopus, Embase, Web of Science, Cochrane Library, and international clinical trial registries. Trials reporting the use of visnadine by any route in women with SD were eligible. We performed screening, data extraction, and risk of bias assessment in a double-blind approach. The primary outcomes were the Female Sexual Function Index (FSFI) and its domains. Secondary outcomes were safety, arousal, lubrication, pleasure, orgasm, negative sensations, duration, and overall satisfaction. RESULTS Initially, 242 records were retrieved. We selected nine papers for full-text reading and finally included two RCTs: one with a parallel design and one with a crossover design with a total of 96 patients. One study compared visnadine aerosol with a placebo, while the other compared different frequencies of visnadine aerosol use. Visnadine use showed a statistically significant improvement (p < 0.05) in overall FSFI scores, regardless of the frequency of use. A meta-analysis was not possible due to the high clinical and methodological heterogeneity between available studies. CONCLUSION RCTs regarding the use of visnadine for the Female SD are scarce and methodologically limited. This preliminary evidence shows visnadine as a potentially effective and safe option to alleviate some of the clinical symptoms of SD in heterosexual women. However, future better-designed randomized studies with larger sample numbers are required.
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Affiliation(s)
| | | | | | - Vicente A Benites-Zapata
- Research Unit for the Generation and Synthesis of Health Evidence, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Juan E Blümel
- Faculty of Medicine, Universidad de Chile, Santiago de Chile, Chile
| | - Edward Mezones-Holguín
- Centre of Excellence for Social and Economic Studies in Health, Universidad San Ignacio de Loyola, Lima, Perú
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Schmidt NM, Hennig J, Munk AJL. Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women. Front Behav Neurosci 2024; 18:1386006. [PMID: 38813468 PMCID: PMC11133591 DOI: 10.3389/fnbeh.2024.1386006] [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: 02/14/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
Background As outlined by the dual control model (DCM), individual differences in the regulation of sexual arousal following sexual stimulation depend on two distinct neurophysiological processes: sexual excitation (SE) and sexual inhibition (SI). Although associations with sexual function, behavior, and cue processing have been demonstrated in previous research, underlying neural correlates remain insufficiently explored. Moreover, interactive effects of SE/SI as proposed by the DCM, as well as factors impacting SE/SI properties, such as the use of oral contraceptives (OCs), have not received adequate attention in existing research. Methods 90 healthy, sexually active women (n = 51 using OCs, n = 39 naturally cycling) completed an Emotional-Picture-Stroop-Paradigm (EPSP) while a 64-channel EEG was recorded. LPP amplitudes toward erotic and neutral stimuli were consecutively computed as a marker of motivational salience and approach motivation. Additionally, women provided self-reports of SE/SI and sexual function. Moderation analyses were performed to assess interactive effects of SE/SI in predicting LPP amplitudes and sexual function. Results Sexual function was negatively associated with SI levels but unrelated to SE. Higher SI was associated with reduced LPP amplitudes in response to erotic stimuli. This negative association was, however, attenuated for women high in SE, suggesting interactive effects of SE/SI. Furthermore, women using OCs reported lower SE compared to naturally cycling women. Conclusion The observed findings provide additional psychophysiological evidence supporting the DCM and underscore the relevance of interactive SE/SI effects in stimulus processing and approach motivation. They also highlight the possible impact of OCs on psychosexual variables that warrants further research.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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Żak K, Starek E, Korga-Plewko A, Rasoul-Pelińska K, Abramiuk M, Michalczuk M, Rajtak A, Kotarski J, Frankowska K, Bis L, Ostrowska-Leśko M, Bobiński M. Assessment of the Impact of SARS-CoV-2 Infection on the Sexual Function of Women, Levels of Oxytocin and Prolactin: A Prospective Cohort Study. J Clin Med 2024; 13:2230. [PMID: 38673504 PMCID: PMC11051359 DOI: 10.3390/jcm13082230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: There is a lack of direct evidence on whether SARS-CoV-2 affects women's sexual function through a biological-organic mechanism. Existing studies on the topic are few and have produced contradictory results. This study aims to explore the possible relationship between sex hormones and sexual function in patients who have been infected with SARS-CoV-2. Moreover, we aimed to determine whether these changes are related to the clinical course of COVID-19 and whether they are temporary or long-lasting. (2) Methods: A study was conducted on 104 women, including 64 women infected with COVID-19 and a control group of 40 healthy women, between January 2021 and August 2022. Blood samples were collected to measure prolactin and oxytocin levels, and a clinical assessment was performed 3 and 6 months later. Sexual function self-assessment was captured based on the FSFI scale. (3) Results: Our study found that patients with severe COVID-19 had better sexual satisfaction scores one month after recovery but no discernible difference after six months. High levels of serum prolactin were observed in patients with active COVID-19 but became similar to a control group after one month and remained stable over time. Higher prolactin levels were significantly associated with increased arousal and hydration. Individuals with severe COVID-19 had notably low levels of plasma oxytocin, but there was no correlation between oxytocin levels and sexual satisfaction. (4) Conclusions: The gynecologic symptoms, as well as disturbances in oxytocin and prolactin levels, might be observed in a short time after infection. However, SARS-CoV-2 infection has no lasting effect on sexual function, oxytocin, and prolactin levels among women.
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Affiliation(s)
- Klaudia Żak
- Department of Medical Chemistry, Medical University of Lublin, 20-059 Lublin, Poland
| | - Ernest Starek
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Agnieszka Korga-Plewko
- Independent Medical Biology Unit, Medical University of Lublin, 20-090 Lublin, Poland; (A.K.-P.); (M.M.)
| | - Karolina Rasoul-Pelińska
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Monika Abramiuk
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
- Independent Laboratory of Minimally Invasive Gynecology and Gynecological Endocrinology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Mariola Michalczuk
- Independent Medical Biology Unit, Medical University of Lublin, 20-090 Lublin, Poland; (A.K.-P.); (M.M.)
| | - Alicja Rajtak
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Jan Kotarski
- Independent Laboratory of Cancer Diagnostics and Immunology, Medical University in Lublin, 20-081 Lublin, Poland;
| | - Karolina Frankowska
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Liliana Bis
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
| | - Marta Ostrowska-Leśko
- Chair and Department of Toxicology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Marcin Bobiński
- I Chair and Department of Oncologic Gynecology and Gynecology, Medical University of Lublin, 20-081 Lublin, Poland; (K.R.-P.); (M.A.); (A.R.); (K.F.); (M.B.)
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Moore E, Sitron J. Sexual Self Discrepancies, Sexual Satisfaction, and Relationship Satisfaction in a Cross-Sectional Sample of Women Who Experience Chronic Vaginal Pain during Sexual Intercourse. Healthcare (Basel) 2024; 12:798. [PMID: 38610220 PMCID: PMC11011563 DOI: 10.3390/healthcare12070798] [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: 02/27/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
One out of three women may suffer from chronic vaginal pain during intercourse, a complex health issue that leads to lasting psychological, sexual, emotional, and relational difficulties even after initial relief. Women who experience this pain condition may compare their sexual selves to the societal norm of being pain-free. Comparisons that do not align with one's actual sexual self result in sexual self-discrepancies and may cause emotional distress. Sexual self-discrepancies may hinder sexual and relationship satisfaction for women who experience chronic vaginal pain during sexual intercourse. This mixed-method study examined the sexual self-discrepancies women reported and the degree to which their sexual self-discrepancies were related to their sexual and relationship satisfaction. Results from this cross-sectional study showed that the majority of participants experienced sexual self-discrepancies and that they experienced a significant inverse correlation between sexual self-discrepancies and sexual satisfaction. In multivariate models, sex frequency was the strongest predictor of sexual satisfaction. There were no correlations between sexual self-discrepancies and relationship satisfaction. Future measurement research should examine the role of sex frequency in the experience of sexual satisfaction. Education on maximizing pleasure and minimizing pain may aid women to cope with the negative impact of pain.
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Affiliation(s)
| | - Justin Sitron
- Center for Human Sexuality Studies, Interdisciplinary Sexuality Research Collaborative, Widener University, Chester, PA 19013, USA;
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Yang Y, Huang XX, Huo RX, Lin JY. Sexual health in women with Sjogren's syndrome: A review. Eur J Obstet Gynecol Reprod Biol 2023; 291:1-9. [PMID: 37801781 DOI: 10.1016/j.ejogrb.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 09/07/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Rheumatic diseases, mainly affecting women, including rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, etc., are chronic, inflammatory, autoimmune disorders that may involve multiple organs or systems and are closely related to sexual health, which is an important aspect of human physical and mental health. Sjogren's syndrome (SS) is the second most common rheumatic illnesses after rheumatoid arthritis with a female predominance. At present, the research on sexual health of female SS patients is still scarce and difficult to summarize. OBJECTIVES The objective of our study was to systematically review the literature for the influence of maternal SS on sexual health, such as sexual function, sex hormones, fertility, and pregnancy outcomes. METHODS We performed a comprehensive literature search based on PubMed and Web of science databases from inception to 1 November 2022. Outcomes were divided into 4 categories: sex hormones, sexual function, fertility, and pregnancy and offspring outcomes. RESULTS A total of 756 potentially eligible papers were retrieved. After eliminating duplicate articles and reviewing the titles and abstracts to exclude records, we read the remaining 92 articles in full for further evaluation, and selected 42 studies. Results on sex hormones, sexual function, fertility and pregnancy and offspring outcomes were reported in 13, 12, 3 and 14 SS-related articles, respectively. The levels of some sex hormones in SS patients may have undergone changes. Female patients with SS have a high prevalence of sexual dysfunction compared with controls. Most studies suggested SS had an adverse impact on maternal and fetal outcomes following pregnancy. However, there is insufficient evidence that directly indicating the fertility of SS women is diminished. CONCLUSIONS In summary, certain aspects of sexual health (sexual function, sex hormones and pregnancy outcomes) are impaired in SS women. Screening for sexual health problems in SS female should become an integral part of medical clinical practice. Rheumatologists should be aware of this association and collaborate with gynecologists, obstetricians, psychologists, and other experts on this issue to determine appropriate therapeutic approaches.
