1
|
Lewis Johnson T, Rowland LM, Ashraf MS, Clark CT, Dotson VM, Livinski AA, Simon M. Key Findings from Mental Health Research During the Menopause Transition for Racially and Ethnically Minoritized Women Living in the United States: A Scoping Review. J Womens Health (Larchmt) 2024; 33:113-131. [PMID: 38079223 PMCID: PMC10880275 DOI: 10.1089/jwh.2023.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Background: Racially and ethnically minoritized (REM) women experience social and structural factors that may affect their response to mental health treatment and menopausal symptoms during the menopause transition (MT). This scoping review on mental health during the MT for REM women in the United States was conducted to characterize factors associated with mental health challenges. Materials and Methods: Five databases were searched. Articles were included if focused on MT in REM women in the United States and its territories with specific mental illnesses and published in English from 2005 to 2021. Titles and abstracts and full text were screened. Screening and data collection were completed in duplicate by two reviewers in Covidence. Results: Sixty-five articles were included and indicate that REM women experience a disproportionate burden of depressive symptoms during the MT. Less evidence is reported about anxiety, Post-Traumatic Stress Disorder, psychosis, schizophrenia, and other mental illnesses. The risk factors associated with mental illness during MT are social, structural, and biological. Treatment response to therapeutic interventions is often underpowered to explain REM differences. Conclusion: Depression during the MT is associated with negative outcomes that may impact REM women differentially. Incorporating theoretical frameworks (e.g., intersectionality, weathering) into mental health research will reduce the likelihood that scientists mislabel race as the cause of these inequities, when racism and intersecting systems of oppression are the root causes of differential expression of mental illness among REM women during the MT. There is a need for interdisciplinary research to advance the mental health of REM women.
Collapse
Affiliation(s)
- Tamara Lewis Johnson
- Women's Mental Health Research Program, Office of Disparities Research and Workforce Diversity, National Institute of Mental Health, NIH, Rockville, Maryland, USA
| | - Laura M. Rowland
- Neuroscience of Mental Disorders and Aging Program, Division of Translational Research, National Institute of Mental Health, NIH, Rockville, Maryland, USA
| | - Mahela S. Ashraf
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Crystal T. Clark
- Department of Psychiatry, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Vonetta M. Dotson
- Department of Psychology and Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Alicia A. Livinski
- National Institutes of Health Library, Office of Research Services, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Institute for Public Health, and Medicine (IPHAM)—Center for Health Equity Transformation, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
2
|
Dilixiati D, Kadier K, Laihaiti D, Lu JD, Rezhake R, Azhati B, Rexiati M. The relationship between sleep disorders, quality, and duration and sexual dysfunction: a systematic review and meta-analysis. J Sex Med 2023:7143630. [PMID: 37186140 DOI: 10.1093/jsxmed/qdad054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The associations between sexual dysfunction (SD) and sleep disorders, sleep quality, and sleep duration remain unclear. AIM To assess the relationship between sleep and SD through a literature review and meta-analysis. METHODS The PubMed, Scopus, Embase, Ovid MEDLINE, and Cochrane Library databases were systematically searched from inception to November 10, 2022. OUTCOMES Pooled relative risks and 95% CIs were used to examine the association of sleep disorders with SD in longitudinal studies. Pooled odds ratios (ORs) and 95% CIs were used to examine the associations between SD and sleep disorders, sleep quality, and sleep duration in cross-sectional studies. RESULTS Forty-three articles, including 11 longitudinal studies and 32 cross-sectional studies, were included in the quantitative analysis. The pooled relative risk of SD in patients with sleep disorders was 1.97 in longitudinal studies (95% CI, 1.46-2.67, P < .001; heterogeneity: I2 = 95.0%, P < .001), while the pooled OR of SD in patients with sleep disorders was 2.05 in cross-sectional studies (95% CI, 1.76-2.39, P < .001; heterogeneity: I2 = 91.4%, P < .001). When compared with controls, subjects with poor sleep quality had a 1.49-fold increased risk of SD (OR, 1.49; 95% CI, 1.31-1.71, P < .001; heterogeneity: I2 = 73.4%, P < .001). In addition, short sleep duration was associated with the risk of SD (OR, 1.14; 95% CI, 1.06-1.22, P < .001; heterogeneity: I2 = 0.0%, P = .849). CLINICAL IMPLICATIONS The risk of SD is significantly increased in patients with sleep disorders and poor sleep quality, indicating that clinicians should monitor sleep among patients with SD. STRENGTHS AND LIMITATIONS This study is the most comprehensive meta-analysis of the association between sleep and SD to date. However, different sleep disorders may have varying associations with sleep duration and sleep quality; thus, we could not identify the independent effects across the studies. CONCLUSION Our systematic review and meta-analysis results suggest that sleep disorders, especially obstructive sleep apnea, increase the risk of SD in men and women. Poor sleep quality is significantly associated with SD. Short sleep duration is associated with an increased risk of SD.
Collapse
Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Duolikun Laihaiti
- Department of Joint Surgery, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Changji 831199, China
| | - Jian-De Lu
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Remila Rezhake
- Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830017, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, Urumqi 830054, China
| |
Collapse
|
3
|
Mandera-Grygierzec A, Kostrzewska P, Szuster E, Pawlikowska-Gorzelańczyk A, Biernikiewicz M, Rusiecka A, Mrozek-Szetela A, Sobieszczańska M, Rożek-Piechura K, Markiewicz M, Kałka D. Low Exercise Tolerance as a Marker of Erectile Dysfunction and Depression among Post-Myocardial Infarction Men. Healthcare (Basel) 2023; 11:healthcare11091213. [PMID: 37174755 PMCID: PMC10178144 DOI: 10.3390/healthcare11091213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/15/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Evidence has grown recently on the correlation between lifestyle and physical activity, and their impact on the functioning of the entire organism. In addition, a decrease in physical efficiency may be an indicator of the early diagnosis of systemic diseases. The aim of this study was to determine whether there is a relationship between exercise tolerance and possible erectile dysfunction or mental disorders. A cross-sectional study was conducted among 254 men in 4 cardiac rehabilitation centers in Poland using the standardized International Index of Erectile Function 5 (IIEF-5) and Beck Depression Inventory (BDI) questionnaires. Erectile dysfunction was directly proportional to the metabolic equivalent of the task (MET) variable. An increase in exercise tolerance by 1 point was associated with an increase in the IIEF-5 score by 1.62 points, indicating a reduction in the severity of erectile dysfunction. The 1-point increase in MET was associated with a 1.8-point decrease in BDI, indicating that an increase in exercise tolerance is associated with a decrease in the severity of depressive disorders. Increasing the tolerance of physical effort has a beneficial effect not only on the general well-being, but also on the sexual and mental health of men. An increase in exercise tolerance is associated with a reduction in the incidence of erectile dysfunction. On the other hand, in patients with depressive disorders, the improvement of exercise tolerance reduces the intensity of depression symptoms. Exercise tolerance can be an early and simple marker at the onset of erectile dysfunction or mood disorders.
Collapse
Affiliation(s)
| | - Paulina Kostrzewska
- Cardiosexology Students Club, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Ewa Szuster
- Cardiosexology Students Club, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | | | | | - Agnieszka Rusiecka
- Statistical Analysis Centre, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Aneta Mrozek-Szetela
- Doctoral School at Wroclaw of Environmental and Life Science, 50-375 Wrocław, Poland
| | | | - Krystyna Rożek-Piechura
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
| | | | - Dariusz Kałka
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wrocław, Poland
- Men's Health Centre in Wroclaw, 53-151 Wrocław, Poland
| |
Collapse
|
4
|
Obi OC, Nnonyelu AC, Onobrakpeya A, Ogundele OJ. Benefits and barriers to physical activity among African women: A systematic review. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 5:59-66. [PMID: 36994171 PMCID: PMC10040374 DOI: 10.1016/j.smhs.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Black women have always been likened to being a less physically active group compared to women of other races/ethnicity, with reports of a high prevalence of obesity and other cardiometabolic diseases among them. The purpose of this study is to examine the health benefits of physical activity on women of color, as well as barriers that inhibit their participation. We searched PubMed and Web of Science databases for relevant research articles. Included articles were: Published in the English Language from 2011 to February 2022; conducted predominantly on black women, African women, or African American women. Articles were identified, screened, and data extracted following the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guidelines. The electronic search produced 2 043 articles, and 33 articles were reviewed after meeting the inclusion criteria. 13 articles focused on the benefits of physical activity while 20 articles addressed the barriers to physical activity. It was found that physical activity has various benefits for black women participants but they are being hindered from participation by some factors. These factors were grouped into four themes, namely Individual/Intrapersonal barriers, Socio-economic barriers, Social barriers, and Environmental barriers. Various studies have examined the benefits and barriers of physical activity among women of different racial and ethnic backgrounds, but there have been very few studies of African women, with the majority focusing on one geographical area. In addition to exploring these benefits and barriers, this review offers recommendations on the areas researchers should focus on to promote physical activity in this population.
Collapse
|
5
|
Rahmani A, Afsharnia E, Fedotova J, Shahbazi S, Fallahi A, Allahqoli L, Ghanei-Gheshlagh R, Abboud S, Alkatout I. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022; 19:1098-1115. [PMID: 35752457 DOI: 10.1016/j.jsxm.2022.03.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.
