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Angus-Leppan H, Arkell R, Watkins L, Heaney D, Cooper P, Shankar R. New valproate regulations, informed choice and seizure risk. J Neurol 2024:10.1007/s00415-024-12436-8. [PMID: 38896265 DOI: 10.1007/s00415-024-12436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 06/21/2024]
Abstract
Valproate is the most effective medication for generalised epilepsies, and several specific epilepsy syndromes. For some people, it will be the only medication to establish seizure remission, and withdrawing it carries risks of seizure recurrence and Sudden Unexpected Death in Epilepsy (SUDEP). It is also of proven efficacy for bipolar disorder and migraine prevention. Guidelines based on observational and epidemiological studies stress that maternal valproate related teratogenicity and neurodevelopmental effects are significantly higher than for other antiseizure medications (ASMs). It should, therefore, only be used if other medications are ineffective and after balancing the teratogenicity risk. Regulatory restrictions have changed prescribing practices and reduced valproate use. The number of other medications that must be trialled in the different conditions for which valproate has effectiveness and the consequences of the lack of efficacy of those drugs leading to significant harm including death remains unexplored. Risk minimisation measures (RMMs) for valproate, chiefly Pregnancy Prevention practices (PPP), consider foetal risk and not risk to people living with epilepsy. In the United Kingdom (UK), limitations relating to valproate use in all people < 55 years commenced in January 2024. While the evidence in child-bearing women is not disputed, the data in males are based on animal models, case reports, and one commissioned, unpublished, non-peer reviewed report unavailable to the UK public, stakeholder charities or professionals. Evidence suggests that 30-40% of people switching from valproate have breakthrough seizures. Thus, an estimated 21,000-28000 people in the UK will imminently be exposed to the potential hazards of breakthrough seizures, including death. There is little government investment in monitoring the effects of these changes to valproate prescribing on patient health and quality of life. This review summarises the history of valproate regulation, evidence underpinning it and argues how the latest regulations in the UK do not align with the country's medical regulatory bodies ethical principles nor with the Montgomery principles of informed patient choice and autonomy. It dissects how such regulations infringe Common Law principles, nor give due regard for patient outcomes beyond reproduction. The paper looks to provide recommendations to redress these concerns while appreciating the core need for such governance to emerge in the first place.
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Affiliation(s)
- Heather Angus-Leppan
- University of East London, Stratford, E15 4LZ, UK.
- National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, Queen Square, London, WC1N 3BG, UK.
- Royal Free London, Pond Street, London, NW3 2QG, UK.
| | - Rachel Arkell
- University of East London, Stratford, E15 4LZ, UK
- Kent Law School, University of Kent, Canterbury, CT2 7NS, UK
- Centre for Reproductive Research and Communication, British Pregnancy Advisory Service (BPAS), London, UK
| | - Lance Watkins
- University of South Wales, Pontypridd, UK
- University of Plymouth, Plymouth, UK
| | - Dominic Heaney
- National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, Queen Square, London, WC1N 3BG, UK
| | - Paul Cooper
- University of Manchester, Manchester, UK
- Manchester Centre for Clinical Neurosciences, Greater Manchester, Salford Royal Hospital, Stott Lane, Salford, M6 8HD, UK
| | - Rohit Shankar
- Peninsula School of Medicine, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK
- University of Plymouth, Plymouth, UK
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Cicek Ozdemir S, Dogan Gangal A, Senturk Erenel A. The Effect of Sexual Counseling Based on PLISSIT and EX-PLISSIT Models on Sexual Function, Satisfaction, and Quality of Life: A Systematic Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02898-2. [PMID: 38890226 DOI: 10.1007/s10508-024-02898-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 03/27/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024]
Abstract
This systematic review and meta-analysis study aimed to investigate the effect of sexual counseling based on PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) and EX-PLISSIT models on sexual function, satisfaction, and quality of sexual life. We searched seven electronic databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, ProQuest, Scopus, and PubMed). Studies published between January 1, 2010, and August 16, 2022, were included in the search. Eighteen articles were eligible for inclusion in the analysis. There was a significant difference in the sexual function scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (standardized mean difference (SMD): 1.677; 95% CI 0.668, 2.686; p < 0.05) and "sexual and communication satisfaction" sub-dimension of sexual life quality (SMD: 0.748; 95% CI 0.022, 1.475; p < 0.05). There was no difference in the sexual satisfaction (SMD: 0.425; 95% CI - 0.335, 1.184; p > 0.05) and quality of sexual life scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (SMD: - 0.09; 95% CI - 0.211, 0.032; p > 0.05). PLISSIT and EX-PLISSIT models-based sexual counseling on sexual function was affected by the moderator variables of the time of evaluation of the results after the intervention, type of comparison group, the study population, and by whom the intervention was applied. Sexual counseling based on the PLISSIT and EX-PLISSIT models improved sexual function scores and "sexual and communication satisfaction" sub-dimension of sexual life quality.
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Affiliation(s)
- Sevil Cicek Ozdemir
- Nursing Department, Faculty of Health Sciences, Kutahya Health Sciences University, 43100, Kutahya, Turkey.
| | - Aliye Dogan Gangal
- Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ayten Senturk Erenel
- Nursing Department, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
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Hassanein MM, Huri HZ, Abduelkarem AR. The impact of perceived vaginal and urinary symptoms and treatment burden in predicting sexual functioning among perimenopausal and postmenopausal women. Int J Gynaecol Obstet 2024. [PMID: 38874110 DOI: 10.1002/ijgo.15736] [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: 03/13/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE This study aimed to explore the relationship between urogenital symptom frequency and severity, perception of vaginal treatment burden, and female sexual desire, arousal, and satisfaction. METHODS A cross-sectional study was conducted with a sample of 326 patients from three tertiary care hospitals in the United Arab Emirates. The frequency and severity of urogenital symptoms, emotional and physical functioning, and treatment burden were assessed using the validated genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVATQ). To examine the mediating roles of emotional and physical functioning, as well as the perceived treatment burden on sexual functioning, a partial least squares-structural equation model was developed using the SmartPLS 4 Software. RESULTS The measurement model was successfully established. All constructs had a reliability of > 0.70 and discriminant validity of < 0.90. Emotional, physical and sexual functioning showed an adjusted R2 values of 0.377, 0.282 and 0.169, respectively.The multistep multiple mediator model revealed a full mediation effect of both emotional and physical functioning between symptom, treatment burden and sexual functioning. The model showed high predictive performance with all manifest variables showing lower mean absolute errors compared to the naiive benchmark model. CONCLUSION This study enhances our understanding of the relationships between urogenital symptoms, perceived treatment burden, emotional functioning, and sexual well-being. The findings emphasize the importance of addressing emotional well-being in managing urogenital symptoms and in addressing emotional factors associated with the use of vaginal treatments.
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Affiliation(s)
- Mohammed M Hassanein
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hasniza Zaman Huri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Abduelmula R Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Virkkunen V, Kero K, Koivisto M, Niiranen T, Heinonen O, Stenholm S, Polo‐Kantola P. Associations between arterial health and sexual function in women aged 60-64 years. Acta Obstet Gynecol Scand 2024; 103:1132-1141. [PMID: 38482868 PMCID: PMC11103145 DOI: 10.1111/aogs.14826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Female sexual dysfunction is very common, but its determinants remain under-investigated. Vasculogenic impairments are suggested to be related to female sexual dysfunction, but previous literature regarding the association is scarce. This study aims to study the association between arterial health and female sexual function in women in their 60s. MATERIAL AND METHODS The sample for this cross-sectional study comprised 117 women (aged 60-64 years) who participated in the Finnish Retirement and Aging study. Arterial health was measured according to the participants' pulse wave velocity, ankle-brachial index, blood pressure, and pulse pressure. Sexual function was measured using the Female Sexual Function Index, which resulted in a total score and six sub-scores. Associations were examined using multivariable regression analyses, which were adjusted for age, relationship happiness, systemic menopausal hormone therapy and/or local estrogen, smoking, alcohol risk use, body mass index, and depressive symptoms. RESULTS Higher diastolic blood pressure was associated with a higher total Female Sexual Function Index score (β = 0.24, 95% confidence interval [CI] 0.07-0.41) and with higher desire (β = 0.02, 95% CI 0.01-0.04), arousal (β = 0.04, 95% CI 0.01-0.08), lubrication (β = 0.04, 95% CI 0.002-0.08), satisfaction (β = 0.03, 95% CI 0.003-0.05), and pain (β = 0.06, 95% CI 0.02-0.10) sub-scores. Also, higher ankle-brachial index was associated with higher satisfaction sub-score (β = 2.10, 95% CI 0.44-3.73) and lower pulse pressure was associated with higher orgasm sub-score (β = 0.03, 95% CI 0.0002-0.06). Other associations between ankle-brachial index and Female Sexual Function Index scores were statistically insignificant, but considering the magnitude the findings may imply clinical significance. Systolic blood pressure and pulse wave velocity were not associated with sexual function. CONCLUSIONS This study suggested a plausible association between higher diastolic blood pressure and female sexual function, but considering clinical significance our findings suggest an association between higher ankle-brachial index and good sexual function in women in their 60s.
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Affiliation(s)
- Viivi Virkkunen
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
| | - Katja Kero
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
| | - Mari Koivisto
- Department of BiostatisticsUniversity of TurkuTurkuFinland
| | - Teemu Niiranen
- Department of Internal MedicineTurku University Hospital, University of TurkuTurkuFinland
- Department of Public Health SolutionsFinnish Institute for Health and WelfareHelsinkiFinland
| | - Olli Heinonen
- Paavo Nurmi Center & Unit for Health and Physical ActivityUniversity of TurkuTurkuFinland
| | - Sari Stenholm
- Department of Public HealthTurku University Hospital, University of TurkuTurkuFinland
- Center for Population Health ResearchTurku University Hospital, University of TurkuTurkuFinland
- Research ServicesTurku University Hospital and University of TurkuTurkuFinland
| | - Päivi Polo‐Kantola
- Department of Obstetrics and GynecologyTurku University Hospital and University of TurkuTurkuFinland
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Schwesig R, Macht K, Heidenreich T, Vetter A, Hoyer J. Women's Safety Behaviors before and during Sexual Activity: Psychometric Properties of Its Self-Report Questionnaire in German Women. JOURNAL OF SEX & MARITAL THERAPY 2024:1-16. [PMID: 38807418 DOI: 10.1080/0092623x.2024.2357129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Sexual safety behaviors (SSB) may constitute a relevant factor for the development and maintenance of sexual dysfunctions. The present study aims to improve the understanding of SSB in women. A total of N = 923 women completed an online survey consisting of the Questionnaire on Behaviors Before and During Sexual Activities, a measure of SSB, and a set of other questionnaires that assessed sexual dysfunctions, anxiety, depression, and other clinically relevant variables. Exploratory and confirmatory factor analyses of the QBSA revealed a robust three-factor solution with 1) cognitive and behavioral avoidance, 2) use of lubricants, and 3) thought and body control. While some SSB were generally common in women, others discriminated well between women with sexual dysfunctions, women with sexual problems, and women without impairment. SSB was significantly negatively associated with women's level of sexual functioning and positively with repetitive and negative thought processes, depression, and anxiety. Overall, the concept of SSB can be reliably measured and SSBs correlate meaningfully with variables measuring women's mental health. We argue that the concept of SSB should be further developed as it can enrich present sexual therapeutic treatment approaches, especially in the context of cognitive-behavioral therapy.
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Affiliation(s)
- Rebekka Schwesig
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Klara Macht
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Thomas Heidenreich
- Faculty Social Work, Education and Nursing Sciences, Esslingen University, Esslingen, Germany
| | - Anna Vetter
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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van Eickels D, Schick M, Germeyer A, Rösner S, Strowitzki T, Wischmann T, Ditzen B. Predictors of partnership and sexual satisfaction and dyadic effects in couples affected by endometriosis and infertility. Arch Gynecol Obstet 2024:10.1007/s00404-024-07516-z. [PMID: 38705889 DOI: 10.1007/s00404-024-07516-z] [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: 09/17/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Endometriosis and infertility are associated with impaired partnership and sexuality of the patients, but also of their male partners. Also, endometriosis is one of the most common causes of infertility, resulting in a large overlap of both pathologies. The aim of this study was to determine the association of different predictors of partnership and sexual satisfaction and dyadic effects in couples with endometriosis and infertility. METHODS A cross-sectional study was conducted with n = 62 women with endometriosis and n = 46 partners, including a total of n = 44 couples, some of whom were affected by infertility. The questionnaire included items on partnership, sexuality, depression, social support, and desire for a child. Multiple linear regression and the actor-partner-interdependence-model were used for analysis. RESULTS Significant dyadic effects only occurred in couples with both endometriosis and infertility. Depression showed a significant negative actor effect in men for partnership satisfaction and a negative actor and partner effect in women for sexuality satisfaction (p < .05). For women, social support showed a significant positive actor effect for partnership satisfaction (p < .05), age showed a significant actor and partner effect for sexuality satisfaction (p < .05). CONCLUSION The results show a significant association of endometriosis and infertility with partnership and sexuality satisfaction. Infertility could be a decisive factor. However, the large overlapping of both endometriosis und infertility in many couples support the importance of further studies to differentiate between the both effects. TRIAL REGISTRATION German Clinical Trials Register DRKS00014362 on the 29.03.2018.