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Affiliation(s)
- Yang Yang
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xin-Xiang Huang
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rong-Xiu Huo
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jin-Ying Lin
- Department of Rheumatology and Immunology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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Alavi-Arjas F, Goodman MP, Simbar M, Alavi Majd H, Nahidi F. The strength of correlation between female genital self-image and sexual function: a systematic review and meta-analysis. J Sex Med 2023; 20:1376-1383. [PMID: 37814530 DOI: 10.1093/jsxmed/qdad118] [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: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/24/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Mounting evidence indicates that female genital aesthetic complaints impact sexual relationships. AIM The study sought to determine the strength of the correlation between genital self-image and sexual function. METHODS Electronic databases were comprehensively searched including PubMed, Web of Science, Scopus, PsycINFO, Embase, and the Cochrane Library from January 2000 to December 2022. After duplicate removal, 146 articles were retrieved by searching keywords in titles and abstracts. OUTCOMES A positive correlation is noted between genital self-image and sexual function; the strength of this correlation was 0.375. RESULTS By omitting irrelevant articles according to the eligibility criteria, 16 articles remained for a total of 13 505 participants. All but 1 of them indicated a statistically significant positive correlation between genital self-image and sexual function. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity. CLINICAL IMPLICATIONS The results of this study may be used in counseling women with sexual dysfunction who are dissatisfied with their genital appearance. STRENGTHS AND LIMITATIONS This study is the first systematic review to reveal the strength of the correlation between genital self-image and sexual function. The most important limitation of this study is the heterogeneity of the studies reported. CONCLUSION This systematic review indicates a positive correlation between genital self-image and sexual function. The results are restricted by inconsistency of the articles considered. Using different tools in different cultural contexts without considering confounding factors leads to a wide range of correlation sizes and significant heterogeneity is evident.
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Affiliation(s)
- Fatemeh Alavi-Arjas
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Michael P Goodman
- Department of Obstetrics and Gynecology, California Northstate University College of Medicine, Elk Grove CA 95757, United States
- The Labiaplasty and Vaginoplasty Training Institute of America, Winters, CA 95694, United States
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, 1971653313, Iran
| | - Fatemeh Nahidi
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
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Ventura-Aquino E, Ågmo A. The elusive concept of sexual motivation: can it be anchored in the nervous system? Front Neurosci 2023; 17:1285810. [PMID: 38046659 PMCID: PMC10691110 DOI: 10.3389/fnins.2023.1285810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Sexual motivation is an abstract concept referring to the mechanisms determining the responsivity to sexually relevant stimuli. This responsivity determines the likelihood of producing a sexual response and the intensity of that response. Both responsivity to stimuli and the likelihood of making a response as well as the intensity of response are characteristics of an individual. Therefore, we need to assume that the concept of sexual motivation materializes in physiological mechanisms within the individual. The aim of the present communication is to analyze the requisites for the endeavor to materialize sexual motivation. The first requisite is to provide an operational definition, making the concept quantifiable. We show that parameters of copulatory behavior are inappropriate. We argue that the intensity of sexual approach behaviors provides the best estimate of sexual motivation in non-human animals, whereas the magnitude of genital responses is an exquisite indicator of human sexual motivation. Having assured how to quantify sexual motivation, we can then proceed to the search for physiological or neurobiological underpinnings. In fact, sexual motivation only manifests itself in animals exposed to appropriate amounts of gonadal hormones. In female rats, the estrogen receptor α in the ventrolateral part of the ventromedial nucleus of the hypothalamus is necessary for the expression of sexual approach behaviors. In male rats, androgen receptors within the medial preoptic area are crucial. Thus, in rats sexual motivation can be localized to specific brain structures, and even to specific cells within these structures. In humans, it is not even known if sexual motivation is materialized in the brain or in peripheral structures. Substantial efforts have been made to determine the relationship between the activity of neurotransmitters and the intensity of sexual motivation, particularly in rodents. The results of this effort have been meager. Likewise, efforts of finding drugs to stimulate sexual motivation, particularly in women complaining of low sexual desire, have produced dismal results. In sum, it appears that the abstract concept of sexual motivation can be reliably quantified, and the neurobiological bases can be described in non-human animals. In humans, objective quantification is feasible, but the neurobiological substrate remains enigmatic.
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Affiliation(s)
- Elisa Ventura-Aquino
- Escuela Nacional de Estudios Superiores, Unidad Juriquilla, UNAM, Juriquilla, Mexico
| | - Anders Ågmo
- Department of Psychology, University of Tromsø, Tromsø, Norway
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Fabricio AMF, Sato TO, Gomes da Silva S, Poli GG, de Araujo Silva CM, Padovez RDFCM, Rodrigues de Souza DP, Driusso P, Beleza ACS. Prevalence and factors associated with sexual dysfunction in brazilian women: a cross-sectional study. Int Urogynecol J 2023; 34:2507-2511. [PMID: 37222738 DOI: 10.1007/s00192-023-05562-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/15/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Changes in the mechanisms that modulate sexual response can contribute to the development of female sexual dysfunction (FSD). Although the prevalence of FSD in Brazil has been established, its associated risk factors have not been thoroughly examined. This study aimed to determine the prevalence of FSD in Brazilian women and identify any factors that may be associated with its presence. METHODS This study used a cross-sectional design and included women aged 18 years or older who had engaged in sexual activity within the past four weeks. Participants completed the Female Sexual Function Index (FSFI) and a sociodemographic and health questionnaire. Two groups were created based on FSFI scores: those with risk for FSD (score >26.55) and those without. The study used t-tests for independent samples to compare quantitative variables between the groups, and the chi-squared test, to compare categorical variables. Binomial logistic regression was used to test the association between sociodemographic and health variables and FSD. RESULTS FSD had a prevalence of 31.7% (95% CI: 28.2%-35.5%). The results indicated that practice of physical activity was inversely associated with FSD (OR: 0.64, 95% CI: 0.45-0.92), whereas urinary incontinence (OR: 2.55, 95% CI: 1.68-3.87) and post-menopause (OR: 4.69, 95% CI: 1.66-13.3) were directly associated with FSD. CONCLUSIONS A high prevalence of FSD was observed among Brazilian women in this study. Physically active women are less likely to have FSD. Menopause and the presence of urinary incontinence can negatively impact female sexual function.
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Affiliation(s)
| | - Tatiana Oliveira Sato
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | - Stéfany Gomes da Silva
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | - Giovana Garçoni Poli
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
| | | | | | | | - Patricia Driusso
- Federal University of São Carlos (UFSCar), Rod. Washington Luís km 235 -SP-310, São Carlos, SP, Brazil
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Saltzman RG, G Campbell K, J Ripps S, Golan R, Cabreja-Castillo MA, Garzon AM, Rahman F, Caceres LV, Tovar JA, Khan A, Hare JM, Ramasamy R. The impact of cell-based therapy on female sexual dysfunction: a systematic review and meta-analysis. Sex Med Rev 2023; 11:333-341. [PMID: 37279578 DOI: 10.1093/sxmrev/qead023] [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: 01/17/2022] [Revised: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Female sexual dysfunction (FSD) is a complex issue affecting women of all ages; it involves several overlapping body systems and profoundly affects quality of life. The use of cell-based therapy, such as mesenchymal stem cells, has recently been investigated as a potential treatment for FSD. OBJECTIVES This systematic review and meta-analysis aim to assess FSD outcomes following cell-based therapy. METHODS We evaluated peer-reviewed articles from multiple online databases through November 2022 to identify studies that used cell-based therapy and reported sexual function outcomes in women. We performed a meta-analysis using data pooled from 3 clinical trials at our institution: CRATUS (NCT02065245), ACESO (NCT02886884), and CERES (NCT03059355). All 3 trials collected data from the Sexual Quality of Life-Female (SQOL-F) questionnaire as an exploratory outcome. RESULTS Existing literature on this topic is scarce. Five clinical studies and 1 animal study were included in the systematic review, and only 2 clinical studies were considered good quality: 1 reported significant SQOL-F improvement in women 6 months after cell therapy, and 1 reported posttherapy sexual satisfaction in all women. When individual patient data were pooled in a meta-analysis from 29 women across 3 trials at our institution, the SQOL-F was not significantly improved. CONCLUSION Despite growing interest in cell-based therapy for women's sexual health, this important issue is understudied in the literature. The optimal route, source, and dose of cell therapy to produce clinically meaningful change have yet to be determined, and further research is needed in larger randomized placebo-controlled clinical trials.
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Affiliation(s)
- Russell G Saltzman
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Katherine G Campbell
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Sarah J Ripps
- College of Medicine, Florida State University, Tallahassee, FL 32304, United States
| | - Roei Golan
- College of Medicine, Florida State University, Tallahassee, FL 32304, United States
| | - Maria A Cabreja-Castillo
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Ana Maria Garzon
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Farah Rahman
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Lina V Caceres
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Jairo A Tovar
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Aisha Khan
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Joshua M Hare
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
- Division of Cardiovascular Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, 33136. United States
| | - Ranjith Ramasamy
- Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
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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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Velten J, Margraf J. Exploring barriers and facilitators to women's intention and behavior to seek treatment for distressing sexual problems. PLoS One 2023; 18:e0288205. [PMID: 37463132 DOI: 10.1371/journal.pone.0288205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
Many women experience distressing problems with sexual functioning, most commonly in the form of low sexual desire or arousal, difficulties reaching orgasm, or genito-pelvic pain with sexual activity. Although effective treatments are available, more than half of the women who experience distressing sexual problems do not seek professional help. Understanding help-seeking patterns, experiences with treatment providers, and barriers to treatment is crucial to address this underutilization. Examining the role of personal characteristics, sexual problem symptoms, and cognitive factors in explaining the intention to seek treatment can help identify individuals who are most reluctant to seek help. Psychological online interventions are a promising resource to increase the availability of effective treatments. Knowledge about the predictors of women's intention to use internet-delivered treatments, as well as information about personal preferences regarding their scope, can help tailor them to women's needs. To address these research questions, cross-sectional data of 800 women (Mage = 30.49, range = 18-73) were analyzed. While many women considered clinical psychologists to be the most qualified treatment providers, gynecologists were cited as the most likely first point of contact. Among women not utilizing any treatments, many reported a preference for dealing with a sexual problem on their own as a reason not to seek help. Higher help-seeking intention was related to living in a larger city, experiencing higher sexual distress, experiencing pain or difficulties with vaginal penetration, higher self-stigma. and lower sexual assertiveness. Women who were convinced of the effectiveness of psychological online interventions and who appreciated the benefits of anonymity indicated that they were more likely to use them. Understanding what factors influence women's decisions about whether or not to seek professional help for distressing sexual problems is key to reducing the underutilization of available resources and developing treatments that meet their needs and preferences.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
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12
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Mao Q, Cai T, Li H, Chu Y, Cui Y, Wu J. The efficacy of CO 2 laser in the treatment of genitourinary syndrome of menopause: a systematic review and meta-analysis of randomized controlled trials. Lasers Med Sci 2023; 38:152. [PMID: 37382691 DOI: 10.1007/s10103-023-03808-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
CO2 laser has been proposed as a treatment strategy for genitourinary syndrome of menopause (GSM). In order to assess its efficacy for treating GSM, we conducted a systematic review and meta-analysis. To identify the current state of randomized controlled trials on CO2 laser therapy for GSM, a literature review was conducted. We systematically searched the following databases: PUBMED, EMBASE and the Cochrane Controlled Trials Register. In addition, a review of the references in the retrieved studies was carried out. Of 562 identified studies, 9 were eligible and were included in our analysis, involving 523 patients in total. Based on our analysis, CO2 laser has no statistical difference compared with estrogen in VHI (p = 0.87), FSFI total score (p = 0.19), FSFI-Arousal (p = 0.11), FSFI-Desire (p = 0.72), FSFI-Orgasm (p = 0.45) and FSFI-Satisfaction (p = 0.08). The meta-analysis also showed that CO2 laser significantly improved FSFI-Lubrication scores compared with estrogen therapy (p = 0.0004). Furthermore, compared with the sham group, CO2 laser group had statistically improved VHI scores (p = 0.003) and FSFI scores (p < 0.00001). CO2 laser therapy may be an effective alternative to estrogen therapy for GSM both in cases where estrogen is not applicable because of comorbidities and in cases in which women do not desire to take estrogen.
