Relationship between Health Literacy and Sexual Function and Sexual Satisfaction in Infertile Couples Referred to The Royan Institute

The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women

BACKGROUND

The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women.

METHOD

This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5-7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests.

RESULTS

The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05).

CONCLUSION

The results of this research indicated that CBT and sexual health education are effective in improving women's sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir .

The association between sexual health literacy and sexual function of women in Iran

BACKGROUND

Considering the importance of sexual health literacy in promoting individual sexual health and ultimately improving family and social health as well as the effect of health literacy on sexual function, this study was designed and conducted to determine the association between sexual health literacy and sexual function among women.

MATERIALS AND METHODS

This was a cross-sectional study. A total of 420 women referring to health centers were entered into the study using one-stage cluster sampling method. Data collection tools included a demographic questionnaire, Iranian Adult Sexual Health Literacy Assessment Questionnaire, and the Persian version of the Female Sexual Function Assessment Questionnaire (FSFI). Data were collected and entered into SPSS 22 and logistic regression.

RESULTS

The results of the logistic regression test showed that the variable of sexual health literacy was effective on women's sexual function (P = 0.021) so that the chances of having a desirable sexual function in women with excellent were 4.222 times more than women with inadequate health literacy; the variables of employment status, level of education, duration of marital life, and the number of sexual intercourses per recent week were the factors affecting women's sexual function (P < 0.05).

CONCLUSION

The results of this study pointed out the existence of an undesirable level of sexual function and a desirable level of sexual health literacy among participating women. Hence, designing and implementing the training plans to promote sexual function among these women is necessary.

The effect of women's sexual functioning on quality of their sexual life

INTRODUCTION

Considering the high prevalence of sexual dysfunction among women and the role of quality of sexual life in women's life and health, in addition to the important role of sexual function evaluation in measuring quality of life, this study aimed to determine the effect of female sexual function on the quality of sexual life.

MATERIAL AND METHODS

This research was a descriptive and cross-sectional. The population of this study was 420 women from Qazvin in 2020, who were selected by multi-stage sampling. The data collection tool was a demographic questionnaire and Persian version of the Female Sexual Function Assessment questionnaire (FSFI) and Sexual Quality of Life Questionnaire (SQOL-F). Data were analyzed using SPSS 23, and descriptive statistics and logistic regression were applied.

RESULTS

The mean (SD) of sexual function score was 21.56 (4.83) out of 36, therefore, it was at an unfavorable level. Also, the mean (SD) score of sexual quality of life 59.71 (19.21) was out of 108 (moderate). The results of logistic regression test showed that the variables of sexual function, age and level of education of women were the factors affecting the quality of women's sexual life (P < 0.05).

CONCLUSIONS

Young women with lower sexual function, and lower level of education had lower quality of sexual life. Hence, it is necessary to pay more attention to these women in designing educational programs for improving the quality of their sexual life.

Sexual Health Literacy, a Strategy for the Challenges of Sexual Life of Infertile Women: A Qualitative Study

Background:

Sexual health literacy enables an understanding and application of sexual health information and has benefits beyond health. Health literacy is an important element for achieving cognitive skills in health promotion. One of the most important problems in sexual health and sexual function in women is infertility. This study aims to explore the dimensions of sexual health literacy among women with infertility.

Materials and Methods:

In this qualitative study, a total of 18 individual interviews with 15 Iranian women with infertility, and three key informants, were conducted in infertility centers in Rasht (the North of Iran). Data were collected through in-depth semi-structured interviews using interview guide questions. Data were analyzed using the conventional content analysis approach.

Results:

Five themes emerged: informational needs of sexual health, information seeking, informational perception, validation of information, and information application. Sexual issues are taboo in Iranian culture. They are not taught in health and educational centers. All the participants believed that there was a lack of information about the sexual response cycle, preventing sexually transmitted infections, targeted intercourse, and consequences of infertility in sexual life. Participants mentioned the embarrassment, privacy, and lack of centers for sexual health as information-seeking barriers. Searching different sources and questioning the informants were ways for understanding information. Women evaluated the accuracy of the information by considering the validity of the source of information, comparing information from different sources, and asking the experts. They applied the information received about sexual health, satisfaction, and especially targeted intercourse to increase the chance of pregnancy.

Conclusion:

Sexual health literacy in infertile women includes different dimensions. It can help promote sexual health, satisfaction, and increasing the chance of pregnancy.

Male Sexual Dysfunctions in the Infertile Couple-Recommendations From the European Society of Sexual Medicine (ESSM)

INTRODUCTION

Sexual dysfunctions (SDs) have been frequently reported among male partners of infertile couples due to psychogenic, relational and/or organic issues related with the inability to conceive. Likewise, male infertility (MI) could be a consequence of sexual dysfunctions.

AIM

To review the evidence on the prevalence and treatment of male SDs in men of infertile couples and provide clinical recommendations on behalf of the European Society of Sexual Medicine (ESSM).

METHODS

The MEDLINE database was searched in September 2019 for randomized clinical trials (RCTs), meta-analyses and open-label prospective or retrospective studies investigating the presence of erectile dysfunction (ED) and/or ejaculatory dysfunctions (EjDs) and/or low sexual desire (LSD) in conjunction with infertility.

MAIN OUTCOME MEASURE

The panel provided statements on: (i) Prevalence and association between SDs and MI; (ii) Treatment of male SDs in men of infertile couples.

RESULTS

ED has been reported in 9% to 62% of male partners of infertile couples, with severe impairment observed in only 1% to 3% of ED cases. Moreover, worse semen parameters have been associated with greater ED severity. Phosphodiesterase type 5 inhibitors (PDE5is) can be safely used to treat ED among patients seeking fatherhood. Male partners of infertile couples are at higher risk of premature ejaculation (PE). Retrograde ejaculation (RE) and anejaculation are a cause of MI and can be managed with electroejaculation (EEJ) or penile vibratory stimulation (PVS) or, alternatively, with oral treatments, however the latter with limited documented success. Low sexual desire has been reported by one third of men of infertile couples.

CONCLUSION

ED could significantly affect male partners of infertile couple; PDE5is should be suggested to ensure an effective and satisfactory sexual relationship of the couple. Anejaculation and RE should be considered as a possible cause of MI and treated accordingly. Low sexual desire is frequently reported among men of infertile couple and could be a symptom of other systemic conditions or psychological distress. Capogrosso P, Jensen CFS, Rastrelli G, et al. Male Sexual Dysfunctions in the Infertile Couple-Recommendations From the European Society of Sexual Medicine (ESSM). J Sex Med 2021;9:100377.