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Drewes M, Kalder M, Kostev K. Factors associated with the diagnosis of depression in women followed in gynecological practices in Germany. J Psychiatr Res 2021; 141:358-363. [PMID: 34304041 DOI: 10.1016/j.jpsychires.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are many diagnoses in the field of gynecology that can severely impact the lives of patients and that are associated with an increased risk of developing depression. The goal of this study was to investigate which gynecological diagnoses are associated with depression. METHODS This retrospective case-control study based on the Disease Analyzer database (IQVIA) included 5893 women aged 18 years or older with depression and 5893 age-matched pairs followed in 256 gynecological practices in 2019 (index date). A multivariate logistic regression model was used to study the association between 33 pre-defined diagnoses documented within five years prior to the index date and depression diagnosis. RESULTS In total, 9 diseases were significantly associated with diagnosis of depression. The strongest association was observed for breast cancer (Odds Ratio (OR: 2.11 (95% Confidence Interval (CI): 1.76-2.52)), followed by female infertility (OR: 1.91 (95% CI: 1.48-2.47)), cancer of female genital organs excl. breast (OR: 1.87 (95% CI: 1.32-2.66)), and sexual dysfunction (OR: 1.63 (95% CI: 1.27-2.09). Other diseases that showed a significant association with depression included endometriosis, mastodynia, candidiasis, infections with a predominantly sexual mode of transmission, and urinary incontinence. Patients with a higher number of different disorders were more likely to be diagnosed with depression (ORs from 1.40 for two disorders to 2.38 for >6 disorders as compared to no disorders). CONCLUSION A wide range of diseases documented in gynecologists' practices were associated with depression diagnosis. Understanding all of these associations may help gynecologists to refer women promptly to psychologists or psychiatrists who may help to manage depression in this population.
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Affiliation(s)
- Maja Drewes
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, Philipps University of Marburg, Marburg, Germany
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Azar M, Bradbury-Jones C, Kroll T. Middle-aged Lebanese women's interpretation of sexual difficulties: a qualitative inquiry. BMC Womens Health 2021; 21:203. [PMID: 34001078 PMCID: PMC8127220 DOI: 10.1186/s12905-020-01132-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/19/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The study explores women's perception and experience of sexual difficulties. The need to address the subject was triggered by the scarcity of research that reflects on women's subjective views on sexual difficulties. This is particularly crucial for middle-aged women who frequently experience hormonal and psychosocial changes that may affect their sexual life. METHODS Using in-depth individual and focus groups interviews, 52 Lebanese women aged 40-55 years discussed their thoughts, feelings and behaviours concerning sexual difficulties. Women were recruited purposefully from clinical and non-clinical settings to get maximum sampling variation that provided rich information and deep understanding of the subject. Recordings were transcribed verbatim and analysed about the framework analysis. Many strategies were adopted to ensure rigour. RESULTS Women's narratives led to four themes: women's inability to communicate sexual desires and concerns; male sexual difficulties; marital conflicts; and sexual difficulties as context-bound. Women's sexual difficulties are driven by double standards and inhibiting sexual socialisation. Once married, many women had very challenging sexual experiences. They were obliged to silently bear their husbands' poor sexual performance to protect their masculinity and thus their social image and identity. Women's narratives also showed that marital conflicts, daily life problems as well as physical and psychological burdens further challenged their sexual wellbeing and contributed to their sexual difficulties. CONCLUSION The study makes a unique contribution to voicing women's views and concerns as sexuality is insufficiently researched and reported in Lebanon. It emphasises the multidimensional nature of female sexual difficulties, particularly the gender-based norms that inhibit their sexual selves and profoundly affect their sexual wellbeing and capacity to claim their sexual likes and dislikes. Findings have implications on research and practice to help women prevent and overcome their sexual difficulties.
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Affiliation(s)
- Mathilde Azar
- Faculty of Health Sciences - University of Balamand. St George Health Complex, Youssef Sursock Street. P.o. Box. 166378 Ashrafieh, Beirut, 1100-2807, Lebanon.
| | | | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, UK
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Pérez-López FR, Ornat L, Pérez-Roncero GR, López-Baena MT, Sánchez-Prieto M, Chedraui P. The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis. Gynecol Endocrinol 2020; 36:1015-1023. [PMID: 32880200 DOI: 10.1080/09513590.2020.1812570] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM To systematically compare sexual function between non-treated women with and without endometriosis. METHODS A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis. RESULTS In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea. CONCLUSION Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.
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Affiliation(s)
- Faustino R Pérez-López
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | - Lía Ornat
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | | | | | - Manuel Sánchez-Prieto
- Departament of Obstetrics and Gynecology, Instituto Universitario Dexeus, Barcelona, Spain
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Luo L, Xiao C, Xiang Q, Zhu Z, Liu Y, Wang J, Deng Y, Zhao Z. Significant Increase of Sexual Dysfunction in Patients With Renal Failure Receiving Renal Replacement Therapy: A Systematic Review and Meta-Analysis. J Sex Med 2020; 17:2382-2393. [PMID: 33082104 DOI: 10.1016/j.jsxm.2020.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND It has been shown that sexual dysfunction (SD) is highly prevalent among patients with chronic renal failure (CRF), and starting renal replacement therapy may even increase it. However, SD is an infrequently reported problem in these treated patients. AIM To investigate the prevalence of SD among patients with CRF undergoing renal replacement therapy, by a meta-analysis method. METHODS PubMed, Embase, and the Cochrane Library were systematically searched for all studies assessing sexual function in patients with CRF receiving renal replacement therapy from January 2000 to April 2020. Relative risk (RR) with 95% CIs was used for analysis to assess the risk of SD in patients with CRF receiving renal replacement therapy. The cross-sectional study quality methodology checklist was used for the cross-sectional study. The methodologic quality of the case-control and cohort studies was assessed with the Newcastle-Ottawa Scale. Data were pooled for the random-effect model. Sensitivity analyses were conducted to assess potential bias. The Begg and Egger tests were used for publication bias analysis. OUTCOMES The prevalence of SD among patients with CRF receiving renal replacement therapy was summarized using pooled RR and 95% CI. RESULTS This meta-analysis included 3,725 participants from 10 studies. Of these, 737 were patients with CRF receiving renal replacement therapy. The mean age of participants ranged from 32.75 to 56.1 years. Based on the random-effect model, synthesis of results demonstrated that the prevalence of SD was significantly increased among patients with CRF receiving renal replacement therapy in women (RR = 2.07, 95% CI: 1.47-2.91, P = .000; heterogeneity: I2 = 78.7%, P = .000) and in men (RR = 2.95, 95% CI: 2.16-4.02, P = .000; heterogeneity: I2 = 86.1%, P = .000). Estimates of the total effects were generally consistent in the sensitivity analysis. No evidence of publication bias was observed. CLINICAL IMPLICATIONS Patients with CRF receiving renal replacement therapy had a significantly increased risk of SD, which suggests that clinicians should evaluate sexual function, when managing patients with CRF receiving renal replacement therapy. STRENGTHS AND LIMITATIONS This is the first study to explore the prevalence of SD among patients with CRF undergoing renal replacement therapy based on all available epidemiologic studies. However, all included studies were an observational design, which may downgrade this evidence. CONCLUSION The prevalence of SD is significantly increased among patients with CRF receiving renal replacement therapy. More research studies are warranted to clarify the relationship. Luo L, Xiao C, Xiang Q, et al. Significant Increase of Sexual Dysfunction in Patients With Renal Failure Receiving Renal Replacement Therapy: A Systematic Review and Meta-Analysis. J Sex Med 2020;17:2382-2393.
