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
|
Pastoor H, Mousa A, Bolt H, Bramer W, Burgert TS, Dokras A, Tay CT, Teede HJ, Laven J. Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2024; 30:323-340. [PMID: 38237144 PMCID: PMC11063549 DOI: 10.1093/humupd/dmad034] [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: 08/03/2023] [Revised: 11/13/2023] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and distressing endocrine disorder associated with lower quality of life, subfertility, diabetes, cardiovascular disease, depression, anxiety, and eating disorders. PCOS characteristics, its comorbidities, and its treatment can potentially influence sexual function. However, studies on sexual function in women with PCOS are limited and contradictory. OBJECTIVE AND RATIONALE The aim was to perform a systematic review of the published literature on sexual function in women with PCOS and assess the quality of the research and certainty of outcomes, to inform the 2023 International Guidelines for the Assessment and Management of PCOS. SEARCH METHODS Eight electronic databases were searched until 1 June 2023. Studies reporting on sexual function using validated sexuality questionnaires or visual analogue scales (VAS) in PCOS populations were included. Random-effects models were used for meta-analysis comparing PCOS and non-PCOS groups with Hedges' g as the standardized mean difference. Study quality and certainty of outcomes were assessed by risk of bias assessments and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method according to Cochrane. Funnel plots were visually inspected for publication bias. OUTCOMES There were 32 articles included, of which 28 used validated questionnaires and four used VAS. Pooled Female Sexual Function Index (FSFI) scores in random-effects models showed worse sexual function across most subdomains in women with PCOS, including arousal (Hedges's g [Hg] [95% CI] = -0.35 [-0.53, -0.17], I2 = 82%, P < 0.001), lubrication (Hg [95% CI] = -0.54 [-0.79, -0.30], I2 = 90%, P < 0.001), orgasm (Hg [95% CI] = -0.37 [-0.56, -0.19], I2 = 83%, P < 0.001), and pain (Hg [95% CI] = -0.36 [-0.59, -0.13] I2 = 90%, P < 0.001), as well as total sexual function (Hg [95% CI] = -0.75 [-1.37, -0.12], I2 = 98%, P = 0.02) and sexual satisfaction (Hg [95% CI] = -0.31 [-0.45, -0.18], I2 = 68%, P < 0.001). Sensitivity and subgroup analyses based on fertility status and body mass index (BMI) did not alter the direction or significance of the results. Meta-analysis on the VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness, and lower sexual satisfaction in women with PCOS compared to controls, with no differences in the perceived importance of a satisfying sex life. No studies assessed sexual distress. GRADE assessments showed low certainty across all outcomes. WIDER IMPLICATIONS Psychosexual function appears to be impaired in those with PCOS, but there is a lack of evidence on the related distress scores, which are required to meet the criteria for psychosexual dysfunction. Health care professionals should discuss sexual function and distress and be aware of the multifactorial influences on sexual function in PCOS. Future research needs to assess both psychosexual function and distress to aid in understanding the degree of psychosexual dysfunction in PCOS. Finally, more diverse populations (e.g. non-heterosexual and more ethnically diverse groups) should be included in future studies and the efficacy of treatments for sexual dysfunction should also be assessed (e.g. lifestyle and pharmacological interventions).
Collapse
Affiliation(s)
- Hester Pastoor
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Hanneke Bolt
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Wichor Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Tania S Burgert
- Department of Pediatrics, Division of Pediatric Endocrinology, Children’s Mercy Kansas City, Kansas City, MO, United States
| | - Anuja Dokras
- Penn Medicine, Penn Fertility Care, Reproductive Endocrinology and Infertility, Philadelphia, PA, USA
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Clinical Sciences, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Joop Laven
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
3
|
Barbagallo F, Cucinella L, Tiranini L, Chedraui P, Calogero AE, Nappi RE. Obesity and sexual health: focus on postmenopausal women. Climacteric 2024; 27:122-136. [PMID: 38251874 DOI: 10.1080/13697137.2024.2302429] [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: 09/03/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Menopause is a cardiometabolic transition with many women experiencing weight gain and redistribution of body fat. Hormonal changes may affect also several dimensions of well-being, including sexual function, with a high rate of female sexual dysfunction (FSD), which displays a multifactorial etiology. The most important biological factors range from chronic low-grade inflammation, associated with hypertrophic adipocytes that may translate into endothelial dysfunction and compromised blood flow through the genitourinary system, to insulin resistance and other neuroendocrine mechanisms targeting the sexual response. Psychosocial factors include poor body image, mood disorders, low self-esteem and life satisfaction, as well as partner's health and quality of relationship, and social stigma. Even unhealthy lifestyle, chronic conditions and putative weight-promoting medications may play a role. The aim of the present narrative review is to update and summarize the state of the art on the link between obesity and FSD in postmenopausal women, pointing to the paucity of high-quality studies and the need for further research with validated end points to assess both biomarkers of obesity and FSD. In addition, we provide general information on the diagnosis and treatment of FSD at menopause with a focus on dietary interventions, physical activity, anti-obesity drugs and bariatric surgery.