Collapse
Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Afsharnia
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Julia Fedotova
- International Research Centre "Biotechnologies of the Third Millennium", St. Petersburg, Russian Federation. Laboratory of Neuroendocrinology, ITMO University, I.P. Pavlov Institute of Physiology RASci., St. Petersburg, Russia
| | - Shirin Shahbazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran; Breastfeeding Research Center-Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Fallahi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Reza Ghanei-Gheshlagh
- Social Determinants of Health Research Center, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan University of Medical, Sciences, Sanandaj, Iran
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
6
|
Kim JI, Zhu D, Davila J, Lee J, Chubak BM, Melamed ML, Abraham N. Female Sexual Dysfunction as Measured by Low Sexual Frequency is Associated with Lower Socioeconomic Status: An Analysis of the National Health and Nutrition Examination Survey (NHANES), 2007-2016. J Sex Med 2022; 19:90-97. [PMID: 34696997 DOI: 10.1016/j.jsxm.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/04/2021] [Accepted: 09/24/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Female sexual dysfunction (FSD) is a complex disorder of biopsychosocial etiology, and FSD symptoms affect more than 40% of adult women worldwide. AIM In this cross-sectional study, we sought to investigate the association between FSD and socioeconomic status (SES) in a nationally representative female adult population. METHODS Economic and sexual data for women aged 20-59 from the 2007-2016 National Health and Nutrition Examination Survey, a United States nationwide representative database, was analyzed. Poverty income ratio (PIR), a ratio of family income to poverty threshold, was used as a measure of SES, and low sexual frequency was used as a measure of FSD. The association between FSD and SES was analyzed using survey-weighted logistic regression after adjusting for relevant social and gynecologic covariates, such as marital status and history of pregnancy, as well as significant medical comorbidities. OUTCOMES We found that FSD, as measured by low sexual frequency, was associated with lower SES. RESULTS Among the 7,348 women of mean age 38.4 (IQR 29-47) included in the final analysis, 26.3% of participants reported sexual frequency of 0-11 times/year and 73.7% participants reported sexual frequency >11 times/year. Participants of PIR <2 were 92% more likely to report sexual frequency ≤11 times/year than those of PIR ≥2 after adjusting for demographics, social history, gynecologic history and significant medical conditions (OR = 1.92; 95% CI = 1.21-3.05; P < .006). CLINICAL IMPLICATIONS The evaluation and treatment of FSD may benefit from a comprehensive approach that takes SES into account. STRENGTHS & LIMITATIONS This study is limited by its cross-sectional design, but it is strengthened by a large, nationally representative sample with extensive, standardized data ascertainment. CONCLUSION Lower SES and lower sexual frequency are directly correlated among female adults in the United States; future studies should focus on social determinants of health as risk factors for FSD.
Collapse
Affiliation(s)
- Joseph I Kim
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Denzel Zhu
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jonathan Davila
- Department of Urology, Montefiore Medical Center, Bronx, NY, USA
| | - Justin Lee
- Department of Urology, Columbia University Medical Center, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michal L Melamed
- Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nitya Abraham
- Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Urology, Montefiore Medical Center, Bronx, NY, USA
| |
Collapse
|
7
|
Tavoli A, Tavoli Z, Effatpanah M, Montazeri A. Prevalence and associated risk factors for sexual dysfunction among postmenopausal women: a study from Iran. Womens Midlife Health 2021; 7:10. [PMID: 34838138 PMCID: PMC8626990 DOI: 10.1186/s40695-021-00069-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Female Sexual Dysfunction (FSD) is a distressing condition linked to menopause. This study aimed to determine the prevalence and contributing factors for FSD among postmenopausal women. METHODS This was a cross-sectional study. A convenience sample of postmenopausal women attending a gynecology clinic in a teaching hospital affiliated with Tehran University of Medical Sciences was enrolled into the study. The Female Sexual Function Index (FSFI) was used to assess sexual function. In addition, demographic and psychosocial information were recorded. The association between sexual function and anxiety and depression were examined to explore the data. RESULTS In all 162 postmenopausal women were studied. We performed general linear regression analysis to assess the relationship between sexual function and anxiety while including demographic variables in the model. The results showed that the model could explain about 46% of the variance observed in sexual function (adjusted R2 = 0.467). The analysis indicated that among independent variables, age (p < 0.001), sexual frequency (p < 0.001), and anxiety (p = 0.003) were significant contributing factors associated with sexual function. A similar analysis evaluating the relationship between sexual function and depression in menopausal women found that age (p < 0.001), sexual frequency (p < 0.001), and depression (p = 0.003), were significant contributing factors associated with sexual function; explaining about 46% of the variance observed (adjusted R2 = 0.466). CONCLUSION The findings showed that nearly half of menopausal women had sexual dysfunction in this convenience sample of women seeking gynecologic care. Women reporting sexual dysfunction also reported a higher prevalence of anxiety and depression. Indeed, recognition of such factors requires a holistic therapeutic approach to sexual dysfunction among postmenopausal women.
Collapse
Affiliation(s)
- Azadeh Tavoli
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Zahra Tavoli
- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Effatpanah
- Department of Psychiatry, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
| |
Collapse
|
8
|
Menopausal symptoms in the Southwest United States: A cross-sectional survey of women from areas with different socioeconomic resources. Maturitas 2021; 154:7-12. [PMID: 34736580 DOI: 10.1016/j.maturitas.2021.08.110] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Menopausal symptoms may differ by geography and ethnicity, but the impact of socioeconomic factors is less clear. The purpose of this study was to compare menopausal symptoms in women from areas of Arizona with different socioeconomic resources. STUDY DESIGN Women aged 40-65 years in two cohorts were surveyed: (1) Phoenix women attending either a clinic for patients who are uninsured or a clinic for people experiencing homelessness; and (2) Scottsdale women living in zip codes with higher average income and neighborhood advantage (surveyed by mail). Surveys included the Greene Climacteric Scale (GCS) and demographic questions. MAIN OUTCOME MEASURES GCS score by domain and subdomain, corrected for age, race, menopause stage and menopausal hormone therapy (HT). RESULTS Phoenix participants (N = 104) were 51.2 years old (SD 6.45), Hispanic (54.4%), White (28.2%) or African American (8.7%), and uninsured (53.0%). Scottsdale participants (N = 151) were 52.6 years old (SD 5.52), mostly White (94.7%) and insured (100%). Three percent of Phoenix women were on HT vs. 23.3% in Scottsdale (p < 0.001). Multivariate analysis revealed higher total GCS scores in the Phoenix vs. Scottsdale cohort (39.13 vs 30.14, p < 0.001), which was also seen in the psychological and somatic domains, as well as the anxiety and depression subdomains. No statistically significant differences were seen in the vasomotor or sexual dysfunction domains. CONCLUSION In a group of women living in Arizona from distinct socioeconomic areas, significant differences were demonstrated in menopausal symptom bother specifically with higher psychological and somatic symptoms in women who were uninsured or experiencing homelessness independent of age, race, menopause stage and HT use. Future studies controlling for co-morbidities associated with lower socioeconomic status such as depression would provide further insight into this population of midlife women.
Collapse
|
9
|
Stout ME, Hawkins MAW. Temporal Relationships Between Pain During Intercourse (PDI), Loneliness, and Depressive Symptoms Among Women. Sex Med 2021; 9:100444. [PMID: 34649130 PMCID: PMC8766269 DOI: 10.1016/j.esxm.2021.100444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background Painful sex can lead to increased psychological distress, including major depressive disorder, and the experience of loneliness may explain this association. Aims We aimed to investigate loneliness as a mediator between painful sex and depressive symptoms and hypothesized that women who experienced greater pain during intercourse (ie, more severe and more frequent pain) would endorse higher rates of loneliness and, in turn, higher rates of depressive symptoms at a 6-month follow-up. Methods Participants were 148 adults who were assigned female at birth (78.4% white, 77% partnered, 31.14 ± 10.9 years old) and completed an online, anonymous survey including the Female Sexual Function Index (FSFI), UCLA Loneliness Scale-3 (ULS), and demographic information. Main Outcome Measure Depressive symptoms, measured via the Patient Health Questionnaire-8 (PHQ8) at baseline (T1) and 6-month follow-up (T2) were used as the outcomes of the present study. Results Painful sex and ULS at T1 were significantly correlated with each other and with PHQ8 at T1 (r = 0.590). However, change in PHQ8 from T1 to T2 was not significantly correlated with ULS (r = 0.024) or any other key study variables, indicating that that ULS was not a significant mediator of the relationship between painful sex at T1 and change in PHQ8 (standardized indirect effect = 0.011; 99% CI = −0.114 to 0.188). Conclusion These findings are consistent with previous studies highlighting that painful sex is related to depressive symptoms through loneliness cross-sectionally, suggesting that future treatments for depressive symptoms among women who experience painful sex might target loneliness. Stout ME, Hawkins MAW. Temporal Relationships Between Pain During Intercourse (PDI), Loneliness, and Depressive Symptoms Among Women. Sex Med 2021;9:100444.
