1
|
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.
Collapse
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
| |
Collapse
|
2
|
Dilixiati D, Cao R, Mao Y, Li Y, Dilimulati D, Azhati B, Rexiati M. Association between cardiovascular disease and risk of female sexual dysfunction: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:782-800. [PMID: 38297501 DOI: 10.1093/eurjpc/zwae042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/04/2024] [Accepted: 01/30/2024] [Indexed: 02/02/2024]
Abstract
AIMS Female sexual dysfunction (FSD) is a considerably underestimated condition. It has been repeatedly reported that patients with cardiovascular diseases (CVD) may suffer from an increased risk of FSD. However, there is still a lack of comprehensive and systematic evaluation of various CVD and FSD. We aimed to elucidate the association between CVD and FSD through a comprehensive literature review and meta-analysis. METHODS AND RESULTS The PubMed, Scopus, Embase, and Cochrane Library databases were systematically searched from inception to 28 February 2023. We identified all relevant studies reporting the risk of FSD in subjects with or without CVD. The associations between CVD and the risk of FSD were assessed by calculating pooled odds ratios (ORs) (cross-sectional studies) and risk ratios (RRs) (longitudinal studies) with 95% CIs. We employed random-effects models to account for potential heterogeneity, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale. Fifty-four articles with 148 946 individuals were included in our meta-analysis. Compared with control subjects, subjects with CVD had a 1.51-fold increased risk of FSD (OR 1.51 95% CI, 1.34-1.69, P < 0.001, heterogeneity I2 = 91.4%, P < 0.001). Subgroup analyses indicated that the association between CVD and FSD remained significant in longitudinal studies (RR 1.50 95% CI, 1.21-1.86, P < 0.001, heterogeneity I2 = 86.7%, P < 0.001). Particularly, hypertension (OR 1.41 95% CI, 1.23-1.62, P < 0.001, heterogeneity I2 = 82.7%, P < 0.001), stroke (OR 1.81 95% CI, 1.54-2.12, P < 0.001, heterogeneity I2 = 0%, P < 0.423), and myocardial infarction (OR 2.07 95% CI, 1.60-2.67, P < 0.001 heterogeneity I2 = 82.4%, P < 0.001) were significantly associated with FSD. Meta-regression revealed that the primary sources of heterogeneity in FSD are attributable to adjustments for covariates, study design, and study population. CONCLUSION Our meta-analysis indicated that patients with CVD suffer from a greater risk of developing FSD. Meanwhile, we validated these findings in longitudinal queues. Notably, conditions such as hypertension, stroke, and myocardial infarction demonstrated a significant association with the incidence of FSD.
Collapse
Affiliation(s)
- Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Ruotong Cao
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Yishen Mao
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Yuting Li
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Daniyaer Dilimulati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Baihetiya Azhati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| | - Mulati Rexiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
- Xinjiang Clinical Medical Research Center of Urogenital Diseases, No. 137, Li Yushan South Road, Xinshi district, Xinjiang Uygur Autonomous Region, Urumqi 830054, China
| |
Collapse
|
3
|
Armeni A, Armeni E, Augoulea A, Delialis D, Angelidakis L, Papaioannou M, Kaparos G, Alexandrou A, Georgopoulos N, Vlahos N, Stamatelopoulos K, Lambrinoudaki I. Sexual function scores are associated with arterial stiffness in postmenopausal women. J Sex Med 2024; 21:145-152. [PMID: 38048636 DOI: 10.1093/jsxmed/qdad158] [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: 07/07/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Female sexual dysfunction (FSD) has been suggested to be correlated with the burden of cardiovascular risk factors. AIM We aimed to evaluate the possible association between functional indices of vascular function and FSD scores in apparently healthy postmenopausal women. METHODS This cross-sectional study included 116 postmenopausal women who underwent assessment of endothelial function with measurement of flow-mediated dilation (FMD) of the branchial artery and arterial stiffness estimation with measurement of the carotid-femoral pulse wave velocity (PWV). We used the Greene Climacteric Scale to evaluate vasomotor symptomatology, the Female Sexual Function Index (FSFI) to evaluate FSD and the Beck Depression Inventory to evaluate mood disorder. Low sexual function was defined as an FSFI score <26.55. OUTCOMES These included FSFI and low sexual function scores as well as measures of PWV and FMD. RESULTS Sexual function scores were associated with measures of blood pressure (normal vs low sexual function; systolic blood pressure: 120.2 ± 15.0 mm Hg vs 113.4 ± 14.6 mm Hg; analysis of covariance P = .026; diastolic blood pressure: 75.9 ± 10.5 mm Hg vs 70.3 ± 9.9 mm Hg; analysis of covariance P = .012; both adjusted for age, body mass index, current smoking, and PWV). Systolic blood pressure, but not diastolic blood pressure, was associated with FSFI (B = 0.249, P = .041) and PWV (B = 0.392, P < .001). PWV measures were associated with FSFI (B = -0.291, P = .047) and pulse pressure (B = 0.355, P = .017). FMD measures were also associated with FSFI (B = 0.427, P = .033). All models were adjusted for age, body mass index, current smoking, insulin resistance, vasomotor symptomatology, and Beck Depression Inventory. CLINICAL IMPLICATIONS Our findings demonstrate that lower scores of sexual function are associated with deteriorated vascular function mainly manifested as arterial stiffening, further contributing to systolic blood pressure changes. STRENGTHS AND LIMITATIONS The strength of this study is the carefully selected healthy sample of postmenopausal women, with simultaneous assessment of climacteric symptomatology and mood disorders. The limitations include the small sample size, the cross-sectional design, and the recruitment of consecutive outpatients of a university menopause clinic. CONCLUSION Longitudinal studies and interventions to improve FSD should further assess the clinical relevance of these findings.