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Affiliation(s)
- Lianmin Luo
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Chenglin Xiao
- Department of Urology, The Second Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Qian Xiang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Zhiguo Zhu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Yangzhou Liu
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Jiamin Wang
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Yihan Deng
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China
| | - Zhigang Zhao
- Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China.
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Hamzehgardeshi Z, Malary M, Moosazadeh M, Khani S, Pourasghar M, Alianmoghaddam N. Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran. BMC WOMENS HEALTH 2020; 20:233. [PMID: 33054812 PMCID: PMC7556956 DOI: 10.1186/s12905-020-01097-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022]
Abstract
Background Various socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age. Methods This was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16–49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables. Results The mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD. Conclusion Some socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.
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Affiliation(s)
- Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mina Malary
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Haft-e Tir Square, Po Box 7394736147, Shahroud, Iran.
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.,Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Soghra Khani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.,Research Center of Diabetes, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Pourasghar
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Milić Vranješ I, Jakab J, Ivandić M, Šijanović S, Zibar L. FEMALE SEXUAL FUNCTION OF HEALTHY WOMEN IN EASTERN CROATIA. Acta Clin Croat 2019; 58:647-654. [PMID: 32595250 PMCID: PMC7314299 DOI: 10.20471/acc.2019.58.04.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim was to evaluate sexual function of healthy women in Croatia and the possible impact of depression, anxiety, and sociodemographic factors. A total of 204 healthy women filled in a basic sociodemographic questionnaire, the Patient Health Questionnaire-9, Anxiety Disorder-7, and Female Sexual Function Index (FSFI). Almost half of study subjects (47.1%) reported at least some degree of sexual dysfunction defined as an FSFI score lower than 26.55. Study results suggest sexual dysfunction of women in Croatia as a still unrecognized problem. More room in research and in the public must be given to this issue.
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Affiliation(s)
| | - Jelena Jakab
- 1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Gynecology and Obstetrics, Osijek University Hospital Centre, Osijek, Croatia; 3Department of Pathophysiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Cardiology, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Nephrology, Osijek University Hospital Centre, Osijek, Croatia
| | - Marul Ivandić
- 1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Gynecology and Obstetrics, Osijek University Hospital Centre, Osijek, Croatia; 3Department of Pathophysiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Cardiology, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Nephrology, Osijek University Hospital Centre, Osijek, Croatia
| | - Siniša Šijanović
- 1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Gynecology and Obstetrics, Osijek University Hospital Centre, Osijek, Croatia; 3Department of Pathophysiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Cardiology, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Nephrology, Osijek University Hospital Centre, Osijek, Croatia
| | - Lada Zibar
- 1Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Gynecology and Obstetrics, Osijek University Hospital Centre, Osijek, Croatia; 3Department of Pathophysiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Department of Cardiology, Osijek University Hospital Centre, Osijek, Croatia; 5Department of Nephrology, Osijek University Hospital Centre, Osijek, Croatia
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Abstract
Although more than 80% of women experience some degree of psychological or physical symptoms around menopause, both women and clinicians have misconceptions about how hormonal changes relate to menopausal symptoms and psychological conditions. Recently, several large-scale, longitudinal studies have been conducted to better characterize symptoms and changes that occur around menopause. This article offers current evidence for symptoms that occur in the early menopause transition, including vasomotor symptoms, mood changes, sleep problems, and changes in sexual functioning.
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Sexual Function of Postmenopausal Women Addicted to Alcohol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081639. [PMID: 30072650 PMCID: PMC6121656 DOI: 10.3390/ijerph15081639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 12/03/2022]
Abstract
Introduction: Alcoholism impairs female sexual functions (decreased sex drive, reduced vaginal fluid, difficulty to experience orgasm). Aim: The aim of this study was to evaluate the course of perimenopausal period and sexual life of female alcoholics. Methods: 97 women at the age of 40–60 years were qualified with a diagnosed history of alcoholism (studied group). For the control group, 92 women at the age of 40–60 without a history of alcoholism were qualified. Questionnaires assessing female sexual function (Female Sexual Function Index—FSFI), the severity of perimenopausal symptoms (Menopause Rating Scale—MRS) and the degree of alcohol addiction (Michigan Alcoholism Screening Test—MAST) were obtained from each participant. Main outcome measures: To assess the sexual function of perimenopausal women addicted to alcohol. Results: The studied and control groups were significantly different (p = 0.00) in terms of severity of menopausal symptoms (MRS). The research showed lower quality of sexual life (FSFI) of women from the studied group. Conclusions: Population of women with diagnosed alcohol dependence enter the menopausal stage at the similar age as the population of female non-drinkers. The time of alcohol abuse is an important factor having an impact on both the course of menopause and the dynamics of the perimenopause period, leading to symptom escalation. The population of female alcoholics shows a decrease in sexual activity and the prevalence of sexual disorders.