Collapse
Affiliation(s)
- F Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - L Cucinella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| | - L Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - P Chedraui
- Escuela de Posgrados en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - R E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| |
Collapse
|
4
|
Alur-Gupta S, Dokras A, Cooney LG. Management of polycystic ovary syndrome must include assessment and treatment of mental health symptoms. Fertil Steril 2024; 121:384-399. [PMID: 38244713 DOI: 10.1016/j.fertnstert.2024.01.018] [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: 11/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder with reproductive and metabolic manifestations affecting millions of women worldwide. The health risks associated with PCOS, however, go beyond physical health. Over the past decade, data have emerged demonstrating a high risk of concurrent mental health conditions, specifically depression and anxiety, but extending into other aspects of psychological health, including body image distress, eating disorders, and sexual dysfunction. International surveys suggest physician knowledge about the mental health associations with PCOS is poor and that patients are often dissatisfied regarding counseling-related psychological issues. We performed a review of mental health comorbidities in individuals with PCOS, including depression, anxiety, body image distress, eating disorders, psychosexual dysfunction, and decreased quality of life, as well as evaluated the impact of common PCOS treatments on these conditions. Most meta-analyses in reproductive age women demonstrate increased risks of these conditions, although data are more limited in adolescents and older adults. In addition, the impact of PCOS treatments on these conditions as well as data on first-line treatments in the PCOS population is limited. All providers involved in the multidimensional care of individuals with PCOS should be aware of these mental health risks to provide appropriate screening, counseling and referral options. Future studies should be designed to evaluate targeted treatment for individuals with PCOS.
Collapse
Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Middleton, Wisconsin
| |
Collapse
|
5
|
Eickman K, Maxwell R, McGinnis LK, Stanczyk F, Legro R, Lindheim SR. Total and bioavailable 25-hydroxyvitamin D is not associated with improved sexual dysfunction following vitamin D supplementation in women with polycystic ovarian syndrome: a pilot study. J Sex Med 2024; 21:240-247. [PMID: 38303661 PMCID: PMC10906494 DOI: 10.1093/jsxmed/qdad176] [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: 02/23/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Vitamin D (Vit D) deficiency has been linked to symptoms of polycystic ovary syndrome (PCOS), yet little is known about Vit D supplementation as a treatment for sexual dysfunction (SDy) in women with PCOS. AIM To explore the implications of serum total 25-hydroxyvitamin D (25[OH]D) and bioavailable 25[OH]D (bio-25[OH]D) status and replacement on women with PCOS and SDy. METHODS Reproductive-age women with PCOS who were not desiring fertility were eligible provided that they also had SDy, as assessed by the Female Sexual Function Index (FSFI), and were without severe depression, as evaluated by the Beck Depression Inventory II (BDI-II). Participants were given the recommended dietary allowance of Vit D (600 IU daily) plus hormonal contraception (HC; cyclic ethinyl estradiol/drospirenone) or no HC for 6 months. Comparisons between groups were analyzed by chi-square test and t-test, and Pearson's correlation coefficient analyzed correlations between FSFI with demographics, BDI-II, androgen levels, and total and bio-25[OH]D. OUTCOMES The outcomes included SDy (FSFI <26.55), total and serum bio-25[OH]D levels, and total and free testosterone. RESULTS A total of 42 women without severe depression completed the FSFI, with 28 (66.7%) having SDy. All FSFI domains, including arousal, lubrication, orgasm, and pain, were significantly lower as compared with women without SDy, with no associations with respect to demographics, total and free testosterone, or total and bio-25[OH]D. Vit D replacement was initiated with HC (n = 18) or no HC (n = 10), and for those completing the study, FSFI improved (score >26.55) in 61% (11/18) regardless of the treatment group. A time-treatment effect showed a significant change for the domain of orgasm, suggesting that HC had more of an impact than Vit D replacement. Improvement in sexual function as a dichotomous variable was not associated with age, body mass index, other demographics, total and free testosterone, total and bio-25[OH]D, or HC use. CLINICAL IMPLICATIONS Due to the prevalence of SDy in women with PCOS, efficacious treatment options are necessary. STRENGTHS AND LIMITATIONS This study is the first to analyze the effect of Vit D supplementation on SDy in women with PCOS. Limitations included the small number of participants who completed the study, thus limiting meaningful conclusions and generalizability. CONCLUSION Vit D status was not associated with SDy and BDI-II. While HC may have played a role, standard Vit D supplementation could not account for the noted improvement in FSFI in women with PCOS.
