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Sobel T, David P. Impact of Chronic Medical Disease on Sexual Function and Other Conditions. Obstet Gynecol Clin North Am 2024; 51:323-340. [PMID: 38777487 DOI: 10.1016/j.ogc.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Chronic diseases are prevalent and impact sexual health and function. Screening for and managing sexual dysfunction in women with chronic diseases is important to optimize well-being and quality of life. Clinicians should consider the biopsychosocial impact of chronic diseases on sexual health, screen for direct and indirect factors, and identify medications that may cause dysfunction. The authors recommend a multidisciplinary approach to treat sexual dysfunction in women with chronic diseases, including sexual medicine specialists, sex therapists, and pelvic floor physical therapists when indicated. This review provides a practical approach to assessing and managing sexual dysfunction in women with chronic diseases.
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Affiliation(s)
- Talia Sobel
- Department of Internal Medicine, Division of Women's Health, Mayo Clinic Arizona, 13737 North 92nd Street, Scottsdale, AZ 85260, USA.
| | - Paru David
- Department of Internal Medicine, Division of Women's Health, Mayo Clinic Arizona, 13737 North 92nd Street, Scottsdale, AZ 85260, USA
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Ruffolo AF, Serati M, Casiraghi A, Benini V, Scancarello C, Di Dedda MC, Garbagnati C, Braga A, Candiani M, Salvatore S. The Impact of Systemic Sclerosis on Sexual Health: An Italian Survey. Healthcare (Basel) 2023; 11:2346. [PMID: 37628543 PMCID: PMC10454073 DOI: 10.3390/healthcare11162346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/05/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE To evaluate the impact of systemic sclerosis (SSc) on vulvovaginal atrophy (VVA) and sexual health in an Italian population. METHODS An Italian survey about the prevalence and severity of VVA (on a 0 to 10 scale) and sexual dysfunction (using the Female Sexual Function Index-FSFI) through an anonymous online questionnaire. We investigated couple relationships and intimacy with partners, the predisposition of patients to talk about their sexual problems, physicians' receptivity, and treatment scenarios. Risk factors for VVA symptoms and sexual dysfunction were assessed. RESULTS A total of 107 women affected by SSc were enrolled. Of these, 83.2% of women (89/107) complained about VVA symptoms and 89.7% (among sexually active women; 87/97) about sexual dysfunction. Menopausal status did not affect VVA symptoms, while age was the only independent risk factor for sexual dysfunction. About 70% (74/107) of women reported a negative impact of disturbances on intimacy with their partner. A total of 63 women (58.9%) had never discussed their sexual problems and VVA condition with a physician. Lubricants were the only treatment prescribed, and 75% of women would welcome new therapies, even if experimental (62.9%). CONCLUSIONS In women with SSc, VVA symptoms and sexual dysfunction are highly prevalent, independently from menopause. In more than half of the investigated women with SSc, we found reluctance to talk about their sexual problems, despite being symptomatic. This should encourage physicians to investigate vulvovaginal and sexual health. SSc patients would welcome the advent of new treatment possibilities for their VVA and sexual complaints.
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Affiliation(s)
- Alessandro Ferdinando Ruffolo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (A.F.R.); (A.C.); (V.B.); (M.C.); (S.S.)
- Gynecological Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59037 Lille, France
| | - Maurizio Serati
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy;
| | - Arianna Casiraghi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (A.F.R.); (A.C.); (V.B.); (M.C.); (S.S.)
| | - Vittoria Benini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (A.F.R.); (A.C.); (V.B.); (M.C.); (S.S.)
| | - Chiara Scancarello
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy;
| | - Maria Carmela Di Dedda
- Department of Obstetrics and Gynecology, ASST FBF-SACCO Macedonio Melloni Hospital, 20129 Milan, Italy;
| | - Carla Garbagnati
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Via Commenda 12, 20122 Milan, Italy;
| | - Andrea Braga
- Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, 6850 Mendrisio, Switzerland;
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (A.F.R.); (A.C.); (V.B.); (M.C.); (S.S.)
| | - Stefano Salvatore
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (A.F.R.); (A.C.); (V.B.); (M.C.); (S.S.)