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AlAwlaqi A, Amor H, Hammadeh ME. Role of hormones in hypoactive sexual desire disorder and current treatment. J Turk Ger Gynecol Assoc 2017; 18:210-218. [PMID: 29278235 PMCID: PMC5776161 DOI: 10.4274/jtgga.2017.0071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Over the decades, female sexual dysfunction (FSD) has grown to be an increasingly potential problem that complicates the quality of life among women. In the current review, FSD refers to recurrent and persistent problems with sexual orgasm, desire, or response. One of the most common subtypes of FSD that has evoked increased research interest in the scientific community is hyposexuality. Today, there is a consensus that hyposexuality is a multifactorial condition that manifests with reduced sexual desire resulting in significant interpersonal distress. The objective of the current review was to examine how hormonal profile triggers propagate hypoactive sexual desire disorder (HSDD), and to highlight effective treatment interventions that can be used to manage the condition. The current review describes HSDD as a sexual dysfunction characterized by the absence or lack of sexual desire and fantasies for sexual activities. The review argues that even if the role of sexual hormones is essential in modulating HSDD through therapeutic interventions, an effective comprehension of the biologic mechanisms underlying HSDD is necessary. There is a consensus in the literature that HSDD still poses significant challenges due to the lack of properly formulated treatment regimens and absence of clear clinical guidelines. That is, a better intervention consisting of both psycho-relational and biologic aspects is compulsory if tailored management and accurate diagnosis of HSDD in clinical practice are to be realised. The review concludes that, to date, a reliable clinical intervention to manage hyposexuality is still absent and more interventions, in terms of safety and efficacy, are required. Thus, additional investigation is required to document precise hormonal or non-hormonal pharmacotherapeutic agents for individualised care among patients with HSDD.
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Affiliation(s)
- Ahmed AlAwlaqi
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
| | - Houda Amor
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
| | - Mohamed E Hammadeh
- Department of Obstetrics and Gynaecology, University of Saarland, Homburg, Germany
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Varanda S, Ribeiro da Silva J, Costa AS, Amorim de Carvalho C, Alves JN, Rodrigues M, Carneiro G. Sexual dysfunction in women with Parkinson's disease. Mov Disord 2016; 31:1685-1693. [DOI: 10.1002/mds.26739] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 06/15/2016] [Accepted: 06/26/2016] [Indexed: 12/30/2022] Open
Affiliation(s)
- Sara Varanda
- Neurology Department; Hospital de Braga; Braga Portugal
| | | | - Ana Sofia Costa
- Neurocognition Unit, Neurology Department; Hospital de Braga; Braga Portugal
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12
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Abstract
OBJECTIVE To examine the effect of hormonal contraception on sexual desire. MATERIALS AND METHODS We performed a cross-sectional analysis of 1,938 of the 9,256 participants enrolled in the Contraceptive CHOICE Project. This subset included participants enrolled between April and September 2011 who completed a baseline and 6-month telephone survey. Multivariable logistic regression was used to assess the association between contraceptive method and report of lacking interest in sex controlling for potential confounding variables. RESULTS More than 1 in 5 participants (23.9%) reported lacking interest in sex at 6 months after initiating a new contraceptive method. Of 262 copper intrauterine device (IUD) users (referent group), 18.3% reported lacking interest in sex. Our primary outcome was more prevalent in women who were young (younger than 18 years: adjusted odds ratio [OR] 2.04), black (adjusted OR 1.78), and married or living with a partner (adjusted OR 1.82). Compared with copper IUD users, participants using depot medroxyprogesterone (adjusted OR 2.61, 95% confidence interval [CI] 1.47-4.61), the vaginal ring (adjusted OR 2.53, 95% CI 1.37-4.69), and the implant (adjusted OR 1.60, 95% CI 1.03-2.49) more commonly reported lack of interest in sex. We found no association between use of the hormonal IUD, oral contraceptive pill, and patch and lack of interest in sex. CONCLUSION CHOICE participants using depot medroxyprogesterone acetate, the contraceptive ring, and implant were more likely to report a lack of interest in sex compared with copper IUD users. Future research should confirm these findings and their possible physiologic basis. Clinicians should be reassured that most women do not experience a reduced sex drive with the use of most contraceptive methods.
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Affiliation(s)
- Amanda Boozalis
- Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
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Santoro N, Worsley R, Miller KK, Parish SJ, Davis SR. Role of Estrogens and Estrogen-Like Compounds in Female Sexual Function and Dysfunction. J Sex Med 2016; 13:305-16. [DOI: 10.1016/j.jsxm.2015.11.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/13/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
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14
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Serum Androgen Levels and Sexual Function Before and One Year After Treatment of Uterine Cervical Cancer: A Pilot Study. J Sex Med 2016; 13:413-24. [DOI: 10.1016/j.jsxm.2015.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 12/07/2015] [Accepted: 12/21/2015] [Indexed: 11/23/2022]
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Kim K, Hong JP, Cho MJ, Fava M, Mischoulon D, Lee DW, Heo JY, Jeon HJ. Loss of sexual interest and premenstrual mood change in women with postpartum versus non-postpartum depression: A nationwide community sample of Korean adults. J Affect Disord 2016; 191:222-9. [PMID: 26682491 DOI: 10.1016/j.jad.2015.11.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/04/2015] [Accepted: 11/30/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study. METHOD A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery. RESULTS Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD. CONCLUSIONS Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD.
