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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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Rodrigues AMDBP, Neto OB, Seguro CS, da Silva WF, Gonzalez RH, Santos DDAT, de Lira CAB, Viana RB. Does yoga improve sexual function? A systematic review and meta-analysis of randomized clinical trials. Complement Ther Clin Pract 2024; 56:101864. [PMID: 38830273 DOI: 10.1016/j.ctcp.2024.101864] [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: 01/05/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults. METHODS Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines. RESULTS Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups. CONCLUSION Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
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Affiliation(s)
| | - Octavio Barbosa Neto
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Hugo Gonzalez
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Borges Viana
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil.
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Suvaal I, Hummel SB, Mens JWM, Tuijnman-Raasveld CC, Tsonaka R, Velema LA, Westerveld H, Cnossen JS, Snyers A, Jürgenliemk-Schulz IM, Lutgens LCHW, Beukema JC, Haverkort MAD, Nowee ME, Nout RA, de Kroon CD, van den Hout WB, Creutzberg CL, van Doorn HC, Ter Kuile MM. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial. Br J Cancer 2024:10.1038/s41416-024-02775-8. [PMID: 38961193 DOI: 10.1038/s41416-024-02775-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers. METHODS Eligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time. RESULTS In total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly. DISCUSSION Sexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment. CLINICAL TRIAL REGISTRATION NCT03611517.
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Affiliation(s)
- Isabelle Suvaal
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Susanna B Hummel
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan-Willem M Mens
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Roula Tsonaka
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Laura A Velema
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henrike Westerveld
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jeltsje S Cnossen
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - An Snyers
- Department of Radiation Oncology, Radboudumc, Nijmegen, The Netherlands
| | | | | | - Jannet C Beukema
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie A D Haverkort
- Department of Radiation Oncology, Radiotherapiegroep, Arnhem, The Netherlands
| | - Marlies E Nowee
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Remi A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Cor D de Kroon
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilbert B van den Hout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Helena C van Doorn
- Department of Gynaecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Moniek M Ter Kuile
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
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Fang Y, Liu F, Zhang X, Chen L, Liu Y, Yang L, Zheng X, Liu J, Li K, Li Z. Mapping global prevalence of menopausal symptoms among middle-aged women: a systematic review and meta-analysis. BMC Public Health 2024; 24:1767. [PMID: 38956480 DOI: 10.1186/s12889-024-19280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis. METHODS Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis. RESULTS A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51-68.29) and lowest of formication (20.5%, 95% CI 13.44-28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p < 0.01), while personal factors, such as menopausal stage, had an influence on most menopausal symptoms, particularly in vaginal dryness. Prevalence of vagina dryness in postmenopausal women (44.81%) was 2-fold higher than in premenopausal women (21.16%, p < 0.01). Furthermore, a remarkable distinction was observed between body mass index (BMI) and prevalence of sleep problems, depression, anxiety and urinary problems. CONCLUSION The prevalence of menopausal symptoms affected by both social and personal factors which calls for attention from general public.
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Affiliation(s)
- Yiqiao Fang
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, Sichuan, 610041, China
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Fen Liu
- Department of Operating Room, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xinyue Zhang
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lei Chen
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, Sichuan, 610041, China
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yang Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
| | - Lin Yang
- Department of Gynecology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jiaye Liu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, Sichuan, 610041, China
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Kewei Li
- Department of Pediatric Department, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, Sichuan, 610041, China.
| | - Zhihui Li
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, No.37 Guoxue Road, Chengdu, Sichuan, 610041, China.
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
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Dell'Utri CM, Manzoni E, Bonfanti I, Marrocco F, Barbara G, Pifarotti P, Chiaffarino F. Should I stay for local hormone therapy or should I go for radiofrequency to treat vulvovaginal atrophy? A patient preference trial. Menopause 2024:00042192-990000000-00343. [PMID: 38954491 DOI: 10.1097/gme.0000000000002393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE To compare patient satisfaction rate in postmenopausal women who chose dynamic quadripolar radiofrequency or topical estrogens as their preferred treatment for genitourinary syndrome of menopause. METHODS Patients were divided into two groups according to their preference: one was treated with estrogen therapy (ET) and the other with dynamic quadripolar radiofrequency treatment (RF). All patients included fulfilled a series of validated questionnaires, at baseline and at the 6-mo follow-up, in order to evaluate the discomfort degree associated with the presence of vulvovaginal atrophy and the impact of the reported symptoms on QoL and sexuality. RESULTS After propensity score matching, the proportion of women considering themselves satisfied with their genital health conditions was extremely small at study entry (5.2% of the RF group and 6.9% of the ET group), while at a 6-mo follow-up, it increased to 46.7% and 46.6%, respectively. No statistically significant between-group differences were found regarding mean numerical rating scale scores for dryness and dyspareunia at follow-up (5.6 ± 2.6 vs 5.3 ± 2.3, P = 0.5; and 2.9 ± 2.5 vs 3.0 ± 2.7, P = 0.46). At 6-mo follow-up, we observed no statistically significant differences between the two groups regarding the other items evaluated. RF treatment was overall well tolerated. CONCLUSION The use of quadripolar radiofrequency devices seems effective, but it is not associated with better clinical outcomes compared with topical hormone treatment, which is a substantially cheaper and more convenient treatment for genitourinary syndrome of menopause. Therefore, we suggest limiting the use of dynamic quadripolar radiofrequency selectively when topical estrogens are not effective, not tolerated, or contraindicated.
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Affiliation(s)
- Chiara Mf Dell'Utri
- From the Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Manzoni
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Irene Bonfanti
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Francesca Marrocco
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | | | - Paola Pifarotti
- From the Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Chiaffarino
- From the Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Jorge CH, Bø K, Chiazuto Catai C, Oliveira Brito LG, Driusso P, Kolberg Tennfjord M. Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 231:51-66.e1. [PMID: 38191016 DOI: 10.1016/j.ajog.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of pelvic floor muscle training in treating female sexual dysfunction. DATA SOURCES A systematic review of databases, including PubMed, Ovid Medline, CINAHL, Embase, BVSalud, Scopus, and Cochrane Library, was performed in July 2021 and updated in May 2023. STUDY ELIGIBILITY CRITERIA Full-text articles of randomized controlled trials comparing pelvic floor muscle training with no intervention or another conservative treatment were included. At least 1 arm of these trials aimed to improve women's sexual function or treat sexual dysfunction. METHODS The data for this review were extracted and analyzed by 2 independent reviewers. Data on the characteristics of each intervention were extracted using the Consensus on Exercise Reporting Template. The risk of bias and certainty of evidence were assessed using the Physiotherapy Evidence Database (PEDro) scale and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria, respectively. A meta-analysis was conducted considering the posttreatment mean score difference in the Female Sexual Function Index between the control and treatment groups. RESULTS A total of 21 randomized controlled trials were included in this review. The Consensus on Exercise Reporting Template revealed varying quality of the pelvic floor muscle training protocols. Four studies were included in the meta-analysis showing that pelvic floor muscle training improved arousal (1.49; 95% confidence interval, 0.13-2.85), orgasm (1.55; 95% confidence interval, 0.13-2.96), satisfaction (1.46; 95% confidence interval, 0.14-2.77), pain (0.74; 95% confidence interval, 0.11-1.37), and the Female Sexual Function Index overall score (7.67; 95% confidence interval, 0.77-14.57). Very low certainty of evidence due to the data's high clinical and statistical heterogeneity was found according to the GRADE criteria. No side effects of the interventions were reported. CONCLUSION This systematic review and meta-analysis showed that pelvic floor muscle training improved female Female Sexual Function Index total score and several subscales; however, the certainty of the evidence is low.
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Affiliation(s)
- Cristine Homsi Jorge
- Pelvic Floor Muscle Function Laboratory, Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences and Department of Obstetrics and Gynecology, Akershus University Hospital, Nordbyhagen, Norway
| | - Camila Chiazuto Catai
- Pelvic Floor Muscle Function Laboratory, Health Science Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Merete Kolberg Tennfjord
- Department of Health and Exercise, School of Health Sciences, Kristiania University College, Oslo, Norway
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Poston AM, Oliver TL, Lanti A, Benning SD. Why College Women and Men Refrain from Sex Despite Desire: Development of the No Sex Despite Desire (NSDD) Measure. JOURNAL OF SEX RESEARCH 2024:1-14. [PMID: 38940432 DOI: 10.1080/00224499.2024.2368695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Humans have sex for myriad reasons, many unrelated to desire. But under what conditions does sexual desire not lead to sex? We investigated reasons college students refrain from sex despite desire and having an attractive, willing partner and relationships between these reasons and other aspects of sexuality and personality. For item generation, 604 participants identified 109 reasons why individuals may refrain from sex despite desire. For construct validation, 712 participants reported the frequency they experienced these reasons on a novel measure. Every reason evidencing discernible gender differences was endorsed more by women. These items largely concentrated in factors of Personal Insecurities and Principled Concerns. No gender differences emerged on the Partner Issues factor. Factors differentially related to sexuality and personality variables. Principled Concerns related negatively to sociosexual behavior and attitudes and positively to sexual traditionalism across genders. Partner Issues positively correlated with sociosexual behavior and desire for women. Personal Insecurities negatively correlated with sociosexual attitudes for men. Principled Concerns related to sexual functioning issues for women. Personal Insecurities and Principled Concerns related to worse sexual functioning for men. Personal Insecurities related to Neuroticism across genders. These results suggest potential directions for therapeutic interventions and further research.
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Boeri L, De Lorenzis E, Lucignani G, Turetti M, Silvani C, Zanetti SP, Longo F, Albo G, Salonia A, Montanari E. Oral preparation of hyaluronic acid, chondroitin sulfate, N-acetylglucosamine, and vitamin C improves sexual and urinary symptoms in participants with recurrent urinary tract infections: a randomized crossover trial. J Sex Med 2024; 21:627-634. [PMID: 38721680 DOI: 10.1093/jsxmed/qdae052] [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: 11/26/2023] [Revised: 03/22/2024] [Accepted: 03/31/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Intravesical instillation of hyaluronic acid (HA) has been associated with reduced sexual dysfunction in participants with recurrent urinary tract infections (rUTIs), but the efficacy of an oral treatment has never been investigated. AIM To investigate the efficacy of an oral preparation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C in improving sexual and urinary symptoms in a cohort of reproductive-age participants with rUTI. METHODS In a monocentric randomized crossover pilot trial, participants with rUTI who were referred to our institute between March 2022 and April 2023 were randomized 1:1 in 2 groups: intervention vs control. All participants had an oral preparation of cranberry, D-mannose, propolis extract, turmeric, and Boswellia twice a day for 3 months. The intervention group also included an oral preparation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C once a day for 3 months. Crossover of treatment occurred at 3 months for an additional 3 months. At baseline and 3 and 6 months, participants were evaluated clinically and with the International Prostate Symptom Score (IPSS) and Female Sexual Function Index (FSFI). Descriptive statistics and logistic regression models tested the impact of the intervention on urinary and sexual symptoms at each follow-up assessment. OUTCOMES Improvement in sexual and urinary symptoms as measured by the FSFI and IPSS. RESULTS Overall, 27 (54%) participants had an FSFI score <26.5 at enrollment. At 3 months, FSFI scores were higher in the intervention group vs control (P < .001), but IPSS scores were lower (P = .03). After crossover of treatment, FSFI and IPSS scores remained stable in the intervention group. However, after crossover, the control group showed a significant improvement in IPSS and FSFI scores (all P < .01) vs the 3-month assessment. At last follow-up, urinary and sexual symptoms were comparable between groups. In logistic regression analyses, the intervention group was associated with early improvement in sexual symptoms (odds ratio, 3.9; P = .04) and urinary symptoms (odds ratio, 5.1; P = .01) after accounting for clinical confounders. CLINICAL IMPLICATIONS Combination treatment with HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C is effective if started immediately or even after a few months from symptoms in participants with rUTI. STRENGTHS AND LIMITATIONS The main limitation is the lack of long-term follow-up. CONCLUSION The oral formulation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C could be an effective therapy against urinary and sexual distress in participants with rUTI (NCT06268483; ClinicalTrials.gov).