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Affiliation(s)
- Qiancheng Mao
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Tong Cai
- The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Haijuan Li
- Department of Clinical Nutrition, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Yongli Chu
- Department of Scientific Research, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China.
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China.
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13
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Allen A, Tully-Wilson C. Early Adaptive Schemas and Sexual Wellbeing in Women: Exploring Differences in Menopausal Status. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023:1-29. [PMID: 37361625 PMCID: PMC10185943 DOI: 10.1007/s41042-023-00100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
There is limited research concerning the relationship between early adaptive schema, from Young's Schema Theory, and women's sexual wellbeing. Schema Theory posits that early adaptive schema start forming in early childhood from core emotional needs being met, and positively influence individuals' concept of self, relationships with others, and their behaviours. Building on this theory, the current study explored the relationship of early adaptive schema and adult women's sexual wellbeing at pre-, peri-, and post-menopause. Four hundred and sixty-seven women, mostly partnered and heterosexual, from over ten countries, participated in an online survey measuring relationships between early adaptive schema and sexual wellbeing, measured by sexual functioning and sexual satisfaction. The strength of association of early adaptive schema and sexual well-being were evaluated in addition to known predictors. The results showed higher early adaptive schema were associated with higher sexual wellbeing, measured by sexual satisfaction and sexual functioning,with medium-to-large effect sizes, at pre and peri-menopause, and produced a non-significant result for post-menopause. The association of early adaptive schema continued after known factors were accounted for. The results support the use of early adaptive schema to promote sexual wellbeing for women at pre- and peri-menopause.
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Affiliation(s)
- Andrew Allen
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
| | - Colleen Tully-Wilson
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
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14
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Caruso G, Falzone L, Palermo G, Ricci D, Mazza G, Libra M, Caruso S, Gattuso G. Analysis of hsa-miR-19a-3p and hsa-miR-19b-3p modulation and phosphodiesterase type 5 expression in the vaginal epithelium of premenopausal women with genital arousal disorder. J Sex Med 2023:7143629. [PMID: 37185899 DOI: 10.1093/jsxmed/qdad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have investigated the role of the phosphodiesterase type 5A (PDE5A) isoenzyme in female genital tissue disorders, exclusively taken from cadavers, as well as the epigenetic mechanisms responsible for the regulation of PDE5A levels. AIM The aim was to study the in vivo association between microRNA (miRNA) expression and the expression levels of PDE5A in women with female genital arousal disorder (FGAD) compared with healthy women. METHODS Premenopausal women affected by FGAD (cases) and sexually healthy women (control group) underwent microbiopsy of the periclitoral anterior vaginal wall for the collection of tissue samples. Computational analyses were preliminarily performed in order to identify miRNAs involved in the modulation of PDE5A by using miRNA-messenger RNA interaction prediction tools. Differences in the expression levels of miRNAs and PDE5A were finally investigated in cases and control subjects by using the droplet digital polymerase chain reaction amplification system and stratifying women considering their age, number of pregnancies, and body mass index. OUTCOMES Expression levels of miRNAs were able to target PDE5A and the tissue expression in women with FGAD compared with healthy women. RESULTS The experimental analyses were performed on 22 (43.1%) cases and 29 (56.9%) control subjects. Two miRNAs with the highest interaction levels with PDE5A, hsa-miR-19a-3p (miR-19a) and hsa-miR-19b-3p (miR-19b), were identified and selected for validation analyses. A reduction of the expression levels of both miRNAs was observed in women with FGAD compared with the control subjects (P < .05). Moreover, PDE5A expression levels were higher in women with FGAD and lower in women without sexual dysfunctions (P < .05). Finally, a correlation between body mass index and the expression levels of miR-19a was found (P < .01). CLINICAL IMPLICATIONS Women with FGAD had higher levels of PDE5 compared with control subjects; therefore, the administration of PDE5 inhibitors (PDE5 inhibitors) could be useful in women with FGAD. STRENGTHS AND LIMITATIONS The strength of the current study was to analyze genital tissue obtained in vivo from premenopausal women. A limitation was to not investigate other factors, including endothelial nitric oxide synthetases, nitric oxide, and cyclic guanosine monophosphate. CONCLUSION The results of the present study indicate that the modulation of selected miRNAs could influence PDE5A expression in genital tissues in healthy women or in those with FGAD. Such findings further suggest that treatment with PDE5 inhibitors, as a modulator of PDE5A expression, could be indicated for women with FGAD.
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Affiliation(s)
- Giuseppe Caruso
- Research Group for Sexology, Gynecological Clinic, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
| | - Gaia Palermo
- Research Group for Sexology, Gynecological Clinic, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Daria Ricci
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
| | - Gabriele Mazza
- Research Group for Sexology, Gynecological Clinic, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
| | - Salvatore Caruso
- Research Group for Sexology, Gynecological Clinic, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy
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Ju R, Ruan X, Yang Y, Xu X, Cheng J, Bai Y, Shi Y, Yang X, Li R, Mueck AO. A multicentre cross-sectional clinical study on female sexual dysfunction in postmenopausal Chinese women. Maturitas 2023; 172:15-22. [PMID: 37079998 DOI: 10.1016/j.maturitas.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/25/2023] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the factors affecting the sex lives of postmenopausal Chinese women, especially the influence of body weight, climacteric symptoms and androgens. METHODS A total of 437 postmenopausal women were investigated in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University and two allied medical institutions from April 2020 to March 2021. Sociodemographic data were collected. Female sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI). The modified Kupperman index was used to assess climacteric symptoms. Methods based on liquid chromatography-tandem mass spectrometry were employed to measure the serum levels of total testosterone, bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone. Pearson's correlation coefficient and multiple linear regression analyses were performed to determine the correlation between characteristics and FSFI scores. RESULTS The multivariate linear regression analysis revealed that the modified Kupperman index score and the factor unsatisfactory marital relations had the strongest negative correlations with all FSFI domains (P < 0.05); secondary education level was negatively associated with desire, arousal and orgasm (P < 0.05). Total testosterone positively affected the score for pain (P < 0.05). There was no correlation between bioavailable testosterone, free testosterone, androstenedione and dehydroepiandrosterone and all FSFI domains (P > 0.05). CONCLUSION Climacteric symptoms and sociodemographic factors had a notable effect on sexual function. It is necessary to provide more attention to and intervention for their climacteric symptoms to improve the quality of life of postmenopausal women.
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Affiliation(s)
- Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China; Clinical Trial Institution Office, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China; University Women's Hospital and Research Centre for Women's Health, Department of Women's Health, University of Tuebingen, Tuebingen, Germany.
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China
| | - Xin Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care, Beijing, China
| | - Yongtao Bai
- Department of Gynecology, Beijing Chaoyang District Taiyanggong Community Health Service Centre, Beijing, China
| | - Yanhong Shi
- Department of Gynecology, Beijing Chaoyang District Taiyanggong Community Health Service Centre, Beijing, China
| | - Xingzi Yang
- Department of Gynecology, Beijing Chaoyang District Taiyanggong Community Health Service Centre, Beijing, China
| | - Ruiling Li
- Department of Gynecology, Beijing Chaoyang District 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, Beijing, China; University Women's Hospital and Research Centre for Women's Health, Department of Women's Health, University of Tuebingen, Tuebingen, Germany
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16
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Dan V, Pauer C. Empowered, Handmaid, or Rejector? The Framing of Low Libido in Women according to Scholarly Investigations of Public Communication. HEALTH COMMUNICATION 2023; 38:705-713. [PMID: 34493138 DOI: 10.1080/10410236.2021.1971356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The quest for a Viagra equivalent for women has both reignited concerns over female oppression and rekindled hope for gender equality. Communication about decreased desire in women has come under intense scrutiny, especially in terms of the ways in which it may legitimize one view or the other. We present a systematic review of academic research on public communication about low libido in women and drugs/devices designed to increase it. A total of 1,309 records were screened, with 20 studies identified for final analysis (6 monographs, 11 articles, and 3 book chapters). Existing research found that the empowered frame predominated, according to which women sought to increase their libido of their own accord to enhance their individual sexual pleasure. The handmaid frame was described as somewhat less common; here, women resorted to treatment to save their relationships as they feared that inability to fulfill their "wifely duty" could alienate their partners. Importantly, scholars often reported that the empowered and handmaid frames co-occurred. The rejector frame, which suggested fluctuations in libido were normal and should not be medically treated, was described in existing work as least common. These results seem to suggest that low libido in women was constructed as a problem in need of a solution more often than not. As this may prompt women to think of their bodies as malfunctioning machines, it is possible that the framing of low libido in public communication can exacerbate existing trends toward pathologizing the waning of desire.