Collapse
Affiliation(s)
- Madison E Stout
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
| |
Collapse
|
10
|
Effect of Hypnosis on Anxiety: Results from a Randomized Controlled Trial with Women in Postmenopause. J Clin Psychol Med Settings 2021; 28:868-881. [PMID: 34403019 DOI: 10.1007/s10880-021-09810-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 01/27/2023]
Abstract
Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale. Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously. Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average, experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis to reduce symptoms of anxiety among postmenopausal women.Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number NCT01293695 ( https://clinicaltrials.gov/ct2/show/NCT01293695?term=Elkins&cond=hot+flashes&draw=2&rank=2 ).
Collapse
|
11
|
Prairie BA, Kling JM, Buras MR, Butterfield RJ, Jenkins M. Differences in menopausal symptoms and female sexual function by region and ethnicity in West Texas and Central Arizona: a cross-sectional survey. Menopause 2021; 28:1037-1043. [PMID: 34284430 DOI: 10.1097/gme.0000000000001810] [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: 11/25/2022]
Abstract
OBJECTIVE To evaluate menopausal symptoms and sexual problems in Hispanic and non-Hispanic women in two Southwest areas. METHODS An anonymous survey including the Green Climacteric Scale (GCS), Female Sexual Function Index (FSFI), and demographics was distributed to English and Spanish-speaking women age 40 to 60 in Scottsdale, Arizona, and West Texas. FSFI for sexually active women and GCS scores for the Hispanic and non-Hispanic women in Texas were analyzed with multivariable analysis and compared between Texas and Arizona for Non-Hispanic participants. RESULTS Predominantly non-Hispanic women (70%), average age 51.5 (SD = 7.25) completed questionnaires (199 West Texas, 163 Scottsdale). A majority of sexually active women (88%) were found to be at risk of sexual dysfunction. Within the Texas cohort, GCS score was estimated to be 3.49 points lower (less symptoms) in Hispanic versus non-Hispanic participants [95% CI -6.58 to -0.40, P = 0.03], and FSFI score was estimated to be 2.31 points lower (more symptoms) in Hispanic versus non-Hispanic participants [95% CI -4.49 to -0.14, P = 0.04]. Among non-Hispanic women, GCS scores were lower (less symptoms) in Texas versus Arizona by 10.25 points [95% CI -14.83 to -5.66, P < 0.01], while FSFI scores were higher overall (less symptoms) in Texas by 3.65 points [95% CI 0.53-6.77), P = 0.02]. All FSFI and GCS scores were adjusted for multiple variables. CONCLUSIONS In a group of menopausal women from the Southwest, most reported symptoms were consistent with FSD, and the degree of sexual problems appeared to be greater in the Hispanic participants from Texas.
Collapse
Affiliation(s)
- Beth A Prairie
- Women's Institute, Allegheny Health Network, Pittsburgh, PA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - Matthew R Buras
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ
| | | | - Marjorie Jenkins
- School of Medicine Greenville, University of South Carolina, Greenville, SC
- Prisma Health Upstate, Greenville, SC
| |
Collapse
|
12
|
Speed D, Cragun RT. Response to "Masturbation: Scientific Evidence and Islam's View". JOURNAL OF RELIGION AND HEALTH 2021; 60:1668-1671. [PMID: 29654401 DOI: 10.1007/s10943-018-0627-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- David Speed
- Department of Psychology, University of New Brunswick, 100 Tucker Road, Saint John, NB, E2L 4L5, Canada.
| | | |
Collapse
|
13
|
Mukarram M, Rao V, Mukarram M, Hondula DM, Buras MR, Kling JM. Menopausal Symptoms in Underserved and Homeless Women Living in Extreme Temperatures in the Southwest. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:44-52. [PMID: 33786530 PMCID: PMC8006778 DOI: 10.1089/whr.2020.0083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/12/2022]
Abstract
Background: Little is known about menopausal symptoms in underserved women. Aim: To better understand self-reported menopausal symptoms in underserved and homeless women living in extreme heat during different seasons. Methods: A cross-sectional study, including the Greene Climacteric Scale (GCS), climate-related questions, and demographics was administered June to August of 2017 and December to February 2018 to women 40-65 years of age. Results: In 104 predominantly Hispanic (56%), uninsured (53%), menopausal (56%), and mid-aged (50 ± 9.5) women, 57% reported any bother, while 20% of these women reported "quite a bit" or "extreme" bother from hot flushes. The total GCS score was a mean of 41 ± 15.0; out of 63 indicating significant symptoms, the psychological and somatic clusters were highest. Women did not think temperature outside influenced their menopausal symptoms at either time point (69% in winter vs. 57% in summer, p = 0.23). In multivariable analyses after adjusting for race, body mass index, and living situation neither season nor temperature was associated with self-reported hot flush bother. While one-third of women reported becoming ill from the heat, 90% of women reported not seeking care from a doctor for their illness. Conclusion: Menopausal, underserved, homeless women living in Arizona reported few vasomotor symptoms regardless of season, and endorsed psychological and somatic complaints. Socioeconomic factors may influence types of bothersome menopausal symptoms in this population of women.
Collapse
Affiliation(s)
- Mahnoor Mukarram
- Barrett, The Honors College at Arizona State University, Tempe, Arizona, USA
| | - Veena Rao
- Barrett, The Honors College at Arizona State University, Tempe, Arizona, USA
| | - Maheeyah Mukarram
- Barrett, The Honors College at Arizona State University, Tempe, Arizona, USA
| | - David M. Hondula
- School of Geographical Sciences and Urban Planning Arizona State University, Tempe, Arizona, USA
| | - Matthew R. Buras
- Department of Health Sciences Research, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Juliana M. Kling
- Division of Women's Health Internal Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| |
Collapse
|
14
|
Soltan MR, Raheem TAA, Soliman SS, Saleh NM, Khatery BH. Depression and anxiety as risk factors for female sexual pain. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00061-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Abstract
Background
Female sexual pain is a complex multifactorial condition. Most of researches have focused on underlying biomedical factors. Although psychological, psychiatric, and relational factors have been studied as possible correlates, limited research has been made in this area about the Egyptian population. The present study aimed to evaluate prevalence of female sexual pain among a sample of Egyptian females and detect its correlation with depression and anxiety. Female sexual function index (FSFI) was used to evaluate sexual pain in 450 women calculating their pain domain scores. Their scores were correlated to demographic data, genital health complaints, depression, and anxiety symptoms.
Results
The prevalence of marked severe sexual pain was 31.6% and that of trivial pain was 68.4% in the studied group. In the study group, 75 (16.7%) females had depressive symptoms, and 40 (8.9%) females had anxiety symptoms. Patients with severe depression had significantly marked severe pain than patients with minimal depression (p < 0.001 respectively). Patients with severe anxiety had significantly lower pain score than patients without (p < 0.001). Pain score had significant negative correlation with each of the depression score (r − 0.524, p < 0.001) and the anxiety score (r − 0.305, p < 0.001). Patients with gynecological causes especially fungal infection had significantly severe marked pain than patients without any other physical causes (< 0.001).
Conclusions
Anxiety, depression, and the presence of gynecological causes especially fungal infection were significantly independent risk factors for more sexual pain.
Collapse
|
15
|
Cortés YI, Marginean V, Berry D. Physiologic and psychosocial changes of the menopause transition in US Latinas: a narrative review. Climacteric 2020; 24:214-228. [PMID: 33174466 DOI: 10.1080/13697137.2020.1834529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Latinos comprise the fastest-growing minority group in the USA, with Hispanic women (Latinas) constituting 17% of women aged 45-54 years. The menopause transition (MT) is associated with many physiological, behavioral, and psychosocial changes that can affect disease risk in women. While several epidemiologic investigations have enhanced our understanding of the MT, to date, menopause research has mostly focused on non-Latina White women. As a consequence, there is a dearth of information on strategies for managing menopause-related issues in Latinas and important factors to consider to provide culturally appropriate care and promote lifestyles that may reduce adverse health outcomes. This narrative review summarizes existing evidence of the MT in Latinas, with a focus on hormonal alterations, menopausal symptoms, mental health, cognition, and cardiometabolic health. The clinical and research implications of the current literature will also be discussed.
Collapse
Affiliation(s)
- Y I Cortés
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - V Marginean
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
16
|
Ji X, Singleterry S, Kulikova A, Harrison Y, Shivakumar G, Brown ES. Association of menopause symptoms with depressive symptom severity in a diverse community-based sample. Maturitas 2020; 143:78-80. [PMID: 33308640 DOI: 10.1016/j.maturitas.2020.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/09/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
The Dallas Heart Study dataset was used to examine relationships between menopausal symptoms and depressive symptom severity in 384 women (37-73 years old) self-reporting as menopausal. Self-reported menopausal symptoms were grouped based on the Menopause-specific Quality of Life Questionnaire (MENQOL). Depressive symptom severity was assessed using the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). The relationship between menopause symptom groups, ethnicity and QIDS-SR was evaluated using multiple linear regression. Endorsement of sexual symptoms was positively associated with QIDS-SR score (β = .12, p = .031), suggesting that sexual dysfunction during menopause may be a predictor of underlying depressive symptoms.