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Affiliation(s)
- Luca Boeri
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Elisa De Lorenzis
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Gianpaolo Lucignani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Matteo Turetti
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Carlo Silvani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Stefano Paolo Zanetti
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Fabrizio Longo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Giancarlo Albo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, 20122, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, 20143, Italy
| | - Emanuele Montanari
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, 20122, Italy
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Ashton L, Nataksuka H, Johnson CM, Kenne K, Kreder KJ, Kruse R, Wendt L, Takacs EB, Vollstedt AJ. A Single Injection of Platelet-Rich Plasma Injection for the Treatment of Stress Urinary Incontinence in Females: A Randomized Placebo-Controlled Trial. Urology 2024:S0090-4295(24)00499-0. [PMID: 38942391 DOI: 10.1016/j.urology.2024.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/22/2024] [Accepted: 06/21/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To determine the efficacy of a single injection of platelet-rich plasma into the anterior vaginal wall at the mid-urethra compared to placebo, as there is emerging evidence that platelet-rich plasma may help treat female stress urinary incontinence. METHODS This was a single-blind, randomized, placebo-controlled clinical trial at a single institution. Females with bothersome, demonstrable stress-predominant urinary incontinence were enrolled. Participants were randomized to either injection of 5 mL autologous platelet-rich plasma or saline at the anterior vaginal wall at the mid-urethra. The primary outcome was composite treatment success at six months, defined as a negative cough stress test and an answer of "much better" or "very much better" on the Patient's Global Impression of Improvement. RESULTS Fifty patients were enrolled in the study and randomized to the platelet-rich plasma group (n = 25) or the saline placebo group (n = 25). There was no statistically significant difference in the primary outcome between the two groups. Adverse events were minor, and the rate of adverse events was similar between both groups. CONCLUSIONS In this randomized placebo-controlled study, we were unable to demonstrate a difference in stress urinary incontinence treatment success between platelet-rich plasma and saline injections. At this time, there is insufficient evidence to offer a one-time platelet-rich plasma injection into the anterior vaginal wall for treatment of female stress urinary incontinence.
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Affiliation(s)
| | | | | | | | | | | | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa.
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Almadori A, Palmieri S, Coho C, Evans C, Elneil S, Albert J. Reconstructive surgery for women with female genital mutilation: A scoping review. BJOG 2024. [PMID: 38923662 DOI: 10.1111/1471-0528.17886] [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: 12/14/2023] [Revised: 05/24/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Female genital mutilation (FGM) is a global public health concern. However, reconstructive surgery remains unavailable in many countries. OBJECTIVES This scoping review, guided by Joanna Briggs Institute (JBI) principles, explores indications, referral routes, eligibility, care pathways and clinical outcomes of reconstructive surgery for FGM. SEARCH STRATEGY Medical Subject Headings (MeSH) terms and subject headings were searched in EMBASE, MEDLINE, SCOPUS, Web of Science and publicly available trial registers. SELECTION CRITERIA Any primary experimental and quasi-experimental study addressing reconstructive surgery for FGM, and its impact on women, published before June 2023. DATA COLLECTION AND ANALYSIS After removing duplicates from the search results, titles and abstracts were screened and data were extracted. Disagreements were resolved through panel discussion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram depicts the search results and inclusion process. MAIN RESULTS A total of 40 studies were included. Multidisciplinary teams were involved in 40% (16/40) of the studies, and psychosexual counselling was offered in 37.5% (15/40) of studies. Clitoral reconstruction using Foldes' technique was predominant (95%, 38/40). A total of 7274 women underwent some form of reconstruction. Post-surgery improvement was reported in 94% of the cases (6858/7274). The complication rate was 3% (207/7722 women with reconstruction). CONCLUSIONS Further research and clinical trials are needed. Although the outcomes suggest improved sexual function and quality of life post-surgery, the evidence remains limited. Advocating surgical reconstruction for survivors of FGM is vital for addressing health disparities and potential cost-effectiveness.
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Affiliation(s)
- Aurora Almadori
- Division of Surgery and Interventional Science, University College of London, London, UK
- Department of Plastic Surgery, NHS Royal Free Hospital London Trust, London, UK
| | - Stefania Palmieri
- University College London, Hospitals NHS Foundation Trust, London, UK
| | | | - Catrin Evans
- The Nottingham Centre for Evidence Based Healthcare, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Soheir Elneil
- Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Juliet Albert
- University of Nottingham, Nottingham, UK
- Division of Womens, Children and Clinical Support, Imperial College Healthcare NHS Trust (ICHNT), London, UK
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11
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Carter J, Pugh SL, Arring N, Littell RD, Page SJ, Rowland KM, Goodman JR, Razaq W, Siddique S, Borges M, Kachnic LA, Barton DL. NRG-CC004 ancillary data study-exploring the effect of bupropion on sexual desire in female cancer survivors with and without vulvovaginal symptoms. J Sex Med 2024:qdae061. [PMID: 38856026 DOI: 10.1093/jsxmed/qdae061] [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: 11/22/2023] [Revised: 03/12/2024] [Accepted: 05/14/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Female cancer survivors often experience estrogen-deprivation symptoms, which may lead to decreases in sexual desire, vulvovaginal health (lubrication, dryness, discomfort), and sexual satisfaction. Interventions are needed to address these concerns. AIM The objective of this secondary analysis was to determine if women with higher (better) scores on the Female Sexual Function Index (FSFI) lubrication and pain subscales reported higher desire scores based on treatment with bupropion vs placebo. METHODS Participants were part of NRG Oncology's NRG-CC004 (NCT03180294), a randomized placebo-controlled clinical trial evaluating bupropion (150 vs 300 mg) to improve sexual desire in survivors of breast or gynecologic cancer. All participants with baseline data from the FSFI lubrication, pain, and desire subscales with 5- and/or 9-week data were analyzed. The FSFI subscale scores were correlated using Spearman correlation coefficients. Logistic regression was used to determine associations between FSFI desire and other FSFI subscales while accounting for treatment arm and other covariates. OUTCOMES The primary outcome of NRG Oncology's NRG-CC004 (NCT03180294) randomized phase II dose-finding trial was change from baseline to 9 weeks on the FSFI desire subscale score. Similar to the parent study, the primary outcome for this ancillary data study was the FSFI desire subscale score at 5 and 9 weeks. RESULTS Overall, 230 participants completed the FSFI at baseline and 189 at 9 weeks. The strongest correlations were between lubrication and pain at baseline (all participants, rho = 0.77; bupropion arms, rho = 0.82), week 5 (all participants, rho = 0.71; bupropion arms, rho = 0.68), and week 9 (all participants, rho = 0.75; bupropion arms, rho = 0.78), and the weakest correlations were between desire and pain. In patients in the treatment arms there were no interactions between lubrication or pain.The impact of various covariates on the FSFI score for desire at 9 weeks demonstrated that participants of non-White race (odds ratio [OR], 0.42; 95% CI, 0.21-0.81; P = .010), with a high lubrication score (OR, 0.36; 95% CI, 0.21-0.61; P = .0002), with a high pain score (less pain) (OR, 0.50; 95% CI, 0.29-0.87; P = .014), or with prior pelvic surgery (OR, 0.38; 95% CI, 0.23-0.63; P = .0002) had lower odds of having low desire. CLINICAL IMPLICATIONS Acute estrogen-deprivation symptoms should be addressed prior to sexual desire intervention. STRENGTHS AND LIMITATIONS This secondary analysis was not powered to examine all variables. CONCLUSION Lubrication and pain were predictors of low desire. Therefore, vulvovaginal atrophy and associated genitourinary symptoms of menopause such as vaginal dryness and dyspareunia should be addressed prior to or in parallel with interventions for sexual desire.
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Affiliation(s)
- Jeanne Carter
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA 19103, United States
| | - Noel Arring
- University of Tennessee, Knoxville, TN 37966, United States
| | | | - Seth J Page
- Cancer Center of Kansas, Wichita, KS 67460, United States
| | | | - Judie R Goodman
- Trinity Health St. Joseph Mercy Oakland, Pontiac, MI 48341, United States
| | - Wajeeha Razaq
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | | | - Monica Borges
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA 19103, United States
| | - Lisa A Kachnic
- Columbia University Medical Center, New York, NY 10032, United States
| | - Debra L Barton
- University of Tennessee College of Nursing, Knoxville, TN 37996, United States
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12
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Déa CA, Moreira ECH, Zamboti CL. Sexual function, quality of life, anxiety, and depression in women of reproductive age using hormonal, nonhormonal, and no contraceptive methods. J Sex Med 2024:qdae060. [PMID: 38842258 DOI: 10.1093/jsxmed/qdae060] [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: 11/01/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial. AIM In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods. METHODS This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. OUTCOMES Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P < .05), as well as higher anxiety and depression levels (P = .03, for both), increased pain (P = .01), and poorer overall health (P = .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P < .05). CLINICAL IMPLICATIONS The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods. STRENGTHS AND LIMITATIONS The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample. CONCLUSION Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.
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Affiliation(s)
- Caroline Andrade Déa
- Department of Physiotherapy, State University of Londrina, Londrina, Paraná 86038-350, Brazil
| | | | - Camile Ludovico Zamboti
- Department of Physiotherapy, State University of Londrina, Londrina, Paraná 86038-350, Brazil
- Department of Physical Therapy, School of Science and Technology of Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo 19060-900, Brazil
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13
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Schwesig R, Borchardt M, Velten J, Hoyer J. Psychometric Properties of the Diagnostic Interview for Sexual Dysfunctions in Women in a Symptom-Reporting Sample. Assessment 2024:10731911241253659. [PMID: 38828910 DOI: 10.1177/10731911241253659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
While structured clinical interviews are considered the gold standard for diagnosing mental disorders, respective instruments are still lacking in the field of sexual dysfunctions. The study evaluates the psychometric properties of the new Diagnostic Interview for Sexual Dysfunctions in Women (DISEX-F), which is based on the eleventh edition of the International Statistical Classification of Diseases (ICD-11) and the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in a sample of 100 women with self-reported sexual problems. Participants were interviewed twice by trained diagnosticians with the DISEX-F. A third diagnostician evaluated the audio records of the initial interview. Participants also completed self-report measures of sexual functioning/distress and interview acceptance. The DISEX-F demonstrates excellent inter-rater reliability, good test-retest reliability, and strong convergent and discriminant evidence of validity. Furthermore, it achieves high acceptance among participants. Discordant diagnostic outcomes were especially linked to false differential diagnostic decisions and information variance in participants reporting. The results strongly support using the DISEX-F for women presenting with self-reported sexual problems in practice and research.
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14
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van Zwol-Janssens C, Pastoor H, Laven JSE, Louwers YV, Jiskoot G. Sexual function in women with premature ovarian insufficiency (POI): Systematic review and meta-analysis. Maturitas 2024; 184:107994. [PMID: 38644091 DOI: 10.1016/j.maturitas.2024.107994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/21/2024] [Accepted: 04/07/2024] [Indexed: 04/23/2024]
Abstract
Premature ovarian insufficiency (POI) is a rare condition characterized by loss of ovarian function before the age of 40. POI seems associated with mood disorders and sexual dysfunction. However, there is a lack of high-quality evidence relating to the impact of POI on sexual function. Therefore, we conducted a systematic review and meta-analysis to evaluate sexual function in women with POI compared to women without the condition. The following online databases were systematically searched up to January 2023: EMBASE, Medline (Ovid), Web of Science, Cochrane, PsychInfo, and Google Scholar. Random effects models were used for analyses, with data reported as Hedges' g and 95 % confidence interval, and the risk of heterogeneity was evaluated. The protocol of this study was registered with PROSPERO (CRD42023437203). A total of 10 studies were included in the systematic review and 5 studies involving 352 women with POI were included in the meta-analysis. Eight of the ten studies concluded that women with POI have reduced sexual function. An overall medium Hedges' g effect size of -0.72 was found (ranging between -0.20 and -1.29) in favor of control women, with moderate heterogeneity (I2 = 64 %). Stratified studies of women on systemic hormone replacement therapy (HRT) showed an even higher Hedges' g effect size, of -0.82 (95 % CI -1.18, -0.47). In conclusion, sexual function in women with POI is reduced compared with control women. Sexual function should be discussed with women with POI and they should be offered psychosexual counseling.