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Affiliation(s)
- Viorela Dan
- Department of Media and Communication, LMU Munich
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17
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Ghanbari-Homaie S, Ataei-Almanghadim K, Mirghafourvand M. Effect of vitamins on sexual function: A systematic review. INT J VITAM NUTR RES 2023; 93:154-163. [PMID: 33779240 DOI: 10.1024/0300-9831/a000703] [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] [Indexed: 11/19/2022]
Abstract
Sexual dysfunction can adversely affect the quality of life, self-confidence, and interpersonal relationships. Some studies reported a relationship between vitamin supplementation and sexual health. This systematic review aimed to evaluate the effect of vitamins on female and male sexual function. All relevant English and Persian articles published in English databases (Medline, Scopus, Cochrane Library, Web of Sciences, Psycho-Info, and Proquest) and Farsi databases (SID and Magiran) until July 2020 were searched. The Cochrane Handbook for Systematic Reviews of Interventions was used for assessing the risks of bias. A total of 11 randomized controlled trials (RCTs) on 337 women, 472 men, and 35 couples were included. One study reported that vitamin D 300000 IU supplement administrated twice through intramuscular injection (at the beginning and after four weeks) had a significant effect on female sexual function (p<0.05), whereas another study showed that vitamin D 2000 IU supplement for six months did not have any significant effect on female sexual function (p>0.05). A study reported the significant effect of niacin (vitamin B3) 1500 mg daily for 12 weeks on erectile function (p=0.004). The results showed that vitamins A, C, and E had no significant effect on male and female sexual function. The conduction of trials with long-term interventions is recommended to reach a more definitive conclusion about the effect of vitamins on sexual function.
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Affiliation(s)
- Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khatereh Ataei-Almanghadim
- Student Research Committee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing & Midwifery, Tabriz University of Medical Sciences, Iran
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18
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Goldstein SW, Goldstein I, Kim NN, Kellogg-Spadt S, Murina F. Safety and efficacy of fractional CO2 laser treatment to the vestibule: a randomized, double-blind, sham-controlled, prospective 3-site clinical study in women with vestibular pain. J Sex Med 2023; 20:800-812. [PMID: 36779572 DOI: 10.1093/jsxmed/qdac053] [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: 10/08/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 02/14/2023]
Abstract
BACKGROUND Data are limited regarding fractional CO2 laser as a nonhormonal treatment for vestibular pain. AIM We sought to perform what is, to our knowledge, the first multisite prospective randomized, double-blind, sham-controlled clinical trial to assess the safety and efficacy of fractional CO2 laser treatment to the vestibule in women with vestibular pain. METHODS Subjects (n = 70) meeting inclusion/exclusion criteria at each of 3 sites were randomized 2:1 to active or sham (zero energy) fractional CO2 laser treatment using the vestibular probe (SmartXide2 V2LR - MonaLisa Touch, DEKA, Florence, Italy). Subjects in each treatment arm received 3 treatments 4 weeks apart. At the initial follow-up (week 12), subjects were unblinded and those initially assigned to sham started active treatment. OUTCOMES Outcome measures included changes from baseline in sexual activity diaries and scores for the Vulvoscopic Genital Tissue Appearance Scale (VGTA), vestibular cotton-tipped swab testing, McGill Pain Questionnaire, Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and the O'Leary-Sant voiding and pain indices, the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI). RESULTS After active treatment, VGTA scores significantly improved in 5 parameters. Pain associated with cotton-tipped swab testing was significantly reduced at weeks 4 through 16 (mean change from baseline -0.64 [95% CI, -0.79 to -0.50] and -1.31 [95% CI, -1.46 to -1.16], respectively). FSFI pain domain scores improved significantly at weeks 12 and 16 (mean change from baseline 0.925 [95% CI, 0.10-1.75] and 1.22 [95% CI, 0.40-2.05], respectively). FSFI total scores increased significantly at weeks 12 and 16 (mean change from baseline 6.24 [95% CI, 2.64-9.85] and 4.96 [95% CI, 1.36-8.57], respectively). FSDS-R scores decreased significantly at weeks 12 and 16 (mean change from baseline -5.84 [95% CI, -8.80 to -2.87] and -9.15 [95% CI, -12.11 to -6.18], respectively). ICSI scores decreased significantly at weeks 12 and 16 (mean change from baseline -0.91 [95% CI, -1.65 to -0.18] and -0.754 [95% CI, -1.49 to -0.02], respectively). ICPI scores decreased significantly at week 16 (mean change from baseline -0.99 [95% CI, -1.63 to -0.34]). In contrast, there were no significant changes in outcomes in the sham arm. No serious adverse events occurred. CLINICAL IMPLICATIONS Fractional CO2 laser treatment in women with vestibular pain resulted in improvement from baseline in multiple key outcome measures of vestibular health. STRENGTHS AND LIMITATIONS Strengths of the study were that it was a multisite prospective randomized double-blind, sham-controlled clinical trial that included multiple measures related to vestibular pain and sexual function. Limitations were the nonvalidated primary outcome measure and limited study cohort. CONCLUSION Fractional CO2 laser therapy is a safe and effective nonhormonal treatment for vestibular pain.
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Affiliation(s)
| | - Irwin Goldstein
- San Diego Sexual Medicine, San Diego, CA United States.,Sexual Medicine, Alvarado Hospital, San Diego, CA United States
| | - Noel N Kim
- Institute for Sexual Medicine, San Diego, CA United States
| | | | - Filippo Murina
- Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, Milan, Italy.,Università degli Studi, Milan, Italy
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19
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Ye SL, Feng Y, Zhou RY, Luo CG. Acupuncture for female sexual dysfunction: a case report. Acupunct Med 2023; 41:55-57. [PMID: 36284465 DOI: 10.1177/09645284221125427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Sen-Lin Ye
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Feng
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ru-Yi Zhou
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cai-Gui Luo
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Sichuan Provincial Hospital of Traditional Chinese Medicine), Chengdu, China
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20
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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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21
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Vahedpoorfard Z, Ferdosi S, Rahimi H, Motedayyen H. Effect of Humulus lupulus L. (Hop) on Postmenopausal Sexual Dysfunction: A Randomized Clinical Trial. Int J Clin Pract 2023; 2023:9528335. [PMID: 37101856 PMCID: PMC10125751 DOI: 10.1155/2023/9528335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/09/2023] [Accepted: 03/30/2023] [Indexed: 04/28/2023] Open
Abstract
Objective Female sexual dysfunction is a common distressing problem among women, which may result from reducing circulating endogenous estrogen. Humulus lupulus L. (hop) has antioxidant, anti-inflammatory, anticancer, and estrogenic properties. Therefore, this study aimed to assess the efficacy of hop on postmenopausal sexual dysfunction. Methods In the current randomized clinical trial, study populations consisted of 63 postmenopausal women who were randomly categorized into two groups. In the hop group (N = 33), women received the vaginal gel containing Hop extract every day for seven days and then continued for two months, twice weekly. In the estradiol group (N = 30), women were treated with vaginal estradiol (0.625 mg) over two 28-day cycles (21 days of therapy and seven days rest). The sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire before and after intervention. Results No statistically significant differences in FSFI scores (sexual desire, sexual arousal, vaginal lubrication, satisfaction, orgasm, sexual pain, and total FSFI) (P > 0.05) were noticed after treatment between the hop and estradiol groups. Conclusion Vaginal hop was as effective as estradiol in improving the sexual dysfunction among postmenopausal women with no adverse events. This trial is registered with IRCT20210405050859N1.
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Affiliation(s)
- Zahra Vahedpoorfard
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Samira Ferdosi
- Department of Obstetrics and Gynecology, Kashan University of Medical Sciences, Kashan, Iran
| | - Habibollah Rahimi
- Department of Biostatics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Sarmento ACA, Costa APF, Lírio J, Eleutério Jr J, Baptista PV, Gonçalves AK. Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:986-994. [PMID: 36446564 PMCID: PMC9708399 DOI: 10.1055/s-0042-1756148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women. DATA SOURCES We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied. SELECTION OF STUDIES We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women. DATA COLLECTION Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors. DATA SYNTHESIS A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study). CONCLUSION We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).
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Affiliation(s)
| | - Ana Paula Ferreira Costa
- Postgraduate Program student in Health Science, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Juliana Lírio
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - José Eleutério Jr
- Department of Obstetrics and Gynecology, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | - Ana Katherine Gonçalves
- Postgraduate Program student in Health Science, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil,Address for correspondence Ana Katherine Gonçalves, Professor rua Major Laurentino de Morais, 1.218/1.301, Natal, RN, 59020-390Brazil
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Baniotopoulos P, Pyrgidis N, Minopoulou I, Tishukov M, Sokolakis I, Hatzichristodoulou G, Dimitroulas T. Treatment of Sexual Dysfunction in Women with Systemic Autoimmune Rheumatic Disorders: A Systematic Review. Sex Med Rev 2022; 10:520-528. [PMID: 37051964 DOI: 10.1016/j.sxmr.2022.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/16/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023]
Abstract
Abstract
Introduction
Female sexual dysfunction (SD) is an under-recognized and undertreated problem in patients with systemic autoimmune rheumatic disorders (SARDs).
Objectives
To summarize and evaluate the existing treatment modalities for SD in females with SARDs.
Methods
A systematic review was conducted following the PRISMA guidelines. Electronic databases were searched up to April 2022 for studies that assessed the use of pharmacological and non-pharmacological treatment modalities for the management of SD in females with SARDs. Randomized and observational studies were included. (PROSPERO: CRD42022296381).
Results
Seven studies with 426 females with SD were included. Seven different treatment modalities belonging to 5 different classes (androgen therapy, phosphodiesterase-5 inhibitors, exercise, education and local creams) were evaluated in patients with systemic lupus erythematosus, rheumatoid arthritis and systemic sclerosis. The majority of the studies were of low methodological quality. Standardized patient education and 8-week aerobic walking programs were successful in improving female SD. Local creams improved dyspareunia in females with systemic sclerosis. Testosterone did not significantly improve SD in patients with systemic lupus erythematosus. Accordingly, tadalafil did not result in a significant improvement of SD in females with systemic sclerosis, based on the Female Sexual Function Index.
Conclusion
There is a lack of sufficient evidence to recommend a certain management strategy for SD in females with SARDs. Nonpharmacological therapy and lubricant creams may be beneficial in females with SARDs. No benefit was demonstrated after androgen therapy or tadalafil. Still, no definite conclusions can be drawn due to the important limitations of the available literature. Overall, our results may be considered preliminary and further research in the field is mandatory.