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Affiliation(s)
- Deborah van Eickels
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany.
| | - Maren Schick
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ariane Germeyer
- Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Sabine Rösner
- Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Thomas Strowitzki
- Department of Gynecological Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
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Shettima FB, Wakil MA, Sheikh TL, Abdulaziz M, Rabbebe IB, Wakawa IA, Placidus O. Prevalence and correlates of sexual dysfunction among patients with schizophrenia spectrum disorder on antipsyhotic medications in Maiduguri, Northeastern Nigeria. Int J Psychiatry Med 2024; 59:373-392. [PMID: 37616598 DOI: 10.1177/00912174231196612] [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] [Indexed: 08/26/2023]
Abstract
OBJECTIVES Despite the importance of a satisfying sexual life, most patients with schizophrenia spectrum disorders do not discuss sexual issue with their clinicians. The current study seeks to determine the prevalence and socio-clinical correlates of sexual dysfunction among patients with schizophrenia spectrum disorders receiving typical and atypical antipsychotic medications. The second objective is to determine the frequency and correlates of specific sexual dysfunction (desire, arousal, erection/lubrication and orgasm) by gender and drug type using the Arizona Sexual Experience Scale. METHODOLOGY This cross-sectional study used standardized structured interviewer based survey to assess sexual dysfunction among patients with schizophrenia that are both sexually active and inactive at a tertiary hospital in Maiduguri from December 2020 to April 2021. Participants were also assayed for prolactin using ELISA Kit for a possible association with sexual dysfunction. RESULTS The overall prevalence of sexual dysfunction among patients with schizophrenia spectrum disorder receiving antipsychotics was 34% with patients on typical and atypical antipsychotics reporting rates of 36.8% and 24.6%, respectively. Among the typical and atypical antipsychotics, patients receiving haloperidol (40.3%) and risperidone (37.5%) reported a relatively higher frequency of sexual dysfunction compared to those receiving clozapine (18.2%). Independent correlates of sexual dysfunction were: female gender (OR = 1.89, 95% CI = 1.17-3.06; P = .010), being unmarried (OR = 1.51, 95% CI = 1.17-1.96; P = .001), pseudoparkinsonism (OR = 1.66, 95% CI = 1.02-2.69; P = .008), prolactin (OR = 2.15, 95% CI = 1.34-3.43; P = .001) and severity of illness (OR = 1.34, 95% CI = 1.03-1.75; P = .030). CONCLUSION Sexual dysfunction is prevalent among patients with schizophrenia spectrum disorder receiving either typical or atypical antipsychotics.
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Affiliation(s)
- Falmata Baba Shettima
- Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Maiduguri, Nigeria
| | - Musa Abba Wakil
- Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Maiduguri, Nigeria
| | | | | | - Isa Bukar Rabbebe
- Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Maiduguri, Nigeria
| | - Ibrahim Abdu Wakawa
- Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Maiduguri, Nigeria
| | - Ogualili Placidus
- Departmental of Mental Health, Federal Neuropsychiatric Hospital Maiduguri, Maiduguri, Nigeria
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Ceasar RC, Ladi-Seyedian SS, Escobar D, Han J, Koh K, Porten S, Chu C, Gould EE, Bhanvadia S. "I think my vagina is still there?": Women's perspectives on sexual function and dysfunction following radical cystectomy for bladder cancer, a qualitative study. J Sex Med 2024; 21:464-470. [PMID: 38491395 DOI: 10.1093/jsxmed/qdae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/22/2024] [Accepted: 01/28/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Women's sexual health after radical cystectomy is an important but poorly understood aspect of bladder cancer survivorship. Dedicated investigation is needed to elucidate patient perceptions on sexual function and dysfunction in this setting. AIMS In this study we sought to qualitatively examine women's perceptions and experiences of sexual health following radical cystectomy for bladder cancer. METHODS We conducted one-on-one qualitative telephone interviews with 40 women who underwent radical cystectomy in the past 6 months to 5 years and signed a research consent form to be contacted for future studies. We examined women's experiences of engaging in sexual activity after surgery and their attitudes toward sex and body image. We audio recorded, transcribed, and coded the interviews using ATLAS.ti software and applied grounded theory methods for analysis. OUTCOMES For data that emerged during the qualitative interviews that was related to lack of knowledge about how physical and psychological sexual health would be affected after surgery, we reviewed and discussed transcripts that enabled coding of the data into emerging topic areas. RESULTS Our analysis yielded 4 main themes. (1) Women reported receiving little to no information from providers about female sexual dysfunction prior to or after radical cystectomy. Women wished they had been provided more information about female sexual dysfunction from their clinicians, including strategies for postoperative self-pleasure and nonintercourse methods of sexual pleasure with partners. (2) Women shared that they were not sexually active following surgery due to physical and mental barriers. (3) When women did try to engage in sex, they described feeling disappointed that it did not feel the same as prior to surgery. (4) Some women found that physical therapy helped them to physically and mentally recover their strength to engage in sexual activity again. CLINICAL IMPLICATIONS Clinicians must directly address sexual health concerns with patients who undergo radical cystectomy. STRENGTHS AND LIMITATIONS This study has several key strengths. Investigation into women's sexual function and dysfunction addresses a gap in understanding of this component of women's health-related quality of life after radical cystectomy, which represents an unmet need. The large number of interviews conducted as well as the in-depth information obtained through one-on-one interviews are additional strengths. This study also has limitations, including possible shortcomings of telephone interviews compared with in-person interviews. However, telephone interviews were beneficial because the interviews took place during the COVID-19 pandemic and spared patients from extra visits or from having to travel long distances to the respective medical centers. Other possible limitations were that patients may have been reluctant to share all of their experiences and that patients who underwent urostomies, also termed ileal conduits, were overrepresented in this study compared with women who underwent continent urine diversions, which allow greater control over urine output. CONCLUSION Broadening the understanding of sexual health beyond sexual intercourse to encompass sexuality and self-pleasure can provide clinicians, patients, and their families with more effective preparation and strategies to care for an essential aspect of their wellbeing.
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Affiliation(s)
- Rachel Carmen Ceasar
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, 1845 N Soto St, Los Angeles, CA 90032, United States
| | - Seyedeh-Sanam Ladi-Seyedian
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Domenique Escobar
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Jullet Han
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Kailyn Koh
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
| | - Sima Porten
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Carissa Chu
- Department of Urology, University of California, San Francisco, 400 Parnassus Ave, San Francisco, CA 94143, United States
| | - Erin E Gould
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, 1845 N Soto St, Los Angeles, CA 90032, United States
| | - Sumeet Bhanvadia
- Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Ave, Los Angeles, CA 90033, United States
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Gonçalves ACN, Amorim RB, Domingues BDS, Sousa JVA, Veiga DF. Female Sexual Function Index Adaptation for Breast Cancer Patients (FSFI-BC): Brazilian Portuguese Translation and Cultural Adaptation. Clin Breast Cancer 2024:S1526-8209(24)00105-8. [PMID: 38729822 DOI: 10.1016/j.clbc.2024.04.005] [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: 07/26/2023] [Revised: 01/21/2024] [Accepted: 04/06/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The assessment of female sexual function after diagnosis and treatment of breast cancer is relevant, as cancer can negatively affect sexuality and, therefore, quality of life. Instruments assessing female sexuality can be useful in clinical practice. However, there are few validated instruments available for this purpose. This study aimed to translate the Female Sexual Function Index Adaptation for Breast Cancer Patients (FSFI-BC) into Brazilian Portuguese and culturally adapt it for use in Brazil. PATIENTS AND METHODS Translation and cross-cultural adaptation followed the linguistic validation process, according to international guidelines. The instrument was translated and back-translated by independent translators. Sixty women aged 25 to 70 years who had been diagnosed and surgically treated for breast cancer at least 6 months previously participated in the cultural adaptation process. Participants were stratified into sexually active or inactive. Internal consistency was analyzed using Cronbach's alpha coefficient. RESULTS Mean participant age was 52.5 years. For sexually active women, reliability analysis (Cronbach's alpha) showed excellent internal consistency between the items of the subscales 'Desire/Arousal' (α = 0.912) and 'Orgasm' (α = 0.904), and good internal consistency for 'Lubrication' (α = 0.814) and 'Pain' (α = 0.839). For sexually inactive women, excellent internal consistency was observed between the items of the subscale 'Reason for Inactivity - difficulty lubricating' (α = 0.930), and good internal consistency for the other subscales. The instrument had face and content validity. CONCLUSIONS FSFI-BC was translated and culturally adapted to the context of the Brazilian population.
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Affiliation(s)
- Ana Cláudia Neves Gonçalves
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo - Unifesp, São Paulo, Sao Paulo, Brazil; School of Medical Sciences, Universidade do Vale do Sapucaí - Univás, Pouso Alegre, Minas Gerais, Brazil
| | - Renata Bites Amorim
- Division of Breast Surgery, Universidade do Vale do Sapucaí - Univás, Pouso Alegre, Minas Gerais, Brazil
| | - Bianca de Souza Domingues
- School of Medical Sciences, Universidade do Vale do Sapucaí - Univás, Pouso Alegre, Minas Gerais, Brazil
| | - Júlia Vieira Araújo Sousa
- School of Medical Sciences, Universidade do Vale do Sapucaí - Univás, Pouso Alegre, Minas Gerais, Brazil
| | - Daniela Francescato Veiga
- Graduate Program in Translational Surgery, Universidade Federal de São Paulo - Unifesp, São Paulo, Sao Paulo, Brazil; Division of Plastic Surgery, Universidade do Vale do Sapucaí - Univás, Pouso Alegre, Minas Gerais, Brazil.
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10
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Seyedolmohadesin M, Ashkani M, Ghadikolaei TS, Mirshekar M, Bostanghadiri N, Aminzadeh S. Unraveling the complex relationship: Multiple sclerosis, urinary tract infections, and infertility. Mult Scler Relat Disord 2024; 84:105512. [PMID: 38428292 DOI: 10.1016/j.msard.2024.105512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is an immune system disorder that affects the central nervous system (CNS) and progressively damages nerve fibers and protective myelin. People with MS often experience a wide range of complications, including lower urinary tract dysfunction, urinary tract infections (UTIs) and sexual dysfunction. MS is common in young people and can lead to sexual dysfunction (SD) and infertility, which becomes more pronounced as the disease progresses. RESULTS Over the past two decades, significant advances have been made in the management of MS, which may slow the progression of the disease and alter its course. However, UTI and SD remain significant challenges for these patients. Awareness of the underlying complications of MS, such as UTIs and infertility, is crucial for prevention, early detection and appropriate treatment, as there is a causal relationship between UTIs and the use of corticosteroids during an attack. CONCLUSION This article provides an overview of potential microbial pathogens that contribute to the development of MS, as well as an assessment of people with MS who report UTIs and infertility.
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Affiliation(s)
- Maryam Seyedolmohadesin
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Azad University, Tehran, Iran
| | - Maedeh Ashkani
- Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Taravat Sadeghi Ghadikolaei
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Mirshekar
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narjess Bostanghadiri
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soheila Aminzadeh
- Toxicology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Toxicology, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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11
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Kaundal A, Renjhen P, Kumari R, Jha RP, Marwaha PD, Kaur H, Kaushal S, Malik N, Gupta J. Female sexual dysfunction-knowledge, attitude, practices, and barriers encountered by medical fraternity across the country: A web-based cross-sectional study. J Family Med Prim Care 2024; 13:1284-1290. [PMID: 38827699 PMCID: PMC11141967 DOI: 10.4103/jfmpc.jfmpc_1013_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/20/2023] [Accepted: 10/09/2023] [Indexed: 06/04/2024] Open
Abstract
Introduction Sexual dysfunction in women is common yet often remains underdiagnosed due to the lack of adequate training and experience of the doctors to manage female sexual dysfunctions. This study was done to assess the knowledge and attitude of medical professionals toward female sexual dysfunction and the various practices and barriers they encounter while managing women with sexual dysfunction. Materials and Methods A web-based cross-sectional study was done using the snowball sampling method. A well-structured, self-administered, and pre-validated questionnaire containing 27 items was administered through social media. Data was collected and evaluated to assess their knowledge, practices they follow, and barriers encountered while managing female sexual dysfunction. Results A total of 513 doctors participated in the study. Out of all, only 11.1% of the doctors were often seeing patients with sexual dysfunction. Loss of desire (44%), painful intercourse (33%), lack of lubrication (18%), and anorgasmia (5%) are common symptoms with which women present. The majority of doctors (78.9%) were comfortable in starting a conversation, over half (52.6%) were confident in making a diagnosis, and 51.3% were confident in providing sexual counseling. Yet, only 11.1% were routinely screening women for sexual dysfunctions, and 33.8% were providing counseling regarding sexual issues. Lack of time (31.6%), lack of adequate training (57.3%), unavailability of effective treatment (11.9%), patient discomfort (60.62%), and patient's reluctance to seek treatment (15.8%) were the barriers encountered by doctors. When assessed for knowledge, around 30.9% had excellent knowledge (≥75th percentile) about female sexual dysfunction. Conclusion Sexual dysfunction among women is an important health issue that significantly affects the social, mental, and physical well-being of those suffering from it. Screening for sexual dysfunction should be done routinely in day-to-day clinical practice to improve the overall quality of life of a couple.