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Affiliation(s)
- Charissa van Zwol-Janssens
- Erasmus MC, Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - Hester Pastoor
- Erasmus MC, Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Joop S E Laven
- Erasmus MC, Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Yvonne V Louwers
- Erasmus MC, Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Geranne Jiskoot
- Erasmus MC, Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, PO Box 2040, 3000 CA Rotterdam, the Netherlands
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15
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Cheng V, Chi-Shing WT, Lee A, Lee R. The effects of a real-time temperature monitoring non-ablative monopolar radiofrequency technology on vulvovaginal atrophy symptoms in postmenopausal Chinese women. J Cosmet Dermatol 2024; 23:2030-2043. [PMID: 38450826 DOI: 10.1111/jocd.16251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Vulvovaginal atrophy (VVA) includes a wide range of conditions affecting the reproductive and urinary systems, often requiring careful evaluation and management for optimal health. AIMS This study aims to evaluate the symptom management effects of a real time temperature-monitored non-ablative RF device for the treatment of postmenopausal Chinese women with VVA symptoms. METHODS This pilot study involved 24 postmenopausal Chinese women with one or more VVA symptoms, who wished to remain sexually active. VHIS, VAS, and FSFI were used to track and evaluate various aspects of the patient's condition. Analyses were conducted at the end of the study to verify the statistical significance of the treatment's results. RESULTS All patients reported substantial, statistically significant, improvements on every VVA symptom tracked. Approximately 80% of the patients reported total symptom reversal at 12-week post-treatment follow-up. CONCLUSION This pilot study demonstrated that non-ablative, monopolar RF technology equipped with real time temperature monitoring is feasible and safe in the treatment of postmenopausal women with VVA symptoms, and efficacious at up to 12 weeks post-treatment.
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Affiliation(s)
| | - William Tai Chi-Shing
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
- The Laboratory for Probiotic and Prebiotic Research in Human Health, The Hong Kong Polytechnic University, Hong Kong, China
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16
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Berkane Y, Saget F, Lupon E, Mocquard C, Pluvy I, Watier E, Lellouch AG, Duisit J, Chaput B, Bertheuil N. Abdominoplasty and Lower Body Lift Surgery Improves the Quality of Life after Massive Weight Loss: A Prospective Multicenter Study. Plast Reconstr Surg 2024; 153:1101e-1110e. [PMID: 37189244 DOI: 10.1097/prs.0000000000010683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS The authors performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with preoperative and postoperative evaluation were included. RESULTS The mean age of the patients was 43.2 ± 13.2 years. All categories of the Medical Outcomes Study Short-Form 36 Health Status Survey questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months postoperatively. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03 at 6 and 12 months, respectively) and in all domains (ie, self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (ie, desire, arousal, lubrication, satisfaction), but only desire remained improved at 12 months. CONCLUSIONS Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss and the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Yanis Berkane
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - François Saget
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Elise Lupon
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Nice, Côte d'Azur University
| | - Camille Mocquard
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Besancon, Franche-Comté University
| | - Eric Watier
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - Jérôme Duisit
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Benoit Chaput
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
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17
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Virkkunen V, Kero K, Koivisto M, Niiranen T, Heinonen O, Stenholm S, Polo‐Kantola P. Associations between arterial health and sexual function in women aged 60-64 years. Acta Obstet Gynecol Scand 2024; 103:1132-1141. [PMID: 38482868 PMCID: PMC11103145 DOI: 10.1111/aogs.14826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Female sexual dysfunction is very common, but its determinants remain under-investigated. Vasculogenic impairments are suggested to be related to female sexual dysfunction, but previous literature regarding the association is scarce. This study aims to study the association between arterial health and female sexual function in women in their 60s. MATERIAL AND METHODS The sample for this cross-sectional study comprised 117 women (aged 60-64 years) who participated in the Finnish Retirement and Aging study. Arterial health was measured according to the participants' pulse wave velocity, ankle-brachial index, blood pressure, and pulse pressure. Sexual function was measured using the Female Sexual Function Index, which resulted in a total score and six sub-scores. Associations were examined using multivariable regression analyses, which were adjusted for age, relationship happiness, systemic menopausal hormone therapy and/or local estrogen, smoking, alcohol risk use, body mass index, and depressive symptoms. RESULTS Higher diastolic blood pressure was associated with a higher total Female Sexual Function Index score (β = 0.24, 95% confidence interval [CI] 0.07-0.41) and with higher desire (β = 0.02, 95% CI 0.01-0.04), arousal (β = 0.04, 95% CI 0.01-0.08), lubrication (β = 0.04, 95% CI 0.002-0.08), satisfaction (β = 0.03, 95% CI 0.003-0.05), and pain (β = 0.06, 95% CI 0.02-0.10) sub-scores. Also, higher ankle-brachial index was associated with higher satisfaction sub-score (β = 2.10, 95% CI 0.44-3.73) and lower pulse pressure was associated with higher orgasm sub-score (β = 0.03, 95% CI 0.0002-0.06). Other associations between ankle-brachial index and Female Sexual Function Index scores were statistically insignificant, but considering the magnitude the findings may imply clinical significance. Systolic blood pressure and pulse wave velocity were not associated with sexual function. CONCLUSIONS This study suggested a plausible association between higher diastolic blood pressure and female sexual function, but considering clinical significance our findings suggest an association between higher ankle-brachial index and good sexual function in women in their 60s.
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Affiliation(s)
- Viivi Virkkunen
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
| | - Katja Kero
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
| | - Mari Koivisto
- Department of BiostatisticsUniversity of TurkuTurkuFinland
| | - Teemu Niiranen
- Department of Internal MedicineTurku University Hospital, University of TurkuTurkuFinland
- Department of Public Health SolutionsFinnish Institute for Health and WelfareHelsinkiFinland
| | - Olli Heinonen
- Paavo Nurmi Center & Unit for Health and Physical ActivityUniversity of TurkuTurkuFinland
| | - Sari Stenholm
- Department of Public HealthTurku University Hospital, University of TurkuTurkuFinland
- Center for Population Health ResearchTurku University Hospital, University of TurkuTurkuFinland
- Research ServicesTurku University Hospital and University of TurkuTurkuFinland
| | - Päivi Polo‐Kantola
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
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18
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Bottorff EC, Gupta P, Ippolito GM, Moore MB, Rodriguez GM, Bruns TM. Short-Term Dorsal Genital Nerve Stimulation Increases Subjective Arousal in Women With and Without Spinal Cord Injury: A Preliminary Investigation. Neuromodulation 2024; 27:681-689. [PMID: 38573280 DOI: 10.1016/j.neurom.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/23/2023] [Accepted: 02/13/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Female sexual dysfunction (FSD) affects an estimated 40% of women. Unfortunately, FSD is understudied, leading to limited treatment options for FSD. Neuromodulation has shown some success in alleviating FSD symptoms. We developed a pilot study to investigate the short-term effect of electrical stimulation of the dorsal genital nerve and tibial nerve on sexual arousal in healthy women, women with FSD, and women with spinal cord injury (SCI) and FSD. MATERIALS AND METHODS This study comprises a randomized crossover design in three groups: women with SCI, women with non-neurogenic FSD, and women without FSD or SCI. The primary outcome measure was change in vaginal pulse amplitude (VPA) from baseline. Secondary outcome measures were changes in subjective arousal, heart rate, and mean arterial pressure from baseline. Participants attended one or two study sessions where they received either transcutaneous dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS). At each session, a vaginal photoplethysmography sensor was used to measure VPA. Participants also rated their level of subjective arousal and were asked to report any pelvic sensations. RESULTS We found that subjective arousal increased significantly from before to after stimulation in DGNS study sessions across all women. TNS had no effect on subjective arousal. There were significant differences in VPA between baseline and stimulation, baseline and recovery, and stimulation and recovery periods among participants, but there were no trends across groups or stimulation type. Two participants with complete SCIs experienced genital sensations. CONCLUSIONS To our knowledge, this is the first study to measure sexual arousal in response to short-term neuromodulation in women. This study indicates that short-term DGNS but not TNS can increase subjective arousal, but the effect of stimulation on genital arousal is inconclusive. This study provides further support for DGNS as a treatment for FSD.
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Affiliation(s)
- Elizabeth C Bottorff
- Biomedical Engineering Department, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Priyanka Gupta
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | | | - Mackenzie B Moore
- Biomedical Engineering Department, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Gianna M Rodriguez
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Tim M Bruns
- Biomedical Engineering Department, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
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Dickstein DR, Edwards CR, Rowan CR, Avanessian B, Chubak BM, Wheldon CW, Simoes PK, Buckstein MH, Keefer LA, Safer JD, Sigel K, Goodman KA, Rosser BRS, Goldstone SE, Wong SY, Marshall DC. Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus. Nat Rev Gastroenterol Hepatol 2024; 21:377-405. [PMID: 38763974 DOI: 10.1038/s41575-024-00932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/21/2024]
Abstract
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine R Rowan
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Bella Avanessian
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health at Temple University, Philadelphia, PA, USA
| | - Priya K Simoes
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael H Buckstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie A Keefer
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Stephen E Goldstone
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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20
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Martínez-Maestre MÁ, Castelo-Branco C, Calderón AM, Espigado I, Pérez-Simón JA, González-Cejudo C. Genital chronic graft-versus-host disease: an unmet need that requires trained gynecologists. Climacteric 2024; 27:275-281. [PMID: 38415712 DOI: 10.1080/13697137.2024.2314521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Menopause and chronic graft-versus-host disease (cGvHD) are the leading causes of morbidity after allogeneic hematopoietic stem cell transplantation (alloHSCT). Genitalia are one of the target organs of cGvHD causing sexual dysfunction and local symptoms, which may impair women's quality of life. The aim of this study is to describe the prevalence and clinical characteristics of genital cGvHD. METHODS A retrospective cross-sectional observational study was performed including 85 women with alloHSCT. All women were diagnosed and counseled by a trained gynecologist. Health-related quality of life was assessed by the Cervantes Short-Form Scale and sexual function was evaluated by the Female Sexual Function Index. RESULTS Seventeen women (20%) included in the study were diagnosed with genital cGvHD. The main complaints were vulvovaginal dryness (42.2%) and dyspareunia (29.4%), the presence of erythema/erythematous plaques (52.9%) being the most frequent sign. Median time from transplant to diagnosis of genital cGvHD was 17 months among those with mild involvement, 25 months for moderate and 42 months for severe forms. Mortality was 29.4% in patients who developed cGvHD with genital involvement versus 8.8% among those without (p = 0.012). CONCLUSION Early gynecological evaluation might allow to identify patients with mild forms of genital cGvHD, potentially enabling better management and improved outcomes.
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Affiliation(s)
| | - C Castelo-Branco
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A M Calderón
- Department of Gynecology, Virgen del Rocío University Hospital, Seville, Spain
| | - I Espigado
- Department of Haematology, University Hospital Virgen del Rocío, Institute of Biomedicine of Seville (IBIS), CSIC, University of Seville, Seville, Spain
| | - J A Pérez-Simón
- Department of Haematology, University Hospital Virgen del Rocío, Institute of Biomedicine of Seville (IBIS), CSIC, University of Seville, Seville, Spain
| | - C González-Cejudo
- Department of Gynecology, Virgen del Rocío University Hospital, Seville, Spain
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21
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Uzdil N, Özgüç S. The effect of exposure to emotional violence on sexual function, sexual quality of life and psychological well-being in women: Structural equation modeling. Arch Psychiatr Nurs 2024; 50:14-20. [PMID: 38789226 DOI: 10.1016/j.apnu.2024.03.004] [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: 09/02/2023] [Revised: 09/24/2023] [Accepted: 03/03/2024] [Indexed: 05/26/2024]
Abstract
Emotional violence is all of the destructive behaviors that humiliate the individual and cause him/her to feel under pressure to disrupt mental health. These destructive behaviors can affect women's sexuality. In this study, it was aimed to determine the effect of exposure to emotional violence on sexual function, sexual life quality, and psychological well-being in women. The study was conducted in a descriptive and relational screening model. The sample of the study consisted of 213 women. Personal information forms, the female sexual function index, the sexual quality of life questionnaire, the exposure to emotional violence scale, and the psychological well-being scale were used in the study. Structural equation modeling was used to determine the direct and indirect predictive power of the independent variable on the dependent variable. The effect of exposure to emotional violence on psychological well-being (β = -0.323; p < 0.001), and the effect of quality of sexual life on psychological well-being were statistically significant (β =0.315; p < 0.001). Moreover, the effect of exposure to emotional violence on sexual life quality was determined to be statistically significant (β = -0.665; p < 0.001). The effect of quality of sexual life on female sexual function was statistically significant (β = -0.288; p = 0.002). Furthermore, while the effect of psychological well-being on the female sexual function index was not statistically significant (β = -0.101; p = 0.266), the effect of exposure to emotional violence scale on the female sexual function index was statistically significant (β = -0.087; p = 0.373). The mediating role of exposure to emotional violence in the relationship between sexual life quality and psychological well-being was high. Furthermore, the sexual life quality of 43.6 % of women was explained by exposure to emotional violence. On the other hand, 28.7 % of psychological well-being score was explained by the sexual life quality and exposure to emotional violence.