Collapse
Affiliation(s)
- Kira Eickman
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL 32827, United States
| | - Rose Maxwell
- Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Fairborn, OH 45324, United States
| | - Lynda K McGinnis
- Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, United States
| | - Frank Stanczyk
- Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, United States
| | - Richard Legro
- Department of Obstetrics and Gynecology, College of Medicine, Penn State University, State College, PA 16801, United States
| | - Steven R Lindheim
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL 32827, United States
- Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Fairborn, OH 45324, United States
- Center for Reproductive Medicine, Renji Hospital; School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
| |
Collapse
|
6
|
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
|
7
|
McNabney SM, Gletsu-Miller N, Rowland DL. Sexual Function and Satisfaction in the Context of Obesity. Curr Diab Rep 2023; 23:315-327. [PMID: 37632680 DOI: 10.1007/s11892-023-01523-1] [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] [Accepted: 08/07/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE OF REVIEW Sexual dysfunction is commonly associated with overweight/obesity, but the underlying physiological and psychosocial mechanisms are not fully understood. This review contextualizes the obesity-sexual (dys)function relationship, describes recent insights from the medical and social science literature, and suggests opportunities for continued research. RECENT FINDINGS Although sexual dysfunction has been historically evaluated as a consequence/outcome of obesity, it is increasingly considered as a harbinger of future metabolic comorbidities, including type 2 diabetes and cardiovascular disease. Body image dissatisfaction is a consistent predictor for lower sexual satisfaction across BMI categories, likely mediated by cognitive distraction during partnered sex. To fully capture the relationship between obesity and sexual dysfunction, multidisciplinary research approaches are warranted. While clinically significant weight loss tends to improve sexual functioning for women and men, higher body image satisfaction may independently promote sexual function and satisfaction without concomitant weight loss.
Collapse
Affiliation(s)
- Sean M McNabney
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Nana Gletsu-Miller
- Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
| |
Collapse
|
8
|
Abstract
IMPORTANCE AND OBJECTIVES Evaluation and treatment of dyspareunia remains a significant unmet need despite the availability of safe and effective treatments. The objectives of this review are to consider evaluation techniques, the medical causes, and treatment options for dyspareunia in postmenopausal women. METHODS This narrative review used PubMed to search for English-language articles related to postmenopausal dyspareunia. Search terms included, but were not limited to, dyspareunia, genitourinary syndrome of menopause, sexual dysfunction, postmenopausal dyspareunia, posthysterectomy dyspareunia, and postcancer dyspareunia. FINDINGS Many postmenopausal women with dyspareunia do not discuss their symptoms with their physicians. Healthcare clinicians should broach the topic of dyspareunia with their patients using oral or written questionnaires. In addition to a thorough medical history and physical examination, various tools can be used as further assessments, including vaginal pH, vaginal dilators, imaging, vulvar biopsy, vulvoscopy and photography, the cotton swab test, sexually transmitted infection screening, and vaginitis testing. Although dyspareunia in postmenopausal women is often due to the genitourinary syndrome of menopause, other conditions can also cause dyspareunia, including hypertonic pelvic floor, hysterectomy, cancer treatment, lichen conditions, vulvar cancer, vestibulodynia, and pelvic organ prolapse. Some of the treatments discussed include lubricants, moisturizers, vaginal estrogen, ospemifene, dehydroepiandrosterone, local testosterone therapy, cannabidiol, and fractional CO2 laser treatments. In some cases, dyspareunia may need to be specifically addressed by pelvic floor physical or sex therapists. CONCLUSIONS Dyspareunia is a common issue in postmenopausal women, which remains largely untreated. Women with dyspareunia require a thorough history, targeted physical examination, and coordination of multiple disciplines including medical clinicians, pelvic floor physical therapists, and sex therapists.
Collapse
Affiliation(s)
- Lauren F Streicher
- From the Northwestern Medicine Center for Sexual Medicine and Menopause, Northwestern Medicine, Chicago, IL
| |
Collapse
|
9
|
del Río Olvera FJ, Sánchez-Sandoval Y, García-Rojas AD, Rodríguez-Vargas S, Ruiz-Ruiz J. The Prevalence of the Risk of Sexual Dysfunction in the First and Third Trimesters of Pregnancy in a Sample of Spanish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3955. [PMID: 36900965 PMCID: PMC10002309 DOI: 10.3390/ijerph20053955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Sexuality is a central aspect for all human beings. Research into the prevalence of sexual dysfunction in pregnant Spanish women is scarce. The aim of this work is to examine the prevalence of risk of sexual dysfunctions in pregnant Spanish women and determine in which trimester the greatest difficulties in sexual response occur. The sample consisted of 180 pregnant Spanish women, with an average age of 32.03 years (SD = 4.93). The participants completed a questionnaire for socio-demographic data, as well as the female sexual function index, the state/trait depression inventory, and the dyadic adjustment scale. The results indicate that the percentage of women with a risk of sexual dysfunction was 65% in the first trimester and 81.11% in the third trimester. Likewise, the highest score on the depression questionnaire was in the third trimester, and the couple's relationship also improved in the third trimester. To improve women's sex lives during pregnancy, it is recommended to increase sexual education and information for both pregnant women and their partners.