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Affiliation(s)
- Kiwon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Dong-Woo Lee
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Jung-Yoon Heo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Health Sciences & Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea; Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Freeman EW, Sammel MD. Methods in a longitudinal cohort study of late reproductive age women: the Penn Ovarian Aging Study (POAS). Womens Midlife Health 2016; 2:1. [PMID: 30766699 PMCID: PMC6299955 DOI: 10.1186/s40695-016-0014-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/17/2016] [Indexed: 12/05/2022] Open
Abstract
Background This report describes the methods utilized in the Penn Ovarian Aging Study (POAS), which is a longitudinal cohort study of hormone dynamics and menopausal symptoms of women in the menopause transition. Methods/Design The cohort is a community-based sample of generally healthy women enrolled in the late reproductive years. The study population is a stratified random sample of African-American and Caucasian women, identified by random digit dialing. Of the 1427 women who were identified as potentially eligible, 578 women were eligible after full screening; 75 % of the eligible women enrolled in the study (436/578). At Period 14 (14 years after study enrollment), 67 % remained active and were fully evaluated (293/436). Attrition was non-differential with respect to the sample characteristics. The aims of the project overall are to 1) identify within-woman trends of reproductive hormones (estradiol, follicle stimulating hormone, hormone, lutinizing hormone, inhibin B, dehydroepiandrosterone, testosterone, and anti-mullerian hormone), cofactors such as race, body mass index (BMI), age, physical and behavioral symptoms, and their predictions of menopausal symptoms, and patterns around the final menstrual period; 2) identify associations of hormone dynamics with physical and behavioral symptoms that occur with ovarian aging and identify racial differences in these factors; 3) identify associations of genetic polymorphisms with levels and longitudinal trends in menopausal symptoms. The cohort consists of 436 late reproductive-age women at enrollment, and now has 18 years of approximately annual follow-up assessments. Menopausal stage based on concurrent menstrual dates is identified at each follow-up period. Discussion Studies of the cohort have shown that hot flashes can occur well before menopause and extend 10 or more years beyond menopause for sizeable numbers of women; provide evidence for new-onset depressed mood in the menopause transition and show that the final menstrual period is pivotal in the increases in depressive symptoms prior to menopause and decreases postmenopausal; suggest that poor sleep is common in the late reproductive years but increases in relation to the final menstrual period in only a small proportion of women; and show effects of obesity on reproductive hormones in the menopause transition. To date, more than 50 studies of the cohort are published in medical journals, demonstrating the relevance of these data to the clinical care of mid-life women. Electronic supplementary material The online version of this article (doi:10.1186/s40695-016-0014-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ellen W Freeman
- 1Department of Obstetrics/Gynecology and Department of Psychiatry, 3701 Market Street, Suite 820 (Mudd Suite), Philadelphia, PA 19104 USA
| | - Mary D Sammel
- 2Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, U.S, Philadelphia, USA
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Johnson AK, Johnson AJ, Barton D, Elkins G. Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial. Int J Clin Exp Hypn 2016; 64:213-24. [PMID: 26894424 DOI: 10.1080/00207144.2016.1131590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.
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Affiliation(s)
| | | | - Debra Barton
- b University of Michigan School of Nursing , Ann Arbor , USA
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Randolph JF, Zheng H, Avis NE, Greendale GA, Harlow SD. Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition. J Clin Endocrinol Metab 2015; 100:258-66. [PMID: 25412335 PMCID: PMC4283018 DOI: 10.1210/jc.2014-1725] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether reproductive hormones are related to sexual function during the menopausal transition. DESIGN The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. MAIN OUTCOME MEASURES Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. RESULTS Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. CONCLUSIONS Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.
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Affiliation(s)
- John F Randolph
- University of Michigan Health System (J.F.R.), Division of Reproductive Endocrinology and Infertility, Ann Arbor, Michigan 48109; University of Michigan School of Public Health (J.F.R., H.Z., S.D.H.), Department of Epidemiology, Ann Arbor, Michigan 48109; Wake Forest School of Medicine (N.E.A.), Department of Social Sciences and Health Policy, Winston-Salem, North Carolina 27157; and Geffen School of Medicine at University of California Los Angeles (G.A.G.), Los Angeles, California 90095
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Rabiee M, Nasirie M, Zafarqandie N. Evaluation of Factors Affecting Sexual Desire During Menopausal Transition and Post Menopause. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-25147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mollaoğlu M, Tuncay FÖ, Fertelli TK. Investigating the sexual function and its associated factors in women with chronic illnesses. J Clin Nurs 2013; 22:3484-91. [PMID: 24580790 DOI: 10.1111/jocn.12170] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To evaluate sexual dysfunction and the factors that affect sexual dysfunction in women with chronic disease. BACKGROUND Sexual dysfunction is one of the most common problems in women with chronic disease. There is limited understanding of the related factors of sexual dysfunction in women with chronic disease, with research currently limited to other problems and problems related to chronic diseases. DESIGN This research was conducted as a descriptive survey. METHODS This study involved 100 female inpatients at clinics of internal medicine of a university hospital. Data were collected with a patients identification form and a female sexual function index (KCFI). Kruskal-Wallis test, test of significance of difference between two means and test of significance of difference between two pairs were used in the data analysis. RESULTS Sixty-five percentage of women in the sample were defined to have sexual dysfunction. The majority of women expressed pain during sexual intercourse, problems in orgasm and satisfaction, and reluctance to have sex. Older age, being unemployed, being in menopause, fatigue, sleep disorder, and pain and weakness in extremities were the factors that were found to significantly affect the prevalence of sexual dysfunction (p < 0.05). CONCLUSIONS This study concluded that sexual function of women with chronic disease is affected negatively. Chronic disease-related symptoms, experienced changes in the body and psychosocial problems are changing the lives of women. Ultimately, these changes also affect sexual activity. RELEVANCE TO CLINICAL PRACTICE Determination of the factors affecting sexual activity in women with chronic disease is important for women' ability to cope with sexual dysfunction and keep it under control. To be able to accomplish this, it is necessary for healthcare personnel, the partners and family to work together.
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Affiliation(s)
- Mukadder Mollaoğlu
- Department of Nursing, Health Sciences Faculty, Cumhuriyet University, Sivas, Turkey
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Grewal GS, Gill JS, Sidi H, Gurpreet K, Jambunathan ST, Suffee NJ. Sexual desire disorder in female healthcare personnel in Malaysia. Asia Pac Psychiatry 2013; 5 Suppl 1:14-20. [PMID: 23857832 DOI: 10.1111/appy.12037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The aim of this study was to determine the prevalence and risk factors for female sexual desire disorder (FSDD) among healthcare personnel at selected healthcare facilities in Malaysia. METHODS Two hundred and one female healthcare workers from three large tertiary hospitals were selected by stratified random sampling to participate in this cross-sectional study. Validated questionnaires were used to assess depression, anxiety, and sexual function in women and erectile dysfunction (ED) in their partners. RESULTS The prevalence of FSDD was 18.9%. Women with low sexual desire were more likely to have higher educational attainment (OR = 3.06; 95% CI; 1.22-7.66), lower frequency of sexual intercourse (OR = 12.81; 95% CI; 4.43-37.83), two or more children (OR = 3.05; 95% CI; 1.02-9.09), duration of marriage of 20 years or more (OR = 2.62; 95% CI; 1.27-5.40), and a spouse with ED (OR = 2.86; 95% CI; 1.08-7.56). DISCUSSION FSDD is common among female healthcare personnel in Malaysia, affecting nearly one in five women. The implication of low sexual desire is important in terms of contributing to a meaningful sexual relationship, and indirectly affects the quality of life of the healthcare personnel.