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Affiliation(s)
- Nurcan Uzdil
- Department of Psychiatric Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Safiye Özgüç
- Department of Psychiatric Nursing, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey.
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22
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García JC, Maraver FM, Rodríguez Jiménez I, Ríos-Pena L, Carmen Rubio Rodríguez M. Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders. Eur J Obstet Gynecol Reprod Biol 2024; 299:43-53. [PMID: 38833773 DOI: 10.1016/j.ejogrb.2024.05.027] [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: 02/14/2024] [Revised: 04/06/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. STUDY DESIGN From January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26). We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. RESULTS Cervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively). Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%). Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). CONCLUSIONS Cervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.
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Affiliation(s)
- Jorge Cea García
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain.
| | - Francisco Márquez Maraver
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Inmaculada Rodríguez Jiménez
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Laura Ríos-Pena
- Institute of Science and Technology, Loyola University, De las Universidades Ave., 41 704 Dos Hermanas, Seville, Spain
| | - M Carmen Rubio Rodríguez
- Department of Radiation Oncology in HM Hospitals, University Hospital Sanchinarro, 10 De Oña St., 28 050, Madrid, Spain and Puerta del Sur, 70 Carlos V Ave., 28 938, Móstoles, Madrid, Spain.
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23
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Daniluc RI, Craina M, Thakur BR, Prodan M, Bratu ML, Daescu AMC, Puenea G, Niculescu B, Negrean RA. Comparing Relationship Satisfaction and Body-Image-Related Quality of Life in Pregnant Women with Planned and Unplanned Pregnancies. Diseases 2024; 12:109. [PMID: 38920541 PMCID: PMC11202619 DOI: 10.3390/diseases12060109] [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: 04/12/2024] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/27/2024] Open
Abstract
This comparative cross-sectional study conducted at the "Pius Brinzeu" healthcare center in Timisoara explored the differential impacts of pregnancy planning status on sexual function, body image, and relationship satisfaction among pregnant women. Employing the Female Sexual Function Index (FSFI), Body Esteem Scale for Adolescents and Adults (BESAQ), and the Beck Depression Inventory (BDI-II), the study analyzed responses from 107 participants divided into groups of planned (n = 59, mean age 28.5 ± 5.2) and unplanned (n = 48, mean age 27.3 ± 4.8) pregnancies. In the first trimester, unplanned pregnancies reported higher median scores in desire (4.7 vs. 3.6, p = 0.005), arousal (4.5 vs. 3.8, p = 0.001), and lubrication (4.6 vs. 3.7, p = 0.015) compared to planned pregnancies. Satisfaction scores also favored unplanned pregnancies in the first trimester (4.8 vs. 3.9, p = 0.009). Similar trends were observed in subsequent trimesters, with unplanned pregnancies consistently reporting higher FSFI scores, indicating a robust sexual function. Risk factors significantly associated with sexual dysfunction were a higher BMI in the first trimester (beta coefficient: -0.124, p = 0.019), unmarried civil status (beta coefficient: -0.323, p = 0.045), history of previous abortion (beta coefficient: -0.451, p = 0.012), irregular menstrual cycles (beta coefficient: -0.384, p = 0.026), and rural living area (beta coefficient: -0.278, p = 0.034). Notably, unplanned pregnancy itself was not a significant risk factor for sexual dysfunction (beta coefficient: -0.054, p = 0.095). Regarding relationship dynamics, planned pregnancies exhibited significantly higher satisfaction with partner support (4.1 ± 0.9 vs. 3.7 ± 1.1, p = 0.041) and communication within the couple (4.0 ± 1.0 vs. 3.5 ± 1.2, p = 0.020), whereas unplanned pregnancies reported higher satisfaction with emotional closeness (4.3 ± 0.7 vs. 3.8 ± 1.0, p = 0.004). Concerns about managing professional activities and household chores were significantly more prevalent in the unplanned pregnancy group (62.50% vs. 33.90%, p = 0.014). Unplanned pregnancies demonstrated better initial sexual function but faced greater challenges in relationship satisfaction and managing pregnancy demands. Identifying and addressing the risk factors associated with sexual dysfunction can provide targeted interventions to improve the well-being of pregnant women, regardless of pregnancy planning status.
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Affiliation(s)
- Razvan-Ionut Daniluc
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-I.D.); (M.P.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Barkha Rani Thakur
- Faculty of General Medicine, MediCiti Institute of Medical Sciences, Hyderabad 501401, India;
| | - Mihaela Prodan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-I.D.); (M.P.)
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Melania Lavinia Bratu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (R.-I.D.); (M.P.)
- Center for Neuropsychology and Behavioral Medicine, Discipline of Psychology, Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Center for Cognitive Research in Neuropsychiatric Pathology, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Ana-Maria Cristina Daescu
- Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
- Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - George Puenea
- Department XVI, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Bogdan Niculescu
- Department of Sports and Health, “Constantin Brancusi” University, 210152 Targu Jiu, Romania;
| | - Rodica Anamaria Negrean
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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24
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Evans CNB, Badenhorst A, Van Wijk FJ. The impact of pharmacotherapy on sexual function in female patients being treated for idiopathic overactive bladder: a systematic review. BMC Womens Health 2024; 24:290. [PMID: 38755593 PMCID: PMC11097459 DOI: 10.1186/s12905-024-03103-1] [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: 01/23/2023] [Accepted: 04/19/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Overactive bladder (OAB) is a condition defined by urgency with or without incontinence which disproportionately affects female patients and has a negative impact on sexual enjoyment and avoidance behaviour. Pharmacotherapy can be considered one of the main options for treating OAB. This research set out to determine the impact of pharmacotherapy on sexual function in females with OAB. METHODS This research used the robust methodology of a systematic review. The clinical question was formulated using the PICO (population, intervention, control, and outcomes) format to include females being treated with pharmacotherapy (anticholinergics or beta-3 adrenergic agonists) for idiopathic OAB with the use of a validated questionnaire assessing self-reported sexual function at baseline and post-treatment. The review incorporated the MEDLINE, PubMed and EMBASE databases. The AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) appraisal tool was used to guide the review process. Two reviewers worked independently in screening abstracts, deciding on the inclusion of full-texts, data extraction and risk of bias assessment. RESULTS In female patients with OAB, pharmacotherapy does seem to offer at least partial improvement in self-reported sexual function outcomes after 12 weeks of therapy. Still, the value of this finding is limited by an overall poor quality of evidence. Patients with a higher degree of bother at baseline stand to benefit the most from treatment when an improvement within this health-related quality of life domain is sought. CONCLUSION This research should form the basis for a well-conducted randomized controlled study to accurately assess sexual function improvements in females being treated with pharmacotherapy for OAB.
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Affiliation(s)
- Christopher Neal Bruce Evans
- Surgery Masters in Urology, the University of Edinburgh (Edinburgh Surgery Online, Deanery of Clinical Sciences) and Life Groenkloof Hospital, Suite 209, Life Groenkloof Hospital, 50 George Storrar Drive, Groenkloof, Pretoria, 0181, South Africa.
| | - Anja Badenhorst
- General Practitioner, University of Pretoria, Pretoria, South Africa
| | - Frans Jacob Van Wijk
- Private Uro-Gynaecologist/Urologist, Pelvic Wellness Unit, The Urology Hospital, Pretoria, South Africa
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25
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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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26
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Figueiredo PAO, Costa TSLDM, Lima MDDA, Magalhães AG, Bezerra IFD, Driusso P, de Sousa VPS. Self-Perception of Sexual Dysfunction of Adult Brazilian Women of Reproductive Age: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2165-2173. [PMID: 38736543 PMCID: PMC11088390 DOI: 10.2147/jmdh.s442074] [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: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Sexual dysfunction (SD) comprises disorders in sexual desire, arousal, orgasm, and lubrication. The importance of self-perceived SD relies on its relation to personal values, sex education, and partnership. We aimed to analyze the association between self-perceived SD and the Female Sexual Function Index (FSFI) in adult women of reproductive age and the correlation between age and sexual function. Material and Methods This analytical cross-sectional study included 285 women aged 18 to 49 years, sexually active for at least four weeks, cisgender and heterosexual, and with Internet access. Women were divided into control (CG, control group; without SD) or study group (SG, study group; with SD) and responded to a self-applicable online survey containing a sociodemographic characterization, an interview about SD knowledge, and the FSFI test. The Chi-square test of independence (χ2) analyzed the association between self-perceived SD and FSFI-assessed SD. Pearson's correlation coefficient investigated the correlation between age and FSFI. Results Included women had a mean age of 29.57 years ± 7.11 years. Self-perceived SD showed a moderate association (Cramer's V = 0.590) with the FSFI score (χ2 [2] = 91.500; p < 0.001). A weak, negative, and significant correlation was observed between age and the FSFI desire domain (r = -0.120; p = 0.030; r2 = 1.440). Conclusion Women with self-perceived SD were 68% more likely to present FSFI-assessed SD. Regarding the FSFI desire domain, sexual function decreased with age.
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Affiliation(s)
| | | | - Mateus Dantas de Azevedo Lima
- Multicampus School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil
| | - Adriana Gomes Magalhães
- Multicampus School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil
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Sood R, Mara KC, Vencill JA, Kling JM, Faubion SS. Association of resilience with female sexual dysfunction. Maturitas 2024; 183:107939. [PMID: 38367366 DOI: 10.1016/j.maturitas.2024.107939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES Female sexual dysfunction (FSD), a common concern affecting women of all ages, is often mediated by important psychological factors. Resilience has been shown to correlate with psychological well-being across different groups of people. The aim of this study was to assess if there is an association between resilience and FSD. STUDY DESIGN This cross-sectional study included 4,366 women (mean [SD] age, 51.7 [11]) seen in women's health clinics at 1 of 3 geographic Mayo Clinic locations. Participants completed the Brief Resilience Scale, the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale-Revised (FSDS-R). MAIN OUTCOME MEASURES We used univariate and multivariable logistic regression analyses to assess associations between resilience, sexual function, and sexual distress, adjusting for potential confounding variables. RESULTS FSD criteria (FSFI ≤26.55 and FSDS-R ≥ 11) were met by 55.8 % of women. Low, normal, and high levels of resilience were reported by 17.3 %, 57.1 %, and 25.6 % of participants, respectively. The univariate analysis showed that higher resilience was associated with lower sexual distress, lower odds of FSD, and better sexual function. Multivariable analysis adjusted for potential confounders showed that the association persisted and that higher resilience correlated with better sexual function and lower odds of FSD. CONCLUSIONS In this large cross-sectional study, women with higher resilience scores had better sexual function and lower odds of FSD. Additional studies with diverse women are needed to confirm this association and to determine whether women with FSD could benefit from enhancing resilience as a therapeutic strategy.
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Affiliation(s)
- Richa Sood
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America.