Collapse
Affiliation(s)
- Xincheng Ji
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sydney Singleterry
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Alexandra Kulikova
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Yaprak Harrison
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Geetha Shivakumar
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States; VA North Texas Health Care System, Dallas, TX, United States
| | - E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, United States.
| |
Collapse
|
17
|
Bailey SC, Andrews EN, Halton CC, Wolf MS. Evaluation of a Discussion Guide to Promote Patient Understanding of Menopause and Informed Treatment Decision-Making. J Womens Health (Larchmt) 2020; 30:445-451. [PMID: 32857643 DOI: 10.1089/jwh.2020.8436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Patient-provider communication surrounding menopause symptoms and treatment is often limited. We developed and evaluated a health literacy-appropriate discussion guide to support patient education. Materials and Methods: A cross-sectional randomized study was conducted among 100 English-speaking women, aged 45-60 years, in Chicago, IL, and Durham, NC. Participants were randomly assigned to review either the discussion guide or a standard education material (n = 50 per arm) and to complete an open book knowledge questionnaire; they then rated the appearance and quality of both materials. Bivariate analyses examined knowledge and satisfaction by study arm and across sociodemographic characteristics. Multivariable models tested the effectiveness of the discussion guide to improve knowledge compared with the standard material. Results: Women receiving the discussion guide demonstrated significantly higher knowledge scores compared with those who reviewed the standard material (mean [M] = 20.0, standard deviation [SD] = 2.7, vs. M = 18.1, SD = 2.6; p < 0.001); 82.0% of those exposed to the discussion guide correctly answered ≥85% of knowledge items compared with only 48.0% of those reviewing the standard material (p < 0.001). In multivariable analyses, participants receiving the discussion guide displayed significantly greater knowledge in comparison with those receiving the standard material regardless of whether knowledge was examined as a score (∝ = 1.9, 95% confidence interval [CI]: 0.9-2.9, p < 0.001) or 85% threshold (odds ratio: 5.7, 95% CI: 2.0-16.2, p < 0.001). More than two-thirds of women (68%) preferred the discussion guide; it was rated highly in terms of appearance and content. Conclusions: The discussion guide improved understanding of menopause symptoms and treatment options in comparison with a current standard and was well received by a diverse audience.
Collapse
Affiliation(s)
- Stacy Cooper Bailey
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Emma N Andrews
- U.S./Global Medical Affairs, Pfizer, Inc., New York, New York, USA
| | - Candida C Halton
- School of Social Sciences, University of Westminster, London, United Kingdom.,Consultant at Studio Health, London, United Kingdom
| | - Michael S Wolf
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
18
|
Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial. J Sex Med 2020; 17:1467-1475. [PMID: 32273244 DOI: 10.1016/j.jsxm.2020.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Poor sleep quality consequences among shift working nurses are well recognized. AIM To investigate the impact of sleep improvement on sexual quality of life. METHODS The study was a parallel randomized controlled trial, conducted among 120 female nurses in 2 educational hospitals in the Northeast of Iran, Shahroud. Using random blocks of four, 120 eligible participants were randomly assigned to study groups. Data collecting tools included a demographic data questionnaire, Pittsburgh Sleep Quality Index to assess sleep quality, and the survey of sexual quality of life-female and Sexual Self-Efficacy Questionnaire to evaluate level of sexual quality of life and sexual self-efficacy, respectively. The intervention consisted of 3 weekly sleep intervention sessions that lasted from 90 to 120 minutes. OUTCOMES The study's primary and secondary outcomes were sleep quality, and the level of sexual self-efficacy and sexual quality of life, respectively. RESULTS By 3-month follow-up, the loss to follow-up rate was 5.9%. The mean sleep quality score was 7.61 ± 2.26 in the recruited participants. Following the intervention, the sleep quality score showed statistically significant differences compared to the control group [mean difference (CI 99.98%), -1.89 (-2.40, -1.38)]. Participants in the intervention group showed modest increases in both measures; sexual self-efficacy [mean difference (CI 99.98%), 8.82 (6.83, 10.81)] and sexual quality of life [mean difference (CI 99.98%), 19.64 (18.08, 21.20)]. CLINICAL IMPLICATIONS These findings suggest that sleep improvement could promote the sexual quality of life among shift working nurses. STRENGTHS & LIMITATIONS Strengths of this study include the use of a validated outcome measure. Focusing the study on female nurses and the small size of the study population are the limitations. CONCLUSION Improved sleep showed an impact on sexual quality of life among rotating female shift workers. Khastar H, Mirrezaie SM, Chashmi NA, et al. Sleep Improvement Effect on Sexual Life Quality Among Rotating Female Shift Workers: A Randomized Controlled Trial. J Sex Med 2020;17:1467-1475.
Collapse
|
19
|
Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. Biomed Pharmacother 2019; 112:108585. [DOI: 10.1016/j.biopha.2019.01.046] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 02/07/2023] Open
|
20
|
Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities. Sex Med Rev 2019; 8:3-17. [PMID: 30928249 DOI: 10.1016/j.sxmr.2018.12.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Dyspareunia has been traditionally divided into superficial (introital) dyspareunia and deep dyspareunia (pain with deep penetration). While deep dyspareunia can coexist with a variety of conditions, recent work in endometriosis has demonstrated that coexistence does not necessarily imply causation. Therefore, a reconsideration of the literature is required to clarify the pathophysiology of deep dyspareunia. AIMS To review the pathophysiology of deep dyspareunia, and to propose future research priorities. METHODS A narrative review after appraisal of published frameworks and literature search with the terms (dyspareunia AND endometriosis), (dyspareunia AND deep), (dyspareunia AND (pathophysiology OR etiology)). MAIN OUTCOME VARIABLE Deep dyspareunia (present/absent or along a pain severity scale). RESULTS The narrative review demonstrates potential etiologies for deep dyspareunia, including gynecologic-, urologic-, gastrointestinal-, nervous system-, psychological-, and musculoskeletal system-related disorders. These etiologies can be classified according to anatomic mechanism, such as contact with a tender pouch of Douglas, uterus-cervix, bladder, or pelvic floor, with deep penetration. Etiologies of deep dyspareunia can also be stratified into 4 categories, as previously proposed for endometriosis specifically, to personalize management: type I (primarily gynecologic), type II (nongynecologic comorbid conditions), type III (central sensitization and genito-pelvic pain/penetration disorder), and type IV (mixed). We also identified gaps in the literature, such as lack of a validated patient-reported questionnaire or an objective measurement tool for deep dyspareunia and clinical trials not powered for sexual outcomes. CONCLUSION We propose the following research priorities for deep dyspareunia: deep dyspareunia measurement tools, inclusion of the population avoiding intercourse due to deep dyspareunia, nongynecologic conditions in the generation of deep dyspareunia, exploration of sociocultural factors, clinical trials with adequate power for deep dyspareunia outcomes, partner variables, female sexual response, pathways between psychological factors and deep dyspareunia, and personalized approaches to deep dyspareunia. Orr N, Wahl K, Joannou A, et al. Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities. Sex Med Rev 2020;8:3-17.
Collapse
|
21
|
Segura A, Ballester P, Ajo R, Inda MDM, Urbano A, Muriel J, Ochando I, Margarit C, Martinez E, Peiró AM. Endothelial nitric oxide synthase gene polymorphisms and erectile dysfunction in chronic pain. Gene 2019; 1:100005. [PMID: 32550542 PMCID: PMC7285905 DOI: 10.1016/j.gene.2019.100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/29/2018] [Accepted: 12/17/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate whether endothelial nitric oxide synthase (eNOS) T786C, 4VNTR and G894 T gene polymorphisms could mediate in andrological treatment response in Spaniards. SUBJECT PATIENTS/METHODS The study participants were Spaniard males with erectile dysfunction (ED) and chronic pain (n = 105) recruited at the Pain Unit. eNOS polymorphisms were genotyped by quantitative polymerase chain reaction using Taqman specific probes. Statistical analyses were carried out using R-3.2.4 software. RESULTS A total of 69 patients required andrological treatment and 76% of them improved ED upon iPED5 (20%), testosterone (35%) or iPDE5/testosterone treatment (45%); being significantly better in T786C-CC patients. Multivariate regression analysis indicated that age, opioid daily dose and carriage of T786C-C allele influenced the risk and ED severity in Spaniard chronic pain patients. CONCLUSION T786C polymorphism at eNOS locus appeared to be a major contributor in the variable erectile function iPDE5/testosterone response in Spaniards.