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Harris AL, Vitzthum VJ. Darwin's legacy: an evolutionary view of women's reproductive and sexual functioning. JOURNAL OF SEX RESEARCH 2013; 50:207-246. [PMID: 23480070 DOI: 10.1080/00224499.2012.763085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
On the Origin of species, published just over 150 years ago, has deeply influenced thinking in both scientific and wider communities. Darwin's legacy includes recognition of the fact that all organisms evolve; that variation within and between species is natural and normal; and that an evolutionary approach to understanding the sources and consequences of this variation comprises theoretical frameworks, testable hypotheses, and rigorously collected evidence. With an eye toward facilitating communication and productive collaboration among researchers from different intellectual traditions who nonetheless share a common interest in women's reproductive and sexual functioning, we discuss evolutionary concepts and models, summarize the known variability in ovarian functioning and consider the implications of this variability for conducting sex research, and evaluate the relative merits of various biomarkers that serve as proxy measurements of a woman's reproductive and hormonal status. With these perspectives and methods from reproductive ecology at hand, we examine several contentious issues: the links between hormones and sexuality in premenopausal and perimenopausal women, the causes of premenstrual syndrome, and the existence (or not) of menstrual synchrony. In none of these cases is as much known as is often claimed. In each, there are abundant opportunities for innovative, albeit challenging, research.
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Affiliation(s)
- Amy L Harris
- Anthropology Department, Indiana University, Bloomington 47405, USA
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Atlantis E, Sullivan T. Bidirectional Association Between Depression and Sexual Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2012; 9:1497-507. [DOI: 10.1111/j.1743-6109.2012.02709.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Woods NF, Mitchell ES, Smith-Di Julio K. Sexual desire during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. J Womens Health (Larchmt) 2012; 19:209-18. [PMID: 20109116 DOI: 10.1089/jwh.2009.1388] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AIMS To describe levels of sexual desire across the menopausal transition (MT) and early postmenopause (PM), including effects of age, MT-related factors, health, stress, symptoms (hot flash, sleep, mood), and social opportunity factors. METHODS A subset of Seattle Midlife Women's Health Study (SMWHS) participants who provided data during the early reproductive, early and late menopausal transition stages, or postmenopause (n = 286), including menstrual calendars for staging the MT, annual health reports between 1990 and 2005, and morning urine samples assayed for estrone glucuronide (E(1)G), testosterone (T), and follicle-stimulating hormone (FSH) was included. Multilevel modeling using the R program was used to test factors related to sexual desire. RESULTS Women experienced a significant decrease in sexual desire during the late MT stage (p < 0.01) and early PM (p < 0.0001). Those with higher urinary E(1)G and T reported significantly higher levels of sexual desire, whereas those with higher FSH levels reported significantly lower sexual desire (p < 0.0001, 0.06, and 0.0002, respectively). Women using hormone therapy also reported higher sexual desire (p = 0.02). Those reporting higher perceived stress reported lower sexual desire (p < 0.0001), but history of sexual abuse did not have a significant effect. Those most troubled by symptoms of hot flashes, fatigue, depressed mood, anxiety, difficulty getting to sleep, early morning awakening, and awakening during the night also reported significantly lower sexual desire (p range from <0.03 to 0.0001), but there was no effect of vaginal dryness. Women with better perceived health reported higher sexual desire (p < 0.0001), and those reporting more exercise and more alcohol intake also reported greater sexual desire (p < 0.0001). Having a partner was associated with lower sexual desire. CONCLUSIONS Clinicians working with women traversing the MT should be aware that promoting healthy sexual functioning among midlife women requires consideration of their changing biology as well as ongoing life challenges.
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Affiliation(s)
- Nancy Fugate Woods
- Department of Family and Child Nursing, University of Washington, Seattle, Washington 98195-7260, USA.
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Abstract
OBJECTIVE The aim of this study was to examine the relationship between reproductive history and menopausal symptoms among urban women. METHODS This was a cohort study of women aged 35 to 47 years recruited in Philadelphia, PA. Two hundred ninety-one premenopausal women meeting the study eligibility criteria and contributing reproductive health history and infertility information completed the assessments of occurrence and severity of several menopausal symptoms over a 14-year period. Reproductive history included the number of pregnancies, live births, preterm deliveries, and miscarriages. Trying to get pregnant for more than 1 year was used as an assessment of infertility. The occurrence of severe hot flashes, vaginal dryness, and decreased libido was evaluated. RESULTS Women scoring positive on the infertility index were significantly more likely to report severe decreased libido (odds ratio [OR], 1.86; 95% CI, 1.05-3.31) and were more than twice as likely to report severe vaginal dryness (OR, 2.79; 95% CI, 1.19-6.94) in multivariable models. None of the other reproductive health indices were related to the report of severe hot flashes, vaginal dryness, or decreased libido. The race-specific models continued to find a significant increased risk of severe vaginal dryness (OR, 2.79; 95% CI, 1.22-6.36) and decreased libido (OR, 1.87; 95% CI, 1.04-3.34) among white women scoring positive on the infertility index; however, the relationship did not remain significant among African American women. CONCLUSIONS Severe vaginal dryness and decreased libido are common and important considerations of the menopausal transition, and the experience of infertility problems may influence the report of severe vaginal dryness and decreased libido particularly among white women.
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Davison SL, Davis SR. Androgenic hormones and aging--the link with female sexual function. Horm Behav 2011; 59:745-53. [PMID: 21215268 DOI: 10.1016/j.yhbeh.2010.12.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/22/2010] [Accepted: 12/29/2010] [Indexed: 01/23/2023]
Abstract
In women, sexual function, hormones and aging are inextricably related. Sexual activity in women involves interest and motivation, the ability to become aroused and achieve orgasm, the pleasure of the experience and subsequent personal satisfaction. Androgens, as endogenous hormones or given as a therapy, potentially influence female sexual function, with research into the effects of exogenous androgens in women mostly devoted to effects on sexual desire. Some studies have been conducted to delineate the effects of testosterone on arousal, however arousal determined by laboratory measures does not always correlate with subjective reporting of a sensation of arousal. Overall large randomised controlled trials of exogenous testosterone show benefits over placebo on sexual desire, arousal, orgasm, pleasure and satisfaction. The aspects of consideration of androgen therapy for women that continue to stimulate debate in this therapeutic area include whether female sexual dysfunction is a condition that merits pharmacotherapy, how effective is such treatment and whether testosterone therapy is safe.
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Affiliation(s)
- Sonia L Davison
- Women's Health Research Program, Central Clinical School, Monash University, Clayton, Victoria, Australia.