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States of America
| | - Jennifer A Vencill
- Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN, United States of America; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States of America
| | - Stephanie S Faubion
- Women's Health, Mayo Clinic, Jacksonville, FL, United States of America; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States of America
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28
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Wang C, Che Y, Zhang Y, Guan T, Wang J, Du X. Analysis of pelvic floor muscle electromyography parameters in women with or without sexual dysfunction. Sex Health 2024; 21:SH24026. [PMID: 38743840 DOI: 10.1071/sh24026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
Background To investigate the differences in pelvic floor muscle (PFM) electromyography (EMG) parameters between women with or without sexual dysfunction (FSD) and their correlations. Methods Women who voluntarily participated in a questionnaire-based survey on sexual function and underwent PFM EMG in Weifang People's Hospital during the period from March 2021 to December 2021 were retrospectively enrolled. The female sexual (dys)function was measured using the Female Sexual Function Index. Glazer PFM EMG was performed using a Melander instrument (MLD A2 Deluxe). The differences in PFM EMG parameters between women with or without FSD were compared, and the relationships between PFM EMG parameters and FSD were analysed using multiple linear regression models. Results A total of 305 women were enrolled, with 163 in the FSD group and 142 in the non-FSD group. Comparisons of PFM EMG parameters between these two groups revealed that the FSD group had significantly higher peak EMG amplitude during the phasic (flick) contractions and shorter recovery latency during the tonic contractions than the non-FSD group (both P P Conclusions The results of the pelvic floor EMG in this study suggest that the pelvic floor muscles of women with FSD may be more susceptible to fatigue, and may have poorer coordination of their pelvic floor muscles.
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Affiliation(s)
- Chunyan Wang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Yan Che
- People's Hospital of Weifang City, Weifang, Shandong Province, China; and NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
| | - Yumei Zhang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Tingfeng Guan
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Jie Wang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Xinying Du
- People's Hospital of Weifang City, Weifang, Shandong Province, China
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Spielmans GI, Ellefson EM. Small Effects, Questionable Outcomes: Bremelanotide for Hypoactive Sexual Desire Disorder. JOURNAL OF SEX RESEARCH 2024; 61:540-561. [PMID: 36809187 DOI: 10.1080/00224499.2023.2175192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Efficacy outcomes are only informative to the extent that they are validated. We examined the measurement properties of efficacy measures from the phase III ("RECONNECT") bremelanotide trials for hypoactive sexual desire disorder (HSDD) in women. Continuous efficacy outcomes, including a) the Female Sexual Function Index (FSFI) and its Desire domain (FSFI-D) and b) the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) and its item assessing distress due to low desire (FSDS-DAO #13) have questionable, at best, validity evidence for women with HSDD. We found no validity evidence for previously published categorical treatment response outcomes from the RECONNECT trials. All efficacy results should be reported, but results on 8 of the 11 clinicaltrials.gov-specified efficacy outcomes were heretofore unpublished (including FSDS-DAO total score, FSFI total score, FSFI arousal domain, and items from the Female Sexual Encounter Profile-Revised). We analyzed these outcomes, upon which effect sizes ranged from nil to small. Several other continuous and categorical outcomes generated modest apparent benefits, though nearly all of these outcomes were likely derived post-hoc. Across RECONNECT trial data from two prior publications and the current study, bremelanotide's benefits are statistically modest and limited to outcomes for which scant evidence of validity among women with HSDD exists.
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Affiliation(s)
- Glen I Spielmans
- Department of Psychology, Metropolitan State University, Saint Paul, Minnesota, USA
| | - Elaine M Ellefson
- Department of Psychology, Metropolitan State University, Saint Paul, Minnesota, USA
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Shah SFH, Merchant SA, Shah SA. Female sexual dysfunction in psoriasis: a systematic review and meta-analysis using the Female Sexual Function Index. Int J Impot Res 2024; 36:232-241. [PMID: 36456639 DOI: 10.1038/s41443-022-00650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
Psoriasis is an inflammatory skin condition that can negatively affect numerous domains for quality of life, including sexual function. We aimed to systematically compare sexual function between women with and without psoriasis through meta-analysis. Databases were searched for studies assessing sexual function in women with and without psoriasis using the Female Sexual Function Index (FSFI). Meta-analyses were conducted in R (v4.1.2) to determine: (i) the odds ratio (OR) of sexual dysfunction and (ii) the mean difference (MD) for FSFI scores and sub-scores. Eight studies (five case-control, three cross-sectional) were eligible for review, encompassing 563 women with psoriasis and 525 controls. Risk of bias for included studies was considered as low to moderate. Psoriasis was associated with greater odds of female sexual dysfunction (OR 2.67, 95% CI 1.93,3.69; p < 0.0001). Compared to controls, women with psoriasis had significantly lower mean scores for desire (p < 0.0001), arousal (p = 0.002), lubrication (p = 0.003), orgasm (p < 0.0001), satisfaction (p < 0.0001) and total scores (p < 0.0001). Mean pain scores did not significantly differ between psoriasis patients and controls (p = 0.051). We identified significantly impaired sexual function in women with psoriasis compared to controls, suggesting that routine assessment of sexual health may be beneficial. Prospective studies of larger sample size are required in order to explore the underlying mechanisms and risk factors.
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Krapf JM, Kopits I, Holloway J, Lorenzini S, Mautz T, Goldstein AT. Efficacy of in-office lysis of clitoral adhesions with excision of keratin pearls on clitoral pain and sexual function: a pre-post interventional study. J Sex Med 2024; 21:443-451. [PMID: 38515327 DOI: 10.1093/jsxmed/qdae034] [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: 04/24/2023] [Revised: 01/08/2024] [Accepted: 02/04/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Keratin pearls are foci of central keratinization within concentric layers of squamous cells that can form under the clitoral prepuce and cause pain (clitorodynia); in-office removal of keratin pearls may reduce clitoral pain and improve sexual function. AIM This study aims to investigate clitoral pain and sexual function in women with partial clitoral phimosis and keratin pearls before and after in-office lysis of clitoral adhesions with keratin pearl excision (LCA-KPE). METHODS A pre-post interventional study evaluated patients who underwent LCA-KPE between January 2017 and February 2023 in 2 metropolitan gynecology clinics specializing in vulvar pain. Patients presenting with keratin pearls and partial clitoral phimosis identified through retrospective chart review were asked to complete postprocedure questionnaires and provide subjective responses on clitoral discomfort, sexual function, sexual distress, and their experience with in-office LCA-KPE. Bivariate analyses with paired t tests were conducted to determine the effect of LCA-KPE. Qualitative data were analyzed with thematic coding. OUTCOMES An 11-point pain visual analog scale was utilized to determine pre- and postprocedure clitoral discomfort and difficulty with orgasm. Female sexual dysfunction was measured with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised. RESULTS A total of 32 of 74 patients who met inclusion criteria completed postprocedure surveys (43% response rate). Mean clitoral pain for respondents was 6.91 at baseline and 2.50 after LCA-KPE (P < .001). Mean difficulty with orgasm was significantly decreased from 5.45 at baseline to 3.13 after LCA-KPE (P < .001). Participants had a mean FSFI total score of 17.68 after treatment compared with a mean total baseline FSFI of 12.12 (P = .017). The mean FSFI score for pain was 2.43 at follow-up compared with 1.37 at baseline (P = .049). There was no significant difference in the mean Female Sexual Distress Scale-Revised score before vs after the procedure (P = .27). Qualitative themes described the procedure as painful but worthwhile, with 77% of participants reporting the overall experience as positive. Recurrence rate overall was 28%, with a median of 2 repeat procedures. CLINICAL IMPLICATIONS Recognizing keratin pearls as a structural cause of clitoral pain and offering in-office treatment is an important tool in addressing clitorodynia and improving sexual function. STRENGTHS AND LIMITATIONS This is the largest study to date documenting the occurrence, identifying associated pain conditions, and evaluating procedural outcomes for clitoral keratin pearls. This study was limited by a relatively small sample size. CONCLUSION In-office LCA-KPE significantly reduced clitoral discomfort and difficulty with orgasm.
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Affiliation(s)
- Jill M Krapf
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
- Department of Obstetrics and Gynecology, George Washington University, Washington DC 20037, United States
| | - Isabella Kopits
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
| | - Jessica Holloway
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
| | - Sylvia Lorenzini
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
| | - Theodora Mautz
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
| | - Andrew T Goldstein
- Department of Gynecology, The Centers for Vulvovaginal Disorders, Washington DC 20037, United States
- Department of Obstetrics and Gynecology, George Washington University, Washington DC 20037, United States
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Pereira GMV, Cartwright R, Juliato CRT, Domoney C, Iglesia CB, Brito LGO. Treatment of women with vaginal laxity: systematic review with meta-analysis. J Sex Med 2024; 21:430-442. [PMID: 38508858 DOI: 10.1093/jsxmed/qdae028] [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: 08/08/2023] [Revised: 01/18/2024] [Accepted: 02/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Despite several treatments that have been used for women reporting vaginal laxity (VL), to our knowledge no systematic review is available on the topic so far. AIM In this study, we sought to summarize the best available evidence about the efficacy and safety of interventions for treating VL, whether conservative or surgical. METHODS A comprehensive search strategy was performed in Medline, Embase, Scopus, Web of Science, and Cochrane Library for reports of clinical trials published from database inception to September 2022. Studies selected for inclusion were in the English language and were performed to investigate any type of treatment for VL, with or without a comparator, whether nonrandomized studies or randomized controlled trials (RCTs). Case reports and studies without a clear definition of VL were excluded. OUTCOMES The outcomes were interventions (laser, radiofrequency, surgery, and topical treatment), adverse effects, sexual function, pelvic floor muscle (PFM) strength, and improvement of VL by the VL questionnaire (VLQ). RESULTS From 816 records, 38 studies remained in the final analysis. Laser and radiofrequency (RF) were the energy-based treatment devices most frequently studied. Pooled data from eight observational studies have shown improved sexual function assessed by a Female Sexual Function Index score mean difference (MD) of 6.51 (95% CI, 5.61-7.42; i2 = 85%, P < .01) before and after intervention, whether by RF (MD, 6.00; 95% CI, 4.26-7.73; i2 = 80%; P < .001) or laser (MD, 6.83; 95% CI, 5.01-8.65; i2 = 92%; P < .01). However, this finding was not shown when only 3 RCTs were included, even when separated by type of intervention (RF or laser). When RF treatment was compared to sham controls, VLQ scores did not improve (MD, 1.01; 95% CI, -0.38 to 2.40; i2 = 94%; P < .001). Patient PFM strength improved after interventions were performed (MD, 4.22; 95% CI, 1.02-7.42; i2 = 77%; P < .001). The ROBINS-I (Risk Of Bias In Nonrandomized Studies of Interventions) tool classified all non-RCTs at serious risk of bias, except for 1 study, and the risk of bias-1 analysis found a low and unclear risk of bias for all RCTs. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) certainty of the evidence was moderate for sexual function and the VLQ questionnaire and low for PFM strength. CLINICAL IMPLICATIONS Sexual function in women with VL who underwent RF and laser treatment improved in observational studies but not in RCTs. Improvement in PFM strength was observed in women with VL after the intervention. STRENGTHS AND LIMITATIONS Crucial issues were raised for the understanding of VL, such as lack of standardization of the definition and for the development of future prospective studies. A limitation of the study was that the heterogeneity of the interventions and different follow-up periods did not make it possible to pool all available data. CONCLUSIONS Vaginal tightening did not improve sensation in women with VL after intervention, whereas RF and laser improved sexual function in women with VL according to data from observational studies, but not from RCTs. PFM strength was improved after intervention in women with VL.