Collapse
Affiliation(s)
| | - Yolanda Sánchez-Sandoval
- Institute of Biomedical Research and Innovation of Cádiz (INIBICA), University of Cadiz, 11519 Cadiz, Spain
| | - Antonio Daniel García-Rojas
- Department of Pedagogy, Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21002 Huelva, Spain
| | | | | |
Collapse
|
10
|
Li W, Wang Y, Xu M, Liao Y, Zhou H, Ma H, Geng Q. Temporal Trends and Differences in Sexuality among Depressed and Non-Depressed Adults in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14010. [PMID: 36360889 PMCID: PMC9654390 DOI: 10.3390/ijerph192114010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to examine temporal trends and differences in sexuality between depressed and non-depressed adults aged 18-59 in the United States from 2005 to 2016. A total of 21,437 people (5432 with depression) were enrolled in this cross-sectional study. From 2005-2008 to 2013-2016, the average age at first sexual intercourse decreased, while the proportion of normal frequency of sexual activity and heterosexual sexual orientation increased among all the participants. Some differences in sexuality were found between the depressed and non-depressed groups. The average age at first sexual intercourse (p < 0.001), the proportion of normal frequency of sexual activity (p < 0.001), and heterosexual sexual orientation (p < 0.001) were lower in depressed participants, and the differences did not change over time (pfor trend = 0.926 of average age at first sexual intercourse, pfor trend = 0.823 of normal frequency of sexual activity, pfor trend = 0.926 of heterosexual sexual orientation). Moreover, these differences were associated with marital status (pfor interaction < 0.001 by average age at first sexual intercourse), employment status (pfor interaction < 0.001 by average age at first sexual intercourse), education status (pfor interaction = 0.023 by heterosexual sexual orientation) and family income status (pfor interaction = 0.013 by average age at first sexual intercourse and pfor interaction = 0.017 by normal frequency of sexual activity). In conclusion, the study found that the age at first sexual intercourse decreased and the frequency of sexual intercourse increased in all the participants, and differences in sexuality between depressed and non-depressed participants were present; however, these differences had no further increase or decrease during the 12-year period. These differences were associated with marital status, employment status, education status, and family income status. These findings show differences in sexuality between depressed and non-depressed patients but are somewhat different from previous studies; the results may provide directions for future research and social work.
Collapse
Affiliation(s)
- Weiya Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Yu Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Mingyu Xu
- School of Medicine, South China University of Technology, Guangzhou 510641, China
| | - Yingxue Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Haofeng Zhou
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| | - Qingshan Geng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510317, China
| |
Collapse
|
11
|
Hoang VT, Nguyen HP, Nguyen VN, Hoang DM, Nguyen TST, Nguyen Thanh L. “Adipose-derived mesenchymal stem cell therapy for the management of female sexual dysfunction: Literature reviews and study design of a clinical trial”. Front Cell Dev Biol 2022; 10:956274. [PMID: 36247008 PMCID: PMC9554747 DOI: 10.3389/fcell.2022.956274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
Hormone imbalance and female sexual dysfunction immensely affect perimenopausal female health and quality of life. Hormone therapy can improve female hormone deficiency, but long-term use increases the risk of cardiovascular diseases and cancer. Therefore, it is necessary to develop a novel effective treatment to achieve long-term improvement in female general and sexual health. This study reviewed factors affecting syndromes of female sexual dysfunction and its current therapy options. Next, the authors introduced research data on mesenchymal stromal cell/mesenchymal stem cell (MSC) therapy to treat female reproductive diseases, including Asherman’s syndrome, premature ovarian failure/primary ovarian insufficiency, and vaginal atrophy. Among adult tissue-derived MSCs, adipose tissue-derived stem cells (ASCs) have emerged as the most potent therapeutic cell therapy due to their abundant presence in the stromal vascular fraction of fat, high proliferation capacity, superior immunomodulation, and strong secretion profile of regenerative factors. Potential mechanisms and side effects of ASCs for the treatment of female sexual dysfunction will be discussed. Our phase I clinical trial has demonstrated the safety of autologous ASC therapy for women and men with sexual hormone deficiency. We designed the first randomized controlled crossover phase II trial to investigate the safety and efficacy of autologous ASCs to treat female sexual dysfunction in perimenopausal women. Here, we introduce the rationale, trial design, and methodology of this clinical study. Because aging and metabolic diseases negatively impact the bioactivity of adult-derived MSCs, this study will use ASCs cultured in physiological oxygen tension (5%) to cope with these challenges. A total of 130 perimenopausal women with sexual dysfunction will receive two intravenous infusions of autologous ASCs in a crossover design. The aims of the proposed study are to evaluate 1) the safety of cell infusion based on the frequency and severity of adverse events/serious adverse events during infusion and follow-up and 2) improvements in female sexual function assessed by the Female Sexual Function Index (FSFI), the Utian Quality of Life Scale (UQOL), and the levels of follicle-stimulating hormone (FSH) and estradiol. In addition, cellular aging biomarkers, including plasminogen activator inhibitor-1 (PAI-1), p16 and p21 expression in T cells and the inflammatory cytokine profile, will also be characterized. Overall, this study will provide essential insights into the effects and potential mechanisms of ASC therapy for perimenopausal women with sexual dysfunction. It also suggests direction and design strategies for future research.