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Affiliation(s)
| | - Nikolaos Pyrgidis
- Department of Urology , Nuremberg , Germany
- ‘Martha-Maria’ Hospital Nuremberg , Nuremberg , Germany
| | - Ioanna Minopoulou
- Fourth Department of Internal Medicine , Thessaloníki , Greece
- Medical School , Thessaloníki , Greece
- Hippokration General Hospital , Thessaloníki , Greece
- Aristotle University of Thessaloniki , Thessaloníki , Greece
| | - Maksim Tishukov
- Medical School , Thessaloniki , Greece
- Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Ioannis Sokolakis
- Department of Urology , Nuremberg , Germany
- ‘Martha-Maria’ Hospital Nuremberg , Nuremberg , Germany
| | | | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine , Thessaloníki , Greece
- Medical School , Thessaloníki , Greece
- Hippokration General Hospital , Thessaloníki , Greece
- Aristotle University of Thessaloniki , Thessaloníki , Greece
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24
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Helmi ZR. Comparative Study of 150 vs. 200 Units of Botulinum Toxin as Treatment for Vaginismus. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:854-865. [PMID: 35817081 PMCID: PMC9948261 DOI: 10.1055/s-0042-1751287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To comparatively evaluate the outcome of treatment with 150 versus 200 units (U) of botulinum toxin in achieving pain-free intercourse and relieving muscle contraction in order to allow gynecological examination. METHODS In this comparative prospective observational study, 99 patients with vaginismus were treated with botulinum toxin injections from September 2016 to August 2021. Diagnosis and grading of vaginismus severity were assessed using a Female Sexual Function Index (FSFI) questionnaire. Under local or general anesthesia, botulinum toxin diluted with preservative-free saline (150 U and 200 U) was injected into, above, and below the right and left bulbospongiosus muscle and the lateral submucosal areas of the introitus and perineal body using an insulin syringe. Patients were recalled after 2 weeks, and the postoperative outcome was recorded using a similar preoperative questionnaire. RESULTS Overall, the mean age of patients was 30.2 years. The baseline and clinical characteristics were comparable between the 2 groups (p > 0.05). Significant improvements were seen in the pain and anxiety scores of finger penetration, dilator use, intercourse, and cotton swab in individual groups. The intergroup comparisons between 150 U and 200 U of Botox were not statistically significant (p > 0.05). CONCLUSION Low-dose Botox (150 U) is equally effective as high dose Botox injections (200 U) in vaginismus patients. Therefore, Botox-150 U can be used to treat vaginismus as an alternative to high doses of the same substance.
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Affiliation(s)
- Zeena R Helmi
- Department of Gynecology and Obstetrics, College of Medicine, Mustansiriyah University, Baghdad, Iraq
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25
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Prabhu SS, Hegde S, Sareen S. Female sexual dysfunction: A potential minefield. Indian J Sex Transm Dis AIDS 2022; 43:128-134. [PMID: 36743096 PMCID: PMC9890990 DOI: 10.4103/ijstd.ijstd_82_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
Female sexual dysfunction (FSD) is a much-neglected aspect of feminine health, especially in patriarchal cultures. We collated data from pertinent published literature on FSD to explore the types, associations, and best possible approach to FSD in the Indian context. We fed search words "female sexual dysfunction," "sexual health," "India," into medical search engines such as PubMed, Google Scholar, Clinical Key, ProQuest, SciVal for locating pertinent articles from which data was synthesized and extracted. Female sexual response is complex and is influenced by physiological, behavioral, social, and cultural factors. The latest Diagnostic and Statistical Manual of Mental Disorders-5 criteria classified FSD into female sexual interest/arousal disorder, female orgasmic disorder and genito-pelvic pain/penetration disorder, along with categories common to both genders like substance/drug induced and other unspecified subsets. Diagnosis requires detailed and specific history taking and clinical evaluation to rule out comorbidities. Treatment is multifaceted and prolonged, involving pharmacological, psychological, and behavioral therapy in both partners. Almost all Indian studies in this field have small sample sizes and none of the studies focused on FSD as the primary complaint. FSD is still an unexplored field of Indian medicine. Although newer treatment options and techniques are being explored, there is much to achieve. We need to develop culturally suitable questionnaires taking into account the Indian female psyche. Management should be holistic and involve focused liaison clinics, including dermatology, gynecology, psychiatry, clinical psychology, and urology specialties.
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Affiliation(s)
- Smitha S. Prabhu
- Department of Dermatology and Venereology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Snigdha Hegde
- Department of Dermatology and Venereology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Suhani Sareen
- Department of Dermatology and Venereology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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The Effect of Type of Delivery on Female Postpartum Sexual Functioning: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071212. [PMID: 35885738 PMCID: PMC9322469 DOI: 10.3390/healthcare10071212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/26/2022] [Indexed: 11/22/2022] Open
Abstract
Female sexual function could be considered as multifactorial. Specific physiological structures and hormonal fluctuations postpartum, along with the psychological adjustment of women, could result in altered sexual function. The primary aim of this review was to systematically appraise the existing data on the effect of mode of delivery on female sexual function. This review was designed based on the PRISMA statement guidelines. An extensive literature search was performed in the Pubmed, Scopus, and PsycInfo databases, using prespecified inclusion/exclusion criteria, between the 20 September and 10 October 2021. Studies’ quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. The initial search involved 1592 studies. The last step of the screening procedure yielded 16 studies, including 41,441 subjects with a mean age of 29.9 years. Studies included groups with spontaneous and assisted vaginal and C-section delivery modes. No statistically significant difference between groups was found. The type of delivery appears to be irrelevant regarding this relationship. Moderating factors seemed to indirectly influence this relationship. Health professionals should educate expectant mothers and be aware of the possibility that delivery method could affect sexual function.
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The association between Parkinson's disease and Sexual dysfunction: Clinical correlation and therapeutic implications. Ageing Res Rev 2022; 79:101665. [PMID: 35690383 DOI: 10.1016/j.arr.2022.101665] [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: 10/11/2021] [Revised: 03/25/2022] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
Sexual function which comprises of desire, arousal, orgasm and satisfaction and pain, involves coordinated physiologic responses from multiple different pathways. Sexual dysfunction (SD) occurs when these domains of the sexual response cycle are affected. SD is a common but under-recognized non-motor feature in Parkinson's disease (PD), a common age-related neurodegenerative disorder. SD significantly affects the quality of life of PD patients and their partners. Advanced age, gender, hormone deficiency, neuropsychiatric and medical comorbidities contribute to SD in PD. Possible potential pathological mechanisms include vasculogenic, endocrinologic, neurogenic and psychogenic factors. Various therapeutic interventions, both pharmacological and non-pharmacological modalities have been suggested to improve SD in PD. However, erectile dysfunction (ED) is the only SD with evidence-based treatment available. Non-pharmacological therapies are also offering promising evidence in the improvement of SD. A multidisciplinary approach in the assessment, investigation, and treatment is needed to address the real life complex issues (gender and comorbidities, neurobiological, vasoactive, hormonal as well as psychosocial aspects). Future clinical studies with validated and standardized methods in assessing SD as well as experimental models will be necessary for better insight into the pathophysiology. This would facilitate appropriate therapy and improve sexual rehabilitation in PD patients.
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da Silva Lara LA, Rufino AC, Oliveira FF, Rossato S, Borges CS, Reis RM. Female sexual dysfunctions: an overview on the available therapeutic interventions. Minerva Obstet Gynecol 2022; 74:249-260. [PMID: 35147017 DOI: 10.23736/s2724-606x.22.04966-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
INTRODUCTION There are different types of female sexual dysfunctions (FSDs), and FSD in general has a high prevalence worldwide. Studies of FSD should consider it as a multifactorial disorder that has biological, psychological, environmental, and relational aspects. In this review we discuss the available therapeutic interventions for FSD. EVIDENCE ACQUISITION For the current narrative review the PubMed database was searched to identify all publications up to 30 March 2021 that were systematic reviews and meta-analyses which examined therapeutic interventions for FSDs based on the diagnostic classifications of ICD-10 and ICD-11. EVIDENCE SYNTHESIS Thirty systematic reviews and meta-analyses were included in this review. Hormone therapy (HT) and testosterone are effective to improve sexual desire in menopausal women. In these women HT and ospemiphene may improve pain during intercourse. Flibanserin may improve sexual desire and may reduce desire-related distress in premenopausal women. Bremelanotide is effective to improve desire, arousal, and orgasm scores. Evidence are still limited on the efficacy of psychoactive drugs, phosphodiesterase type 5 (PDE5), oxytocin, herbal drugs, and tibolone to treat FSDs. Psychological interventions such as cognitive-behavior therapy, mindfulness training, sensate focus, bibliotherapy are effective for the management of several different FSDs. CONCLUSIONS The management of FSDs may require multidisciplinary and interdisciplinary approaches. Pharmacological and nonpharmacological interventions appears to have potential as a treatment for FSDs, but there are currently no gold standards regarding recommended treatment modalities, and the duration, frequency, and intensity of therapy sessions.
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Affiliation(s)
- Lucia A da Silva Lara
- Reproduction Center, Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil -
| | - Andrea C Rufino
- Faculty of Medicine, State University of Piauí, Piauí, NE, Brazil
| | - Flávia F Oliveira
- Endometriosis Sector, Faculty of Medicine, Hospital das Clínicas, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Serena Rossato
- Reproduction Center, Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Charles S Borges
- Reproduction Center, Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rosana M Reis
- Reproduction Center, Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
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Rodrigues Eberhardt P, La Rosa VL, Marques Cerentini T, Caruso S, Ragusa R, De Franciscis P, Riemma G, Machado de Souza C, Telles da Rosa LH, Viana da Rosa P. Sexual dysfunctions in female university students and the correlation with body image: a cross-sectional study. J Psychosom Obstet Gynaecol 2022; 43:85-90. [PMID: 32812466 DOI: 10.1080/0167482x.2020.1806818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE This study aims to correlate female sexual dysfunctions and dissatisfaction with female university students' body image. METHODS 276 female university students completed an online questionnaire, including sociodemographic data, the Female Sexual Function Index, and the Body Shape Questionnaire. RESULTS 31.1% reported some degree of dissatisfaction with body image, and 39.5% had a risk of female sexual dysfunction. The majority of women with a risk of female sexual dysfunctions (69.4%) had no concerns with shape, and the majority of women without sexual problems (67.7%) had no concerns with shape. Pearson's coefficient underlined no correlation between Body Shape Questionnaire and Female Sexual Function Index domains. CONCLUSION The body image perception did not seem to affect the sexual function of female university students in our sample. However, it is important to further investigate these variables to improve women's quality of life.