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Brotto LA. The DSM diagnostic criteria for hypoactive sexual desire disorder in women. ARCHIVES OF SEXUAL BEHAVIOR 2010; 39:221-39. [PMID: 19777334 DOI: 10.1007/s10508-009-9543-1] [Citation(s) in RCA: 164] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion "persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" that causes "marked distress or interpersonal difficulty." This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women's experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
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Wierman ME, Nappi RE, Avis N, Davis SR, Labrie F, Rosner W, Shifren JL. Endocrine Aspects of Women's Sexual Function. J Sex Med 2010; 7:561-85. [DOI: 10.1111/j.1743-6109.2009.01629.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Gracia CR, Sammel MD, Charlesworth S, Lin H, Barnhart KT, Creinin MD. Sexual function in first-time contraceptive ring and contraceptive patch users. Fertil Steril 2010; 93:21-8. [DOI: 10.1016/j.fertnstert.2008.09.066] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 09/01/2008] [Accepted: 09/18/2008] [Indexed: 01/23/2023]
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Brotto LA, Bitzer J, Laan E, Leiblum S, Luria M. Women's Sexual Desire and Arousal Disorders. J Sex Med 2010; 7:586-614. [DOI: 10.1111/j.1743-6109.2009.01630.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Binfa L, Robertson E, Ransjö-Arvidson AB. Chilean Women's Reflections About Womanhood and Sexuality During Midlife in a Swedish or Chilean Context. Health Care Women Int 2009; 30:1093-110. [DOI: 10.1080/07399330903276777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arias‐Castillo L, Ceballos‐Osorio J, Ochoa JJ, Reyes‐Ortiz CA. Correlates of Sexuality in Men and Women Aged 52–90 Years Attending a University Medical Health Service in Colombia. J Sex Med 2009; 6:3008-18. [DOI: 10.1111/j.1743-6109.2009.01488.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Prevalence of symptoms in relation to androgen concentrations in women using estrogen plus progestogen and women using estrogen alone. Menopause 2009; 16:149-55. [DOI: 10.1097/gme.0b013e31817f45b6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
Sexuality is innate within all women to a greater or lesser extent, and is affected by a number of extrinsic factors that occur in the menopausal transition. Assessing hormone status is difficult as evidence exists that sex hormones may differ between ethnic groups, and that bio-assays may be insensitive at lower testosterone levels. Data are available on the prevalence of female sexual dysfunction, but results from cross-sectional studies differ from those of longitudinal studies. The original traditional models of human sexual response have been challenged, and new models have been defined which show more complex interaction between intrinsic and extrinsic factors. Definitions of sexual dysfunction have been redefined. There are a limited number of randomized, placebo-controlled trials of drugs to improve sexual function. These include sildenafil citrate, tibolone and hormone replacement therapy. Randomized controlled trials on testosterone replacement in naturally and/or surgically menopausal patients with female sexual dysfunction have been criticized for a high placebo response rate and short duration. This chapter seeks to put sexuality into perspective and to define both function and dysfunction.
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Affiliation(s)
- Joan Pitkin
- Northwick Park; St Marks Hospital, N.W. London Hospitals, NHS Trust, Watford Road, HA1 3UJ, UK.
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HAYES R, BENNETT C, DENNERSTEIN L, TAFFE J, FAIRLEY C. Are aspects of study design associated with the reported prevalence of female sexual difficulties? Fertil Steril 2008; 90:497-505. [DOI: 10.1016/j.fertnstert.2007.07.1297] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 06/04/2007] [Accepted: 07/02/2007] [Indexed: 11/30/2022]
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Hayes RD, Dennerstein L, Bennett CM, Sidat M, Gurrin LC, Fairley CK. Risk Factors for Female Sexual Dysfunction in the General Population: Exploring Factors Associated with Low Sexual Function and Sexual Distress. J Sex Med 2008; 5:1681-93. [DOI: 10.1111/j.1743-6109.2008.00838.x] [Citation(s) in RCA: 255] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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NELSON DEBORAHB, SAMMEL MARYD, FREEMAN ELLENW, LIN HUI, GRACIA CLARISAR, SCHMITZ KATHRYNH. Effect of Physical Activity on Menopausal Symptoms among Urban Women. Med Sci Sports Exerc 2008; 40:50-8. [DOI: 10.1249/mss.0b013e318159d1e4] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Schover LR. Androgen therapy for loss of desire in women: is the benefit worth the breast cancer risk? Fertil Steril 2007; 90:129-40. [PMID: 18023435 DOI: 10.1016/j.fertnstert.2007.05.057] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 05/23/2007] [Accepted: 05/23/2007] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To contrast the limited evidence that androgen therapy is an effective treatment for low sexual desire in women with the extensive literature suggesting that androgens promote breast cancer. DESIGN Evidence from population studies of women is reviewed on the association between endogenous androgen levels and sexual function or satisfaction. Recent randomized trials of testosterone therapy for low desire are critiqued in terms of methodology and generalizability. Research on endogenous testosterone levels and breast cancer risk in both premenopausal and postmenopausal women is summarized, as are recent studies of androgenic hormonal therapy and breast cancer risk. SETTING Literature review. PATIENT(S) Not applicable. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Not applicable. RESULT(S) Endogenous androgen levels are not correlated with sexual desire in population-based studies of aging women. Factors that are strongly associated with low desire include pain with sexual activity, emotional distress, life stress, and relationship conflict. The efficacy of testosterone therapy for women's desire problems is modest. Expectancy effects were not adequately controlled in randomized trials. Epidemiological findings agree that higher endogenous serum androgen levels confer increased breast cancer risk both before and after menopause. Androgenic hormonal replacement regimens also increase the risk of breast cancer. CONCLUSION(S) Testosterone supplementation should not be prescribed to women with low sexual desire unless long-term studies can demonstrate its efficacy and safety. Treatments for low sexual desire in women should address its common correlates: relationship distress, emotional distress, and dyspareunia.
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Affiliation(s)
- Leslie R Schover
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77230-1439, USA.