Collapse
Key Words
- BMI, body mass index
- CNP, chronic non-cancer pain
- Chronic pain
- ED, erectile dysfunction
- EF, Erectile function
- Erectile dysfunction
- IIEF, International Index of Erectile Function
- NO, nitric oxide
- Pharmacogenetics
- T786C
- VAS, Visual analogue scale
- cGMP, 3′,5′-cyclic guanosine monophosphate
- eNOS gene
- eNOS, endothelial nitric oxide synthase
- iPDE5
- iPDE5, phosphodiesterase type 5 inhibitors
- mSLQQ-QOL, modified Sexual Life Quality Questionnaire
Collapse
Affiliation(s)
- Ana Segura
- Andrology Unit, University General Hospital of Alicante (HGUA), Alicante, Spain
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Pura Ballester
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Raquel Ajo
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - María-del-Mar Inda
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Antonio Urbano
- Genetics Unit, Clínica Vistahermosa HLA-Hospital, Alicante, Spain
- Histology and Anatomy Department, Miguel Hernández University (UMH), Alicante, Spain
| | - Javier Muriel
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
- Occupational Observatory, University Miguel Hernández of Elche (UMH), Alicante, Spain
| | - Isabel Ochando
- Genetics Unit, Clínica Vistahermosa HLA-Hospital, Alicante, Spain
- Histology and Anatomy Department, Miguel Hernández University (UMH), Alicante, Spain
| | - César Margarit
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
- Pain Unit, HGUA, Alicante, Spain
| | | | - Ana M. Peiró
- Neuropharmacology on Pain Research Unit, Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO), Alicante, Spain
- Clinical Pharmacology, HGUA, Alicante, Spain
| |
Collapse
|
22
|
Female sexual dysfunction in Egyptian women with anxiety: prevalence and patterns. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0896-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
23
|
Stout ME, Meints SM, Hirsh AT. Loneliness Mediates the Relationship Between Pain During Intercourse and Depressive Symptoms Among Young Women. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1687-1696. [PMID: 29511895 PMCID: PMC6035118 DOI: 10.1007/s10508-017-1138-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 11/16/2017] [Accepted: 12/13/2017] [Indexed: 06/08/2023]
Abstract
Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p < .05). Results of the mediation analysis indicated that loneliness was a significant mediator of the relationship between pain during intercourse and depressive symptoms (indirect effect = 0.077; 95% CI 0.05-0.19). After accounting for loneliness, pain during intercourse was not significantly related to depressive symptoms, suggesting that loneliness fully mediated the relationship between pain during intercourse and depressive symptoms. These findings are consistent with previous studies highlighting that pain during intercourse is related to depressive symptoms. The current study adds to that literature and suggests that more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms. This line of work has important implications for treating women who experience depressive symptoms and pain during intercourse.
Collapse
Affiliation(s)
- Madison E Stout
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Samantha M Meints
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University at Indianapolis, 402 N Blackford St., Indianapolis, IN, 46202, USA.
| |
Collapse
|
24
|
van Driel CM, Stuursma A, Schroevers MJ, Mourits MJ, de Bock GH. Mindfulness, cognitive behavioural and behaviour-based therapy for natural and treatment-induced menopausal symptoms: a systematic review and meta-analysis. BJOG 2018. [PMID: 29542222 PMCID: PMC6585818 DOI: 10.1111/1471-0528.15153] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background During menopause women experience vasomotor and psychosexual symptoms that cannot entirely be alleviated with hormone replacement therapy (HRT). Besides, HRT is contraindicated after breast cancer. Objectives To review the evidence on the effectiveness of psychological interventions in reducing symptoms associated with menopause in natural or treatment‐induced menopausal women. Search strategy Medline/Pubmed, PsycINFO, EMBASE and AMED were searched until June 2017. Selection criteria Randomised controlled trials (RCTs) concerning natural or treatment‐induced menopause, investigating mindfulness or (cognitive‐)behaviour‐based therapy were selected. Main outcomes were frequency of hot flushes, hot flush bother experienced, other menopausal symptoms and sexual functioning. Data collection and analysis Study selection and data extraction were performed by two independent researchers. A meta‐analysis was performed to calculate the standardised mean difference (SMD). Main results Twelve RCTs were included. Short‐term (<20 weeks) effects of psychological interventions in comparison to no treatment or control were observed for hot flush bother (SMD −0.54, 95% CI −0.74 to −0.35, P < 0.001, I2 = 18%) and menopausal symptoms (SMD −0.34, 95% CI −0.52 to −0.15, P < 0.001, I2 = 0%). Medium‐term (≥20 weeks) effects were observed for hot flush bother (SMD −0.38, 95% CI −0.58 to −0.18, P < 0.001, I2 = 16%). [Correction added on 9 July 2018, after first online publication: there were miscalculations of the mean end point scores for hot flush bother and these have been corrected in the preceding two sentences.] In the subgroup treatment‐induced menopause, consisting of exclusively breast cancer populations, as well as in the subgroup natural menopause, hot flush bother was reduced by psychological interventions. Too few studies reported on sexual functioning to perform a meta‐analysis. Conclusions Psychological interventions reduced hot flush bother in the short and medium‐term and menopausal symptoms in the short‐term. These results are especially relevant for breast cancer survivors in whom HRT is contraindicated. There was a lack of studies reporting on the influence on sexual functioning. Tweetable abstract Systematic review: psychological interventions reduce bother by hot flushes in the short‐ and medium‐term. Systematic review: psychological interventions reduce bother by hot flushes in the short‐ and medium‐term.
Collapse
Affiliation(s)
- C M van Driel
- Department of Obstetrics & Gynaecology, University Medical Centre Groningen, Groningen, the Netherlands.,Department of Epidemiology, University Medical Centre Groningen, Groningen, the Netherlands
| | - A Stuursma
- Department of Obstetrics & Gynaecology, University Medical Centre Groningen, Groningen, the Netherlands.,Department of Epidemiology, University Medical Centre Groningen, Groningen, the Netherlands
| | - M J Schroevers
- Department of Health Psychology, University Medical Centre Groningen, Groningen, the Netherlands
| | - M J Mourits
- Department of Obstetrics & Gynaecology, University Medical Centre Groningen, Groningen, the Netherlands
| | - G H de Bock
- Department of Epidemiology, University Medical Centre Groningen, Groningen, the Netherlands
| |
Collapse
|
25
|
Vencill JA, Carlson S, Iantaffi A, Miner M. Mental health, relationships, and sex: exploring patterns among bisexual individuals in mixed orientation relationships. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1419570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Jennifer A. Vencill
- Program in Human Sexuality, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Samantha Carlson
- Program in Human Sexuality, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Michael Miner
- Program in Human Sexuality, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
26
|
Perich T, Ussher J, Parton C. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder. BMC WOMENS HEALTH 2017; 17:110. [PMID: 29145856 PMCID: PMC5689207 DOI: 10.1186/s12905-017-0467-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Background Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Results Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’. Conclusions The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices. Electronic supplementary material The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia. .,School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| |
Collapse
|
27
|
Costa R, Costa D, Pestana J. Subjective sleep quality, unstimulated sexual arousal, and sexual frequency. ACTA ACUST UNITED AC 2017; 10:147-153. [PMID: 29410746 PMCID: PMC5760048 DOI: 10.5935/1984-0063.20170026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction REM sleep deprivation increases unstimulated erections in rats, and total sleep deprivation increases erections during audiovisual sexual stimulation in men, but the effects of sleep problems on human unstimulated sexual arousal are unknown. Objective We examined the associations of subjective sleep quality with unstimulated sexual arousal, satisfaction with sex life, and sexual frequency and desire over the past month. Methods 275 Portuguese (169 women) reported their anxiety, sexual arousal and sexual desire during a resting state, and completed the Pittsburgh Sleep Quality Index, the sexual satisfaction subscale of the LiSat scale, the Desire dimensions of the Female Sexual Function Index (women only) and International Index of Erectile Function (men only). They additionally reported how many days in the past month they engaged in penile-vaginal intercourse, noncoital sex, and masturbation. Salivary testosterone (T) was assayed by luminescence immunoassays. Results Poorer sleep quality correlated with greater unstimulated sexual arousal in men with higher T levels and in women with higher T levels not taking oral contraceptives. In women with lower T, poorer subjective sleep quality correlated with greater sexual dissatisfaction. In both sexes, sleep quality was uncorrelated with sexual desire and sexual frequency over the past month. Discussion Consistently with other studies in humans and animals, the findings are congruent with the notion that lack of sleep can increase sexual arousal, but not sexual frequency. T might play a role in the sexual arousal caused by lack of appropriate sleep.
Collapse
Affiliation(s)
- Rui Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - David Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - José Pestana
- ISPA - Instituto Universitário, - Lisbon - Portugal
| |
Collapse
|
28
|
Costa RM, Oliveira TF. Poorer Subjective Sleep Quality Is Related to Higher Fantasy-Induced Sexual Arousal in Women of Reproductive Age. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:740-748. [PMID: 26549821 DOI: 10.1080/0092623x.2015.1113591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Lack of sleep enhances erections and lubrication the next day. This raises the possibility that poorer subjective sleep quality is related to sexual arousal. To test this hypothesis, sexual arousal was elicited in 70 Portuguese women of reproductive age by means of fantasy. The level of salivary testosterone before and shortly after fantasy was determined by luminescence immunoassays. Participants completed the Pittsburgh Sleep Quality Index (PSQI), reported their sexual arousal before and during fantasy, and how anxious they were after the fantasy. The hypothesis was confirmed. Anxiety did not explain the association, but testosterone response (poststimulus minus baseline) had a slight explanatory effect.