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Affiliation(s)
- Paula Rodrigues Eberhardt
- Department of Health Science and Rehabilitation, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | | | - Taís Marques Cerentini
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.,Research Group for Sexology, University of Catania, Catania, Italy
| | - Rosalia Ragusa
- Health Technology Assessment Committee, University Hospital "G. Rodolico", Catania, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Cislaine Machado de Souza
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil
| | - Luis Henrique Telles da Rosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil
| | - Patricia Viana da Rosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil
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Ramanathan V, Gautham K, Ramasubramaniam UM. Common Pitfalls in the Management of Vaginismus in Couples With Subfertility in India. JOURNAL OF PSYCHOSEXUAL HEALTH 2022. [DOI: 10.1177/26318318221089600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Vaginismus is described as an involuntary pelvic muscular spasm that occurs due to “fear of pain” associated with vaginal penetration which prevents a woman from experiencing penovaginal sexual intercourse despite her wish to do so. In the context of heterosexual couples with subfertility, untreated vaginismus may result in unconsummated marriage and/or reduced quality of sex life and/or can affect a woman’s perception about her potential of femininity and motherhood. Though vaginismus is an easily diagnosable and treatable condition in many instances, it often gets ignored or inadequately/inappropriately managed. There is paucity of practice-informed clinical data on management of vaginismus in couples with subfertility that is contextualized to the Indian setting. The present viewpoint is based on real-world clinical scenarios who presented as couples to a tertiary fertility center with unconsummated marriage as their chief complaint. The intent of this viewpoint is not only to highlight the common pitfalls in the management of vaginismus but also showcase a clinically proven interdisciplinary management approach for assessment and management of vaginismus and any associated sexual problems.
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Affiliation(s)
- Vijayasarathi Ramanathan
- The University of Sydney, Sydney, Australia
- Bloom Fertility & Healthcare, Chennai, Tamil Nadu, India
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Female orgasmic dysfunction and severe climacteric symptomatology in women aged 40 to 59 years. Menopause 2022; 29:654-663. [DOI: 10.1097/gme.0000000000001973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Buggio L, Barbara G, Facchin F, Ghezzi L, Dridi D, Vercellini P. The influence of hormonal contraception on depression and female sexuality: a narrative review of the literature. Gynecol Endocrinol 2022; 38:193-201. [PMID: 34913798 DOI: 10.1080/09513590.2021.2016693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Over the past decades, an increasing number of women have been using hormonal contraception. The potential role of sex hormones in regulating vegetative, psychophysiological, and cognitive functions has been highlighted in several studies, and there is a need to further understand the impact of hormonal contraception on women's quality of life, especially as regards psychological health and sexuality. METHODS We conducted a narrative review aimed at clarifying the mechanisms involved in the interaction between sex hormones and the brain, also focusing on the association between hormonal contraception and mood and sexual function. RESULTS Our findings clarified that hormonal contraception may be associated with depressive symptoms, especially among adolescents, and with sexual dysfunction. However, the evidence included in this review was conflicting and did not support the hypothesis that hormonal contraception directly causes depressive symptoms, major depressive disorder, or sexual dysfunction. CONCLUSIONS The optimal hormonal contraception should be identified in the context of shared decision making, considering the preferences and needs of each woman, as well as her physical and psychosexual conditions.
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Affiliation(s)
- Laura Buggio
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giussy Barbara
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- SVSeD, Service for Sexual and Domestic Violence and Obstetric and Gynecology Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Laura Ghezzi
- Department of Neurology, Washington University, St. Louis, MO, USA
- Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Dhouha Dridi
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Vercellini
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
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Kulkarni A, Sun G, Manuppelli S, Mendez H, Rezendes J, Marin C, Raker CA, Robison K. Sexual health and function among patients receiving systemic therapy for primary gynecologic cancers. Gynecol Oncol 2022; 165:323-329. [DOI: 10.1016/j.ygyno.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/04/2022]
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Lerner T, Bagnoli VR, de Pereyra EAG, Fonteles LP, Sorpreso ICE, Júnior JMS, Baracat EC. Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study. Clinics (Sao Paulo) 2022; 77:100054. [PMID: 35905577 PMCID: PMC9334335 DOI: 10.1016/j.clinsp.2022.100054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hypoactive Sexual Desire Disorder (HSDD) is a very prevalent sexual problem, with limited options for treatment. Given that psychological factors are major contributors to the disorder, a therapy such as Cognitive-Behavioral Therapy (CBT) may be useful to treat HSDD. OBJECTIVE To evaluate the effects of group CBT on women with HSDD. METHOD Clinical trial randomized study with 106 women diagnosed with HSDD, who were divided as follows: Group 1 (n = 53) underwent group CBT for 8-weeks, and Group 2 (n = 53), were put on a waiting list and used as a control group. Sexual function was assessed by the Female Sexual Quotient (FSQQ) at the initial interview and after 6-months. Mann Whitney test was used for group comparison. MAIN OUTCOME MEASURES demographics, education, sexual history, FSQQ and its domains for sexual function assessment. RESULTS Both groups had similar characteristics regarding sexual response, self-image, and relationship with a partner at the initial interview. Women undergoing therapy showed significant improvement in sexual function when compared with the control group. The overall FSQQ result showed an average growth of 18.08 points (95% CI 12.87‒23.28) for the therapy group against a decrease of 0.83 points (95% CI 3.43‒1.77) for controls (p < 0.001). The five domains of the questionnaire also exhibited significant improvement in the therapy group: desire and interest (p = 0.003), foreplay (p = 0.003), excitation and tuning (p < 0.001), comfort (p < 0.001), and orgasm and satisfaction (p < 0.001). CONCLUSION Group CBT was shown to be an effective tool for treating HSDD.
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Affiliation(s)
- Théo Lerner
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Vicente Renato Bagnoli
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elsa Aida Gay de Pereyra
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lucivanda Pontes Fonteles
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - José Maria Soares Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Zhang J, Zhang J, Cong S, Feng J, Pan L, Zhu Y, Zhang A, Ma J. Transcriptome profiling of lncRNA and co-expression network in the vaginal epithelial tissue of women with lubrication disorders. PeerJ 2021; 9:e12485. [PMID: 34824921 PMCID: PMC8590395 DOI: 10.7717/peerj.12485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 10/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Vaginal lubrication is a crucial physiological response that occurs at the beginning of sexual arousal. However, research on lubrication disorders (LD) is still in its infancy, and the role of long non-coding RNAs (lncRNAs) in LD remains unclear. This study aimed to explore the function of lncRNAs in the pathogenesis of vaginal LD. Methods The expression profiles of LD and normal control (NC) lncRNAs were examined using next-generation sequencing (NGS), and eight selected differentially expressed lncRNAs were verified by quantitative real-time PCR. We conducted GO annotation and KEGG pathway enrichment analyses to determine the principal functions of significantly deregulated genes. LncRNA-mRNA co-expression and protein-protein interaction (PPI) networks were constructed and the lncRNA transcription factors (TFs) were predicted. Results From the results, we identified 181,631 lncRNAs and 145,224 mRNAs in vaginal epithelial tissue. Subsequently, our preliminary judgment revealed a total of 499 up-regulated and 337 down-regulated lncRNAs in LD. The top three enriched GO items of the dysregulated lncRNAs included the following significant terms: “contractile fiber part,” “actin filament-based process,” and “contractile fiber”. The most enriched pathways were “cell-extracellular matrix interactions,” “muscle contraction,” “cell-cell communication,” and “cGMP-PKG signaling pathway”. Our results also showed that the lncRNA-mRNA co-expression network was a powerful platform for predicting lncRNA functions. We determined the three hub genes, ADCY5, CXCL12, and NMU, using PPI network construction and analysis. A total of 231 TFs were predicted with RHOXF1, SNAI2, ZNF354C and TBX15 were suspected to be involved in the mechanism of LD. Conclusion In this study, we constructed the lncRNA-mRNA co-expression network, predicted the lncRNA TFs, and comprehensively analyzed lncRNA expression profiles in LD, providing a basis for future studies on LD clinical biomarkers and therapeutic targets. Further research is also needed to fully determine lncRNA’s role in LD development.
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Affiliation(s)
- Jingjing Zhang
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Jing Zhang
- Jiangsu Health Vocational College, Nanjing, China
| | - Shengnan Cong
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jingyi Feng
- High School Affiliated to Nanjing Normal University International Department, Nanjing, China
| | - Lianjun Pan
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Yuan Zhu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Aixia Zhang
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Jiehua Ma
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
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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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Heirati SFD, Ozgoli G, KabodMehri R, Mojab F, Sahranavard S, Nasiri M. The 4-month effect of Vitex agnus-castus plant on sexual function of women of reproductive age: A clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:294. [PMID: 34667794 PMCID: PMC8459874 DOI: 10.4103/jehp.jehp_63_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sexual dysfunction in women is a common disorder. Yet, there is no consensus on its treatment. Few studies have shown that Vitex agnus-castus improves sexual dysfunction in postmenopausal women; the present study was conducted to evaluate the effect of V. agnus-castus on the female sexual function in the reproductive age. MATERIALS AND METHODS This was a double-blinded randomized control clinical trial on the women of reproductive age referred to the gynecology clinic of Al-Zahra Medical Center in Rasht, Iran, from February 2018 to December 2019. The intervention group received Agnugol tablet containing 3.2-4.8 mg dried extract V. agnus-castus (51 participants) and the control group received a placebo tablet (51 participants). All participants received one tablet daily for 16 weeks. The participants were asked to complete the Female Sexual Function Index questionnaire at the beginning of the study and after 4, 8, 12, and 16 weeks. Data were analyzed in SPSS statistics (version 21) using Chi-square test, t-test, Mann-Whitney U-test, analysis of variance, and mixed model to examine the differences between the groups. RESULTS The results showed that the difference between the two groups was not significant in each domain, but there was a significant difference in the overall sexual function mean score so that the intervention group had a higher score than the placebo group after 16 weeks (P < 0.05). CONCLUSION In the present study, it was observed that the consumption of V. agnus-castus during 16 weeks was more effective than the placebo in improving sexual dysfunction. Further studies with larger sample sizes are needed to be able to decide on the prescription of this drug in the clinics.