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Affiliation(s)
- Asmita Kaundal
- Department of Obstetrics and Gynecology, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Prachi Renjhen
- Department of Obstetrics and Gynecology, Baba Saheb Ambedkar Hospital and Medical College, New Delhi, India
| | - Rajeshwari Kumari
- Department of Obstetrics and Gynecology, Guru Teg Bahadur Hospital, New Delhi, India
| | - Ravi P. Jha
- Department of Community Medicine, Baba Saheb Ambedkar Hospital and Medical College, New Delhi, India
| | - Poojan D. Marwaha
- Department of Obstetrics and Gynecology, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Harpreet Kaur
- Department of Obstetrics and Gynecology, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Sushruti Kaushal
- Department of Obstetrics and Gynecology, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Nisha Malik
- Department of Obstetrics and Gynecology, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Jyoti Gupta
- Department of Psychiatry, AIIMS, Bilaspur, Himachal Pradesh, India
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12
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Saadedine M, Faubion SS, Grach SL, Nordhues HC, Kapoor E. Association between obesity and female sexual dysfunction: a review. Sex Med Rev 2024; 12:154-163. [PMID: 38112599 DOI: 10.1093/sxmrev/qead047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Obesity is a global health crisis that has been growing over the past few decades. The economic burden associated with obesity is substantial as it is associated with multiple disabling chronic diseases, such as cardiovascular disease, certain cancers, osteoarthritis, chronic pain, and mental illness. Obesity is known to be a risk factor for sexual dysfunction in men, but this association is less well understood in women. AIMS To provide a narrative review of the available literature on the relationship between overweight/obesity and female sexual dysfunction, elaborate on the possible mechanisms explaining this association, and discuss the effects of weight loss on sexual function in those with obesity. METHODS A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on obesity and sexual function in women. RESULTS The relationship between obesity and female sexual function is not consistent across studies. While women with obesity are more likely to have worse sexual function and avoid sexual activity, many studies have failed to identify these associations. Lifestyle changes resulting in weight loss lead to better sexual function, and bariatric surgery has been shown to improve sexual function in the first couple of years following the procedure; yet, the long-term effects of weight loss and bariatric surgery are still uncertain. CONCLUSIONS The evidence on the relationship between obesity and female sexual function is mixed. Nevertheless, weight loss has been shown to improve sexual function in women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on female sexual function require further study.
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Affiliation(s)
- Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
| | - Stephanie S Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
| | - Stephanie L Grach
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Hannah C Nordhues
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, MN 55905, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN 55905, United States
- Women's Health Research Center, Rochester, MN 55905, United States
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13
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Luz do Nascimento BH, Figueira JR, Rosa-E-Silva ACJDS, Reis RM, Andrade MCR, Brito LGO, Lara LADS. Management of hypoactive sexual desire dysfunction at a specialized service in women's sexual health. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:542-553. [PMID: 38482856 DOI: 10.1080/0092623x.2024.2329081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints.
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Affiliation(s)
| | | | | | - Rosana Maria Reis
- Ribeirão Preto Medical School, São Paulo University, Ribeirão Preto, SP, Brazil
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14
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Wu X, Zheng X, Yi X, Fan B. Association of the second birth mode of delivery and interval with maternal pelvic floor changes: a prospective cohort study. BMC Pregnancy Childbirth 2024; 24:178. [PMID: 38454330 PMCID: PMC10918865 DOI: 10.1186/s12884-024-06366-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes. METHODS This prospective cohort study included women who had a first delivery and were in weeks 36-41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver. RESULTS There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P < 0.001). The women with Cesarean section had a smaller hiatus area and circumference (P < 0.001 and P < 0.001). The hiatus diameters decreased with time in both groups (all P < 0.001) and were smaller after Cesarean section (both P < 0.001). The bladder neck at maximum Valsalva increased with time (all P < 0.001) without significant differences between the two groups. Finally, the proportion of patients with POP-Q stage 0/I increased with time in both groups (all P < 0.001), with the proportions being higher in the Cesarean group (P = 0.002). The birth interval was negatively correlated with the hiatus area (B=-0.17, 95%CI: -0.25, -0.08, P < 0.001) and positively correlated with the bladder neck at rest (B = 0.22, 95%CI: 0.08, 0.35, P = 0.001) and at maximum Valsalva (B = 0.85, 95%CI: 0.65, 1.05, P < 0.001). CONCLUSIONS In conclusion, the mode of delivery at the second birth could influence the hiatus area and circumference and bladder neck size. The birth interval was negatively correlated with the hiatus area and positively correlated with the bladder neck at rest and at maximum Valsalva.
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Affiliation(s)
- Xiaoli Wu
- Department of Ultrasonography, Panzhihua Central Hospital, No.34 Yikang Street, Panzhihua, Sichuan, 617067, China.
| | - Xiu Zheng
- Department of Ultrasonography, Panzhihua Central Hospital, No.34 Yikang Street, Panzhihua, Sichuan, 617067, China
| | - Xiaohong Yi
- Department of Ultrasonography, Panzhihua Central Hospital, No.34 Yikang Street, Panzhihua, Sichuan, 617067, China
| | - Bolin Fan
- Department of Ultrasonography, Panzhihua Central Hospital, No.34 Yikang Street, Panzhihua, Sichuan, 617067, China
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15
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Chongcharoen P, Choobun T, Khanuengkitkong S. Female sexual function index for screening of female sexual dysfunction using DSM-5-TR criteria in Thai women: A prospective cross-sectional diagnostic study. PLoS One 2024; 19:e0298935. [PMID: 38386669 PMCID: PMC10883536 DOI: 10.1371/journal.pone.0298935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Thai Female Sexual Function Index discrimination using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria has not been investigated. This study aimed to evaluate the Female Sexual Function Index as a tool for assessing sexual symptoms and to determine the prevalence of female sexual dysfunction in Thai women using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. This prospective cross-sectional diagnostic study included sexually active women aged ≥18 years, interviewed from January to June 2023. The participants completed the Thai version of a comprehensive of the Female Sexual Function Index questionnaire encompassing general information and self-reported assessments of female sexual function, followed by a semi-structured interview of distress symptom severity. Female sexual function was determined by screening of the total Female Sexual Function Index score, whereas female sexual dysfunction was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. Using receiver operating characteristic curves, a clinical cutoff for the Female Sexual Function Index score of 23.1 was determined to identify female sexual dysfunction (area under the curve, 0.76; 95% confidence interval, 0.71-0.80; sensitivity, 75.6%; specificity, 67.7%; positive predictive value, 77.7%; negative predictive value, 65%). A prevalence of 40.2% for female sexual dysfunction was observed in the study population. The results of this study could be used as practical guidance for the screening of women affected by female sexual dysfunction in Thailand in the future.
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Affiliation(s)
- Patthamaphorn Chongcharoen
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thanapan Choobun
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Siwatchaya Khanuengkitkong
- Department of Obstetrics & Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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16
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Baszak-Radomańska E, Wańczyk-Baszak J, Paszkowski T. Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women. Front Med (Lausanne) 2024; 11:1289418. [PMID: 38449880 PMCID: PMC10916695 DOI: 10.3389/fmed.2024.1289418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools, such as patient-reported outcomes (PROs) and pelvic floor examination, to improve women's sexual wellbeing and to identify predictors of poor quality of sexual life during the well-woman annual visit. Methods A cross-sectional study was designed to examine 300 healthy women to determine whether the sexual quality of life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (the vulva, anus, muscles, and periurethral (VAMP) protocol) of asymptomatic women during the annual bimanual examination (BME) help differentiate patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterion. Results The majority of subjects experienced high sexual wellbeing (82.0% with SQOL score of ≥84), with a mean of 85.7 points. SQOL scores were lower for psychiatric disorders or symptoms (37.0% of subjects), although they did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, and rectal, bowel, or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33.0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity), although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence, and was unrelated to the SQOL score (p = 0.151). Conclusion Women's sexual health is a global health priority. Finding a way to start a discussion with an asymptomatic patient is crucial to increasing patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual wellbeing direct the discussion mainly toward the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked. Gynecological consultation should resolve concerns, identify the problem, and refer for professional sexual care if still needed.
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Affiliation(s)
| | - Jadwiga Wańczyk-Baszak
- Terpa Clinic, OB/GYN Department, Lublin, Poland
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Paszkowski
- Department of Gynecology, Medical University of Lublin, Lublin, Poland
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17
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Abdus-Salam RA, Idowu OC, Akinlusi FM, Bello Y, Morhason-Bello IO. Effect of COVID-19 on sexual function and activities among reproductive-age women in Ibadan, South-West Nigeria. Sex Med 2024; 12:qfae004. [PMID: 38390285 PMCID: PMC10881290 DOI: 10.1093/sexmed/qfae004] [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: 09/23/2023] [Revised: 12/29/2023] [Accepted: 01/16/2024] [Indexed: 02/24/2024] Open
Abstract
Background Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health. Aim To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria. Methods This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at P < .05. Outcomes Respondents were aged 20 to 50 years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers. Results An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores. Clinical Implications Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction. Strength and Limitations Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results. Conclusion A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pandemic lockdown.
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Affiliation(s)
- Rukiyat Adeola Abdus-Salam
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan 200212, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Oluwasegun Caleb Idowu
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan 200212, Nigeria
| | - Fatimat Motunrayo Akinlusi
- Department of Obstetrics and Gynecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja 100254, Nigeria
| | - Yusuf Bello
- Department of Statistics, Faculty of Science, University of Ibadan, Ibadan 200005, Nigeria
- Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
| | - Imran Oludare Morhason-Bello
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan 200212, Nigeria
- Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
- Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
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Bagherinia M, Dolatian M, Mahmoodi Z, Ozgoli G, Alavi Majd H. Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis. BMC Womens Health 2024; 24:64. [PMID: 38267989 PMCID: PMC10809577 DOI: 10.1186/s12905-024-02899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Sexual problems and diminished sexual quality of life can adversely affect the physical, psychological, and emotional health of women. The present study was done to determine the social intermediate factors of health associated with sexual quality of life in women of reproductive age. DESIGN Systematic review and Meta-analysis. DATA SOURCES Embase, Web of Science, PubMed/Medline (NLM), ProQuest, and CENTRAL. ELIGIBILITY CRITERIA Observational studies (cross-sectional, case-control, cohort) from 2010 to 2022 with no language constraints were included. The sexual quality of life, as the main variable of the study, has been evaluated using Symonds women's sexual quality of life scale (SQOL-F). The health social determinants intermediate factors based on WHO model were considered as exposure variables. DATA EXTRACTION AND SYNTHESIS The data of included studies were extracted by two independent persons through a researcher-made checklist according to the study aims. Quality assessment of studies was done using Newcastle-Ottawa instrument. R software (Version R-4.2.1) were used for meta-analysis. Publication bias was evaluated by Egger & Begg tests. Sensitivity analysis was done through one-out remove approach. RESULTS Eventually, 15 studies were eligible to be included in this systematic review and meta-analysis. Variables of depression, quality of marital relation, body image, self-esteem, physical activity, and sexual function were among the health social intermediate factors associated with sexual quality of life. Publication bias had no effect on the obtained results; no study affecting the results was found through sensitivity analysis. CONCLUSION Considering the relationship between modifiable factors and sexual quality of life, it seems that identification of these factors can be an important step towards designing interventional studies to help women experience enhanced sexual quality of life.