Collapse
Affiliation(s)
- Van T. Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, Hanoi, Vietnam
| | - Hoang-Phuong Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, Hanoi, Vietnam
| | - Viet Nhan Nguyen
- Vinmec International Hospital—Times City, Vinmec Health Care System, Hanoi, Vietnam
- College of Health Science, Vin University, Vinhomes Ocean Park, Hanoi, Vietnam
| | - Duc M. Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, Hanoi, Vietnam
| | - Tan-Sinh Thi Nguyen
- Vinmec International Hospital—Times City, Vinmec Health Care System, Hanoi, Vietnam
| | - Liem Nguyen Thanh
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, Hanoi, Vietnam
- Vinmec International Hospital—Times City, Vinmec Health Care System, Hanoi, Vietnam
- College of Health Science, Vin University, Vinhomes Ocean Park, Hanoi, Vietnam
- *Correspondence: Liem Nguyen Thanh,
| |
Collapse
|
12
|
Cipriani S, Simon JA. Sexual Dysfunction as a Harbinger of Cardiovascular Disease in Postmenopausal Women: How Far Are We? J Sex Med 2022; 19:1321-1332. [DOI: 10.1016/j.jsxm.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 05/04/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
|
13
|
Martínez-Giner G, Giménez-De Llano E, Romero-Rubio D, Abad-Pérez MJ, Sánchez-Martínez V. Sexual dysfunction in people treated with long-acting injectable antipsychotics in monotherapy or polypharmacy: a naturalistic study. Int J Ment Health Nurs 2022; 31:576-590. [PMID: 34973049 DOI: 10.1111/inm.12973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/22/2021] [Accepted: 12/12/2021] [Indexed: 01/28/2023]
Abstract
Sexual dysfunction, psychosis, and antipsychotics are known to be related, but the precise association between them is still unknown. Most evidence about the prevalence of sexual dysfunction in people treated with antipsychotic drugs comes from studies with restrictive samples. That is why our main objective was to determine the prevalence of sexual dysfunction in a real-life sample of outpatients treated with antipsychotics, considering gender. A cross-sectional naturalistic study was developed, including people treated with long-acting injectable antipsychotics, with or without other psychotropic drugs. Participants were interviewed to assess sexual satisfaction through a Likert scale (0 to 10) and the presence of sexual dysfunction (the Psychotropic-Related Sexual Dysfunction Questionnaire, PRSexDQ-SALSEX). The participants also had a blood test to determine prolactin (men and women) and testosterone levels (men only). A total of 131 people participated in the study (90 men and 41 women). Some extent of sexual dysfunction was found in 62.2% of men and 51.2% of women. The most frequent sexual dysfunction symptom for both genders was the loss of libido (45%). Hyperprolactinemia was present in 56% of men and 61% of women. The presence of sexual dysfunction was associated with higher doses of antipsychotics, hyperprolactinemia, and smoking in men and with smoking and hyperprolactinemia in postmenopausal women. This study provides real-life evidence of sexual dysfunction and hyperprolactinemia in persons treated with long-acting injectable antipsychotics segregated by gender. The high rates of sexual dysfunction and hyperprolactinemia detected corroborate the need to consider these aspects in clinical practice.
Collapse
|
14
|
McHugh J, Alexander M, Kudesia R, Krant J, Comander A, Tollefson M, Geyer C. Living Your Best Life: Lifestyle Medicine for All Women. Am J Lifestyle Med 2022; 16:577-588. [PMID: 36072687 PMCID: PMC9442465 DOI: 10.1177/15598276221087677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In an era of ever-increasing healthcare expenditures, yet simultaneously worsening outcomes, many of our patients choose between traditional medical care or often unproven alternative therapies. While the recognition of lifestyle change in addressing cardiovascular and metabolic disease grows, there is less understanding of the impact of lifestyle change on issues facing women every day. Millions of women around the globe struggle with infertility, cancer, sexual dysfunction, and dermatologic needs. Yet, research on the benefits of lifestyle change on these conditions is scarce, and gaps exist both in our understanding of evidence-based approaches to address these issues, as well as adequate provider education when evidence exists. The Women’s Health Member Interest Group convened medical experts in these areas that affect women’s lives to provide insights and meaningful education applicable not only for our patients, but also in our own lives.