Collapse
Affiliation(s)
- Rui M Costa
- a Unidade de Investigação em Eco-Etologia , ISPA-Instituto Universitário , Lisbon , Portugal
| | - Tânia F Oliveira
- a Unidade de Investigação em Eco-Etologia , ISPA-Instituto Universitário , Lisbon , Portugal
| |
Collapse
|
29
|
Ajo R, Segura A, Inda MM, Planelles B, Martínez L, Ferrández G, Sánchez A, César Margarit, Peiró AM. Opioids Increase Sexual Dysfunction in Patients With Non-Cancer Pain. J Sex Med 2016; 13:1377-1386. [DOI: 10.1016/j.jsxm.2016.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 01/23/2023]
|
30
|
Sung SC, Jiang HH, Chen RR, Chao JK. Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes. J Clin Nurs 2016; 25:2989-3000. [DOI: 10.1111/jocn.13441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Su-Ching Sung
- Graduate Institute of Health Care; Chang Gung University of Science and Technology; Taoyuan City Taiwan
| | - Huey-Hwa Jiang
- Department of Nursing; Taipei Veterans General Hospital Yuli Branch; Yuli Township Hualian County Taiwan
| | - Ru-Rong Chen
- Medication & Health Center; Banqiao Veterans Home; Veterans Affairs Council; New Taipei City Taiwan
| | - Jian-Kang Chao
- Department of Psychiatry; Pingtung Branch; Kaohsiung Veterans General Hospital; Pingtung Taiwan
- Department of Health Administration; Tzu Chi
University of Science and Technology; Hualien County Taiwan
| |
Collapse
|
31
|
Pimenta F, Maroco J, Leitão M, Leal I. Predictors of stress and depressive mood in Portuguese middle-aged women. J Women Aging 2016; 28:444-53. [DOI: 10.1080/08952841.2015.1018058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
32
|
Thomas HN, Thurston RC. A biopsychosocial approach to women's sexual function and dysfunction at midlife: A narrative review. Maturitas 2016; 87:49-60. [PMID: 27013288 PMCID: PMC4808247 DOI: 10.1016/j.maturitas.2016.02.009] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/15/2016] [Indexed: 01/21/2023]
Abstract
A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.
Collapse
Affiliation(s)
- Holly N Thomas
- University of Pittsburgh, Department of Medicine, United States.
| | | |
Collapse
|
33
|
Vencill JA, Tebbe EA, Garos S. It’s Not the Size of the Boat or the Motion of the Ocean. PSYCHOLOGY OF WOMEN QUARTERLY 2015. [DOI: 10.1177/0361684315587703] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Research on psychological factors related to female sexual functioning has been growing in recent years. Our study draws on the existing sexual health literature and objectification theory to test a model of female sexual functioning. Using structural equation modeling, we examined the associations of body surveillance and internalization of cultural standards of beauty with appearance anxiety, depression, and sexual health (i.e., physical sexual functioning and subjective sexual well-being) in a sample of 426 sexually active, heterosexual, cisgender women. Further, we investigated the role of depression and appearance anxiety as mediators of the associations of body surveillance and internalization of cultural standards of beauty with sexual health. Our findings contribute to the growing body of empirical research that examines the role of sociocultural and psychological factors in female sexual functioning. Results suggest that depression and appearance anxiety fully mediated the relations of body surveillance with sexual well-being. However, internalization of cultural standards of beauty was not significant with any study outcomes. These findings expand on existing objectification theory literature by elucidating the associations of body surveillance and internalization of cultural standards of beauty with sexual functioning as well as by highlighting the importance of attending to body image, appearance anxiety, and depression when working clinically with women reporting concerns with their sexual functioning.
Collapse
Affiliation(s)
- Jennifer A. Vencill
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Elliot A. Tebbe
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| |
Collapse
|
34
|
Hughes AK, Rostant OS, Pelon S. Sexual Problems Among Older Women by Age and Race. J Womens Health (Larchmt) 2015; 24:663-9. [PMID: 26061291 DOI: 10.1089/jwh.2014.5010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The purpose of our study was to examine the prevalence of sexual problems by age and race among older women in the United States and to examine quality of life correlates to sexual dysfunction among non-Hispanic white and African American older women. METHODS A cross-sectional study using self-report surveys was conducted among community-dwelling U.S. women, aged 60 years and over. A total of 807 women aged 61-89 years were included. Self-administered questionnaires assessed sexual dysfunction, satisfaction with life, depressive symptomatology, and self-rated health. Analyses included multivariate logistic regression. RESULTS The mean age of the sample was 66 years. Two-thirds of the sample had at least one sexual dysfunction; the most common for both African American and non-Hispanic white women were lack of interest in sex and vaginal dryness. Prevalence varied by age for each of the sexual dysfunctions. The odds of experiencing sexual dysfunction varied with age and race. Compared with non-Hispanic white women, African American women had lower odds of reporting lack of interest in sex or vaginal dryness. Poor self-rated health, depressive symptomatology, and lower satisfaction with life were associated with higher odds of having some sexual dysfunction. CONCLUSIONS Improved understanding of how sexual dysfunction affects women across multiple age ranges and racial/ethnic groups can assist providers in making recommendations for care that are patient centered. The associations that we identified with quality of life factors highlight the need to assess sexual health care in the aging female population.
Collapse
Affiliation(s)
- Anne K Hughes
- 1 School of Social Work, Michigan State University , East Lansing, Michigan
| | - Ola S Rostant
- 2 The National Institute on Aging Intramural Research Program, National Institutes of Health , Baltimore, Maryland
| | - Sally Pelon
- 1 School of Social Work, Michigan State University , East Lansing, Michigan
| |
Collapse
|
35
|
Kimmes JG, Mallory AB, Cameron C, Köse Ö. A treatment model for anxiety-related sexual dysfunctions using mindfulness meditation within a sex-positive framework. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1013023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
36
|
Petersen M, Kristensen E, Berg S, Midgren B. Long-term effects of continuous positive airway pressure treatment on sexuality in female patients with obstructive sleep apnea. Sex Med 2014; 1:62-8. [PMID: 25356289 PMCID: PMC4184499 DOI: 10.1002/sm2.18] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction Results from a previous study showed that sexuality was negatively affected in females with untreated obstructive sleep apnea (OSA). Data are sparse on the long-term effects of nocturnal continuous positive airway pressure (CPAP) treatment on sexual difficulties and sexual distress in female patients with OSA. Aim The aim of the present study was to investigate the effects after 1 year of CPAP treatment on sexual difficulties, sexual distress, and manifest sexual dysfunction in female patients with OSA. The effect of CPAP on life satisfaction was also investigated. Methods Fifty-four therapy-compliant, female patients (age 22–71) received a survey before and after 1 year of nocturnal CPAP treatment. The questions on this survey were drawn from three self-administered questionnaires: two on sexuality and one on life satisfaction. The results were compared with a population sample. The Epworth Sleepiness Scale was used for assessment of daytime sleepiness. Main Outcome Measures The Female Sexual Function Index, Female Sexual Distress Scale, Manifest Female Sexual Dysfunction, four questions from Life Satisfaction 11, and the Epworth Sleepiness Scale were all used to measure outcome. Results In total, 44 patients responded to the survey (81% response rate). The results were a significant, positive change in manifest female sexual dysfunction, but no significant changes in isolated sexual difficulties or sexual distress. Daytime sleepiness significantly decreased after 1 year. The results from the Life Satisfaction 11 questionnaire remained unchanged after 1 year. Conclusions After 1 year of CPAP treatment, female patients with OSA reported reduced manifest sexual dysfunction. However, it cannot be concluded if this result is due to CPAP treatment alone. Furthermore, reduced daytime tiredness was found in the surveyed population. CPAP treatment, per se, does not seem to affect partner relationships. Petersen M, Kristensen E, Berg S, and Midgren B. Long-term effects of continuous positive airway pressure treatment on sexuality in female patients with obstructive sleep apnea. Sex Med 2013;1:62–68.
Collapse
Affiliation(s)
- Marian Petersen
- The Neuroscience Centre, Rigshospital Copenhagen, Denmark ; Department of Respiratory Medicine and Allergology, Lund University Lund, Sweden
| | - Ellids Kristensen
- Sexological Clinic, Psychiatric Centre Copenhagen, University Hospital of Copenhagen Copenhagen, Denmark ; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen Copenhagen, Denmark
| | - Søren Berg
- Department of ENT, Head and Neck Cancer, Lund University Lund, Sweden
| | - Bengt Midgren
- Department of Respiratory Medicine and Allergology, Lund University Lund, Sweden
| |
Collapse
|
37
|
Sliwinski JR, Johnson AK, Elkins GR. Memory Decline in Peri- and Post-menopausal Women: The Potential of Mind-Body Medicine to Improve Cognitive Performance. INTEGRATIVE MEDICINE INSIGHTS 2014; 9:17-23. [PMID: 25125972 PMCID: PMC4125424 DOI: 10.4137/imi.s15682] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/10/2014] [Accepted: 06/11/2014] [Indexed: 12/17/2022]
Abstract
Cognitive decline is a frequent complaint during the menopause transition and among post-menopausal women. Changes in memory correspond with diminished estrogen production. Further, many peri- and post-menopausal women report sleep concerns, depression, and hot flashes, and these factors may contribute to cognitive decline. Hormone therapy can increase estrogen but is contraindicated for many women. Mind-body medicine has been shown to have beneficial effects on sleep, mood, and hot flashes, among post-menopausal women. Further, mind-body medicine holds potential in addressing symptoms of cognitive decline post-menopause. This study proposes an initial framework for how mind-body interventions may improve cognitive performance and inform future research seeking to identify the common and specific factors associated with mind-body medicine for addressing memory decline in peri- and post-menopausal women. It is our hope that this article will eventually lead to a more holistic and integrative approach to the treatment of cognitive deficits in peri- and post-menopausal women.