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Gao R, Qing P, Sun X, Zeng X, Hu X, Zhang S, Yang Y, Qin L. Prevalence of Sexual Dysfunction in People With Systemic Sclerosis and the Associated Risk Factors: A Systematic Review. Sex Med 2021; 9:100392. [PMID: 34280592 PMCID: PMC8360910 DOI: 10.1016/j.esxm.2021.100392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/10/2021] [Accepted: 05/23/2021] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION The association between systemic sclerosis (SSc) and sexual dysfunction was controversial. AIM To explore the impacts of SSc on sexual function, the prevalence of sexual dysfunction in patients with SSc and associated risk factors. METHODS A systematic review of all published studies was performed. Studies exploring the association between SSc and sexual function were retrieved from PubMed, Web of Science, and EBSCO. All retrieved papers were selected according to the inclusion and exclusion criteria. MAIN OUTCOME MEASURE The impacts of SSc on sexual function, the prevalence of sexual dysfunction in males and females with SSc and associated risk factors. RESULTS A total 12 studies were included in this study. The prevalence of sexual dysfunction in SSc males and SSc females were 76.9-81.4% and 46.7-86.6%, respectively. But the direct impacts of SSc on sexual function were controversial. EULAR SSc activity score ≥3, the number of complications ≥2, and the presence of anticardiolipin antibody and anti U1 ribonucleoprotein antibody in males and resistive index (RI) and the systolic/diastolic (S/D) ratio of clitoral blood in females have potential to be SSc-specific risk factors for sexual dysfunction. CLINICAL IMPLICATIONS Clinicians need to pay more attention to the impacts of SSc on sexual function of patients especially in those with risk factors. STRENGTHS & LIMITATIONS Systematically explored the prevalence of sexual dysfunction in SSc males and females, and the risk factors of sexual dysfunction for SSc were explored innovatively. However, there were some limitations in included studies prevented exploring the impacts of SSc on sexual function deeply. CONCLUSION Sexual dysfunction may be an important symptom of SSc, many risk factors may be associated with sexual dysfunction in males and females with SSc. Gao R, Qing P, Sun X, et al. Prevalence of Sexual Dysfunction in People With Systemic Sclerosis and the Associated Risk Factors: A Systematic Review. Sex Med 2021;9:100392.
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Affiliation(s)
- Rui Gao
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; West China School of Medicine, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Pingying Qing
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaochi Sun
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xun Zeng
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xiao Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Sirui Zhang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yihong Yang
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
| | - Lang Qin
- The Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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Restoux LJ, Dasariraju SR, Ackerman IN, Van Doornum S, Romero L, Briggs AM. Systematic Review of the Impact of Inflammatory Arthritis on Intimate Relationships and Sexual Function. Arthritis Care Res (Hoboken) 2020; 72:41-62. [PMID: 30941870 DOI: 10.1002/acr.23857] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review evidence of the impact of inflammatory arthritis on, or association of inflammatory arthritis with, intimate relationships and sexual function. METHODS Ovid Medline, Ovid PsycINFO, Ovid Embase, and EBSCO CINAHL databases were searched. Two independent reviewers selected articles, extracted data, and conducted manual searches of reference lists from included studies and previous reviews. The quality of evidence was assessed using standard risk-of-bias tools. RESULTS Fifty-five eligible studies were reviewed. Of these, 49 (89%) were quantitative, 5 (9.1%) were qualitative, and 1 (1.8%) used a mixed-method design. Few quantitative studies were rated as low risk of bias (n = 7 [14%]), many were rated as moderate (n = 37 [74%]) or high risk (n = 6 [12%]). Quantitative study sample sizes ranged from 10 to 1,272 participants, with a reported age range 32-63 years. Qualitative study sample sizes ranged from 8 to 57 participants, with a reported age range 20-69 years. In studies reporting the Female Sexual Function Index, all inflammatory arthritis groups demonstrated mean scores ≤26.55 (range of mean ± SD scores: 14.2 ± 7.8 to 25.7 ± 4.7), indicating sexual dysfunction. In studies reporting the International Index of Erectile Function, all inflammatory arthritis groups reported mean scores ≤25 (range of mean ± SD scores: 16.0 ± 5.3 to 23.8 ± 7.0), indicating erectile dysfunction. Key qualitative themes were impaired sexual function and compromised intimate relationships; prominent subthemes included inflammatory arthritis-related pain and fatigue, erectile dysfunction, diminished sexual desire, and sexual function fluctuations according to disease activity. CONCLUSION Sexual dysfunction appears highly prevalent among men and women with inflammatory arthritis, and increased clinician awareness of this impairment may guide provision of tailored education and support.