Collapse
Affiliation(s)
- John McHugh
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Megan Alexander
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Rashmi Kudesia
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Jessica Krant
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Amy Comander
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Michelle Tollefson
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Cynthia Geyer
- USC Keck School of Medicine, Corona del Mar, CA, USA
- Boston University School of Medicine, Las Vegas, NV, USA
- CCRM Fertility Houston & Houston Methodist Hospital, Houston, TX, USA
- SUNY Downstate Medical Center, New York, NY, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| |
Collapse
|
15
|
Angulo J, Hannan JL. Cardiometabolic Diseases and Female Sexual Dysfunction: Animal Studies. J Sex Med 2022; 19:408-420. [DOI: 10.1016/j.jsxm.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/21/2023]
|
16
|
Sahin Y, Karacan T, Hacibey I, Aybek OY, Ozer Z, Cil G, Dincer MM, Guraslan H, Muslumanoglu AY. High visceral adiposity index is associated with female orgasmic disorder in premenopausal women: a cross-sectional study. J OBSTET GYNAECOL 2022; 42:2121-2126. [PMID: 35171070 DOI: 10.1080/01443615.2022.2033185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to evaluate the association between the visceral adiposity index (VAI) and female sexual dysfunction (FSD). This cross-sectional study included 165 premenopausal, sexually active women admitted to the gynaecology outpatient clinic between January 2021 and April 2021. Female Sexual Function Index (FSFI) was used to assess the sexual function of the women. After measuring body mass index (BMI) and waist circumference (WC), biochemical serum analysis was performed. The VAI was calculated for all participants. The relationship between VAI and total FSFI and subdomain scores was investigated. Of the participants, FSD was detected in 65.5%. There was no relationship between the total FSFI scores and age, BMI, WC and VAI (p = .126, p = .675, p = .790, p = .220, respectively). Increased VAI levels were associated with dysfunction in orgasm (p = .008). Although VAI seems not to be directly related to FSD, it may predict the orgasmic disorder in women.Impact StatementWhat is already known on this subject? Obesity and female sexual dysfunction (FSD) are common health problems which adversely affect the biopsychosocial well-being. Although the relationship between FSD and obesity, body mass index (BMI) and waist circumference (WC) has been widely discussed in the literature to date, there is not enough evidence for the link between FSD and visceral adiposity index (VAI) which is a reliable indicator of visceral fat dysfunction.What do the results of this study add?The results of this study showed that none of the factors indicating obesity such as BMI, WC and VAI were correlated with the total FSFI scores. However, a significant positive correlation was found between the VAI and female orgasmic disorder (FOD).What are the implications of these findings for clinical practice and/or further research? The VAI may be a useful tool for detecting FOD patients. Diagnosis and treatment of orgasmic disorder would significantly improve the patient's quality of life and general well-being. Further large-scale and high-evidence studies are needed to clarify the impact of obesity on FSD and the relationship between VAI and FOD.
Collapse
Affiliation(s)
- Yusuf Sahin
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Tolga Karacan
- Department of Obstetrics and Gynecology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim Hacibey
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Yuksel Aybek
- Department of Obstetrics and Gynecology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Zeynep Ozer
- Department of Obstetrics and Gynecology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Cil
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Muhammet Murat Dincer
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Hakan Guraslan
- Department of Obstetrics and Gynecology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Yaser Muslumanoglu
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
17
|
Jeong J, Kim M. Awareness and Related Factors of Dyslipidemia in Menopausal Women in Korea. Healthcare (Basel) 2022; 10:112. [PMID: 35052276 PMCID: PMC8775859 DOI: 10.3390/healthcare10010112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 01/04/2023] Open
Abstract
This study aims to identify the awareness of dyslipidemia and the factors affecting it in menopausal women to prevent cardiovascular disease, a major cause of female mortality. This study used data from 2019, the first year of the eighth (2019-2021) Korea National Health and Nutrition Examination Survey conducted by the Korea Disease Control and Prevention Agency. A total of 975 women fulfilled the selection criteria. Dyslipidemia awareness and the related factors were analyzed with SPSS 26.0 complex sample software. Only 27.3% of menopausal women over age 40 with dyslipidemia were aware of the condition. Factors affecting their awareness level were age, subjective health awareness, body mass index, and underlying disease. The prevalence of dyslipidemia in menopausal women was high, but their awareness was significantly low. This finding confirms the need for measures to improve dyslipidemia awareness to prevent cardiovascular diseases in menopausal women.
Collapse
Affiliation(s)
- Jeonghee Jeong
- Department of Nursing Science, Kyungsung University, Busan 48434, Korea;
| | - Mijin Kim
- Department of Nursing, Daegu Haany University, Gyeongsan-si 38610, Korea
| |
Collapse
|
18
|
Sansone A, Mollaioli D, Ciocca G, Limoncin E, Colonnello E, Jannini EA. Sexual Dysfunction in Men and Women with Diabetes: A Reflection of their Complications? Curr Diabetes Rev 2022; 18:e030821192147. [PMID: 33687898 DOI: 10.2174/1573399817666210309104740] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM), one of the worldwide leading causes of death, is associated with a plethora of micro- and macro-vascular complications which should be carefully investigated and, in case, treated in order to improve quality of life and reduce the risk of premature mortality. OBJECTIVE The study aimed to investigate and report current evidence with regard to the association between sexual dysfunction and diabetes. METHODS A detailed analysis of current literature has been performed on PubMed and Scholar in order to retrieve the most relevant findings pertaining to the study topic. RESULTS Female and male sexual dysfunction often occurs in diabetes; while cardiovascular complications are clearly involved, psychosexological factors, endocrine complications, and endothelial dysfunction all contribute to the pathogenesis of sexual dysfunctions. Psychological symptoms are seldom investigated, yet they should not be overlooked by the clinician; in fact, an interplay between sexual dysfunctions and depressive symptoms has been reported, and beneficial effects in both conditions might be obtained by adequate psychological support. Sexual dysfunctions can also act as early biomarkers of cardiovascular disease, a phenomenon frequently reported in men, in which erectile dysfunction predicts the development of coronary artery disease. Additionally, drug therapies can act in both directions, with treatments for diabetes possibly improving male sexual function and exerting beneficial effects for cardiovascular health being reported for pro-erectile drugs. CONCLUSION Sexual dysfunctions often occur in men and women with diabetes. Investigating micro- and macro-vascular complications might not be enough to prevent the development or worsening of any sexual dysfunction; endocrine and psychological assessments are therefore needed to provide the best chances for adequate treatment.