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Woods NF, Smith-Dijulio K, Percival DB, Tao EY, Taylor HJ, Mitchell ES. Symptoms during the menopausal transition and early postmenopause and their relation to endocrine levels over time: observations from the Seattle Midlife Women's Health Study. J Womens Health (Larchmt) 2007; 16:667-77. [PMID: 17627402 DOI: 10.1089/jwh.2006.0138] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To determine whether hot flashes, depressed mood, sleep, cognitive and sexual symptoms correlate with urinary follicle-stimulating hormone (FSH), estrone (E(1)G), and testosterone (T) and with each other during the menopausal transition and early postmenopause (PM). METHODS Forty-one women who transitioned from middle or late transition stage to PM rated symptoms and provided monthly urine specimens as part of a longitudinal study of the menopausal transition. RESULTS Correlations between endocrine levels and symptom severity ratings over time revealed that hot flash severity was significantly and positively related to FSH and negatively to E1 G. Vaginal dryness was positively correlated with FSH and negatively correlated with T. Decreased sexual desire was correlated negatively with E(1)G levels. Forgetfulness was positively correlated with FSH; difficulty concentrating was negatively correlated with T. Severity of sleep symptoms and depressed mood were not correlated with E(1)G, FSH, or T. Correlations among the symptoms revealed that severity of hot flashes was associated with sleep disruption and forgetfulness. Depressed mood was correlated with sleep disruption, difficulty concentrating, and decreased sexual desire but not with hot flashes or vaginal dryness. Awakening during the night was correlated with decreased sexual desire and vaginal dryness, as well as hot flashes. Forgetfulness was associated with hot flashes and difficulty concentrating, whereas difficulty concentrating was associated with depressed mood and early awakening. CONCLUSIONS Symptoms many women experience during the menopausal transition and early PM are related to different endocrine levels (FSH, E(1)G, and T).
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Affiliation(s)
- Nancy Fugate Woods
- Department of Family and Child Nursing, University of Washington, Seattle, Washington 98195-7260, USA.
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Freeman EW, Sammel MD, Lin H, Gracia CR, Pien GW, Nelson DB, Sheng L. Symptoms associated with menopausal transition and reproductive hormones in midlife women. Obstet Gynecol 2007; 110:230-40. [PMID: 17666595 DOI: 10.1097/01.aog.0000270153.59102.40] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the hypothesis that prevalence of women with menopausal symptoms of hot flushes; aches, joint pain, and stiffness; depressed mood; poor sleep; decreased libido; or vaginal dryness increases with progression through the menopausal transition. METHODS Women in the Penn Ovarian Aging Study were assessed longitudinally for 9 years. Data were obtained from structured interviews, a validated symptom questionnaire, menstrual bleeding dates and early follicular hormone measures (estradiol [E2], follicle-stimulating hormone [FSH], and inhibin b). Menopausal stages were based on menstrual bleeding patterns. Other risk factors included age, race, history of depression, current smoking, body mass index, and perceived stress. Generalized linear regression models for repeated measures were used to estimate associations among the variables with each symptom. RESULTS The prevalence of hot flushes; aches, joint pain, and stiffness; and depressed mood increased in the menopausal transition. Menopausal stage was associated with hot flushes (P<.001); aches joint pain, and stiffness (P<.001); and depressed mood (P=.002). Within-woman fluctuations of E2 were associated with hot flushes and aches. Poor sleep, decreased libido, and vaginal dryness were not associated with menopausal stages. There was 80% power to detect an absolute difference of 11% for libido and vaginal dryness and 17% for poor sleep in the prevalence of these symptoms in the late menopausal transition compared with premenopausal status. CONCLUSION The study highlights the role of menopausal stages for some symptoms of midlife women and indicates that stages in the transition to menopause are associated with hot flushes; aches, joint pain, and stiffness; and depressed mood. Fluctuations of E2, decreased levels of inhibin b, and increased FSH levels were associated with these symptoms. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Ellen W Freeman
- Departments of Obstetrics/Gynecology, Psychiatry, University of Pennsylvania, 3701 Market Street, Philadelphia, PA 19104, USA.
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Reed SD, Newton KM, LaCroix AZ, Grothaus LC, Ehrlich K. Night sweats, sleep disturbance, and depression associated with diminished libido in late menopausal transition and early postmenopause: baseline data from the Herbal Alternatives for Menopause Trial (HALT). Am J Obstet Gynecol 2007; 196:593.e1-7; discussion 593.e7. [PMID: 17547910 PMCID: PMC1976304 DOI: 10.1016/j.ajog.2007.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 11/16/2006] [Accepted: 03/02/2007] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The objective of the study was to evaluate the association of depression, sleep disturbance, and menopausal symptoms with diminished libido. STUDY DESIGN Data from a 2001-2002 baseline survey of 341 peri- and postmenopausal women, aged 45-55 years, participating in a randomized trial, was analyzed. Eligibility included at least 2 hot flashes and/or night sweats per day and no hormone therapy for at least the prior 3 months. The survey evaluated sexual function, depression, sleep, and vasomotor symptoms. We examined the association between these factors, using multivariate regression models. RESULTS Of 341 women, 64% had diminished libido, 18% had moderate to severe depression, and 43% had poor sleep quality. Women averaged 4.6 hot flashes and 1.9 night sweats per day. Depressive symptoms (P = .003), poor sleep (P = .02), and night sweats (P = .04) were significantly associated with diminished libido. CONCLUSION Factors associated with diminished libido in midlife are complex but include depression, disturbed sleep, and night sweats, all common symptoms of the menopausal transition and early menopause.
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Affiliation(s)
- Susan D Reed
- Center for Health Studies, Group Health Cooperative, University of Washington School of Medicine, Seattle, WA, USA
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Hayes RD, Bennett C, Dennerstein L, Gurrin L, Fairley C. Modeling response rates in surveys of female sexual difficulty and dysfunction. J Sex Med 2007; 4:286-95. [PMID: 17367424 DOI: 10.1111/j.1743-6109.2007.00433.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Studies that address sensitive topics, such as female sexual difficulty and dysfunction, often achieve poor response rates that can bias results. Factors that affect response rates to studies in this area are not well characterized. AIM To model the response rate in studies investigating the prevalence of female sexual difficulty and dysfunction. Methods. Databases were searched for English-language, prevalence studies using the search terms: sexual difficulties/dysfunction, woman/women/female, prevalence, and cross-sectional. Studies that did not report response rates or were clinic-based were excluded. A multiple linear regression model was constructed. MAIN OUTCOME MEASURES Published response rates. RESULTS A total of 1,380 publications were identified, and 54 of these met our inclusion criteria. Our model explained 58% of the variance in response rates of studies investigating the prevalence of difficulty with desire, arousal, orgasm, or sexual pain (R(2) = 0.581, P = 0.027). This model was based on study design variables, study year, location, and the reported prevalence of each type of sexual difficulty. More recent studies (beta = -1.05, P = 0.037) and studies that only included women over 50 years of age (beta = -31.11, P = 0.007) had lower response rates. The use of face-to-face interviews was associated with a higher response rate (beta = 20.51, P = 0.036). Studies that did not include questions regarding desire difficulties achieved higher response rates than those that did include questions on desire difficulty (beta = 23.70, P = 0.034). CONCLUSION Response rates in prevalence studies addressing female sexual difficulty and dysfunction are frequently low and have decreased by an average of just over 1% per anum since the late 60s. Participation may improve by conducting interviews in person. Studies that investigate a broad range of ages may be less representative of older women, due to a poorer response in older age groups. Lower response rates in studies that investigate desire difficulty suggest that sexual desire is a particularly sensitive topic.