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Affiliation(s)
- Marzieh Bagherinia
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- , Tehran, Iran.
| | - Zoherh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Şahin AB, Büyüktopcu E, Tükel R. Evaluation of Sexual Function According to Gender and Sexual Orientation during the COVID-19 Pandemic in Turkey: A National Online Survey Study. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:56-62. [PMID: 38556937 PMCID: PMC11003367 DOI: 10.5080/u26948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/22/2022] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Coronavirus Diseases-19 (COVID-19) pandemic that has caused the death of thousands of people affected negatively not only people's physical wellbeing but also their mental health. The aim of this study was to evaluate the sexual function, depression, anxiety and stress, and fear of COVID-19 of individuals according to gender and sexual orientation during the COVID-19 pandemic. METHOD The questionnaire form included sociodemographic data form, the Arizona Sexual Experiences Scale (ASEX), the Depression, Anxiety and Stress Scale-Short Form (DASS-21), and the Fear of COVID-19 Scale (FCV-19S). The form was distributed on social media platforms. RESULTS 1593 sexually active participants were included in the study. 47.5% of the participants were females and 52.5% were males. 86.9% of them were heterosexuals and 13.1% were lesbian, gay, and bisexual (LGB) individuals. ASEX, DASS-21 Depression, Anxiety, and Stress, and FCV-19S scores were significantly higher in females than males (p<0.001). When anxiety, depression, stress, and fear of COVID-19 were controlled, level of sexual dysfunction continued to be higher in women. We found that while the ASEX and FCV-19S scores were similar between the heterosexuals and LGBs (respectively p=0.66 and p=0.31), the DASS-21 Depression, Anxiety, and Stress scores were higher in LGBs (p<0.001). CONCLUSION Our results reveal the effect of the pandemic period on female sexual functions and the importance of addressing this topic in clinical practice and research.
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Affiliation(s)
| | | | - Raşit Tükel
- Prof., İstanbul University, Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
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Tordoff DM, Lunn MR, Chen B, Flentje A, Dastur Z, Lubensky ME, Capriotti M, Obedin-Maliver J. Testosterone use and sexual function among transgender men and gender diverse people assigned female at birth. Am J Obstet Gynecol 2023; 229:669.e1-669.e17. [PMID: 37678647 PMCID: PMC11182338 DOI: 10.1016/j.ajog.2023.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Testosterone use among transgender people likely impacts their experience of sexual function and vulvovaginal pain via several complex pathways. Testosterone use is associated with decreased estrogen in the vagina and atrophic vaginal tissue, which may be associated with decreased vaginal lubrication and/or discomfort during sexual activity. At the same time, increased gender affirmation through testosterone use may be associated with improved sexual function. However, data on pelvic and vulvovaginal pain among transgender men and nonbinary people assigned female at birth are scarce. OBJECTIVE This study aimed to assess the association between testosterone and sexual function with a focus on symptoms that are commonly associated with vaginal atrophy. STUDY DESIGN We conducted a cross-sectional analysis of 1219 participants aged 18 to 72 years using data collected from 2019 to 2021 from an online, prospective, longitudinal cohort study of sexual and/or gender minority people in the United States (The Population Research in Identity and Disparities for Equality Study). Our analysis included adult transgender men and gender diverse participants assigned female at birth who were categorized as never, current, and former testosterone users. Sexual function was measured across 8 Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction domains. RESULTS Overall, 516 (42.3%) participants had never used testosterone, and 602 (49.4%) currently used testosterone. The median duration of use was 37.7 months (range, 7 days to >27 years). Most participants (64.6%) reported genital pain or discomfort during sexual activity in the past 30 days, most commonly in the vagina or frontal genital opening (52.2%), followed by around the clitoris (29.1%) and labia (24.5%). Current testosterone use was associated with a greater interest in sexual activity (β=6.32; 95% confidence interval, 4.91-7.74), higher ability to orgasm (β=1.50; 95% confidence interval, 0.19-2.81), and more vaginal pain or discomfort during sexual activity (β=1.80; 95% confidence interval, 0.61-3.00). No associations were observed between current testosterone use and satisfaction with sex life, lubrication, labial pain or discomfort, or orgasm pleasure. CONCLUSION Testosterone use among transgender men and gender diverse people was associated with an increased interest in sexual activity and the ability to orgasm, as well as with vaginal pain or discomfort during sexual activity. Notably, the available evidence demonstrates that >60% of transgender men experience vulvovaginal pain during sexual activity. The causes of pelvic and vulvovaginal pain are poorly understood but are likely multifactorial and include physiological (eg, testosterone-associated vaginal atrophy) and psychological factors (eg, gender affirmation). Given this high burden, there is an urgent need to identify effective and acceptable interventions for this population.
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Affiliation(s)
| | | | - Bertha Chen
- Stanford University School of Medicine, Palo Alto, CA
| | - Annesa Flentje
- University of California, San Francisco, San Francisco, CA
| | - Zubin Dastur
- Stanford University School of Medicine, Palo Alto, CA
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Lara LADS. Sexual Wellness: A Movement Happening Worldwide. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e745-e746. [PMID: 38141593 DOI: 10.1055/s-0043-1777700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023] Open
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22
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Chok L, Suris JC, Barrense-Dias Y. Characteristics of Young People Reporting a Low Sexual Desire in Switzerland. SEXUALITY & CULTURE 2023; 28:1152-1169. [PMID: 38707677 PMCID: PMC11068582 DOI: 10.1007/s12119-023-10171-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/28/2023] [Indexed: 05/07/2024]
Abstract
This study explores the characteristics of young female and male adults (mean age 26.3 years) reporting a low sexual desire. A 2017 Swiss national survey was carried out among young adults. Participants were divided into two groups based on their level of sexual desire: Low and High. Overall, 17.2% of females and 5.7% of males reported a low sexual desire. At the multivariate level, compared to females in the High group, females in the Low group had higher odds of being dissatisfied with their social life and with their sexual life in the past 4 weeks, having no current relationship and having accepted several times sexual intercourse without really wanting. Compared to males in the High group, males in the Low group had higher odds of reporting a non-heterosexual attraction (trend), having no current relationship and having accepted several times sexual intercourse without really wanting. The prevailing idea that young people, particularly males, always have high levels of sexual desire may not be accurate and warrants further consideration. These results show that sexual desire encompasses social aspects and underscore importance of addressing how stereotypes and social norms may influence our sexuality.
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Affiliation(s)
- Lorraine Chok
- Research Group on Adolescent Health, Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Suris
- Research Group on Adolescent Health, Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Research Group on Adolescent Health, Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Akkoca M, Kocaay AF, Tokgoz S, Er S, Duman B, Ayaz T, Kumbasar H, Gokmen D, Koç MA, Kuzu MA. Psychiatric Symptoms, Aggression, and Sexual Dysfunction Among Patients With Benign Anal Conditions. Am Surg 2023; 89:4297-4304. [PMID: 35195473 DOI: 10.1177/00031348221074225] [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: 11/16/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the incidence of general psychiatric symptoms, aggression levels, and sexual dysfunction in patients with benign anorectal diseases and compare the results with those of healthy control subjects. METHODS We prospectively enrolled consecutive adult patients who presented for treatment of benign perianal diseases and healthy control subjects between June 2017 and December 2018. All patients had either grade 3 or 4 hemorrhoidal disease or perianal fistula with active discharge who had not undergone previous anorectal surgery. We also included a control group with benign subcutaneous lumps presenting for minor surgery. We used the Symptom Checklist-90-Revised Form to evaluate general psychiatric symptoms, the Buss-Perry Aggression Questionnaire (BPAQ) to evaluate aggression levels, and the Arizona Sexual Experiences Scale to evaluate sexual dysfunction. RESULTS A total of 563 patients were assessed for eligibility; after exclusions, 94 with anal fistula, 89 with hemorrhoids, and 59 healthy control subjects were enrolled. The groups were similar with regard to age, gender, and educational level. Physical and verbal aggression, anger, and total BPAQ score were significantly higher in patients with perianal fistula than in those with hemorrhoidal disease and healthy control subjects (P < .001). CONCLUSION This study suggests that patients with perianal fistula have higher levels of aggression than healthy control subjects and those with hemorrhoidal disease. One must bear this in mind during preoperative patient evaluations and obtaining informed consent. Further studies are needed to investigate the reason for this association and potential causality.
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Affiliation(s)
- Muzaffer Akkoca
- Department of General Surgery, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Akin Firat Kocaay
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Serhat Tokgoz
- Department of General Surgery, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Saadettin Er
- Department of General Surgery, Bilkent City Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Berker Duman
- Department of Psychiatry, Division of Consultation-Liaison Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Tugba Ayaz
- Department of Psychiatry, Ege University School of Medicine, İzmir, Turkey
| | - Hakan Kumbasar
- Department of Psychiatry, Division of Consultation-Liaison Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Derya Gokmen
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Ali Koç
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Ayhan Kuzu
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
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Romano D, Zemon V, Foley FW. Age-related differences in the severity of sexual dysfunction symptoms and psychological distress in individuals with multiple sclerosis. Mult Scler Relat Disord 2023; 79:105011. [PMID: 37734187 DOI: 10.1016/j.msard.2023.105011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) is a common symptom for many with multiple sclerosis (MS). However, SD research in general appears to often overlook young adults within their samples, which can be a major issue for better understanding and treatment for the MS population. Few studies have compared age-related differences in distress in response to physical disability. Research has also found that many people diagnosed with MS do not discuss any SD struggles with their providers. The present study hopes to see whether age-related differences exist in the reporting of the levels of primary, secondary, and tertiary SD, as defined by subscale scores of the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), and amount of distress, as defined by the 12-Item Short Form Health Survey (SF-12)'s Mental Component Summary (MCS-12). Additionally, we hope to determine if there are any age-related or sex-related differences in help-seeking behaviors for SD. METHODS Study participants were recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants completed the MSISQ-19, SF-12, and Patient Determined Disease Steps (PDDS), provided demographic information, and responded if they received medical or psychological treatment for SD. Study participants were 5815 respondents (Mage = 51 years, SD = 9.63, 75 % female, 30 % having attained a high school diploma, 35 % scoring "advanced disability" on the PDDS). Young adult (19-39 years), middle adult (40-64 years), and mature adult (65-older) were compared on SD. RESULTS Linear mixed effects modeling revealed that the MSISQ-19 subscale scores were significantly predicted by secondary SD (t = 2.48, p < .13). Young adult participants had the lowest primary SD (M = 13.87, 95 % CI [13.13, 14.61]) when compared to mature adult (M = 14.12, 95 % CI [13.27, 14.97]) and middle adult participants (M = 14.44, 95 % CI [14.21, 14.66]), though none were statistically significant. Mature adults had the lowest secondary SD (M = 16.50, 95 % CI [15.65, 17.35]), a statistically significant difference from the middle adults (M = 18.20, 95 % CI [17.97, 18.42]) and young adults (M = 18.91, 95 % CI [18.17, 19.65]). Mature adults had the lowest tertiary symptoms (M = 10.12, 95 % CI [9.27, 10.96]), followed by young adults (M = 12.23, 95 % CI [11.48, 12.97]), and middle adults (M = 11.65, 95 % CI [11.43, 11.88]), though none were statistically significant. Hierarchical multiple regressions found that age had the most significant impact on SD. When SF-12 MCS-12 was added, linear mixed effects did not reveal any statistically significant results between the age groups and SD levels. In contrast, hierarchical multiple regressions found that SF-12 MCS-12 scores had the most significant impact on SD. There were significant age-related and sex-related differences in help-seeking behaviors in those who sought psychological counseling as opposed to medical treatment for SD. CONCLUSION Our study has highlighted the importance of clinicians assessing for SD and psychological distress within their patients and to consider potential differences in symptom presentations of age groups to better address their unique needs.
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Affiliation(s)
- Danielle Romano
- Ferkauf Graduate School of Psychology, 165 Morris Park Ave, Bronx, NY 10461, United States.
| | - Vance Zemon
- Ferkauf Graduate School of Psychology, 165 Morris Park Ave, Bronx, NY 10461, United States
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, 165 Morris Park Ave, Bronx, NY 10461, United States
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Zeleke FT, Ezedin S, Aleminew F, Alem KG, Tefera DT, Demissie M, Beriso Jima G, Endeshaw F, Belay A, Ayele A, Andebet D, Zegeye AM. Sexual dysfunction and its associated factors among reproductive-age women at Gurage Zone, Southern Ethiopia, 2023. BMC Public Health 2023; 23:2029. [PMID: 37853332 PMCID: PMC10583327 DOI: 10.1186/s12889-023-16938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Female sexual dysfunction is commonly neglected, under-investigated, and under-treated in Ethiopia. Therefore, this study aimed to determine the prevalence and its associated factors of female sexual dysfunction among reproductive-aged women at Gurage zone hospitals, in southern Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 424 reproductive-age group women. A systematic random sampling method was employed and structured questionnaires were used to collect the data through a face-to-face interview. Data were entered into EpiData version 4.6 and analyzed by SPSS version 25.0. Descriptive statistics, and bivariable, and multivariable logistic regression were conducted. Statistical significance was declared at a p-value of < 0.05. RESULT Four hundred two participants completed the interview with a response rate of 94.8%. Arousal dysfunction 91.0% and pain during sexual intercourse 39.3% were the most and the least prevalent domains of female sexual dysfunction respectively. Overall 32.1% of the respondents had female sexual dysfunction. Body mass index (AOR = 3.6; 95% CI: 1.2, 10.8), history of pelvic surgery (AOR = 3.5; 95% CI: 1.3, 9.2), marriage satisfaction (AOR = 3.9; 95% CI: 1.4, 1o.6), a satisfaction of spouses' sex ability (AOR = 3.1; 95% CI: 1.2, 8.5), breastfeeding (AOR = 3.3; 95% CI: 1.6, 7.0), and mode of delivery [vaginal delivery with tear and episiotomy (AOR = 3.7; 95% CI: 1.6, 8.8), instrument assisted vaginal delivery (AOR = 7.0; 95% CI: 1.2, 39.8)], were statistically associated with female sexual dysfunction. All-encompassing professional counseling addressing psychological and interpersonal acts and weight management interventions are needed for couples to maintain sexual functioning.