Collapse
Affiliation(s)
- Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| | - Daniele Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| | - Giacomo Ciocca
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| | - Erika Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| | - Elena Colonnello
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma,Italy
| |
Collapse
|
19
|
Winkley K, Kristensen C, Fosbury J. Sexual health and function in women with diabetes. Diabet Med 2021; 38:e14644. [PMID: 34252220 DOI: 10.1111/dme.14644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/10/2021] [Indexed: 01/02/2023]
Abstract
Sexual dysfunction for women with diabetes is more common than for women without diabetes. The reasons why women with diabetes are a high-risk group are numerous. For example, lack of vaginal lubrication, pain during sex and inability to orgasm can be a consequence of high or low blood glucose levels. Higher rates of depression in people with diabetes can lead to low sexual drive. Wearing of diabetes devices, such as pumps, glucose monitors or lumps from lipohypertrophy around insulin injection sites may affect body image and self-esteem and the inconvenience of self-managing diabetes may affect the spontaneity of sex. This narrative review provides an overview of the problem of sexual dysfunction in women with diabetes, current methods of assessing sexual dysfunction in women, pharmacological and non-pharmacological interventions to treat it and an example of how psychological support for women with diabetes who experience sexual dysfunction can be integrated into a diabetes service. There are still significant gaps in our knowledge of how best to support women with diabetes and sexual dysfunction. However, raising awareness of the problem may help women with diabetes and healthcare professionals to discuss it as part of diabetes clinical consultations.
Collapse
Affiliation(s)
- Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Camilla Kristensen
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jackie Fosbury
- Diabetes Care for You, Sussex Community NHS Foundation Trust, Moulsecoomb Health Centre, Brighton, UK
| |
Collapse
|
20
|
Asci R, Bolat MS, Dündar C, Özdemir AZ, Atmaca A. Impact of a high visceral adiposity index on female sexual dysfunction in sexually active women? Results of a cross-sectional study. Int J Clin Pract 2021; 75:e14611. [PMID: 34235836 DOI: 10.1111/ijcp.14611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS To our knowledge, this is the first study investigating the impact of high visceral adiposity index (VAI) on female sexual dysfunction (FSD). We aimed to show the impact of increased levels of VAI on FSD compared with body mass index (BMI) and waist circumference (WC) particularly in those with metabolic syndrome (MeTS). METHODS We included 158 participants in two groups: Group 1 (n = 68 with normal sexual function) and Group 2 (n = 90 with sexual dysfunction). Demographic, clinic data, presence of MeTS and comorbidities were recorded. The BMI, WC and the VAI were calculated. Sexual function was assessed using the female sexual function index. RESULTS The mean age and all the anthropometric variables were similar between the groups (P > .05). MeTS was associated with lower arousal and lubrication scores than those without MeTS (P = .023). The higher VAI was associated with lower desire, lubrication and orgasm scores (P < .05). Each integer increase of the VAI weakly predicted decrease of desire (P = .015), arousal (P = .015), lubrication (P = .005) and satisfaction (P = .046). The WC and BMI were not a good predictor for FSD in women (OR=1.019, P = .318). CONCLUSION The VAI was linked with lower scores in some female sexual function subdomains, but the correlation coefficient was low, indicating a weak association. Further studies with a higher number of participants are needed to conclude that the VAI may increase the risk of FSD, particularly in patients with MeTS.
Collapse
Affiliation(s)
- Ramazan Asci
- Department of Urology, Ondokuz Mayis University, Samsun, Turkey
| | | | - Cihad Dündar
- Department of Public Health, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Zehra Özdemir
- Department of Obstetrics and Gynecology, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşegül Atmaca
- Department of Endocrinology, Ondokuz Mayis University, Samsun, Turkey
| |
Collapse
|
21
|
Scavello I, Maseroli E, Cipriani S, Di Stasi V, Verde N, Menafra D, Scannerini S, Marchiani S, Rastrelli G, Ricca V, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi L. Cardiometabolic risk is unraveled by color Doppler ultrasound of the clitoral and uterine arteries in women consulting for sexual symptoms. Sci Rep 2021; 11:18899. [PMID: 34552164 PMCID: PMC8458448 DOI: 10.1038/s41598-021-98336-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
Female sexual dysfunction (FSD) may be a mirror of a poor cardiometabolic state. In a small pilot study enrolling 71 women with FSD, we previously demonstrated that clitoral Pulsatility Index (PI) evaluated by using color Doppler ultrasound (CDU), reflecting vascular resistance, was associated with cardiometabolic risk factors. Data on uterine CDU in this context are lacking. First, to confirm previously reported data on the direct association between clitoral PI and cardiometabolic risk factors on a larger study population of women consulting for sexual symptoms; second, to investigate eventual similar correlations between cardiometabolic risk factors and CDU parameters of the uterine artery. We also ascertained whether uterine artery PI, similarly to what had previously been observed for clitoral artery PI, was directly related to body image uneasiness and psychopathological symptoms, assessed by validated questionnaires. N = 230 women consulting our clinic for sexual