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Affiliation(s)
- Glaucia Miranda Varella Pereira
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, Campinas, SP 13083-881, Brazil
- Department of Metabolism, Digestion and Reproduction, Imperial College London SW7 2AZ, UK
- Department of Gynaecology, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Rufus Cartwright
- Department of Metabolism, Digestion and Reproduction, Imperial College London SW7 2AZ, UK
- Department of Gynaecology, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Cássia Raquel Teatin Juliato
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, Campinas, SP 13083-881, Brazil
| | - Claudine Domoney
- Department of Gynaecology, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Cheryl B Iglesia
- Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Centre, Departments of Obstetrics and Gynecology, Georgetown University, School of Medicine, Washington, DC 20007, United States
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas, Campinas, SP 13083-881, Brazil
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Ricucci N, Colonnello E, Limoncin E, Mollaioli D, Sansone A, Jannini EA, Ciocca G. Psychosexological correlates of 372 women with vulvodynia, overactive pelvic floor, postcoital cystitis, and interstitial cystitis. J Sex Med 2024; 21:471-478. [PMID: 38515245 DOI: 10.1093/jsxmed/qdae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/21/2024] [Accepted: 02/04/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Among the plethora of urogynecological conditions possibly affecting women, some of them, less explored, have significant impacts on sexological and psychological health, with a mutual influence. AIM The aim of this study was to investigate the sexological and psychological correlates of four urogynecological pathologies in a sample of women of childbearing age: overactive pelvic floor, vulvodynia, postcoital cystitis, and interstitial cystitis. Women cured of these conditions were also included, to assess the same aspects after the remission of physical symptoms. METHODS We recruited 372 women with an average age of 33.5 years through an online platform shared by a popular forum for women with urogynecological pathologies between March and May 2021. The participants filled out a socio-anamnestic questionnaire and a set of psychometric tests. OUTCOMES Participant data were collected by use of the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Toronto Alexithymia Scale-20, Female Sexual Function Index, and Orgasmometer-F, and the SPSS (Statistical Package for Social Sciences) v.26 was used for data analysis. RESULTS Overactive pelvic floor was reported by 66.4% of the women, vulvodynia by 55%, postcoital cystitis by 58.8%, and interstitial cystitis by 8.3%, and these conditions were often comorbid with each other, with 9.4% and 7% of women reporting having suffered psychological and sexual abuse, respectively. The presence of past abuse was correlated with overactive pelvic floor (P < .05), vulvodynia (P < .01), and major depression (P < .01). Significantly more depression occurred in women with vulvodynia than in the other subgroups (P < .05), except for women with only an overactive pelvic floor. There was no difference between the subgroups in the occurrence of alexithymia, sexual function, and orgasm (P < .05). Interestingly, the prevalence of sexual dysfunction increased in cured women. CLINICAL IMPLICATIONS The lack of significant differences, except for depression, between the pathological subgroups suggests a similar clinical and psychological relevance of the four pathologies studied. The persistence of sexual dysfunctions in cured women may be related to a residual dysfunctional relational modality with the partner. STRENGTHS AND LIMITATIONS The evaluation of both psychological and sexological variables in a group of less-explored urogynecological conditions represents a strength of this study, while a lack of a face-to-face assessment could represent a limitation. CONCLUSION The results of the present study should promote psychosexological interventions in women with these diseases, both during the pathological state and after remission.
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Affiliation(s)
- Noemi Ricucci
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome 00185, Italy
| | - Elena Colonnello
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome 00185, Italy
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Erika Limoncin
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome 00185, Italy
| | - Daniele Mollaioli
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Andrea Sansone
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Emmanuele A Jannini
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Giacomo Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome 00185, Italy
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Ramel S, Gueganton L, Nowak E, Bihan JL, Arnouat B, Belleguic C, Danner-Boucher I, Mankikian J, Payet A, Urban T, Buyse M, Hubeaux K. Sexual dysfunction in cystic fibrosis. J Cyst Fibros 2024:S1569-1993(24)00056-0. [PMID: 38688746 DOI: 10.1016/j.jcf.2024.04.011] [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: 12/22/2023] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Sexual dysfunction (erectile dysfunction in males, sexual dissatisfaction, sexual interest/arousal disorders, and dyspareunia in females) has not been the subject of indepth research in people with cystic fibrosis (CF). This study aimed to determine the prevalence of sexual dysfunction in adults with CF, factors associated with sexual dysfunction, and the impact of sexual dysfunction on quality of life. METHOD We conducted a multicentre study in adults with cystic fibrosis followed in specialist centres in Western France. We assessed erectile dysfunction and its severity using the IIEF5 self-questionnaire (International Index of Erectile Function); the FSFI (Female Sexual Function Index) was used to assess sexual function in females, and we evaluated quality of life in both sexes using the CFQ-R14+ questionnaire. RESULTS In total, 77 males and 74 females completed the sexual function questionnaire (mean age 32+/- 10 and 25+/- 8,5 years respectively). Among them, 21 % of males and 30 % of females reported sexual dysfunction. CFQ-R14+ score was significantly lower in males with erectile dysfunction than those without (p < 0.001). Faecal incontinence was associated with more frequent sexual dysfunction in females and higher severity of erectile dysfunction in males. CONCLUSION The prevalence of sexual disorders is relatively high in males and females with cystic fibrosis. Therefore, it seems important to train specialist teams to address the issue of sexuality without embarrassment, and to encourage them to seek out and treat faecal incontinence, which is associated with greater severity or frequency of these symptoms.
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Affiliation(s)
- Sophie Ramel
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France.
| | - Laetitia Gueganton
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Emmanuel Nowak
- Direction de la Recherche Clinique et de l'Innovation (DRCI), CHU de Brest, Brest, France & Centre d'Investigation Clinique, INSERM CIC 1412, CHU de Brest, Brest, France
| | - Jean Le Bihan
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Baptiste Arnouat
- Dept of Respiratory Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | - Isabelle Danner-Boucher
- Service de Pneumologie, L'Institut Du Thorax, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Julie Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion, France
| | - Thierry Urban
- Département de Pneumologie, CHU d'Angers, Angers, France
| | - Marion Buyse
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France
| | - Katelyne Hubeaux
- CRCM (Centre de Ressources et de Compétences de la Mucoviscidose), Fondation Ildys, Roscoff, France; Service d'explorations fonctionnelles, Fondation Ildys, Roscoff, France
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Ezechi OC, Akinsolu FT, Gbajabiamila TA, Idigbe IE, Ezeobi PM, Musa AZ, Wapmuk AE. Sexual dysfunction among Nigerian women living with HIV infection. PLoS One 2024; 19:e0292294. [PMID: 38635555 PMCID: PMC11025868 DOI: 10.1371/journal.pone.0292294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Sexual dysfunction in women with HIV is a necessary but understudied aspect of HIV complications in women living with HIV. This study reports the prevalence, pattern, and risk factors for sexual dysfunction in women living with HIV in southwest Nigeria. METHODS A validated Female Sexual Function Index was used to determine sexual dysfunction in a cross-sectional study design involving 2926 adult women living with HIV in a large, publicly funded tertiary HIV treatment centre in Lagos, Nigeria. A score of less than 26.5 indicated sexual dysfunction. Multivariate logistic regression analysis was performed to identify risk factors for sexual dysfunction. P<0.05 was considered statistically significant at a 95% confidence interval (CI). RESULTS The prevalence of sexual dysfunction was 71.4%. The types of dysfunctions detected included disorder of desire (76.8%), sexual arousal (66.0%), orgasm (50.0%), pain (47.2%), lubrication (47.2%), and satisfaction (38.8%). Multivariate analysis showed that menopause (aOR: 2.0; 1.4-4.1), PHQ score of 10 and above (aOR: 2.3; 1.7-3.2), co-morbid medical conditions (aOR: 1.8; 1.4-2.7), use of protease inhibitor-based antiretroviral therapy (aOR: 1.3; 1.2-2.1) and non-disclosure of HIV status (aOR: 0.7; 0.6-0.8) were factors associated with sexual dysfunction. CONCLUSIONS Sexual dysfunction is common among Nigerian women living with HIV. Menopause, use of protease inhibitor-based regimens, PHQ score of at least 10, co-morbid medical condition, and non-disclosure of HIV status were associated with sexual dysfunction. National HIV programmes, in addition to incorporating screening and management of sexual dysfunction in the guidelines, should sensitise and train health workers on the detection and treatment of sexual dysfunction.
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Affiliation(s)
- Oliver Chukwujekwu Ezechi
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
- Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Oyo State, Nigeria
| | - Folahanmi Tomiwa Akinsolu
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
- Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Oyo State, Nigeria
| | - Tititola Abike Gbajabiamila
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Ifeoma Eugenia Idigbe
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Paschal Mbanefo Ezeobi
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
- Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Oyo State, Nigeria
| | - Adesola Zadiat Musa
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
- Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Oyo State, Nigeria
| | - Agatha Eileen Wapmuk
- Center for Reproduction and Population Health Studies, Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
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Mínguez-Esteban I, De-la-Cueva-Reguera M, Romero-Morales C, Martínez-Pascual B, Navia JA, Bravo-Aguilar M, Abuín-Porras V. Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders. PLoS One 2024; 19:e0296652. [PMID: 38626037 PMCID: PMC11020383 DOI: 10.1371/journal.pone.0296652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/15/2023] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. METHODOLOGY An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). RESULTS Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). CONCLUSION The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.
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Affiliation(s)
- Isabel Mínguez-Esteban
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- OnelifeCentre, Multidisciplinary Centre for the Prevention and Treatment of Pain, Alcorcón, Spain
| | | | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - Jose A. Navia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Facultad de Educación, Universidad de Alcalá, Alcalá de Henares, España
| | - María Bravo-Aguilar
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
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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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de Souza RSO, Luz AG, Zielinski R, Sarian LOZ, Juliato CRT, Lara LADS, Brito LGO. Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo35. [PMID: 38765528 PMCID: PMC11075431 DOI: 10.61622/rbgo/2024rbgo35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/26/2023] [Indexed: 05/22/2024] Open
Abstract
Objective We aimed to translate and determine cultural validity of the Vaginal Changes Sexual and Body Esteem Scale (VSBE) for Brazilian Portuguese language in postpartum women who underwent vaginal delivery with or without perineal laceration and cesarean section. Methods A cross-sectional study conducted virtually, with online data collection through a survey with 234 postpartum women of 975 that were invited. Clinical, sociodemographic, and psychometric variables from the VSBE questionnaire were analyzed (content validity index, internal consistency, test-retest reliability, construct/structural and discriminant validity). Multivariate analysis was performed to explore associated factors with the presence of perineal laceration. Results One-hundred fifty-eight women experienced vaginal delivery, of which 24.79% had an intact perineum, 33.33% had perineal laceration, and 9.4% underwent episiotomy; and 76 participants had cesarean sections. Women with perineal laceration were older, presented dyspareunia and previous surgeries than women without perineal laceration (p<0.05). For VSBE, a high internal consistency (Cronbach's α > 0.7) was observed, but it did not correlate with Body Attractiveness Questionnaire and Female Sexual Function Index; however, it correlated with the presence of women sutured for perineal laceration. Moreover, VSBE presented good structural validity with two loading factors after exploratory factor analysis. VSBE also demonstrated discriminant validity between the presence or absence of perineal laceration. The presence of urinary incontinence (UI) (OR=2.716[1.015-4.667];p=0.046) and a higher VSBE total score (OR=1.056[1.037-1.075];p<0.001) were the only factors associated with perineal laceration. Conclusion Vaginal Changes Sexual and Body Esteem Scale demonstrated appropriate translation and good internal consistency, discriminant/construct validity and reliability. Vaginal Changes Sexual and Body Esteem Scale total score and presence of UI were associated with women that underwent perineal laceration.
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Affiliation(s)
| | - Adriana Gomes Luz
- Universidade Estadual de CampinasCampinasSPBrazilUniversidade Estadual de Campinas, Campinas, SP, Brazil.
| | - Ruth Zielinski
- University of MichiganMichiganUnited StatesUniversity of Michigan, Michigan, United States.
| | - Luis Otavio Zanatta Sarian
- Universidade Estadual de CampinasCampinasSPBrazilUniversidade Estadual de Campinas, Campinas, SP, Brazil.
| | | | - Lucia Alves da Silva Lara
- Universidade de São PauloFaculdade de Medicina de Ribeirão PretoRibeirão PretoSPBrazilFaculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
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Jobim Fischer V, Rossato Holz M, Billieux J, Andersson G, Vögele C. Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial. JMIR Form Res 2024; 8:e50850. [PMID: 38568720 PMCID: PMC11024748 DOI: 10.2196/50850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. OBJECTIVE This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. METHODS The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. RESULTS Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. CONCLUSIONS Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. TRIAL REGISTRATION ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177.