Collapse
Affiliation(s)
- Jim R Sliwinski
- Department of Psychology and Neuroscience, Mind-Body Medicine Research Laboratory, Baylor University, Waco, Texas, USA
| | - Aimee K Johnson
- Department of Psychology and Neuroscience, Mind-Body Medicine Research Laboratory, Baylor University, Waco, Texas, USA
| | - Gary R Elkins
- Department of Psychology and Neuroscience, Mind-Body Medicine Research Laboratory, Baylor University, Waco, Texas, USA
| |
Collapse
|
38
|
Regulation of the mouse medial prefrontal cortical synapses by endogenous estradiol. Neuropsychopharmacology 2014; 39:2086-94. [PMID: 24608267 PMCID: PMC4104325 DOI: 10.1038/npp.2014.56] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 02/28/2014] [Accepted: 03/04/2014] [Indexed: 12/16/2022]
Abstract
Recent studies suggest that low endogenous estradiol might be a susceptibility factor for anxiety and trauma-related disorders in women. Consistently, fear extinction, a form of inhibitory learning critical for the management of anxiety symptoms, is positively correlated with endogenous estradiol levels. To understand the synaptic basis of the effect of endogenous estradiol on fear extinction, we studied glutamatergic transmission and plasticity in the infralimbic medial prefrontal cortex (IL-mPFC), a brain region crucial for the regulation of fear extinction. Diestrus mice (low estradiol) exhibited a higher basal glutamatergic transmission compared with proestrus mice (high estradiol). Synaptic plasticity was also regulated by endogenous estradiol, which favored synaptic potentiation in a GluN2B-dependent manner. Activation of estrogen receptor β (ERβ) but not ERα rescued synaptic potentiation in diestrus mice by enhancing GluN2B-mediated NMDA receptor transmission. Our results suggest that both endogenous estradiol and ERβ activation facilitate the ability of the IL-mPFC synapses to undergo potentiation, a mechanism necessary for the regulation of fear extinction.
Collapse
|
39
|
Epidemiology of the symptoms of menopause - an intercontinental review. MENOPAUSE REVIEW 2014; 13:203-11. [PMID: 26327856 PMCID: PMC4520365 DOI: 10.5114/pm.2014.43827] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/05/2014] [Accepted: 05/19/2014] [Indexed: 11/23/2022]
Abstract
Introduction The age of menopause is a time of many changes in the psychophysical-social functioning of women, with reduced ovarian hormonal activity and estrogen levels. The most common, troublesome symptoms of menopause age include depressive disorders, sleep disorders, sexual dysfunction, discomfort associated with muscle pain, joint aches, osteoporosis and characteristic hot flashes. Aim of the study Aim of the study is to determine and compare the rate of menopausal symptoms among women living in continents of both Americas, Africa, Australia and Eurasia. Material and methods The results of this work were obtained in 2014 on the basis of the data from a review of the 64 most important studies using the PubMed database. Research published in the period 2000-2014, from Africa, both Americas, Australia and Eurasia, were taken into account. Results The prevalence of menopausal symptoms in African women is disconcertingly high. Women from South America complain about occurrence of depressive, sexual dysfunctions and discomfort associated with muscle pain and joint aches. Symptoms most reported by women in the United States are pains associated with muscles and joints. Women in Australia suffer mainly due to vasomotor symptoms and sexual dysfunction, while in the group of women surveyed in Asia there is observed an alarming increase in the proportion of women reporting depressive disorders. In Europe there was a much greater incidence of sleep disorders and depressive disorders. Conclusions Women around the world suffer from ailments characteristic for the menopausal period regardless of ethnic origin, skin color or socio-demographic factors.
Collapse
|
40
|
Kottmel A, Ruether-Wolf KV, Bitzer J. Do gynecologists talk about sexual dysfunction with their patients? J Sex Med 2014; 11:2048-54. [PMID: 24903187 DOI: 10.1111/jsm.12603] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Female sexual problems and dysfunctions have a high prevalence, ranging from 12% to 80%, depending on the definition being used, underlying comorbidities, and age. Despite the high prevalence, there are only scarce data about the approach gynecologists use to address female sexual dysfunction. AIM The aim of this study is to evaluate the approach of Swiss gynecologists to addressing sexual problems among their outpatients. METHODS After a pilot study including 56 physicians, a modified 19-item self-administered questionnaire was sent to 856 Swiss gynecologists to evaluate their methods of management of patients with sexual issues and their attitudes regarding the integration of sexual health issues into the gynecological consultation. MAIN OUTCOME MEASURES Besides demographic information, the self-administered questionnaire included questions about addressing sexual health as part of consultation routine, estimated frequency of symptoms, reasons for not addressing sexuality, clinical conditions in which sexuality was addressed, and methods of management of sexual problems. RESULTS Of the 341 responding gynecologists (39.8% response rate), 40.4% reported having at least brief (at least 1-2 days) of training in sexual medicine, 7.9% of the respondents routinely explored sexual issues with more than 80% of their patients, 28.2% of the respondents offered appointments specifically for sexual issues, and 85% proposed referrals to specialized colleagues. Lack of motivation for therapy on the part of the patient was mentioned as the most common cause for persisting symptoms (63.3%). Dyspareunia was quoted as the most/second most prevalent type of female sexual dysfunction by 77.1% of the respondents. CONCLUSION We conclude that among Swiss gynecologists, sexual problems are regarded as an important issue in gynecological outpatient care, but addressing patients' sexuality is not yet part of routine practice. Swiss gynecologists seem to be most likely to consider hormonal changes (although not so much those due to oral contraceptives) to necessitate discussion of sexual health issues, while psychosocial transitions or stress seem to be considered less important.
Collapse
Affiliation(s)
- Andrea Kottmel
- Department of Obstetrics and Gynecology, Kaiser Franz Josef Hospital, Vienna, Austria
| | | | | |
Collapse
|
41
|
Senturk Erenel A, Golbasi Z, Kavlak T, Dilbaz S. Relationship between menopausal symptoms and sexual dysfunction among married
T
urkish women in 40–65 age group. Int J Nurs Pract 2014; 21:575-83. [DOI: 10.1111/ijn.12309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Zehra Golbasi
- Department of NursingFaculty of Health ScienceCumhuriyet University Sivas Turkey
| | - Tulay Kavlak
- Gulhane Military Medical Academy Hospital Ankara Turkey
| | | |
Collapse
|
42
|
Silveira LR, Romão APMS, Vieira CS, de Sá Rosa E Silva ACJ, Reis RM, Ferriani RA, Navarro PADAS, Lara LADS. Sexual function of women practicing sex in nonconventional settings. JOURNAL OF SEX & MARITAL THERAPY 2014; 41:294-303. [PMID: 24512136 DOI: 10.1080/0092623x.2014.889055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The quality of sexual intercourse in the context of conjugal visits by women to their jailed partners is unknown. This study aimed to assess the quality of the sex lives and psychological conditions of women attending conjugal visits with their jailed inmate partners. This controlled study involved 124 women between the ages of 18 to 40 years who engaged in sexual relations with their inmate partners (conjugal visit group) or with their partners at home (control group). Sexual function was assessed using a semi-structured questionnaire and the Female Sexual Function Index, and psychological parameters were evaluated using the Hospital Anxiety and Depression scale. The total Female Sexual Function Index scores was similar in the 2 groups. The percentage of women reporting good quality of the relationship was significantly higher in the conjugal visit group. Also, the Hospital Anxiety and Depression scale scores were higher in the conjugal visit group. Depression was a risk factor for sexual dysfunction and had a negative effect on scores in the desire, excitement, lubrication, and sexual satisfaction domains, whereas anxiety was associated with lower sexual desire scores. A regular + poor quality of the relationship and being religious were factors associated with sexual dysfunction. Sexual practices in jail were not a risk for sexual dysfunction in this sample.