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Abstract
OBJECTIVE To examine the relationship between reproductive hormonal dynamics and sexual dysfunction assessed in a cohort of women approaching menopause. METHODS Women in the Penn Ovarian Aging Study were assessed at yearly intervals for 3 years with early follicular hormone measurements (estradiol, follicle-stimulating hormone, luteinizing hormone [LH], sex hormone binding globulin, dehyroepiandrosterone sulfate [DHEAS], total testosterone), anthropometric measures, and extensive questionnaires including the Female Sexual Function Index. Univariable analyses were performed to determine the association between hormones, menopausal status, and sexual dysfunction. Multivariable linear and logistic regression models were created to examine the influence of hormones on sexual function adjusting for the effect of potential confounders. RESULTS The final multivariable model indicated that sexual dysfunction increased with advanced menopausal status, with postmenopausal women being 2.3 times as likely to experience sexual dysfunction compared with premenopausal women (odds ratio 2.3, 95% confidence interval [CI] 1.3-4.1). Low DHEAS serum concentrations were associated with decreased sexual function (odds ratio 1.59, 95% CI 1.19-2.14). Additional risk factors associated with sexual dysfunction included absence of a sexual partner (11.2, 95% CI 6.9-18.1), high anxiety (3.8, 95% CI 1.6-9.2), and children under the age of 18 living at home (1.6, 95% CI 1.1-5.5). Lubrication, orgasm, and pain were specific aspects of sexuality negatively affected by menopause. CONCLUSION This study confirms the observation that sexual dysfunction increases over the menopausal transition. Several factors associated with sexual dysfunction include low DHEAS, absence of a sexual partner, anxiety, and children under the age of 18 living at home. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Clarisa R Gracia
- Department of Obstetrics/Gynecology, Center for Clinical Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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Tavares MC, Topic B, Abreu C, Waga I, Gomes U, Tomaz C, Mattern C. Effects of intra-nasally administered testosterone on sexual proceptive behavior in female capuchin monkeys (Cebus apella). Behav Brain Res 2007; 179:33-42. [PMID: 17280726 DOI: 10.1016/j.bbr.2007.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Accepted: 01/05/2007] [Indexed: 01/23/2023]
Abstract
Sexual dysfunction in the female has been associated with a decrease in androgen levels, which can be reversed by testosterone treatment, however, bearing the risk of adverse side effects. Nasally administered testosterone could be an effective method for androgenic treatment avoiding the first-pass intestinal and hepatic metabolism and side effects. Here we examined the effects of chronic intranasal administration of testosterone on sexual behavior in female capuchin monkeys (Cebus apella) that lived with male cohorts. During 8 days of baseline 10 females were observed for their sexual and non-sexual behavior without drug. They then received daily intranasal testosterone (0.24 mg per nostril, n=5 per group) or placebo gel for 5 days, followed by 5 days of wash out, followed by 5 days of daily intranasal application, whereby the animals that had received testosterone before, now received placebo and vice versa. Diverse sexual and non-sexual behaviors were scored. Blood samples were collected and analyzed for testosterone, estradiol, dihydrotestosterone and progesterone using EIAs. The results revealed an increase in sexual behavior (eyebrow raising, chest rubbing, courtship behavior, masturbation) in the females during testosterone treatment, which seemed to be prolonged even when testosterone treatment was discontinued. These behavioral results were accompanied by an increase in plasma testosterone levels. This study demonstrates the efficacy of testosterone in enhancing sexual behavior in female capuchin monkeys by means of intranasal application, which may be a useful alternative compared to other forms of administration.
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Affiliation(s)
- Maria Clotilde Tavares
- Primate Center and Laboratory of Neurosciences & Behavior, University of Brasília, Brasília, DF, Brazil
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Topic B, Tavares MC, Tomaz C, Mattern C. Prolonged effects of intra-nasally administered testosterone on proceptive behavior in female capuchin monkeys (Cebus apella). Behav Brain Res 2007; 179:60-8. [PMID: 17306379 DOI: 10.1016/j.bbr.2007.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 01/12/2007] [Indexed: 01/23/2023]
Abstract
Sexual dysfunction in the female has been associated with a decrease in androgen levels, which can be reversed by testosterone treatment, however, bearing the risk of adverse side effects. Previously we found that intranasal application of testosterone led to an increase in proceptive behavior in female capuchin monkeys, which was still enhanced beyond treatment pointing to prolonged effects. Here, we sought to replicate our previous findings and to further examine possible prolonged effects of such treatment. During 5 days of baseline females were observed for their sexual and non-sexual behavior without drug. They then received daily intranasal testosterone (0.24 mg per nostril) for 7 days, followed by 15 days of intranasal testosterone application every third day or were left undisturbed (n=5 per group). Diverse sexual and non-sexual behaviors were scored. Blood samples were collected and analyzed for testosterone, estradiol, and progesterone using immunoenzymatic chemiluminescent immunoassay. In accord with our previous results an increase in sexual proceptive behavior was revealed during testosterone treatment, which persisted about 2 weeks beyond treatment in the group receiving testosterone every third day as well as in the group that no longer received any treatment. These behavioral results were accompanied by an increase in plasma testosterone levels. This study demonstrates the efficacy of testosterone in enhancing sexual behavior in female capuchin monkeys by means of intranasal application, and provided evidence that daily substance application is not necessary to maintain beneficial effects on sexual behavior. These findings render the intranasal application procedure to be a useful alternative compared to other forms of administration.
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Affiliation(s)
- Bianca Topic
- Institute of Physiological Psychology, Heinrich-Heine-University of Düsseldorf, Universitätsstr. 1, D-40225 Düsseldorf, Germany.
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