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Affiliation(s)
| | | | | | | | - Lorena Romero
- Alfred Medical Research and Education Precinct, Melbourne, Victoria, Australia
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Zegeye B, Woldeamanuel GG, Negash W, Shibre G. Sexual Satisfaction and Its Associated Factors among Married Women in Northern Ethiopia. Ethiop J Health Sci 2020; 30:169-178. [PMID: 32165806 PMCID: PMC7060387 DOI: 10.4314/ejhs.v30i2.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Sexual satisfaction is an essential component of overall health related quality of life. However, the epidemiology of sexual satisfaction among Ethiopian women is largely unknown. Hence, the present study was undertaken to investigate the sexual satisfaction and its associated factors among married women. Methods Community-based cross-sectional study with mixed approach was conducted from March 1 to April 30, 2019 in Kewot District, Northern Ethiopia on a sample of 397 married women. Quantitative data was collected on a face-to-face interview using a pre-tested questionnaire while qualitative data was collected using in-depth interviews. The new sexual satisfaction scale was used to assess sexual satisfaction of the women. Descriptive statistics and ordinal logistic regression analysis were performed using SPSS version 23. Results The findings showed that half of the participants (50.4%) expressed moderate sexual satisfaction, and only 39% of the participants reported greatest sexual satisfaction. Poor partner communication (AOR = 0.30, 95% CI; 0.11–0.79], poor sexual self-esteem (AOR = 0.17, 95% CI; 0.08 – 0.36), absence of social responsibility (AOR = 6.52, 95% CI; 3.32 – 12.80), poor sexual function (AOR = 0.36, 95% CI; 0.21 – 0.61), no previous information about sexuality (AOR = 0.06, 95% CI; 0.00 – 0.62) and perception of sexual talk as taboo (AOR = 7.15, 95% CI; 3.86 – 13.26) were significantly associated with sexual satisfaction. Conclusion Several factors could affect sexual satisfaction of married women. Therefore, development of educational programs, pre-marriage counseling and continuous education should be conducted.
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Affiliation(s)
- Betregiorgis Zegeye
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Wassie Negash
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Gebretsadik Shibre
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Agaba PA, Meloni ST, Sule HM, Agaba EI, Idoko JA, Kanki PJ. Sexual dysfunction and its determinants among women infected with HIV. Int J Gynaecol Obstet 2017; 137:301-308. [PMID: 28273350 DOI: 10.1002/ijgo.12140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/11/2017] [Accepted: 03/03/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To describe the prevalence of female sexual dysfunction (FSD) and its determinants among women with HIV infection enrolled for care and treatment in an ambulatory care setting. METHODS A questionnaire-based cross-sectional survey was conducted among women attending the HIV clinic of Jos University Teaching Hospital, Nigeria, between March 2013 and February 2014. The self-administered Female Sexual Function Index (FSFI) was used to assess FSD; a score of less than 26.55 indicated FSD. Pearson coefficient was used to assess interdomain correlation, and multiple linear regression was used to identify factors associated with FSD. RESULTS Among 370 participants, 330 (89.2%, 95% confidence interval [CI] 85.6%-92.2%) had FSD. The overall median FSFI score was 19.2 (interquartile range [IQR] 6.4-23.9). The arousal domain had the lowest subscore (median 2.7, IQR 0.0-3.6). The highest interdomain correlations were between lubrication and orgasm (r=0.87), arousal and lubrication (r=0.84), and arousal and orgasm (r=0.81) domains. Satisfactory health (β=3.34, 95% CI 1.16-5.52) and history of alcohol use (β=2.38, 95% CI 0.28-4.47) were independently associated with FSD. CONCLUSION FSD was prevalent among women with HIV infection. Care providers need to routinely address FSD as part of a comprehensive care package in the study setting.
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Affiliation(s)
- Patricia A Agaba
- Department of Family Medicine, University of Jos, Jos, Nigeria.,APIN Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Seema T Meloni
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Halima M Sule
- Department of Family Medicine, University of Jos, Jos, Nigeria.,APIN Centre, Jos University Teaching Hospital, Jos, Nigeria
| | | | - John A Idoko
- National Agency for the Control of AIDS, Abuja, Nigeria
| | - Phyllis J Kanki
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
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