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Affiliation(s)
- Fentahun Tamene Zeleke
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
| | - Semer Ezedin
- Wolkite University Specialized Hospital, Wolkite, Ethiopia
| | - Fentahun Aleminew
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kassa Genetu Alem
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Daniel Tsega Tefera
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mebratu Demissie
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Gudeta Beriso Jima
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fikremariam Endeshaw
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Aynalem Belay
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Alemitu Ayele
- College of Health Sciences, Department of Midwifery, Madawalabu University, Robe, Ethiopia
| | - Demeke Andebet
- Department of Midwifery, Hailu Alemu College, Gojjam, Ethiopia
| | - Ambaye Minayehu Zegeye
- Department of Midwifery, College of Medicine and Health Sciences, Asossa University, Asossa, Ethiopia
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Daescu AMC, Dehelean L, Navolan DB, Pop GN, Stoian DL. Psychometric properties of the Romanian version of the female sexual function index (FSFI-RO). BMC Womens Health 2023; 23:528. [PMID: 37803305 PMCID: PMC10559518 DOI: 10.1186/s12905-023-02676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Female sexual dysfunction (FSD) is a highly prevalent health disorder and no self-report questionnaire on female sexual function is available in Romanian. Therefore we considered the Female Sexual Function Index (FSFI) to be the most appropriate due to its excellent psychometric properties. The FSFI is a measuring scale with 19 items that assess the six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction and pain. The paper aims to analyze the psychometric reliability and validity of the FSFI-RO (Romanian Version of the Female Sexual Function Index). METHODS 385 women (aged 18 to 51) enrolled in the present study. To assess the presence of FSD we used the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for sexual dysfunction. Then we categorized the participants into two groups: the FSD group (41%) and the healthy control group (59%). Women were then asked to fill out a form that included sociodemographic information and the FSFI-RO questionnaire. A sample of 50 women agreed to re-answer FSFI-RO in a 4-week interval in order to evaluate the test-retest validity of the questionnaire. The data were summarized using descriptive statistics: the test-retest reliability was measured by the intraclass correlation coefficient (ICC); Cronbach's alpha was employed to evaluate the internal consistency of the Romanian version of the FSFI, and validity was assessed by the content and construct validity. RESULTS The results showed high test-retest reliability, with ICC from 0.942 to 0.991 in the domains and 0.987 in the total score. Regarding the internal consistency of the FSFI-RO, Cronbach's α coefficients were found to be high (α = 0.944). Convergent construct validity proved to be moderate to high in desire, arousal, lubrication, orgasm and, satisfaction domains, and weak correlation in the pain domain. Regarding the discriminant construct validity, the scores for each domain and the total score showed statistically significant differences between the FSD group and the control group. CONCLUSIONS The FSFI-RO showed similar psychometric properties to those of the original version, therefore being a reliable and valid instrument that can be used in Romanian-speaking women.
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Affiliation(s)
- Ana-Maria Cristina Daescu
- PhD School Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Liana Dehelean
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania.
| | - Dan-Bogdan Navolan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Gheorghe Nicusor Pop
- Department of Cardiology, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
| | - Dana Liana Stoian
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, 300041, Romania
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Al-Qerem W, Ling J, Eberhardt J. Validation of an Arabic version of the female version of The Sexual Dysfunctional Beliefs Questionnaire: a factor analysis study. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:94-104. [PMID: 37787027 DOI: 10.1080/0092623x.2023.2260370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Several questionnaires have been developed to evaluate female sexual dysfunction (FSD) and sexual health problems. However, there is a lack of validated versions of these questionnaires in Arabic. One of the most used instruments is the female version of The Sexual Dysfunctional Beliefs Questionnaire (SDBQ). The current study aimed to validate an Arabic version of the SDBQ. The Arabic version of SDBQ-Female was incorporated into an online questionnaire using and distributed among Jordanian Facebook groups and women-only groups. Factor analysis was performed to investigate evidence for the validity of the questionnaire. 530 females (mean age 30 years, SD = 9) completed the questionnaire. Principal component analysis produced the final model composed of 24 items distributed across four factors: Sexual Desire & Pleasure, Affection Primacy, Sexual Conservatism and Age-Related Beliefs. Confirmatory factor analysis was conducted, and fit indices were acceptable (CMIN/DF = 2.52, GFI = 0.91, AGFI = 0.89, CFI = 0.90, SRMR = 0.05 and RMSEA = 0.05). Income level and marital status both influenced FSD beliefs, with higher scores associated with higher income and being single. The Arabic version of the SDBQ-female demonstrated evidence of validity and reliability. Additional research is necessary to explore beliefs related to FSD within an Arabic context.
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Affiliation(s)
- Walid Al-Qerem
- College of Pharmacy, Al-Zaytoonah University of Jordan, Amman11733, Jordan
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Chester Road, Sunderland, UK
| | - Judith Eberhardt
- School of Social Sciences, Humanities and Law, Teesside University, Borough Road, MiddlesbroughTS1 3BA, UK
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Fernandes C, Soares C, Oliveira J, Gonçalves M, Rosário F. Female sexual dysfunction in an outpatient andrology clinic-A therapeutic opportunity? Rev Int Androl 2023; 21:100369. [PMID: 37478725 DOI: 10.1016/j.androl.2023.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/15/2022] [Accepted: 09/20/2022] [Indexed: 07/23/2023]
Abstract
INTRODUCTION The sexual life of a couple is a dynamic entity, in which the two influence each other mutually, thus the existence of female sexual dysfunction (FSD) can influence the treatment of the man who seeks clinical help. Identify sexual dysfunction in female partners of patients attending an andrology clinic may provide a therapeutic opportunity. The authors aim to assess proportion of FSD in this population by comparison with a control group. MATERIAL AND METHODS A longitudinal study over 12 months timespan. The female partners of patients attending the andrology clinic participating in the study (study group - SG) completed the Female Sexual Function Index (FSFI), as did the women serving as controls (control group - CG). Further data such as age, duration and quality of the relationship and previous relationships was also collected. RESULTS Of the 30 women included in the SG, 14 (46.6%) considered that their current sex life was worse than in previous relationships. Of the 20 women in the CG, 60% considered that their current sex life was better. In the SG, 22 (73.3%) had FSD, with a mean score in the FSFI of 20.5, whereas only 3 women in the CG (15%) had FSD, with a mean score of 30.7 (p<0.01). CONCLUSIONS Our study demonstrated that the proportion of FSD in female partners of patients attending an andrology clinic is significantly higher than control group. FSD treatment should be considered as a therapeutic opportunity for the couple in this setting.
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Affiliation(s)
- Carlos Fernandes
- Endocrinology Department, Hospital da Luz Lisbon, Avenida Lusíada 100, 1500-650 Lisboa, Portugal; Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, 1749-002 Lisboa, Portugal.
| | - Catarina Soares
- Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, 1749-002 Lisboa, Portugal
| | - Jorge Oliveira
- Universidade Lusófona, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Marco Gonçalves
- Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil 53, 1749-002 Lisboa, Portugal
| | - Francisco Rosário
- Endocrinology Department, Hospital da Luz Lisbon, Avenida Lusíada 100, 1500-650 Lisboa, Portugal
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Reis YA, Akay A, Aktan B, Tetik S, Fıratlıgil FB, Kayıkçıoğlu F. The Effect of Clinical Pilates Exercises and Prenatal Education on Maternal and Fetal Health. Z Geburtshilfe Neonatol 2023; 227:354-363. [PMID: 37473767 DOI: 10.1055/a-2096-6454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The mental, physical and sexual health of women as well as maternal and fetal health should be considered during the prenatal and postnatal periods. Investigating the effect of clinical Pilates exercises and prenatal education (CPE & PE) on obstetric and neonatal outcomes as well as the mental, physical, and sexual health of women was intended. METHODS In the second trimester, mothers with singleton pregnancies who attended (n=79, study group) or did not attend (n=80, control group) CPE & PR were recruited to this prospective cohort study, and were evaluated in the prenatal and postnatal periods. Depression was assessed with Beck Depression Inventory (BDI), sexual functions with Female Sexual Function Index (FSFI), muscle strength with Gross Muscle Scales (GMS), and labor pain with Visual Analogue Scale (VAS). In addition, the presence of low back pain (LBP) was questioned. RESULTS No significant association of CPE & PE with obstetric outcomes such as cesarean rates, preterm birth, and neonatal outcomes such as birth weight and Apgar scores were identified. Changes in VAS scores, the incidence of perineal trauma, and episiotomy were not associated with CPE & PE. However, CPE & PE was associated with lower BDI scores, a gradual increase in the total scores of FSFI, increased GMS, and reduced LBP. CONCLUSION CPE & PE had no adverse effects on obstetric and neonatal outcomes and was associated with improved mental, physical, sexual health scores during pregnancy and postpartum.
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Affiliation(s)
- Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Arife Akay
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Berrin Aktan
- Physiotherapist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Sinan Tetik
- Psychologist, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fahri Burçin Fıratlıgil
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Fulya Kayıkçıoğlu
- Department of Obstetrics and Gynecology, Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
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Chiang TY, Lee HY, Chien WC, Su HC, Su YC, Lin CW. The Relationship between Allergic Disease and Sexual Dysfunction: A Scoping Review. Int Arch Allergy Immunol 2023; 185:20-32. [PMID: 37729893 DOI: 10.1159/000533403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/31/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Sexual dysfunction (SD) and allergic disease are common health concerns worldwide and bear a potential relationship. This scoping review is conducted to analyze the currently available data regarding the associations between these two health issues. METHODS A comprehensive literature search was performed in the databases of PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to retrieve studies that were published before January 2023. A narrative synthesis was conducted to analyze the effects of allergic diseases on SD based on the evaluation of the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF). RESULTS Twelve observational studies were included after the selection process. The results generally suggested lower FSFI or IIEF scores in patients with asthma, allergic rhinitis, allergic rhinoconjunctivitis, and urticaria compared to the healthy control groups. The underlying factors of this relationship could be inflammation, psychological factors, hormonal changes, sleep disorders, sexual behavior-related allergic reactions, social economic status, and the use of medications. CONCLUSION SD and allergic disease are interrelated based on the extant literature. This scoping review provides insights into the clinical implications of both entities, while more research studies are warranted to further elucidate this complex relationship.
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Affiliation(s)
- Ting-Yi Chiang
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan,
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan,
| | - Hsiang-Ying Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chen Chien
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Chun Su
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chun Su
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Wei Lin
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Banaei M, Kariman N, Ghasemi V, Roozbeh N, Jahangirifar M. Component of sexual health services for vaginismus management: A qualitative study. PLoS One 2023; 18:e0283732. [PMID: 37556497 PMCID: PMC10411750 DOI: 10.1371/journal.pone.0283732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/15/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Provision of sexual health services requires gender-sensitive management, facilities, and staff, as well as planning for gender-sensitive caregivers and education. Couples suffering from vaginismus face many types of barriers to accessing sexual health services. This qualitative study was conducted to explain the needs of sexual health services in women with primary vaginismus in Iran. METHODS This qualitative study was conducted through the participation of 20 participants including service providers, women with vaginismus and their husbands in 2022, Iran. The samples were selected using purposive sampling method and considering the maximum variation. For data collection, in-depth semi-structured individual interviews were conducted and continued until data saturation was reached. The collected data were analyzed in MAXQDA10 software using conventional content analysis approach based on the criteria proposed by Graneheim and Lundman. RESULTS Data analysis led to the emergence of three main themes: 1) Comprehensive preventive sex education which included the three categories of sex education in the education system, premarital sex education through the health system, and sex education through the media with scientific content; 2) Efficient sexual health clinics which included three categories of therapist's skills, empowerment of sexual therapist, and structural features of sexual health clinics and cultural considerations in establishing sexual health clinics; and 3) Protocol for management and treatment of sexual problems which consisted of sexual education and counseling content, treatment requirements, and sex education approaches. CONCLUSION Based on the results of the study, comprehensive preventive sex education through the education system and the Ministry of Health can improve the attitudes of adolescents and young people. Moreover, it can take a fundamental step in solving sexual problems by providing the infrastructure necessary for the establishment of efficient sexual health clinics and protocols required to manage and treat such problems.