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Affiliation(s)
- Seyedeh Fatemeh Dalil Heirati
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya KabodMehri
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Faraz Mojab
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shamim Sahranavard
- Department of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hoagland KC, Grubbs JB. Pornography Use and Holistic Sexual Functioning: a Systematic Review of Recent Research. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00378-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Improving the identification of genitourinary syndrome of menopause through the utilization of the Day-to-Day Impact of Vaginal Aging questionnaire. ACTA ACUST UNITED AC 2021; 27:1295-1301. [PMID: 33110046 DOI: 10.1097/gme.0000000000001668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Genitourinary syndrome of menopause (GSM) affects nearly 50% of postmenopausal women. Yet women fail to recognize GSM as a chronic condition and are reluctant to discuss their vaginal or sexual complaints with a health care provider. This quality improvement project implemented the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire to improve the identification and diagnosis of GSM in women ≥ 45 years of age presenting for an annual wellness examination or a vulvovaginal/genitourinary complaint. METHODS From October 2019 to February 2020, the DIVA questionnaire was distributed in a large women's health practice setting to women ≥ 45 years of age, for completion before their annual wellness visit or for evaluation of a GSM-related complaint. GSM diagnosis rates during the implementation period were compared with diagnosis rates during a 4-month period immediately preceding the implementation. Data collected during the implementation period were examined to evaluate if GSM diagnosis was more likely in patients who completed the DIVA questionnaire when compared to those women who did not complete the questionnaire. RESULTS Of the 175 women who met the inclusion criteria, 113 completed the DIVA questionnaire. Completion of the DIVA questionnaire demonstrated a relative percentage increase in GSM diagnosis by 30.7% when compared to the 4-month preimplementation period (10.1% to 13.2%, P = 0.231). This change was not statistically significant. During the implementation period, a statistically significant difference in GSM diagnosis was observed for patients who completed the DIVA questionnaire when compared to those patients who did not complete the questionnaire (37.2% vs 9.7%, P < 0.001). When results were stratified by visit type, women presenting for an annual wellness visit who completed the DIVA questionnaire had a higher GSM diagnosis rate than those who did not complete the questionnaire (37.2% vs 10%, P < 0.001). When results were stratified by menopausal status, GSM diagnosis rates were also more likely for postmenopausal women who completed the DIVA questionnaire when compared to those who did not complete the questionnaire (44.2% vs 8.5%, P < 0.001). CONCLUSIONS The DIVA questionnaire is a brief, but comprehensive screening tool that can increase GSM identification and treatment, particularly for postmenopausal, and midlife women presenting for an annual wellness visit in a busy women's health practice setting. : Video Summary:http://links.lww.com/MENO/A655.
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Iqbal S, Akkour K, Bano B, Hussain G, Elhelow MKKA, Al-Mutairi AM, Aljasim BSK. Awareness about Vulvovaginal Aesthetics Procedures among Medical Students and Health Professionals in Saudi Arabia. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:178-184. [PMID: 33860501 PMCID: PMC10183919 DOI: 10.1055/s-0041-1725050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. METHODS This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value < 0.05. RESULTS There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. The majority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. CONCLUSION The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.
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Affiliation(s)
- Shazia Iqbal
- Alfarabi College of Medicine Riyadh, Alfarabi, Kingdom of Saudi Arabia
| | | | - Bushra Bano
- Allama Iqbal Medical College, Lahore, Pakistan
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Sadeghi Bahmani D, Motl RW. Rate, burden, and treatment of sexual dysfunction in multiple sclerosis: The case for exercise training as a new treatment approach. Mult Scler Relat Disord 2021; 51:102878. [PMID: 33761411 DOI: 10.1016/j.msard.2021.102878] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/23/2021] [Accepted: 02/27/2021] [Indexed: 12/29/2022]
Abstract
Multiple sclerosis (MS) is a prevalent immune-mediated and neurodegenerative disease of the central nervous system (CNS) among adults in the United States and worldwide. This disease results in impairments of physical, psychological, and social functions that compromise quality of life. This review focuses on sexual dysfunction, including its prevalence, burden, and management, in persons with MS. Sexual dysfunction is defined as sexual behaviors and experiences characterized as insufficient in quality, duration and frequency. Sexual dysfunction occurs in 40-80% percent of women and 50-90% percent of men with MS. The presence of sexual dysfunction is seemingly predicted by psychological and psychiatric issues such as depression and anxiety; sociodemographic dimensions such as older age, unemployment and lower socioeconomic status; and MS-related issues such as fatigue, higher degree of disability and motor impairments. Sexual dysfunction in persons with MS is further associated with decreased psychological and psychosocial wellbeing and impaired quality of life. There is limited research supporting pharmacological and other approaches for managing sexual dysfunction in MS, and we make the case for exercise training based on recent evidence from randomized controlled trials in MS and putative mechanisms of action targeted by exercise training in MS. This paper concludes by providing a research agenda for a deeper and broader understanding of exercise training and sexual function in MS.
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Affiliation(s)
- Dena Sadeghi Bahmani
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
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Topdagi Yilmaz EP, Oral Ahiskalioglu E, Ahiskalioglu A, Tulgar S, Aydin ME, Kumtepe Y. A Novel Multimodal Treatment Method and Pilot Feasibility Study for Vaginismus: Initial Experience With the Combination of Sacral Erector Spinae Plane Block and Progressive Dilatation. Cureus 2020; 12:e10846. [PMID: 33178502 PMCID: PMC7651775 DOI: 10.7759/cureus.10846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Genito-pelvic pain/penetration disorder, commonly referred to as vaginismus, is a relatively common condition in women of childbearing age and has physical and psychological aspects. Various cognitive and behavioral therapies, dilatators, botulinum injections, and so on have been tried in the treatment. We hypothesize that the combination of sacral erector spinae plane (ESP) block and progressive dilatation treatment increases treatment quality. Methods We performed the sacral ESP block and progressive dilatation, which we added to multimodal treatment for resistant vaginismus cases. After the procedure, all patients were followed up during one menstrual cycle. They were recommended to have sexual intercourse on the day of the procedure. Results In 15 of our treatment-resistant cases, when we added the sacral ESP block, successful penetration after the first block was 73%. Pregnancy occurred in eight patients after the initial one-month follow-up. Four of the 15 patients needed a second block. Conclusions The sacral ESP block added to the multimodal treatment protocol significantly improves treatment quality.
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Affiliation(s)
| | | | - Ali Ahiskalioglu
- Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, TUR.,Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, TUR
| | - Serkan Tulgar
- Anesthesiology, Maltepe University Faculty of Medicine, Istanbul, TUR
| | - Muhammed E Aydin
- Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, TUR.,Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, TUR
| | - Yakup Kumtepe
- Obstetrics and Gynecology, Ataturk University School of Medicine, Erzurum, TUR
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Price T, Zebitz M, Giraldi A, Lokind TS, Treasure J, Sjögren JM. Sexual function and dysfunction among women with anorexia nervosa: A systematic scoping review. Int J Eat Disord 2020; 53:1377-1399. [PMID: 32449544 DOI: 10.1002/eat.23299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research suggests that a variety of biological and psychosocial factors are associated with the sexual health of women diagnosed with anorexia nervosa (AN). This systematic scoping review, conducted in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines, synthesizes the current literature concerning sexual function and dysfunction in women with AN. METHOD We searched PubMed, EMBASE, and PsychInfo for literature published until April 2020. All study designs were eligible for inclusion, providing they focused on sexual function and dysfunction in women with AN. Studies that only included outcomes related to gender identity or sexual orientation were excluded. RESULTS N = 28 studies met criteria for inclusion in the review. All studies were conducted in Western countries and the majority employed either a cohort or cross-sectional design. Although measures of sexual function and dysfunction varied markedly across studies, most studies adopted a biopsychosocial framework. Libido may be linked to body mass index (BMI), while other aspects of sexual functioning and behavior might not be specifically associated with weight status. Limited data are available on evidence-based interventions. DISCUSSION Sexual dysfunction in women with AN is common. Although some of the variance is explained by low BMI, associated physiological sequelae and other psychosocial factors are also involved. Sexual dysfunction is a relevant clinical problem and clinicians should sensitively incorporate questions related to sexual function into their eating disorder assessments. Future research, using more robust designs and validated outcome measures, is needed to better understand causal pathways between the biological and psychosocial correlates of AN and sexual dysfunction. Identifying predictors of sexual function and dysfunction in more diverse groups of people with AN will support the development of evidence-based therapies.
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Affiliation(s)
- Tom Price
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Martin Zebitz
- Research Unit Eating Disorders, Psychiatric Center BALLERUP, Ballerup, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Rigshospitalet Capitol Region of Denmark Psychiatry Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thea Stine Lokind
- Research Unit Eating Disorders, Psychiatric Center BALLERUP, Ballerup, Denmark
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Jan Magnus Sjögren
- Research Unit Eating Disorders, Psychiatric Center BALLERUP, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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The Efficacy of Vaginal Laser and Other Energy-based Treatments on Genital Symptoms in Postmenopausal Women: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol 2020; 28:668-683. [PMID: 32791349 DOI: 10.1016/j.jmig.2020.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This systematic review examined energy-based treatments of the vagina for postmenopausal vaginal symptoms. DATA SOURCES We performed a systematic review from April 2017 (the end date of our previous review) to April 2020, searching Medline, Embase, and Scopus. METHODS OF STUDY SELECTION The inclusion criteria were all randomized studies, prospective studies with >10 cases, and retrospective studies with >20 cases published in English or French that assessed change in postmenopausal vaginal symptoms and/or sexual function in women after energy-based vaginal treatments. Meta-analyses were performed on randomized data. TABULATION, INTEGRATION, AND RESULTS Of the 989 results retrieved, 3 randomized studies, 16 prospective studies, and 7 retrospective studies were included in the review, representing data from 2678 participants. Pooled data from 3 randomized controlled trials show no difference between vaginal laser and topical hormonal treatments for change in vaginal symptoms (-0.14, 95% confidence interval -1.07 to 0.80) or sexual function scores (2.22, 95% confidence interval -0.56 to 5.00). Furthermore, no difference among vaginal laser, topical hormone, and lubricant was demonstrated in sexual function (p = .577). As in our previous review, non-randomized data support energy-based treatments in improving vaginal symptoms, sexual function, and clinician-reported outcomes. No severe adverse events were reported in the included studies. Significant heterogeneity of data arising from differing measures and reported outcomes continues to be an issue, with data remaining low quality, with high risk of bias, and no double-blind or placebo-controlled randomized trials yet reported, although 1 has now completed recruitment. CONCLUSION There are 3 randomized trials comparing energy-based systems with hormonal treatment, with no clinical difference in these 2 approaches. Although prospective data continue to show promising outcomes, without strong evidence from well-powered, double-blind placebo-controlled trials to determine the efficacy of treatment compared with placebo, the use of energy-based treatments should continue to be undertaken in research studies only, with high-quality studies essentially free from bias (International Prospective Register of Systematic Review registration number: 178346).