Collapse
Affiliation(s)
- Liliam Renata Silveira
- a Sexual Medicine Service of the Sector of Human Reproduction, Department of Gynaecology and Obstetrics, Faculty of Medicine of Ribeirão Preto , São Paulo University , Ribeirão Preto , Brazil
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Ninan I. Synaptic regulation of affective behaviors; role of BDNF. Neuropharmacology 2013; 76 Pt C:684-95. [PMID: 23747574 DOI: 10.1016/j.neuropharm.2013.04.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 03/31/2013] [Accepted: 04/02/2013] [Indexed: 12/23/2022]
Abstract
Brain derived neurotrophic factor (BDNF), a neurotrophin essential for nervous system development and synaptic plasticity, has been found to have a significant influence on affective behaviors. The notion that an impairment in BDNF signaling might be involved in affective disorders is originated primarily from the opposing effects of antidepressants and stress on BDNF signaling. Antidepressants enhance BDNF signaling and synaptic plasticity. On the other hand, negative environmental factors such as severe stress suppress BDNF signaling, impair synaptic activity and increase susceptibility to affective disorders. Postmortem studies provided strong support for decreased BDNF signaling in depressive disorders. Remarkably, studies in humans with a single nucleotide polymorphism in the BDNF gene, the BDNF Val66Met which affects regulated release of BDNF, showed profound deficits in hippocampal and prefrontal cortical (PFC) plasticity and cognitive behaviors. BDNF regulates synaptic mechanisms responsible for various cognitive processes including attenuation of aversive memories, a key process in the regulation of affective behaviors. The unique role of BDNF in cognitive and affective behaviors suggests that cognitive deficits due to altered BDNF signaling might underlie affective disorders. Understanding how BDNF modulates synapses in neural circuits relevant to affective behaviors, particularly the medial prefrontal cortical (mPFC)-hippocampus-amygdala pathway, and its interaction with development, sex, and environmental risk factors might shed light on potential therapeutic targets for affective disorders. This article is part of the Special Issue entitled 'BDNF Regulation of Synaptic Structure, Function, and Plasticity'.
Collapse
Affiliation(s)
- Ipe Ninan
- Department of Psychiatry, NYU School of Medicine, SKI 5-3, 540 1st Ave, NY 10016, United States.
| |
Collapse
|
44
|
Lozano Hernández E, Márquez Hernández V, Moya Diéguez JM, Alarcón Rodríguez R. [Changes in sexuality during the menopause]. Aten Primaria 2013; 45:329-30. [PMID: 23374748 PMCID: PMC6983578 DOI: 10.1016/j.aprim.2012.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 12/11/2012] [Accepted: 12/17/2012] [Indexed: 11/03/2022] Open
|
45
|
Williams AA, Williams M. A guide to performing pelvic speculum exams: a patient-centered approach to reducing iatrogenic effects. TEACHING AND LEARNING IN MEDICINE 2013; 25:383-391. [PMID: 24112210 DOI: 10.1080/10401334.2013.827969] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Current training in the United States for pelvic speculum examinations (PSEs) has a primary focus on the physician-centered goal of visualizing the cervix but may not inform practitioners of potential iatrogenic effects. Such oversight leaves trainees unprepared and unskilled in preventing and addressing adverse outcomes. This article incorporates a literature review into a step-by-step guide to aid the teaching of PSEs. SUMMARY Iatrogenic effects of PSEs may include mild discomfort, extreme pain, anxiety, psychological (re)traumatization, and sexual pain disorders. A literature-based guide is presented to identify patients at risk for adverse outcomes, set up the exam room, set up the patient, perform the exam, calm distressed patients, and avoid exam-interfering behaviors. CONCLUSIONS Although PSEs can lead to adverse outcomes, awareness of the iatrogenic effects allows clinicians to utilize techniques to prevent or reduce negative effects. A method of incorporating techniques described in this article into teaching is provided.
Collapse
Affiliation(s)
- Adrienne A Williams
- a Department of Family and Community Medicine , University of Maryland School of Medicine , Baltimore , Maryland , USA
| | | |
Collapse
|
46
|
Assessment of sexual function and related factors in mid-aged sexually active Spanish women with the six-item Female Sex Function Index. Menopause 2012; 19:1224-30. [DOI: 10.1097/gme.0b013e3182546242] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
47
|
Quality of life in a large cohort of mid-aged Colombian women assessed using the Cervantes Scale. Menopause 2012; 19:924-30. [DOI: 10.1097/gme.0b013e318247908d] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
48
|
Lebron-Milad K, Milad MR. Sex differences, gonadal hormones and the fear extinction network: implications for anxiety disorders. BIOLOGY OF MOOD & ANXIETY DISORDERS 2012; 2:3. [PMID: 22738383 PMCID: PMC3384233 DOI: 10.1186/2045-5380-2-3] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 02/07/2012] [Indexed: 01/11/2023]
Abstract
Convergent data from rodents and human studies have led to the development of models describing the neural mechanisms of fear extinction. Key components of the now well-characterized fear extinction network include the amygdala, hippocampus, and medial prefrontal cortical regions. These models are fueling novel hypotheses that are currently being tested with much refined experimental tools to examine the interactions within this network. Lagging far behind, however, is the examination of sex differences in this network and how sex hormones influence the functional activity and reactivity of these brain regions in the context of fear inhibition. Indeed, there is a large body of literature suggesting that sex hormones, such as estrogen, do modulate neural plasticity within the fear extinction network, especially in the hippocampus.After a brief overview of the fear extinction network, we summarize what is currently known about sex differences in fear extinction and the influence of gonadal hormones on the fear extinction network. We then go on to propose possible mechanisms by which sex hormones, such as estrogen, may influence neural plasticity within the fear extinction network. We end with a discussion of how knowledge to be gained from developing this line of research may have significant ramifications towards the etiology, epidemiology and treatment of anxiety disorders.
Collapse
Affiliation(s)
- Kelimer Lebron-Milad
- Department of Psychiatry, Harvard Medical School & Massachusetts General Hospital, Boston, MA, USA.
| | | |
Collapse
|
49
|
Estradiol modulates medial prefrontal cortex and amygdala activity during fear extinction in women and female rats. Biol Psychiatry 2011; 70:920-7. [PMID: 21762880 PMCID: PMC3197763 DOI: 10.1016/j.biopsych.2011.05.016] [Citation(s) in RCA: 261] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/25/2011] [Accepted: 05/09/2011] [Indexed: 01/29/2023]
Abstract
BACKGROUND Men and women differ in their ability to extinguish fear. Fear extinction requires the activation of brain regions, including the ventromedial prefrontal cortex (vmPFC) and amygdala. Could estradiol modulate the activity of these brain regions during fear extinction? METHODS All rat experiments were conducted in naturally cycling females. Rats underwent fear conditioning on Day 1. On Day 2, they underwent extinction training during the metestrus phase of the cycle (low estrogen and progesterone). Extinction recall was assessed on Day 3. Systemic injections of estrogen receptor-beta and -alpha agonists and of estradiol were administered at different time points to assess their influence on extinction consolidation and c-Fos expression in the vmPFC and amygdala. In parallel, healthy naturally cycling women underwent an analogous fear conditioning extinction training in a 3T functional magnetic resonance scanner. Measurement of their estradiol levels and skin conductance responses were obtained throughout the experiment. RESULTS In female rats, administration of the estrogen-receptor beta (but not alpha) agonist facilitated extinction recall. Immediate (but not delayed) postextinction training administration of estradiol facilitated extinction memory consolidation and increased c-Fos expression in the vmPFC while reducing it in the amygdala. In parallel, natural variance in estradiol in premenopausal cycling women modulated vmPFC and amygdala reactivity and facilitated extinction recall. CONCLUSIONS We provide translational evidence that demonstrates the influence of endogenous and exogenous estradiol on the fear extinction network. Our data suggest that women's endogenous hormonal status should be considered in future neurobiological research related to anxiety and mood disorders.
Collapse
|
50
|
Valadares ALR, Pinto-Neto AM, de Souza MH, Osis MJD, da Costa Paiva LHS. The prevalence of the components of low sexual function and associated factors in middle-aged women. J Sex Med 2011; 8:2851-8. [PMID: 21810185 DOI: 10.1111/j.1743-6109.2011.02405.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Female sexual function depends on biological, psychological, and sociocultural contexts. AIM The objective of the present study was to evaluate the prevalence of low levels of functioning in each of the sexual function domains (desire, arousal, and orgasm) and the factors associated with these phenomena, as well as to assess the frequency of sexual activity in this same sample population. METHODS A cross-sectional, population-based study was conducted using an anonymous self-response questionnaire completed by 378 Brazilian-born women of 40-65 years of age with 11 years or more of formal education. The evaluation instrument was based on the Short Personal Experiences Questionnaire. RESULTS The prevalence of low sexual desire was 60.6%; low arousal, 37%; and low orgasmic function, 31.1%. Multiple regression analysis showed that having a sexual partner (prevalence ratio [PR] = 0.69, confidence interval [CI] = 0.53-0.90) and nervousness (PR = 1.33, CI = 1.01-1.75) were factors associated with low sexual desire. Aging (PR = 1.04, CI = 1.02-1.06), having a sexual partner (PR = 0.57, CI = 0.41-0.81), feeling well/excellent (PR = 0.59, CI = 0.41-0.85), and having hot flashes (PR = 1.47, CI = 1.01 = 2.15) were factors found to be associated with low sexual arousal. Having a sexual partner (PR = 0.55, CI = 0.42-0.71), feeling well/excellent (PR = 0.68, CI = 0.49-0.94), and having hot flashes (PR = 2.08, CI = 1.43 = 3.04) were factors found to be associated with low sexual orgasmic function. Having a sexual partner (PR = 0.47, CI = 0.38-0.58), feeling well/excellent (PR = 0.78, CI = 0.69-0.89), and having hot flashes (PR = 1.15, CI = 1.05-1.26) were factors found to be associated with a frequency of sexual activity of once a week or less. CONCLUSIONS In this sample of middle-aged women, low sexual desire was the most prevalent sexual problem. These results highlight the importance of identifying and treating factors associated with each individual component of low female sexual function.
Collapse
|