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Affiliation(s)
- Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Ghasemi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Maryam Jahangirifar
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Meyer M, Westenberg JN, Brunner P, Gürtler M, Wiesbeck GA, Lang UE, Vogel M, Dürsteler KM. Sexual dysfunction prevalence, risk factors, and help-seeking behavior in opioid agonist treatment and general psychiatry: a cross-sectional study. Front Psychiatry 2023; 14:1204236. [PMID: 37608998 PMCID: PMC10440384 DOI: 10.3389/fpsyt.2023.1204236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
Background Mental disorders pose a high risk for the occurrence of sexual dysfunctions (SD). This study aimed to investigate prevalence of risk factors and help-seeking behavior for sexual dysfunctions in patients with opioid use disorder compared to patients seeking psychotherapeutic help. Methods Ninety-seven patients at two opioid agonist treatment (OAT) centers and 65 psychotherapeutic patients from a psychiatric practice (PP) in Switzerland were included in the study. Self-report assessments comprised sexual functioning (IIEF: International Index of Erectile Function; FSFI: Female Sexual Function Index), depressive state, psychological distress, alcohol consumption, nicotine use, and a self-designed questionnaire on help-seeking behavior. We used chi-squared and Mann-Whitney U tests for group comparisons and binary logistic regression models to identify variables predicting the occurrence of sexual dysfunctions. Results There was no statistically significant difference (p = 0.140) in the prevalence of SD between OAT (n = 64, 66.0%) and PP sample (n = 35, 53.8%). OAT patients scored significantly higher in scales assessing nicotine use (p < 0.001) and depressive state (p = 0.005). Male OAT patients scored significantly worse on the Erectile Function scale (p = 0.005) and female PP patients scored significantly worse on the FSFI Pain domain (p = 0.022). Opioid use disorder, higher age, and being female predicted the occurrence of SD in the total sample. In the OAT sample, only higher age remained predictive for the occurrence of SD. A lack of help-seeking behavior was observed in both groups, with only 31% of OAT patients and 35% of PP patients ever having talked about their sexual health with their treating physician. Conclusion SD are common among psychiatric patients receiving OAT and general psychiatric patients seeking psychotherapy. Professionals providing mental healthcare to patients must emphasize prevention and routine assessments of sexual functioning needs.
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Affiliation(s)
- Maximilian Meyer
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jean N. Westenberg
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Patrick Brunner
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Martin Gürtler
- Health Center Allschwil (Gesundheitszentrum Allschwil AG), Allschwil, Switzerland
| | | | - Undine E. Lang
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Marc Vogel
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Kenneth M. Dürsteler
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department for Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Fernández-Pérez P, Leirós-Rodríguez R, Marqués-Sánchez MP, Martínez-Fernández MC, de Carvalho FO, Maciel LYS. Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis. BMC Womens Health 2023; 23:387. [PMID: 37482613 PMCID: PMC10364425 DOI: 10.1186/s12905-023-02532-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/08/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. OBJECTIVES The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. DESIGN A systematic review and meta-analysis was conducted. METHOD Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. RESULTS Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. CONCLUSIONS Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. PROSPERO REGISTRATION CRD42021236155.
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Affiliation(s)
- Paula Fernández-Pérez
- Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | - Mª Pilar Marqués-Sánchez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 24401 Ponferrada, Spain
| | | | | | - Leonardo Y. S. Maciel
- Physical Therapy Department of Lagarto, Universidade Federal de Sergipe, Gov. Marcelo Déda Ave, São José, Lagarto 49400-000 Brazil
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure (CIAFEL), University of Porto, R. Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
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Daescu AMC, Navolan DB, Dehelean L, Frandes M, Gaitoane AI, Daescu A, Daniluc RI, Stoian D. The Paradox of Sexual Dysfunction Observed during Pregnancy. Healthcare (Basel) 2023; 11:1914. [PMID: 37444748 DOI: 10.3390/healthcare11131914] [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: 05/16/2023] [Revised: 06/24/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this study is to analyze the evolution of sexual function throughout pregnancy and highlight the predicting factors of sexual dysfunction in pregnant women. Our study included 144 participants, aged 16 to 45. Patients were evaluated three times during pregnancy by filling out the Female Sexual Function Index (FSFI) and the Body Exposure in Sexual Activities Questionnaire (BESAQ). At the time of the last evaluation, we asked patients to also fill out Beck's Depression Inventory (BDI-II) and a questionnaire regarding their psychological status and relationship satisfaction. We observed that the FSFI lubrication, satisfaction, and pain domains and the FSFI total score significantly decreased from the 1st to the 3rd evaluation. We observed that an increase in BDI score and the presence of abortion in the patient's history increase the risk of developing female sexual dysfunction (FSD). Higher BMIs were found to be a protective factor against FSD, as was being unmarried. The relationship satisfaction score was found to be an independent predictor of FSD. These findings support previous studies that indicate that pregnancy and postpartum sexuality are multifaceted phenomena and that psycho-social factors have a greater impact on sexuality than biological factors.
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Affiliation(s)
- Ana-Maria Cristina Daescu
- Doctoral School Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dan-Bogdan Navolan
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Liana Dehelean
- Neurosciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mirela Frandes
- Functional Sciences Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | - Andrei Daescu
- Department of Mathematics, Politehnica University of Timisoara, 300006 Timisoara, Romania
| | - Razvan-Ionut Daniluc
- Doctoral School Department, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Bond JC, White KO, Abrams JA, Wesselink AK, Wise LA. Sexual dysfunction, distress, and care-seeking among females during the preconception period. Am J Obstet Gynecol 2023; 229:43.e1-43.e12. [PMID: 37001576 PMCID: PMC10330018 DOI: 10.1016/j.ajog.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/08/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Despite the high prevalence of female sexual dysfunction in population-based studies and the importance of sexual functioning for mixed-sex couples attempting conception, little is known about female sexual function in the preconception period. OBJECTIVE This descriptive study aimed to assess the prevalence of female sexual dysfunction, distress, and pain with intercourse in a preconception population of pregnancy planners. The study also explored the extent to which participants discussed their sex lives with a healthcare provider during a preconception visit. STUDY DESIGN We used data from Pregnancy Study Online, a web-based preconception cohort study (August 2020-October 2022). Eligible participants identified as female and were aged 21 to 45 years, residents of the United States or Canada, attempting pregnancy, and not using fertility treatments at cohort entry. At enrollment, participants completed a detailed baseline questionnaire. Thirty days after enrollment, participants were invited to complete an optional questionnaire about sexual function. Our study included 1120 participants who responded to the sexual function questionnaire within 1 year of completing their baseline questionnaire. We assessed sexual dysfunction using the 6-item Female Sexual Function Index, and sexual distress using the Female Sexual Distress Scale, which assess sexual function and distress in the previous 4 weeks, respectively. We also asked participants whether they had discussed their plans to conceive with a healthcare provider, and if so, whether they discussed their sex lives. If not, we collected information on perceived barriers. RESULTS Twenty-five percent of the sample met criteria for female sexual dysfunction, whereas 12.2% met the criteria for sexual distress; 8% of our sample reported both sexual dysfunction and sexual distress. Thirty percent reported at least some pain with intercourse in the past 4 weeks. Although over 80% of the sample reported discussing their conception plans with a healthcare provider, 70% of these participants did not discuss their sex lives. The most commonly reported reasons for not discussing their sex life with a provider was not experiencing a sexual health issue, the provider not asking, feeling nervous/uncomfortable/ashamed, and feeling it was not relevant to becoming pregnant or inappropriate to discuss. The percentage of participants who reported discussing their sex lives varied across provider type, with those seeing midwives having the highest percentage (39%), followed by nurse practitioners (36%) and obstetrician-gynecologists (34%). CONCLUSION Sexual dysfunction, distress, and painful intercourse are prevalent in the preconception period, but participants frequently did not discuss their sex lives when discussing plans to conceive. The provider not asking was a commonly reported barrier. Providers may consider raising the issue of sexual functioning at the time of a preconception visit to better support patients who may be dealing with a sexual function issue while attempting pregnancy. These findings may not generalize beyond a primarily non-Hispanic White, highly educated, and high-income population.
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Affiliation(s)
- Julia C Bond
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.
| | - Katharine O White
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA
| | - Jasmine A Abrams
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT; Boston University School of Public Health, Maternal and Child Health Center of Excellence, Boston, MA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
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Lynn M, Iftekhar N, Adams W, Mumby P. Multidisciplinary approach to the treatment of sexual dysfunction in couples using a biopsychosocial model. J Sex Med 2023; 20:991-997. [PMID: 37170949 DOI: 10.1093/jsxmed/qdad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/28/2023] [Accepted: 04/18/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Given the complexity of the psychological and biological pathologies associated with sexual dysfunction, which affects at least a third of adult women and men worldwide, a multidisciplinary approach has been advocated. AIM To assess sexual functioning, relationship satisfaction, and mood stability pre- and post- treatment at the Loyola University Sexual Wellness Program. METHODS Couples attending the 6-week multidisciplinary Sexual Wellness Program provided consent and completed pre- and post- intervention assessments. Linear mixed effects models were used to estimate the mean change from baseline to first follow-up. A covariance matrix was used to account for dependency. OUTCOMES All patients completed self-reported surveys: Dyadic Adjustment Scale, PROMIS Sexual Function and Satisfaction Measures Brief Profile (Patient-Reported Outcomes Measurement Information), and International Index of Erectile Function. RESULTS There were 85 respondents: 42 men and 43 women. The mean age was 49.82 years (range, 25-77). The largest improvement was on the total Dyadic Adjustment Scale score, which increased by approximately 5.18 points (95% CI, 2.55-7.81). PROMIS scores for global satisfaction with sex life, erectile function, and interest in sexual activity significantly increased from baseline, while the vaginal discomfort score significantly declined. Overall the score for global satisfaction with sex life increased from baseline by approximately 5.57 points (95% CI, 3.03-8.10). On average, men reported a 4.33-point increase (95% CI, 0.04-8.62) in their International Index of Erectile Function score from baseline. CLINICAL IMPLICATIONS A multidisciplinary treatment approach focused on the couple positively affects a couple's relationship, including global satisfaction with sex life, relationship satisfaction, interest in sexual activity, and erectile function. STRENGTHS AND LIMITATIONS This study is one of the few to document the effects of a multidisciplinary treatment approach for both members of a heterosexual couple-male and female. Limitations include the narrow demographics and lack of a control group in our population. Furthermore, this was completed at 1 academic center. CONCLUSION These findings emphasize that multidisciplinary sexual therapy programs aimed at the couple can help address multiple aspects of sexual well-being.
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Affiliation(s)
- Mary Lynn
- Department of Obstetrics and Gynecology, Loyola University Medical System, Maywood, IL 60153, United States
| | - Noama Iftekhar
- Department of Surgery, University of Nevada, Las Vegas, Nevada, NV 89154, United States
| | - William Adams
- Loyola University Medical Center, Department of Medicine, Maywood, IL 60153, United States
| | - Patricia Mumby
- Loyola University Medical Center, Department of Psychiatry and Behavioral Neurosciences, Maywood, IL 60153, United States
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Liu X, Feng Z, Galling B, Qi N, Zhu XQ, Xiao L, Wang G. Gender specific sexual dysfunction in patients with depression. Front Psychiatry 2023; 14:1194228. [PMID: 37398603 PMCID: PMC10309026 DOI: 10.3389/fpsyt.2023.1194228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Background This study aims to investigate the factors associated with sexual dysfunction (SD), with a particular focus on the influence of sex on the occurrence and severity of this condition in patients with major depressive disorder (MDD). Method Sociodemographic and clinical assessments were conducted on 273 patients with MDD (female = 174, male = 99), including the ASEX, QIDS-SR16, GAD-7, and PHQ-15. Univariate analyses, independent samples t-test, Chi-square test, and Fisher's exact test were used as appropriate, and logistic regression analysis was used to identify correlation factors for SD. Statistical analyses were performed using the Statistical Analysis System (SAS 9.4). Result SD was reported in 61.9% of the participants (ASEX score = 19.6 ± 5.5), and the prevalence of it in females (75.3%, ASEX score = 21.1 ± 5.4) was significantly higher than that in males (38.4%, ASEX score = 17.1 ± 4.6). Factors associated with SD included being female, being aged 45 years or above, having a low monthly income (≤750 USD), feeling more sluggish than usual (a QIDS-SR16 Item 15 score of 1 or above), and having somatic symptoms (evaluated with the total score of PHQ15). Limitation The use of antidepressants and antipsychotics might be a confounding factor affecting sexual function. Also, the lack of information in the clinical data regarding the number, duration, and time of onset of the episodes limits the richness of the results. Conclusion Our findings reveal the sex differences in the prevalence and severity of SD in patients with MDD. Evaluated with the ASEX score, female patients showed significantly worse sexual function than male patients. Being female, having a low monthly income, being aged 45 years or above, feeling sluggish, and having somatic symptoms may increase the risk of SD in patients with MDD.