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Affiliation(s)
- Vinicius Jobim Fischer
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Lami A, Alvisi S, Baldassarre M, Zanella S, Amati V, Seracchioli R, Meriggiola MC. Safety and efficacy of non-ablative CO 2 laser treatment of vulvo-vaginal atrophy in women with history of breast cancer. Arch Gynecol Obstet 2024; 309:1575-1583. [PMID: 38253692 DOI: 10.1007/s00404-023-07323-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/27/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Breast cancer survivors (BCS) suffer severe vulvo-vaginal atrophy (VVA) and some of the most effective therapies are contraindicated. In literature we have no data about the non-ablative CO2 laser on these women. The aim of this study was to examine its efficacy, safety and acceptability in BCS. MATERIALS AND METHODS The enrolled women underwent 3 sessions of laser therapy (t0, t1, t2) and a one-month follow up examination (t3). At each time point we measured objective signs of VVA via VHI (Vaginal Health Index) and VuHI (Vulvar Health Index) and subjective parameters (Dryness, Burning, Itching, Dysuria) via visual analog scales (VAS). In sexually active women we evaluated the sexual function with FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Score) scores and MENQOL (menopause quality of life questionnaire). RESULTS We enrolled 26 BCS. The mean VHI, VuVHI, dryness and burning VAS scores improved significantly and this improvement was not influenced by the initial VVA grade. MENQOL sexual domain, Lubrication, Orgasm and Pain domains and FSFI total score improved significantly, while Desire, Arousal and Satisfaction domains of FSFI and FSDS did not. At t0 women using Aromatase Inhibitors suffered more severe vaginal dryness than women using Tamoxifen or no therapy, but the three subgroups improved without differences. No adverse event and minimum discomfort were reported. CONCLUSIONS The non-ablative CO2 laser is a safe and effective treatment of VVA and has positive effects on sexual function in BCS regardless the use of adjuvant therapies and the initial grade of VVA.
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Affiliation(s)
- Alessandra Lami
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Stefania Alvisi
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maurizio Baldassarre
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy
| | - Sara Zanella
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Veronica Amati
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Cristina Meriggiola
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy
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Lee C, Park IJ. Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes. World J Mens Health 2024; 42:304-320. [PMID: 38449456 PMCID: PMC10949018 DOI: 10.5534/wjmh.230335] [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: 11/15/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024] Open
Abstract
Anatomical and physiological differences exist between sex, leading to variations in how diseases, such as rectal cancer, are prevalence and treatment outcomes of diseases including rectal cancer. In particular, in the case of rectal cancer, anatomical differences may be associated with surgical challenges, and these factors are believed to be important contributors to potential disparities in postoperative recovery, associated complications, and oncological outcomes between male and female patients. However, there is still ongoing debate regarding this matter. Significantly, the male pelvic anatomy is distinguished by its narrower dimensions, which can present surgical challenges and impede visual access during operative procedures, rendering it more complex than surgical interventions in the female pelvis. As a result, this anatomical difference leads to a greater occurrence of postoperative complications, such as anastomotic leakage. Moreover, the pelvis houses nerves that are vital for urinary and genital functions, underscoring the need to assess the potential risks of sexual and urinary dysfunction in rectal cancer surgery. These postoperative complications can significantly impact the quality of life; therefore, it is imperative to perform surgery with an understanding of the structural differences between sexes. Therefore, to address the limitations imposed by anatomical structures, new approaches such as robotic surgery, trans-anal total mesorectal excision, and intraoperative neuromonitoring are being introduced. Furthermore, it is essential to conduct research into fundamental mechanisms that may give rise to differences in surgical outcomes and oncological results between sexes. By comprehending the disparities between males and females, we can advance toward personalized treatments. Consequently, this review outlines variations in surgical approaches, complications, and treatments for rectal cancer in male and female patients.
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Affiliation(s)
- Chungyeop Lee
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Ja Park
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Liu C, Zhang Y, Xu Q, Yang C, Tang Y, Zhang Q, Liu X, Yue Y, Yu F. The risk of sexual dysfunction in Chinese women with recurrent pregnancy loss and the associated factors: a multicenter cross-sectional study. Sex Med 2024; 12:qfae031. [PMID: 38803794 PMCID: PMC11128721 DOI: 10.1093/sexmed/qfae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background Recurrent pregnancy loss (RPL) is a severe traumatic event for women of childbearing age. However, the association between RPL and female sexual dysfunction was unknown. Aim The study sought to investigate the association between RPL and sexual dysfunction, and to explore the risk factors of sexual dysfunction for RPL patients. Methods A multicenter cross-sectional study involving both RPL patients and healthy women was performed in 3 different hospitals in West China from May 2021 to January 2023. Baseline information including sociodemographic data and disease histories were collected. The Female Sexual Function Index (FSFI) was used to assess the sexual function of participants. Outcomes The main outcome was the proportion of women at increased risk of sexual dysfunction (total FSFI scores <26.55), and the secondary outcome was risk factors of sexual dysfunction in RPL patients. Results A total of 233 RPL patients and 185 healthy women were included in this study. RPL patients had significantly lower total FSFI scores (median 31.7 [interquartile range, 26.6-33.5] vs 33.0 [interquartile range, 31.2-34.1]; P < .001) and a significantly higher risk of sexual dysfunction than healthy women (24.9% vs 8.6%; P < .001). Body mass index >24 kg/m2 (adjusted odds ratio [OR], 4.132; 95% confidence interval [CI], 1.902-8.976, P < .001), working >8 h/d (adjusted OR, 2.111; 95% CI, 1.020-4.369, P = .044), and unexplained RPL (adjusted OR, 3.785; 95% CI, 1.967-7.280, P < .001) were independent risk factors of sexual dysfunction for RPL patients. Clinical Implications RPL patients, especially those patients with the previously mentioned risk factors, should be focused on the risk of sexual dysfunction, and appropriate preventions could be applied. Strength and Limitations We explored the association between RPL and sexual dysfunction and explored the risk factors of sexual dysfunction among RPL patients for the first time, and the multicenter data increased the generalizability of results. However, the cross-sectional design did not provide an exact causal relationship between RPL and sexual dysfunction, and potential risk factors related to mental health were not investigated. Conclusion RPL patients were at an increased risk of sexual dysfunction. Overweight, fatigue caused by work, and unexplained RPL were risk factors of sexual dysfunction for RPL patients.
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Affiliation(s)
- Chuanjiao Liu
- Department of Laboratory Medicine, Chengdu Qingbaijiang Maternal and Child Health Care Hospital, Qingbaijiang District, Chengdu 610300, Sichuan Province, China
- Department of Laboratory Medicine, Chengdu Qingbaijiang Women’s and Children’s Hospital, West China Second University Hospital, Sichuan University, Chengdu 610300, Sichuan Province, China
| | - Yiduo Zhang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
| | - Qian Xu
- Department of Laboratory Medicine, Chengdu Qingbaijiang Maternal and Child Health Care Hospital, Qingbaijiang District, Chengdu 610300, Sichuan Province, China
- Department of Laboratory Medicine, Chengdu Qingbaijiang Women’s and Children’s Hospital, West China Second University Hospital, Sichuan University, Chengdu 610300, Sichuan Province, China
| | - Chen Yang
- Department of Laboratory Medicine, Chengdu Qingbaijiang Maternal and Child Health Care Hospital, Qingbaijiang District, Chengdu 610300, Sichuan Province, China
- Department of Laboratory Medicine, Chengdu Qingbaijiang Women’s and Children’s Hospital, West China Second University Hospital, Sichuan University, Chengdu 610300, Sichuan Province, China
| | - Yuanting Tang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
| | - Qiong Zhang
- Department of Obstetrics and Gynecology, Ziyang Maternal and Child Health Care Hospital, Ziyang 641300, China
| | - Xiumei Liu
- Department of Obstetrics and Gynecology, Ziyang Maternal and Child Health Care Hospital, Ziyang 641300, China
| | - Yangang Yue
- Department of Laboratory Medicine, Chengdu Qingbaijiang Maternal and Child Health Care Hospital, Qingbaijiang District, Chengdu 610300, Sichuan Province, China
- Department of Laboratory Medicine, Chengdu Qingbaijiang Women’s and Children’s Hospital, West China Second University Hospital, Sichuan University, Chengdu 610300, Sichuan Province, China
| | - Fan Yu
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
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Gupta P, Doherty L, Temprosa M, Pop-Busui R, Gadde KM, Singh P, Owora AH, Wessells H, Sarma AV. Prevalence and predictors of female sexual dysfunction among sexually active women in the diabetes prevention program outcomes study. Neurourol Urodyn 2024; 43:977-990. [PMID: 38501372 DOI: 10.1002/nau.25436] [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: 11/01/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVE To determine the burden and identify correlates of female sexual dysfunction (FSD) among women with prediabetes (PreD) and type 2 diabetes (T2D) enrolled in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS). METHODS The DPPOS visit included the Female Sexual Function Index (FSFI) to determine sexual function. Of 1464 participants, 1320 (90%) completed the (FSFI) and 426 were sexually active. A backward selection multivariable logistic regression model estimated the odds of FSD for sociodemographic, clinical, and diabetes-related covariates. RESULTS One hundred and eighty-five (43%) had a score of ≤26.55 and met the criteria for FSD. After adjustment for DPP treatment and age, urinary incontinence (UI) (odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.15-3.17) and hysterectomy (OR = 1.89, 95% CI = 1.01-3.53) were associated with increased odds of FSD. Increased body mass index was protective for FSD (OR = 0.93 per kg/m2, 95% CI = 0.89-0.96). Michigan Neuropathy Screening Instrument-based peripheral neuropathy (mean±SD scores 1.1±1.3 vs. 0.9±1.1, p < 0.0001) and Electrocardiogram (ECG)-based autonomic dysfunction measures (mean ± SD heart rate levels 64.3 ± 6.8 vs. 65.6 ± 10.2, p = 0.008) were associated with FSD. There were no differences in diabetes rates between women who did (66.5%) and did not (66%) have (p = 0.7). CONCLUSIONS FSD is prevalent in women with PreD and T2D. Our findings suggest that FSD is associated with neuropathic complications commonly observed in PreD and T2D.
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Affiliation(s)
- Priyanka Gupta
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsay Doherty
- Department of Biostatistics and Bioinformatics, Biostatistics Center, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Marinella Temprosa
- Department of Biostatistics and Bioinformatics, Biostatistics Center, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Rodica Pop-Busui
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Kishore M Gadde
- Department of Surgery, University of California Irvine, Orange, California, USA
| | - Prachi Singh
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Arthur H Owora
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, Indiana, USA
| | - Hunter Wessells
- Department of Urology and Diabetes, Research Center, University of Washington School of Medicine, Seattle, Washington, USA
| | - Aruna V Sarma
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
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Reiser E, Böttcher B, Ossig C, Schiller J, Tollinger S, Toth B. Female cancer survivors: sexual function, psychological distress, and remaining fertility. J Assist Reprod Genet 2024; 41:1057-1065. [PMID: 38381389 PMCID: PMC11052740 DOI: 10.1007/s10815-024-03051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE Improved survivorship in cancer patients leads to new challenging issues including potential impairment of quality of life, sexual function, and fertility. The aim of this study was to assess sexual dysfunction (SD) and psychological distress in female cancer survivors who underwent fertility preservation in the past in comparison to reviewed healthy control data from other published studies. Additionally, our focus was on the difference in SD between women with current desire to get pregnant and already completed family planning. METHODS In this prospective study, 53 female cancer survivors who underwent fertility preservation at time of cancer diagnosis between 2010 and 2020 were invited to a gynecological exam, laboratory assessment, and two questionnaires (Female Sexual Function Index (FSFI) and Hospital anxiety and depression scale (HADS)) in 2022. These scores were compared to results in the literature of healthy controls and depending on anti-Mullerian-hormone (AMH) levels, current desire to have a child, and age. RESULTS After a mean follow-up time of 70 ± 50 months, SD was detected in 60.4% (n = 32) of the 53 included patients. Normal results regarding HADS-D/anxiety and HADS-D/depression were found in 88.7% and 94.3% of patients, respectively. At time of follow-up, 69.9% (n = 40) regained regular menstrual cycles, 52.6% (n = 20) < 40 years showed a diminished ovarian reserve with AMH levels < 1.1 ng/ml and 28.3% (n = 15) suffered from infertility. CONCLUSION Female cancer survivors may be at risk for SD. Cancer patients should be informed about possible sexual dysfunction already at the start of cancer treatment and during follow-up. In addition, contraception needs to be addressed if regular cycles occur as more than two-thirds of the women regained regular menstrual cycles.
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Affiliation(s)
- Elisabeth Reiser
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Bettina Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Charlotte Ossig
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Julia Schiller
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Susanne Tollinger
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Bettina Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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Freihart BK, Meston CM. Physiological Synchrony During Partnered Sexual Activity. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:498-511. [PMID: 38545911 DOI: 10.1080/0092623x.2024.2321127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Physiological synchrony (PS) refers to the coordination of bodily responses in close relationships. It seems to be linked to relational well-being, satisfaction, closeness, and empathy. Recent research extends these findings to sexual relationships as well, with evidence suggesting that PS may predict attraction and sexual satisfaction. The current study focuses on PS during sexual activity within established couples. Results suggest that PS develops during sexual activity, in certain contexts, and tends to be greater in magnitude during sexual encounters than during non-sexual interactions. Results may shed light on the dyadic psychophysiological factors relevant to sexual experiences.