Collapse
Affiliation(s)
- Anastasia Armeni
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
- Royal Free Hospital NHS Foundation Trust, UCL Medical School, London NW3 2QG, United Kingdom
| | - Areti Augoulea
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Dimitrios Delialis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Lasthenis Angelidakis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Maria Papaioannou
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - George Kaparos
- Biochemical Laboratory, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Neoklis Georgopoulos
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Nicolaos Vlahos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| |
Collapse
|
4
|
Lou IX, Chen J, Ali K, Chen Q. Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Vasc Health Risk Manag 2023; 19:691-705. [PMID: 37941540 PMCID: PMC10629452 DOI: 10.2147/vhrm.s439334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
Sexual dysfunction pertains to any issue that hinders an individual from attaining sexual contentment. This health issue can have a significant impact on the quality of life and psychological health of affected individuals. Sexual dysfunction can generate stress, anxiety, depression, and low self-esteem, which can lead to a reduction in overall life satisfaction and the quality of interpersonal relationships. Sexual dysfunction can manifest as erectile dysfunction in men or lack of sexual desire in women. Although both sexes can experience sexual problems, there are some significant differences in the manifestation of sexual dysfunction between men and women. In men, sexual dysfunction is usually physical and associated with problems such as erectile dysfunction, while in women, sexual dysfunction is usually related to psychological factors. Additionally, there was an association between hypertension and sexual dysfunction in both the sexes. In men, hypertension can cause erection problems, whereas in women, it can cause vaginal dryness and a decrease in sexual desire. Furthermore, antihypertensive drugs can negatively impact sexual function, which can decrease adherence to drug treatment. However, nebivolol, an antihypertensive drug, has beneficial effects on erectile dysfunction in men. This is believed to be because nebivolol improves blood flow to the penis by producing nitric oxide, which can help improve erections.
Collapse
Affiliation(s)
- Inmaculada Xu Lou
- Department of Cardiology, International Education College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
| | - Jiayue Chen
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
- Department of Cardiology, Hangzhou Clinical Medical College Internal Medicine of Traditional Chinese Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China
| | - Kamran Ali
- Department of Oncology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, People’s Republic of China
| | - Qilan Chen
- Department of Cardiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, 310025, People’s Republic of China
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Codispoti N, Negris O, Myers MC, Petersen A, Nico E, Romanello JP, Rubin RS. Female sexual medicine: an assessment of medical school curricula in a major United States city. Sex Med 2023; 11:qfad051. [PMID: 37720816 PMCID: PMC10501464 DOI: 10.1093/sexmed/qfad051] [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: 04/14/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background Although approximately 41% of women experience sexual dysfunction, limited education on female sexual medicine (FSM) in medical school results in underpreparedness among physicians when addressing these bothersome conditions. Aim This study aims to evaluate the extent to which FSM is represented in medical education by examining current preclinical and clinical curricula. Methods Preclinical curriculum materials on female sexual anatomy, physiology, and pathology, as well as obstetrics and gynecology clinical materials (syllabi, lecture materials, and supplemental resources), were collected from medical schools in the Chicago area. We utilized previous literature to identify specific components of medical school content to evaluate. Outcomes Upon reviewing each institution's curricula, we evaluated materials for topic saturation and assessed goals of each syllabus in terms of required content. Results Curriculum materials were collected from 7 medical schools. In the preclinical assessment, 1 institution identified all anatomic components of the clitoris in our review, 4 discussed the physiology of the female orgasm, 3 highlighted the prevalence and epidemiology of female sexual dysfunction (FSD), 3 addressed treatments for FSD, and 1 instructed a genitourinary physical exam specific to assessing FSD. When assessing obstetrics and gynecology clinical materials, 5 institutions included topics related to FSM. Of these, only 1 institution had corresponding required synchronous clerkship time dedicated to these topics as a 1-hour lecture, in addition to an optional online training to third-year clinical students in comprehensive sexual history-taking practices, including screening for FSD. One other institution offered supplemental case-based gynecology modules including vulvovaginal diseases and chronic pelvic pain, though sexual pleasure, arousal, and libido were not included. Clinical Implications The results of this study highlight the need for the inclusion of standardized curricula related to FSM in medical education to equip future physicians to treat patients with sexual dysfunction. Strengths and Limitations The strengths of this study include that it is the first of its kind to complete a comprehensive review of FSM curricula at a cohort of undergraduate medical institutions. Its limitations include a small sample size of 7 medical schools limited to 1 geographical area. Conclusion Our focused needs assessment of medical schools in the Chicago area reveals inconsistencies in outlined institution-specific course goals related to FSM and thus highlights the need for restructuring the curricula to prepare future physicians to recognize and treat patients with sexual dysfunction.