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Affiliation(s)
- Xinyu Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zizhao Feng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Britta Galling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, School of Medicine, Kiel, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Na Qi
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xue-quan Zhu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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Allen A, Tully-Wilson C. Early Adaptive Schemas and Sexual Wellbeing in Women: Exploring Differences in Menopausal Status. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023:1-29. [PMID: 37361625 PMCID: PMC10185943 DOI: 10.1007/s41042-023-00100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
There is limited research concerning the relationship between early adaptive schema, from Young's Schema Theory, and women's sexual wellbeing. Schema Theory posits that early adaptive schema start forming in early childhood from core emotional needs being met, and positively influence individuals' concept of self, relationships with others, and their behaviours. Building on this theory, the current study explored the relationship of early adaptive schema and adult women's sexual wellbeing at pre-, peri-, and post-menopause. Four hundred and sixty-seven women, mostly partnered and heterosexual, from over ten countries, participated in an online survey measuring relationships between early adaptive schema and sexual wellbeing, measured by sexual functioning and sexual satisfaction. The strength of association of early adaptive schema and sexual well-being were evaluated in addition to known predictors. The results showed higher early adaptive schema were associated with higher sexual wellbeing, measured by sexual satisfaction and sexual functioning,with medium-to-large effect sizes, at pre and peri-menopause, and produced a non-significant result for post-menopause. The association of early adaptive schema continued after known factors were accounted for. The results support the use of early adaptive schema to promote sexual wellbeing for women at pre- and peri-menopause.
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Affiliation(s)
- Andrew Allen
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
| | - Colleen Tully-Wilson
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
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Kamrani M, Rad NN, Zemorshidi F, Khadem-Rezaiyan M. Prevalence of sexual dysfunction in HTLV-1 patients without spastic paraparesis and the association with psychiatric symptoms. Indian J Psychiatry 2023; 65:565-571. [PMID: 37397840 PMCID: PMC10309255 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_388_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 01/31/2023] [Accepted: 04/09/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The findings of previous studies are inconclusive in terms of psychological abnormalities and sexual function in asymptomatic human lymphotropic virus type 1 (HTLV-1) carriers. Aim This study aimed to evaluate the prevalence of sexual dysfunction and its relationship with psychological abnormalities in asymptomatic HTLV-1 carriers. Materials and Methods This cross-sectional study was conducted on asymptomatic HTLV-1 patients who were referred to the Neurology Clinic of a tertiary hospital in Mashhad, Iran. Patients with spastic paraparesis, leukemia, and uveitis, and those with an expanded disability status scale (EDSS) score higher than 2 were excluded. Sexual function in male and female subjects was evaluated using the brief male sexual function inventory (BMSFI) and female sexual dysfunction index (FSFI) questionnaires, respectively. The severity of psychological symptoms was evaluated in all patients using the symptom checklist-90-revised (SCL-90-R) questionnaire. Results A total of 117 patients (61 males and 56 females) with a mean age of 35.3 ± 6.3 years were evaluated. Overall, 50.9% of males had a high and 39.3% of females had a good sexual function. Both male and female patients with poor sexual function were older and had more children compared to those with good sexual function (P < 0.05). There was no significant difference in the distribution pattern of SCL-90 domains between patients with high and low to moderate sexual function among male patients (P > 0.05). Depression, hostility, interpersonal sensitivity, paranoid ideation, and psychological abnormality were significantly more prevalent in female patients with poor sexual function compared to those with good sexual function (P < 0.05). Conclusion The prevalence of psychological abnormalities was high in female with sexual dysfunction and these disorders might have a negative effect on various dimensions of sexual function.
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Affiliation(s)
- Maedeh Kamrani
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Niazi Rad
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Zemorshidi
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Saadedine M, Faubion S, Kingsberg S, Enders F, Kuhle C, Kling JM, Mara K, Kapoor E. Adverse childhood experiences and sexual dysfunction in midlife women: Is there a link? J Sex Med 2023; 20:792-799. [PMID: 37105936 DOI: 10.1093/jsxmed/qdad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND One in 3 children has had at least 1 adverse childhood experience (ACE), and ACEs have been associated with multiple medical and psychiatric morbidities in women later in life, including greater menopause symptom burden. AIM To evaluate the association between ACEs and female sexual dysfunction (FSD) in midlife women. METHODS A cross-sectional analysis from DREAMS-the Data Registry on Experiences of Aging, Menopause, and Sexuality-was conducted with questionnaires completed by women aged 40 to 65 years who presented to a women's health clinic at Mayo Clinic in Rochester, Minnesota, from May 2015 to December 2016. History of ACEs was obtained with the validated ACE questionnaire. FSD was assessed by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised. OUTCOMES The association between ACEs and FSD (defined as Female Sexual Function Index score ≤26.55 and Female Sexual Distress Scale-Revised score ≥11) was evaluated via a multivariable logistic regression model, adjusting for age, menopause status, hormone therapy use, anxiety, depression, relationship satisfaction, hot flash severity, and history of abuse in the past year. RESULTS Women (N = 1572) had a mean age of 53.2 years. Overall 59% reported having at least 1 ACE. When compared with no ACEs, a history of ≥4 ACEs significantly increased the odds of not being sexually active (odds ratio, 1.83; 95% CI, 1.30-2.57; P < .001). Among sexually active women, the proportion of women with FSD increased sequentially as the number of ACEs increased. In the univariate analysis, a history of ≥4 ACEs significantly increased the odds of FSD as compared with no ACEs (odds ratio, 2.12; 95% CI, 1.50-2.99; P < .001). The association remained statistically significant in the multivariable analysis after adjusting for confounders (odds ratio, 1.75; 95% CI, 1.15-2.68; P = .009). CLINICAL IMPLICATIONS The findings highlight an opportunity for clinicians to screen for ACEs in women with sexual dysfunction and offer appropriate treatment and counseling as indicated. STRENGTHS AND LIMITATIONS Strengths of the study include the large cohort, the use of validated tools for assessment of ACEs and FSD, and the adjustment for multiple potential confounding factors. Limitations include the cross-sectional study design, recall bias in reporting ACEs and recent abuse, and the low representation of racially and ethnically diverse women in the cohort. CONCLUSION The study demonstrates an increased risk of sexual inactivity and sexual dysfunction in midlife women who experienced childhood adversity. The sexual dysfunction in women with ACEs seems to be independent of other factors that potentially affect female sexual function in midlife.
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Affiliation(s)
- Mariam Saadedine
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Mayo Clinic Women's Health, Rochester, MN 55902, United States
| | - Stephanie Faubion
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, United States
- Mayo Clinic Women's Health, Rochester, MN 55902, United States
| | - Sheryl Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States
| | - Felicity Enders
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55902, United States
| | - Carol Kuhle
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55902, United States
| | - Juliana M Kling
- Mayo Clinic Women's Health, Rochester, MN 55902, United States
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ 85260, United States
| | - Kristin Mara
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55902, United States
| | - Ekta Kapoor
- Mayo Clinic Women's Health, Rochester, MN 55902, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55902, United States
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN 55902, United States
- Women's Health Research Center, Mayo Clinic, Rochester, MN 55902, United States
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Martin GM, Tremblay J, Gagnon-Girouard MP. Sexual self-concept, functioning, and practices of women with binge eating episodes. Eat Weight Disord 2023; 28:37. [PMID: 37069446 PMCID: PMC10108796 DOI: 10.1007/s40519-023-01565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/21/2023] [Indexed: 04/19/2023] Open
Abstract
PURPOSE Positive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population. METHODS In total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants' sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions. RESULTS Participants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating. CONCLUSIONS Sexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind-body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes. LEVEL OF EVIDENCE Level II: The experimental study is a non-randomized controlled trial.
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Affiliation(s)
- Geneviève Manuela Martin
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, G1V 0A6, Québec, Canada.
| | - Jérôme Tremblay
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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Banaei M, Kariman N, Ozgoli G, Nasiri M, Roozbeh N, Zare F. Sexual function among women with vaginismus: a biopsychosocial approach. J Sex Med 2023; 20:298-312. [PMID: 36755511 DOI: 10.1093/jsxmed/qdac049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/11/2022] [Accepted: 12/08/2022] [Indexed: 02/10/2023]
Abstract
BACKGROUND Vaginismus is known as a type of sexual pain disorder. Regarding the multifactorial nature of vaginismus, the biopsychosocial model is one of the best models to describe this sexual disorder. AIM The present research was conducted to study the determinants of sexual function in women with and without vaginismus based on the biopsychosocial model. METHODS This case-control study was conducted in Iran on 420 women with and without primary vaginismus who met the inclusion criteria. All eligible people were included in the research once their eligibility was verified and their informed permission was acquired; convenience and purposive sampling techniques were used continually. Data collection tools included the demographic and obstetric information form and multiple published scales and questionnaires. Structural equation modeling with LISREL 9.2 software (Scientific Software International) was used to evaluate the determinants of the sexual function of vaginismus. OUTCOMES Participants rated their determinants of sexual function based on the biopsychosocial model. RESULTS The mean ages of the case and control groups were 27.67 and 28.44 years, respectively. The direct, indirect, and total effects of the dimensions of sexual health on sexual function and the diagnostic score of vaginismus of the women with vaginismus were significant (P < .001). Furthermore, based on the results, the diagnostic score of vaginismus in women with vaginismus was significantly affected by the direct, indirect, and cumulative impacts of vaginal penetration cognition and fear of sex (P = .016, P = .005). Women with and without vaginismus were able to accept the models' excellent fit. CLINICAL IMPLICATIONS This study helps inform health planners and policy makers about the sexual function of women with vaginismus, the factors related to this disorder, and the multidimensional nature of this sexual problem. STRENGTHS AND LIMITATIONS This study attempted to offer a more comprehensive and complete view of present knowledge via surveying different aspects of sexual health and by means of valid and reliable tools and path analysis. The study's merits include the use of the biopsychosocial model to evaluate sexual function in women with vaginismus, the use of a variety of questionnaires to compare women with and without vaginismus, and the size of the sample. The research was limited by the fact that electronic sampling was conducted because of the COVID-19 epidemic. CONCLUSION Based on the findings of the present study for the group of women with vaginismus, the direct, indirect, and overall effects of the majority of dimensions of sexual health were significantly correlated with sexual function and vaginismus.
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Affiliation(s)
- Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, 7916613885, Iran
| | - Nourossadat Kariman
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Maliheh Nasiri
- Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, 7916613885, Iran
| | - Fatemeh Zare
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 6135715794, Iran
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Belcher RE, Sim D, Meykler M, Owens-Walton J, Hassan N, Rubin RS, Malik RD. A qualitative analysis of female Reddit users' experiences with low libido: how do women perceive their changes in sexual desire? J Sex Med 2023; 20:287-297. [PMID: 36763942 DOI: 10.1093/jsxmed/qdac045] [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: 05/02/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND The true prevalence of low sexual desire among women is disputed among researchers due to the complex nature and presentation of women's sexual problems. AIM To qualitatively analyze the aspects of libido/sexual desire frequently discussed by Reddit users and compare them with the current understanding of female sexual well-being and sexual desire disorders. METHODS By using the Reddit application programming interface, the TwoXChromosomes subreddit was queried for posts with the keywords libido and sex drive. Posts that were deleted or unrelated to themes of libido/sex drive were excluded. A total of 85 threads-63 queried from the keyword libido and 22 from sex drive-and approximately 2900 comments were qualitatively analyzed per the grounded theory approach. Five independent researchers read and coded each thread to identify dominant themes and emergent concepts. OUTCOMES Outcomes of interest included codes related to sexual dysfunction, libido, orgasm, masturbation, types of sex, psychology, relationships, intimacy, treatment, medications, and health care. RESULTS Posters were primarily heterosexual women in their 20s and 30s. The code categories with the highest frequency were relationships (22.7%, n = 272), libido (22.2%, n = 210), psychological (20.2%, n = 191), medications (7.29%, n = 69), and intimacy (6.0%, n = 57). Users frequently described a decrease in libido secondary to medications, particularly antidepressants and hormonal birth control. Many users discussed the challenges of navigating a relationship with low sexual desire and the resulting sexual distress. Posters described feelings of sadness, anxiety, and guilt due to their low desire. Additionally, users discussed the role that sex plays in relationships, whether as a way to develop intimacy between partners or to achieve orgasm. Finally, posters expressed dissatisfaction with health care addressing their concerns surrounding sexual desire. CLINICAL IMPLICATIONS The study findings-namely, the impact of medications on sexual health, the interaction of sexual desire and mental health, and cited examples of inadequate sexual health care-can help guide sexual well-being research, diagnosis, and public policy. STRENGTHS AND LIMITATIONS Using Reddit as a data source allowed for the analysis of women's experiences outside the preestablished concepts of female sexual desire. Limitations to the study include the potential for posts to be deleted by moderator guidelines, the young demographic distribution of Reddit users, and the popularity-based structure of subreddit threads. CONCLUSION Our results emphasize the psychosocial aspects of sexual desire and the need to redefine sexual problems to encompass the complex nature of female sexual well-being.