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Affiliation(s)
- Bridget K Freihart
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Cindy M Meston
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
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Ramírez-Santos J, Cristóbal-Cañadas D, Parron-Carreño T, Lozano-Paniagua D, Nievas-Soriano BJ. The problem of calculating the prevalence of sexual dysfunction: a meta-analysis attending gender. Sex Med Rev 2024; 12:116-126. [PMID: 38336366 DOI: 10.1093/sxmrev/qead058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Sexuality is an integral part of human health, and sexual dysfunctions are prevalent issues that affect men and women. While reviews on sexual dysfunctions in various diseases have been conducted, overall data are scarce. OBJECTIVES To update the overall prevalence of sexual dysfunctions from available prevalence studies on both sexes. METHODS We used a 2-phase selection process to include cross-sectional studies that were conducted on the adult population and published between 2017 and 2022. The extracted data were prevalence, methodology, sample size, and location. Sensitivity and subgroup analyses were conducted to assess heterogeneity. RESULTS This review analyzed 4407 studies. Twenty-three met the established criteria: 9 on the male population and 14 on the female population. The meta-analysis included 7 articles on males and 13 on females. The prevalence of sexual dysfunction was 31% in men and 41% in women, with significant heterogeneity among the studies. Sociocultural differences and use of varying measurement methods were identified as the main factors contributing to heterogeneity. Subgroup analysis revealed decreased heterogeneity among studies that used the Female Sexual Function Index as a diagnostic tool for females. CONCLUSIONS The review highlights the notable variability in results due to methodological and geographic variations. Therefore, enhancing the training of professionals and standardizing the recording of patient data-through the Female Sexual Function Index and Male Sexual Health Questionnaire or by developing new ones for this purpose-could improve the consistency of research on sexual health.
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Affiliation(s)
| | | | - Tesifón Parron-Carreño
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
| | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, Almería, 04120, Spain
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Moradi Z, Shahali S, Ahmadi F, Montazeri A. Correlates of sexual function in women with acute lumbar disc herniation in Iran: a cross-sectional study. Sci Rep 2024; 14:6430. [PMID: 38499726 PMCID: PMC10948880 DOI: 10.1038/s41598-024-57274-w] [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: 01/24/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024] Open
Abstract
Evidence suggests that lumbar disc herniation (LDH) influences sexual function to a great deal. However, most existing studies have been conducted on men. Thus, the current study aimed to assess sexual function and its correlates in women with acute LDH. This descriptive cross-sectional study was conducted on 350 women of reproductive age with acute LDH in Fasa, Iran in 2023. The mean score of female sexual function was 21.33 (3.38). Almost 80% of women had sexual dysfunction. Women scored lower on sexual desire and the higher on lubrication. As the severity of LDH increased, arousal, lubrication and sexual pain score decreased and low back pain (LBP) score increased (p < 0.05). The number of sexual activities after disc herniation was significantly lower in the women with sexual dysfunction (p < 0.001). Regression analysis showed a significant association between sexual dysfunction and LBP intensity (OR = 1.13, CI 1.02-1.26, p = 0.01) and lumbar disc herniation intensity (OR = 2.22, CI 1.07-4.62, p = 0.03). Lumbar disc herniation (LDH) may significantly affect women's sexual function. Severity of low back pain and severity of lumbar disc herniation were found to be risk factors for sexual dysfunction in this population.
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Affiliation(s)
- Zahra Moradi
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares Univesity, Tehran, Iran
| | - Shadab Shahali
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares Univesity, Tehran, Iran.
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science & Culture, Tehran, Iran
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Dogan O, Ucar E, Yassa M. Does the Surgical Margin Affect Sexual Function Following Linear Labiaplasty Technique? Aesthet Surg J 2024; 44:NP271-NP278. [PMID: 38092694 DOI: 10.1093/asj/sjad368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND How much labial tissue should be left after labiaplasty is a controversial issue. OBJECTIVES The objective was to investigate the effect of residual labial tissue following labiaplasty operations on sexual function. METHODS A total of 150 females who underwent labiaplasty between 2019 and 2021 and their partners were included in the study. In this retrospective study, linear labiaplasty technique was applied according to the patient's request. Patients were either below 1 cm or above 1 cm according to the remaining labial width at follow-up. The remaining labial tissues were classified according to the Motakef classification. Patients with a labial width above 1 cm were included in Group 1, and patients with a labial width below 1 cm were included in Group 2. Sexual function, sexual experience, body image, and erectile function of their partners were compared preoperatively and 2 years postoperatively with appropriate questionnaires. RESULTS Sexual function, sexual experience, and body image of females improved in all patients. However, the improvement was more apparent with with remaining labial tissue of greater than 1 cm. The increase in the survey results of the partners was found to be similar. CONCLUSIONS The sexual function of the patients was better when the width of the labium was longer than 1 cm. This may be due to better protection of the neurovascular structures. This favorable effect was also seen in the subjective evaluation of the partners. LEVEL OF EVIDENCE: 3
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Mutamba BB, Rukundo GZ, Sembajjwe W, Nakasujja N, Birabwa-Oketcho H, Mpango RS, Kinyanda E. A 'hidden problem': Nature, prevalence and factors associated with sexual dysfunction in persons living with HIV/AIDS in Uganda. PLoS One 2024; 19:e0295224. [PMID: 38451991 PMCID: PMC10919729 DOI: 10.1371/journal.pone.0295224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/20/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND We conducted a clinic-based cross-sectional survey among 710 people living with HIV/AIDS in stable 'sexual' relationships in central and southwestern Uganda. Although sexual function is rarely discussed due to the private nature of sexual life. Yet, sexual problems may predispose to negative health and social outcomes including marital conflict. Among individuals living with HIV/AIDS, sexual function and dysfunction have hardly been studied especially in sub-Saharan Africa. In this study, we aimed to determine the nature, prevalence and factors associated with sexual dysfunction (SD) among people living with HIV/AIDS (PLWHA) in Uganda. METHODS We conducted a clinic based cross sectional survey among 710 PLWHA in stable 'sexual' relationships in central region and southwestern Uganda. We collected data on socio-demographic characteristics (age, highest educational attainment, religion, food security, employment, income level, marital status and socio-economic status); psychiatric problems (major depressive disorder, suicidality and HIV-related neurocognitive impairment); psychosocial factors (maladaptive coping styles, negative life events, social support, resilience, HIV stigma); and clinical factors (CD4 counts, body weight, height, HIV clinical stage, treatment adherence). RESULTS Sexual dysfunction (SD) was more prevalent in women (38.7%) than men (17.6%) and majority (89.3% of men and 66.3% of women) did not seek help for the SD. Among men, being of a religion other than Christianity was significantly associated with SD (OR = 5.30, 95%CI 1.60-17.51, p = 0.006). Among women, older age (> 45 years) (OR = 2.96, 95%CI 1.82-4.79, p<0.01), being widowed (OR = 1.80, 95%CI 1.03-3.12, p = 0.051) or being separated from the spouse (OR = 1.69, 95% CI 1.09-2.59, p = 0.051) were significantly associated with SD. Depressive symptoms were significantly associated with SD in both men (OR = 0.27, 95%CI 0.74-0.99) and women (OR = 1.61, 95%CI 1.04-2.48, p = 0.032). In women, high CD4 count (OR = 1.42, 95% CI 1-2.01, p = 0.05) was associated with SD. CONCLUSION Sexual dysfunction has considerable prevalence among PLWHA in Uganda. It is associated with socio-demographic, psychiatric and clinical illness factors. To further improve the quality of life of PLWHA, they should be screened for sexual dysfunction as part of routine assessment.
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Affiliation(s)
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Wilber Sembajjwe
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Richard Stephen Mpango
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Entebbe, Uganda
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Ribeiro S, Pedro J, Martins MV. Psychosocial experiences of involuntary definitive childless women: a comparative study based on reproductive status. Hum Reprod 2024; 39:559-568. [PMID: 38290160 DOI: 10.1093/humrep/deae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
STUDY QUESTION Do involuntary definitive childless women have lower psychosocial adjustment levels than women with infertility diagnoses actively trying to conceive and presumably fertile women? SUMMARY ANSWER Involuntary definitive childless women have lower levels of sexual functioning than infertile women actively trying to conceive and presumably fertile women, and higher levels of depression than presumably fertile women. WHAT IS KNOWN ALREADY Involuntary definitive childless defines those who wanted to become parents but were unable to do so. Studies have provided evidence about infertility and its psychosocial consequences, but there is a lack of knowledge about the impact of involuntary definitive childlessness, namely on sexual function, social support, marital satisfaction, and psychological adjustment. STUDY DESIGN, SIZE, DURATION This associative study was conducted between July 2021 and January 2022 for involuntary definitive childless women and between July 2016 and February 2018 for women with an infertility diagnosis actively trying to conceive as well as presumably fertile women. An online questionnaire announced in social media and gynaecology and fertility clinics was used. The inclusion criteria for all participants were being childless, in a heterosexual relationship and cohabiting for at least 2 years. Specific inclusion criteria for involuntary definitive childless women were: trying to conceive for at least 2 years; not achieving pregnancy because of biological and medical constraints; and not undergoing fertility treatment or being a candidate for adopting a child at time of the study. For women with an infertility diagnosis the inclusion criteria were: actively trying to conceive (naturally or through fertility treatments); having a primary fertility diagnosis; and aged between 22 and 42 years old. For presumably fertile women, the inclusion criteria were: having a parenthood wish in the future; and not knowing of any condition that could prevent them from conceiving. PARTICIPANTS/MATERIALS, SETTING, METHODS Out of 360 women completing the survey, only 203 were eligible for this study (60 involuntary definitive childless women, 78 women with an infertility diagnosis actively trying to conceive, and 65 presumably fertile women). All participants completed a questionnaire including sociodemographic and clinical data, the Female Sexual Function Index, the 2-Way Social Support Scale, the Relationship Assessment Scale, and Hospital Anxiety and Depression Scale. Binary logistic regression was performed to assess the relation between sexual function, social support, marital satisfaction, anxiety, depression, and reproductive status, adjusting for age, and cohabitation length. Presumably fertile women were used as a reference group. MAIN RESULTS AND THE ROLE OF CHANCE Women were 34.31 years old (SD = 5.89) and cohabited with their partners for 6.55 years (SD = 4.57). The odds ratio (OR) showed that involuntary definitive childless women had significantly lower sexual function than infertile women actively trying to conceive (OR = 0.88, 95% CI = 0.79-0.99) and presumably fertile women (OR = 34.89, 95% CI = 1.98-614.03), and higher depression levels than presumably fertile women (OR = 99.89, 95% CI = 3.29-3037.87). Women with an infertility diagnosis actively trying to conceive did not differ from presumably fertile women in sexual function, social support, marital satisfaction, anxiety, and depression. LIMITATIONS, REASONS FOR CAUTION The majority of childless women underwent fertility treatments, and childlessness for circumstantial reasons owing to lack of a partner was not included, therefore these results may not reflect the experiences of all women with an involuntary childless lifestyle. There was a time gap in the recruitment process, and only the definitive childlessness group filled out the questionnaire after the coronavirus disease 2019 pandemic. We did not ask participants if they self-identified themselves with the groups' terminology they were assigned to. WIDER IMPLICATIONS OF THE FINDINGS Our results emphasize the importance of future research to provide a more comprehensive understanding of the adjustment experiences of childless women and an awareness of the poor adjustment they might experience, highlighting the need to keep following women after unsuccessful treatments. Clinical practitioners must attend to these dimensions when consulting involuntary definitive childless women who might not have gone through treatments but also experience these adverse outcomes. STUDY FUNDING/COMPETING INTEREST(S) This study was partially supported by the Portuguese Foundation for Science and Technology. The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Sara Ribeiro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Juliana Pedro
- Centre for Reproductive Genetics A.Barros, Porto, Portugal
- Center for Psychology at University of Porto, Porto, Portugal
| | - Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto, Porto, Portugal
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