Collapse
Affiliation(s)
- Nicolette Codispoti
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, United States
| | - Olivia Negris
- Rush Medical College, Rush University, Chicago, IL 60612, United States
| | - Monica C Myers
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, United States
| | - Anna Petersen
- Rush Medical College, Rush University, Chicago, IL 60612, United States
| | - Elsa Nico
- University of Illinois College of Medicine at Chicago, Chicago, IL 60612, United States
| | | | - Rachel S Rubin
- Medstar Georgetown University Hospital, Department of Urology, Washington, DC 20007, United States
| |
Collapse
|
7
|
Hypertension and reproductive dysfunction: a possible role of inflammation and inflammation-associated lymphangiogenesis in gonads. Clin Sci (Lond) 2021; 134:3237-3257. [PMID: 33346358 DOI: 10.1042/cs20201023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/29/2020] [Accepted: 12/01/2020] [Indexed: 01/12/2023]
Abstract
Hypertension is one of the most prevalent diseases that leads to end organ damage especially affecting the heart, kidney, brain, and eyes. Numerous studies have evaluated the association between hypertension and impaired sexual health, in both men and women. The detrimental effects of hypertension in men includes erectile dysfunction, decrease in semen volume, sperm count and motility, and abnormal sperm morphology. Similarly, hypertensive females exhibit decreased vaginal lubrication, reduced orgasm, and several complications in pregnancy leading to fetal and maternal morbidity and mortality. The adverse effect of hypertension on male and female fertility is attributed to hormonal imbalance and changes in the gonadal vasculature. However, mechanistic studies investigating the impact of hypertension on gonads in more detail on a molecular basis remain scarce. Hence, the aim of the current review is to address and summarize the effects of hypertension on reproductive health, and highlight the importance of research on the effects of hypertension on gonadal inflammation and lymphatics.
Collapse
|
8
|
Female Sexual Dysfunction as a Warning Sign of Chronic Disease Development. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00229-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
9
|
Letica-Crepulja M, Stevanović A, Protuđer M, Popović B, Salopek-Žiha D, Vondraček S. Predictors of Sexual Dysfunction in Veterans with Post-Traumatic Stress Disorder. J Clin Med 2019; 8:jcm8040432. [PMID: 30934864 PMCID: PMC6518171 DOI: 10.3390/jcm8040432] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 01/02/2023] Open
Abstract
Background: The problems in sexual functioning among patients with post-traumatic stress disorder (PTSD) are often overlooked, although scientific research confirms high rates of sexual dysfunctions (SD) particularly among veterans with PTSD. The main objective of this study was to systematically identify predictors of SD among veterans with PTSD. Methods: Three hundred veterans with PTSD were included in the cross-sectional study. The subjects were assessed by the Mini-International Neuropsychiatric Interview (MINI) and self-report questionnaires: PCL-5, i.e., PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with Criterion A, International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), and Relationship Assessment Scale (RAS). Several hierarchical multiple regressions were performed to test for the best prediction models for outcome variables of different types of SD. Results: 65% of participants received a provisional diagnosis of SD. All tested prediction models showed a good model fit. The significant individual predictors were cluster D (Trauma-Related Negative Alterations in Cognition and Mood) symptoms (for all types of SD) and in a relationship status/relationship satisfaction (all, except for premature ejaculation (PE)). Conclusions: The most salient implication of this study is the importance of sexual health assessment in veterans with PTSD. Therapeutic interventions should be focused on D symptoms and intended to improve relationship functioning with the aim to lessen the rates of SD. Psychotropic treatment with fewer adverse sexual effects is of utmost importance if pharmacotherapy is applied. Appropriate prevention, screening, and treatment of medical conditions could improve sexual functioning in veterans with PTSD.
Collapse
Affiliation(s)
- Marina Letica-Crepulja
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
- Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia.
| | - Aleksandra Stevanović
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
- Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center of the Ministry of Health of the Republic of Croatia, 51000 Rijeka, Croatia.
- Department of Basic Medical Sciences, Faculty of Health Studies, University of rijeka, 51000 Rijeka, Croatia.
| | | | | | | | | |
Collapse
|