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Affiliation(s)
- Rachael E Belcher
- School of Medicine, University of Maryland, Baltimore, MD 21201, United States
| | - Danielle Sim
- School of Medicine, University of Maryland, Baltimore, MD 21201, United States
| | - Marcella Meykler
- Albert Einstein College of Medicine, Bronx, NY 10461, United States
| | - Jeunice Owens-Walton
- Medical College of Georgia, Augusta University, Augusta, GA 30912, United States
| | - Naeemul Hassan
- University of Maryland, College Park, MD 20742, United States
| | - Rachel S Rubin
- Department of Urology, Georgetown University, Georgetown, Washington, DC 20007, United States
| | - Rena D Malik
- Department of Urology, University of Maryland, Baltimore, MD 21201, United States
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Yuan D, Zhang XH, Pan J, Zhang YA, Li ZA, Li XL. Predictors of female sexual problems in Shanxi, China: a population-based cross-sectional epidemiologic survey. Sex Med 2023; 11:qfac005. [PMID: 37007848 PMCID: PMC10065183 DOI: 10.1093/sexmed/qfac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Abstract
Background
Large studies on female sexual function have been conducted globally. Nonetheless, whether the state of female sexual function in China is significantly different from that in the rest of the world is largely unknown.
Aim
In this study, we aimed to investigate the associated risk factors for sexual problems in women in Shanxi, China, by conducting a population-based cross-sectional epidemiological survey.
Methods
Using the Chinese version of the Female Sexual Function Index (CV-FSFI), we surveyed women aged 20-70 years to diagnose the sexual problems. We used multiple linear regression models to estimate the risk factors for sexual problems.
Outcomes
We used the CV-FSFI for investigating the female sexual function.
Results
Our results included 6720 women, of whom 1205 were the sexually inactive and 5515 were sexually active. The mean FSFI score for sexually active women was 25.38 ± 4.20 (99% CI 25.27-25.49). Negative numerical coefficients were found for model predictors of age (B = −0.134, P < 0.001), postmenopausal status (B = −2.250, P < 0.001), chronic diseases (B = −0.512, P < 0.001), and gynecologic diseases (B = −0.767, P < 0.001). In contrast, positive numerical coefficients were found for education (B = 0.466, P < 0.001) and cesarean section (B = 0.312, P = 0.009).
Clinical Implications
It is important to pay attention to the sexual health of women and explore the factors influencing the sexual problems of women in China.
Strengths and Limitations
The present study is to our knowledge the first to evaluate the sexual function of women in Shanxi, China. Answers to questions asked in the CV-FSFI survey may be somewhat subjective, and thus additional tools and documentation are probably needed for accurate assessment.
Conclusion
Similarly to other worldwide studies, our study found that increasing age, postmenopausal status, chronic diseases, and gynecological diseases were risk factors for sexual problems, whereas high education levels and cesarean section childbirth were protective factors for sexual problems.
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Affiliation(s)
- Duo Yuan
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University , Taiyuan, China
| | - Xian-hui Zhang
- Department of Internal Medicine, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Jie Pan
- Department of Pathology, Stanford University School of Medicine , CA, 94305 , United States
| | - Ying-an Zhang
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Zhao-ai Li
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
| | - Xiao-li Li
- Department of Obstetrics and Gynecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital , Taiyuan, China
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Saini M, Adebayo SO, Singh H, Singh H, Sharma S. Sustainable development goals for gender equality: Extracting associations among the indicators of SDG 5 using numerical association rule mining. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-222384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The United Nations prescribed the Sustainable Development Goals (SDGs) to various nations to provide enduring answers to widespread problems and to give long-lasting solutions to common issues being faced across the globe. SDG 5 in particular was aimed at minimizing gender inequality by employing 9 targets and 14 indicators. The indicators serve as a yardstick to measure the progress of each of the 9 targets. This research takes an in-depth look at the perspectives of SDG 5 –Gender Inequalities, its targets, and indicators. Furthermore, explanatory data analysis and numerical association rule mining alongside QuantMiner are applied to the generated Indian datasets on SDG 5 to extract patterns and associations among the fourteen indicators of SDG 5. The association rule mining carried out on the indicators reveals the pattern of association among these indicators. Legal provision for women and the rate of crimes against women have a perfect association of 100% while the association between legal provision for women and women who have experienced physical violence stands at 80%. The full relationships of all the 14 indicators are discussed extensively in the result and discussion section. Overall, it is established that these indicators are interdependent. This will make it easier for academics, the general public, and governmental and non-governmental organizations to understand the trends and form informed opinions on issues relating to gender inequality and SDG 5.
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Affiliation(s)
- Munish Saini
- Department of Computer Engineering and Technology, Guru Nanak Dev University, Amritsar, India
| | - Sulaimon Oyeniyi Adebayo
- Department of Computer Engineering, King Fahd University of Petroleum and Minerals, Saudi Arabia
| | - Harnoor Singh
- Department of Computer Engineering and Technology, Guru Nanak Dev University, Amritsar, India
| | - Harpreet Singh
- Department of Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, India
| | - Suchita Sharma
- Department of Computer Science and Engineering, Thapar Institute of Engineering & Technology, Patiala, India
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Tvarozek S, Huser M, Dostalova M, Szypulova M, Horvath I. Evaluating sexual function among women after recurrent pelvic organ prolapse transvaginal mesh repair. J OBSTET GYNAECOL 2022; 42:3666-3671. [PMID: 36476069 DOI: 10.1080/01443615.2022.2153023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We aimed to evaluate women's sexual function before and after pelvic organ prolapse (POP) surgery utilising light transvaginal mesh after a prior hysterectomy. Only sexually active women with recurrent cystocele stage 3-4 according to POP-Q, who had previously undergone vaginal hysterectomy with anterior native tissue repair without apical fixation, were enrolled in the study. Women with previous mesh implant POP surgery, persistent vaginal infection or pelvic inflammatory disease were excluded. All patients were surgically treated between 2012 and 2015 using single-incision transvaginal mesh Calistar A. Sexual function was evaluated before a surgery and two years postoperatively. The assessment was accomplished via the standardised validated Czech translation of PISQ-12SF questionnaire. For each patient, age, BMI and parity were monitored. Out of all (89) eligible patients, 48 patients met inclusion criteria and were subsequently enrolled in our study. Two years postoperatively, 31 women (79.5%) improved their PISQ-12 score; five (12.8%) had equivalent scores, and three patients (7.7%) reported lower scores. Overall PISQ-12 score was 37.1 ± 2.6 postoperatively with a 2.9 ± 2.3 statistically significant positive difference compared to the score preceding surgery. The majority of patients undergoing surgery using Calistar A experienced a significant improvement in sexual function.IMPACT STATEMENTWhat is already known on this subject? Pelvic organ prolapse has a significant impact on women's sexual functioning in an adverse manner. Mesh implant repair is associated with lower rates of prolapse awareness and prolapse re-operation; however, it is linked with safety concerns. One of these concerns is the negative impact on women's sexual function. Evaluative study results following sexual function among women with mesh implant transvaginal repair are contradictory.What do the results of this study add? The results showed, that contrary to finding some of the previous studies, transvaginal mesh implant use could benefit patients with previous native tissue POP surgery failure with a low risk of sexual function deterioration.What are the implications of these findings for clinical practice and/or further research? The study provides clinical data for vaginal mesh implants on women's sexual function in the mid-term outcome. These data can be crucial for selecting the right POP surgical technique and evaluating its benefits and risks.
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Affiliation(s)
- Samuel Tvarozek
- Department of Obstetrics and Gynecology, University Hospital Brno, Brno, Czech Republic
| | - Martin Huser
- Department of Obstetrics and Gynecology, University Hospital Brno, Brno, Czech Republic
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martina Dostalova
- Department of Obstetrics and Gynecology, University Hospital Brno, Brno, Czech Republic
| | - Martina Szypulova
- Department of Obstetrics and Gynecology, University Hospital Brno, Brno, Czech Republic
| | - Ivan Horvath
- Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Vegunta S, Kuhle CL, Vencill JA, Lucas PH, Mussallem DM. Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship. J Clin Med 2022; 11:6723. [PMID: 36431200 PMCID: PMC9698007 DOI: 10.3390/jcm11226723] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.
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Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, 13400 Shea Blvd, Scottsdale, AZ 85259, USA
| | - Carol L. Kuhle
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer A. Vencill
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Pauline H. Lucas
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Dawn M. Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL 32224, USA
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Li G, Yu P, Zhang F, Xu Y, Zhou G, Zhan X, Gao Y, Du X, Liu H, He R. The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China. Sci Rep 2022; 12:19421. [PMID: 36371533 PMCID: PMC9653494 DOI: 10.1038/s41598-022-23974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
To investigate the impact and factors of home quarantine life on women's sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people's spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.
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Affiliation(s)
- Guangyong Li
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Puguang Yu
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Fen Zhang
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yanlong Xu
- grid.8547.e0000 0001 0125 2443Jinshan Hospital of Fudan University, Fudan University, Shanghai, 201500 China
| | - Gaiyan Zhou
- grid.89957.3a0000 0000 9255 8984The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Xuekang Zhan
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yu Gao
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Xiaoli Du
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Hetao Liu
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
| | - Rui He
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
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Amin MA, Mozid NE, Ahmed SB, Sharmin S, Monju IH, Jhumur SS, Sarker W, Dalal K, Hawlader MDH. Status of female sexual dysfunction among postmenopausal women in Bangladesh. BMC Womens Health 2022; 22:401. [PMID: 36195886 PMCID: PMC9533598 DOI: 10.1186/s12905-022-01991-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women's sexual health and physical desire for sex are most important for their emotional and physical well-being. This study aimed to examine the status of sexual dysfunction among postmenopausal women in Bangladesh and assess the significant risk factors behind this. METHODS A cross-sectional study was conducted among 45-55 years in four public and private hospitals in Bangladesh from April 2021 to June 2021 using a multi-stage sampling technique to enroll the study participants. The female sexual function index (FSFI) scale measured the prevalence of FSD, and the relationship of independent risk factors were assessed using a multivariate logistic regression model. RESULTS The total score of FSFI among postmenopausal Bangladeshi women was 18.07 ± 8.51. Among 260 participants, the prevalence of FSD was 56.9%. Out of all the significant risk factors, increasing age, urban population group, multiparous, homemakers, duration of menopause, and postmenopausal women with no hormone therapy were significantly associated with FSD. In contrast, those with regular physical activity were protective of FSD. CONCLUSION In conclusion, a significant proportion of postmenopausal Bangladeshi women are enduring sexual dysfunction. Proper hormonal therapy and non-hormonal therapies such as physical activity and pelvic floor muscle (Kegel) exercise with adequate counseling are helpful to cope in this distressing situation.
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Affiliation(s)
- Mohammad Ashraful Amin
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Nusrat-E Mozid
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh ,Public Health Professional Developmental Society (PPDS), Dhaka, 1205 Bangladesh
| | - Sanjana Binte Ahmed
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Shakila Sharmin
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Imran Hossain Monju
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Shirin Shahadat Jhumur
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Wharesha Sarker
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Koustuv Dalal
- grid.29050.3e0000 0001 1530 0805Division of Public Health Science, Institution for Health Sciences, Mid Sweden University, Sundsvall, Sweden
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Romano Marquez Reis SC, Martins Pinto J, Aparecida Porcatti de Walsh I, Sulyvan de Castro S, Cristina Cortez Carneiro Meirelles M, Santos Pereira-Baldon V. Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study. J Sex Med 2022; 19:1546-1552. [PMID: 35931606 DOI: 10.1016/j.jsxm.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND It is known that sexual problems increase with age but little is known about the predictors of female sexual dysfunction (FSD) in Brazilian climacteric women. AIM To identify predictive factors for FSD in climacteric women. METHODS This is a cross-sectional population-based study carried out through a household survey. OUTCOMES The measures investigated were sociodemographic characteristics, depressive symptoms, level of physical activity, presence of FSD, self-rated health and sleep satisfaction. RESULT A total of 381 climacteric, sexually active women were included, with a mean age of 55.04 (±7.21) years. The prevalence of FSD was 38.3%. All variables investigated were associated with FSD (P < .05). In the final model, the predictors for FSD were low satisfaction with sleep (OR 4.20; 95% CI 2.32-7.62), advanced age (OR 1.04; 95% CI 1.00-1.08), low education level (OR 0.90; 95% CI 0.85-0.97) and having a partner (OR 0.35; 95% CI 0.16-0.76). CLINICAL IMPLICATION These aspects deserve attention from the health team to prevent and identify FSD early in life in climacteric women. STRENGTHS & LIMITATIONS This study support existing data about risk factors for FSD in climacteric women. However, it is not possible to attribute causality to any of the correlates identified, which is a limitation of cross-sectional studies. CONCLUSION Dissatisfaction with sleep, senility, insufficient income, low education, not having a partner, complaints of depression, and the worse perception of global health are predictive factors for FSD in climacteric women.
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