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Aalaie B, Tavana B, Rezasoltani Z, Aalaei S, Ghaderi J, Dadarkhah A. Biofeedback versus electrical stimulation for sexual dysfunction: a randomized clinical trial. Int Urogynecol J 2020; 32:1195-1203. [PMID: 32529563 DOI: 10.1007/s00192-020-04373-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Sexual dysfunction is a common problem in the general population. We compared the effects of biofeedback and electrical stimulation on the symptoms of sexual pain dysfunction in women with urinary stress incontinence. METHODS We carried out a parallel randomized clinical trial in an outpatient department for physical medicine and rehabilitation at a university hospital. Based on DSM-5 criteria for sexual dysfunction, 22 patients with sexual dysfunction and stress incontinence were included and randomly allocated to each study arm. The primary outcome measure was the total score on the Female Sexual Function Index. Each group underwent pertinent treatment for 100 min, two times a week for 6 weeks. RESULTS Both groups showed favorable outcomes in increasing Female Sexual Function Index mean scores and their domains. However, for improving sexual function, women in the biofeedback group benefited more than those receiving electrical stimulation. Biofeedback raised desire, arousal, lubrication, orgasm, and satisfaction scores more than electrical stimulation (all p ≤ 0.025). Both interventions decreased pain during or following vaginal penetration similarly (p = 0.985). CONCLUSIONS Both biofeedback and electrical stimulation increased the Female Sexual Function Index score. However, to improve sexual function, women undergoing biofeedback seem to benefit more than those receiving electrical stimulation. We recommend considering the prescription of biofeedback for the treatment of sexual dysfunction because of its efficacy, lack of adverse effects, and easy application.
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Affiliation(s)
- Behnaz Aalaie
- School of Medicine, Department of Physical Medicine and Rehabilitation, Aja University of Medical Sciences, Etemadzadeh St, Western Fatemi, Tehran, Islamic Republic of Iran, Postal code 1411718541
| | - Behroz Tavana
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Rezasoltani
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Solmaz Aalaei
- School of Medicine, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Ghaderi
- School of Medicine, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dadarkhah
- School of Medicine, Department of Physical Medicine and Rehabilitation, Aja University of Medical Sciences, Etemadzadeh St, Western Fatemi, Tehran, Islamic Republic of Iran, Postal code 1411718541.
- Clinical Biomechanics and Ergonomics Research Center, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran.
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Mirzaee F, Ahmadi A, Zangiabadi Z, Mirzaee M. The Effectiveness of Psycho-Educational and Cognitive-Behavioral Counseling on Female Sexual Dysfunction. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:333-339. [PMID: 32604436 PMCID: PMC10418250 DOI: 10.1055/s-0040-1712483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/31/2020] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Sexual function is a multidimensional phenomenon that is affected by many biological and psychological factors. Cognitive-behavioral sex therapies are among the most common nonpharmacological approaches to psychosexual problems. The purpose of the present study was to investigate the effectiveness of psychoeducational and cognitive-behavioral counseling on female sexual dysfunction. METHODS The present study was a clinical trial with intervention and control groups. The study population consisted of women referring to the general clinic of a governmental hospital in Iran. After completing the demographic questionnaire and Female Sexual Function Index (FSFI), those who obtained the cutoff score ≤ 28 were contacted and invited to participate in the study. Convenience sampling method was used and 35 subjects were randomly allocated for each group. Eight counseling sessions were held for the intervention group (two/week/1.5 hour). Post-test was taken from both groups after 1 month, and the results were statistically analyzed by PASW Statistics for Windows, Version 18 (SPSS Inc., Chicago, IL, USA). RESULTS The total mean scores of FSFI and the subscales of sexual desire, arousal, orgasm, and satisfaction were significantly higher in the intervention group than in the control group after the intervention. In addition, postintervention pain mean scores in the intervention group were significantly lower than in the control group (p < 0.05). CONCLUSION The results of the present study indicate that psychoeducational cognitive-behavioral counseling is effective in improving female sexual function. It is recommended to compare the effects of psychoeducational cognitive-behavioral counseling on sexual dysfunctions of couples and with a larger sample size in future research.
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Affiliation(s)
- Firoozeh Mirzaee
- Razi Nursing and Midwifery Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Atefeh Ahmadi
- Razi Nursing and Midwifery Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Zangiabadi
- Razi Nursing and Midwifery Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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Marques Cerentini T, La Rosa VL, Goulart CDL, Latorre GFS, Caruso S, Sudbrack AC. Female sexual dysfunctions: prevalence and related factors in a sample of young university women – a cross-sectional study. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1748592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | | | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology, University of Catania, Catania, Italy
| | - Ana Cristina Sudbrack
- Physiotherapy Department, University of Santa Cruz do Sul – UNISC, Santa Cruz do Sul, RS, Brazil
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Biglia N, Del Pup L, Masetti R, Villa P, Nappi RE. Vulvovaginal atrophy (VVA) in breast cancer survivors (BCS) is still an unmet medical need: results of an Italian Delphi Panel. Support Care Cancer 2020; 28:2507-2512. [PMID: 31970513 PMCID: PMC7181543 DOI: 10.1007/s00520-019-05272-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/23/2019] [Indexed: 12/02/2022]
Abstract
Abstract Purpose VVA is a common disease, with approximately 50% of all postmenopausal women having related symptoms. VVA has a significant impact on the personal and sexual lives and on many aspects of women’s self-esteem and emotional well-being. It is particularly frequent and severe in patients treated for BC, where it originates significant economic and social costs. Given the lack of published evidence on this subject, a Delphi Panel was carried out to evaluate:The epidemiology of VVA and of its risk-factors/comorbidities in Italy The present standard of care and unmet medical needs The comparison between recent US epidemiological data and the Italian situation The health resources used in VVA BC
The burden of illnessDespite the considerable negative impact on quality of life, a disparity between the high prevalence of this condition and the infrequent clinical diagnosis is documented in medical practice and in surveys. This inaccuracy is thought to be primarily a consequence of patients’ unwillingness and/or reluctance to report symptoms in the clinical setting and of health-care professional’s difficulty in approaching this sensitive topic during routine consultations. Methods A Delphi Panel methodology was used: a first round of written questionnaires, followed by a plenary meeting with a facilitator and by two additional rounds of telephone interviews. Results The prevalence of the condition in Italy can be estimated in 115,000 cases out of 380,000 BC survivors. The Panel confirmed that the epidemiological findings of a recent pharmacoeconomic analysis of a US claims database can be applied to Italian patient population. The Panel confirmed also an estimate of 4.25 additional cases/100/yr of UTI (urinary tract infection) in VVA BC patients (vs. a non-VVA-matched population), of 3.68 additional cases of vulvovaginitis, of 6.97 cases of climacteric symptoms, and of 3.64 cases of bone and joint disorders. As far as the resource use is concerned, in the VVA BC populations, 33.4 additional gynecological visits/100/year can be expected, along with 22.8 additional cancer screenings, 7.07 additional outpatient visits and 5.04 screenings for HPV. Conclusions Even in Italy, a diagnosis of VVA, especially in a BC population, is associated with a relevant increase in the burden of illness and social costs, compared to a control population matched for age without VVA. This is due essentially to an increase in comorbidities and resource utilization with the consequence that an adequate treatment could reduce the impact of the condition.
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Affiliation(s)
- Nicoletta Biglia
- SCDU Ginecologia e Ostetricia, Ospedale Mauriziano Umberto I, Università di Torino, Torino, Italy.
| | - Lino Del Pup
- SOC Ginecologia Oncologica, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Riccardo Masetti
- UOC Chirurgia Senologica, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola Villa
- Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossella E Nappi
- UOSD Ostetricia e Ginecologia - Procreazione Medicalmente Assistita, IRCCS Fondazione Policlinico "S. Matteo", Università degli Studi di Pavia, Pavia, Italy
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Vaishnav M, Saha G, Mukherji A, Vaishnav P. Principles of Marital Therapies and Behavior Therapy of Sexual Dysfunction. Indian J Psychiatry 2020; 62:S213-S222. [PMID: 32055064 PMCID: PMC7001355 DOI: 10.4103/psychiatry.indianjpsychiatry_19_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/10/2020] [Indexed: 01/23/2023] Open
Affiliation(s)
- Mrugesh Vaishnav
- Consultant Psychiatrist and Director, Samvedana Foundation, Ahmedabad, Gujarat, India.,Director, Institute of Psychological and Sexual Research, Samvedana Foundation, Ahmedabad, Gujarat, India.,National President, Indian Psychiatry Society, Kolkata, West Bengal, India.,Direct Council Member, Indian Association of Social Psychiatry, Kolkata, West Bengal, India.,Consultant, Family Planning Association of India, Consultant SECRT, Kolkata, West Bengal, India
| | - Gautam Saha
- Director, Clinic Brain Neuropsychiatric Institute and Research Centre, Kolkata, West Bengal, India.,Immediate Past General Psychiatry India Psychiatric Society, Kolkata, West Bengal, India
| | - Abir Mukherji
- Sr. Consultant Psychiatrist Medica Super Specialty Hospital, AMRI Group of Hospitals, Kolkata, West Bengal, India
| | - Parth Vaishnav
- Consultant Psychiatrist and Co-Director, Samvedana Happiness Hospital, Ahmedabad, Gujarat, India
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Affiliation(s)
- Swati Jha
- Consultant Gynaecologist Subspecialist in Urogynaecology Sheffield Teaching Hospitals NHS Foundation Trust Level 4, Jessop Wing, Tree Root Walk Sheffield S10 2SF UK
| | - Tim Hillard
- Consultant Gynaecologist and Urogynaecologist Department of Obstetrics and Gynaecology Poole Hospital NHS Foundation Trust Longfleet Road Poole Dorset BH15 2JB UK
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