symptoms were examined with clitoral CDU and blood sampling and were asked to fill out the Female Sexual Function Index, the Middlesex Hospital Questionnaire (MHQ) and the Body Uneasiness Test (BUT). In a subgroup of women (n = 164), we also performed transvaginal CDU with measurement of uterine artery parameters. At multivariate analysis, we found a direct association between clitoral PI and body mass index (BMI) (p = 0.004), waist circumference (WC) (p = 0.004), triglycerides (p = 0.006), insulin (p = 0.029) and HOMA-IR (p = 0.009). Furthermore, a correlation between obesity and Metabolic Syndrome (MetS) and a higher clitoral PI was observed (p = 0.003 and p = 0.012, respectively). Clitoral PI was also correlated with MHQ-S (p = 0.010), a scale exploring somatized anxiety symptoms, and BUT-B Positive Symptom Distress Index (p = 0.010), a measure of body image concerns. Similarly, when investigating the uterine artery, we were able to demonstrate an association between its PI and BMI (p < 0.0001), WC (p = 0.001), insulin (p = 0.006), glycated haemoglobin (p = < 0.0001), and HOMA-IR (p = 0.009). Women diagnosed with obesity and MetS showed significantly higher uterine PI values vs. those without obesity or MetS (p = 0.001 and p = 0.004, respectively). Finally, uterine PI was associated with BUT-A Global Severity Index (p < 0.0001) and with several other BUT-A subdomains. Vascular resistance of clitoral and uterine arteries is associated with cardiometabolic risk factors and body image concerns in women consulting for sexual symptoms. If further confirmed in different populations, our data could suggest CDU, a common examination method, as a useful tool for an identification—and possible correction—of cardiometabolic risk factors.
Collapse
Affiliation(s)
- I Scavello
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - S Cipriani
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - V Di Stasi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - N Verde
- Clinical Medicine and Surgery Department, Section of Endocrinology, Unit of Andrology, Reproductive Medicine and Male and Female Sexuality (FERTISEXCARES), Federico II University of Naples, Naples, Italy
| | - D Menafra
- Clinical Medicine and Surgery Department, Section of Endocrinology, Unit of Andrology, Reproductive Medicine and Male and Female Sexuality (FERTISEXCARES), Federico II University of Naples, Naples, Italy
| | - S Scannerini
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - S Marchiani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Rastrelli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.,Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - V Ricca
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - F Sorbi
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - M Fambrini
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - F Petraglia
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy. .,Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| |
Collapse
|
22
|
Syed AH, Chandnani A, Khan A, Bhutto NS, Tahir H, Iqbal A, Aruwani SK, Naz S, Bachani P. Association of Weight Loss With Improved Sexual Function in Females. Cureus 2021; 13:e16849. [PMID: 34522491 PMCID: PMC8425155 DOI: 10.7759/cureus.16849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction The prevalence of obesity in developing countries, including Pakistan, has increased several fold in recent times. Obesity appears to negatively affect sexual functioning, hence affecting the quality of life. Its impact on sexual function is understudied. In this study, we will determine the impact of weight loss in improving sexual function in the local setting. Methods This prospective study was conducted in the endocrinology unit of a tertiary care hospital in Pakistan from February 2019 to January 2021. After taking informed consent, 300 married female participants were enrolled in the study. The questionnaire was composed using the pointers from the female sexual function index (FSFI). The privacy of the participants was fully ensured. After the survey, participants were counseled on losing weight via various techniques. Participants were followed up on day 30, day 60, and finally on day 90. On day 90, the FSFI questionnaire was repeated to assess sexual function. Weight loss was measured at the end of day 90. Result A total of 208 participants completed the study. Significant improvement in FSFI score was seen in participants with weight loss between 2% and 5% of their initial body weight (24.01 ± 2.2 vs. 26.07 ± 2.6; p-value: <0.0001). Similarly, a significant improvement in FSFI score was seen in participants with weight loss of more than 5% (24.17 ± 2.2 vs. 27.01 ± 2.6; p-value: <0.0001). Conclusion In conclusion, weight loss is associated with improved sexual function in females. While discussing complications of obesity, impact on sexual function should also be discussed.
Collapse
Affiliation(s)
| | - Aakash Chandnani
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Asim Khan
- Internal Medicine, Lahore Medical and Dental College, Lahore, PAK
| | - Naila S Bhutto
- Internal Medicine, Chandka Medical College, Larkana, PAK
| | - Hamza Tahir
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Abbas Iqbal
- Internal Medicine, Ayub Teaching Hospital, Abottabad, PAK
| | - Suraj K Aruwani
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sidra Naz
- Internal Medicine, University of Health Sciences, Lahore, PAK
| | - Parkash Bachani
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| |
Collapse
|
23
|
Sotiropoulou P, Ferenidou F, Owens D, Kokka I, Minopoulou E, Koumantanou E, Pavlopoulou I, Apotsos P, Karvouni M, Koumantarou E, Mourikis I, Vaidakis N, Papageorgiou C. The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece. Sex Med 2021; 9:100364. [PMID: 34051539 PMCID: PMC8240326 DOI: 10.1016/j.esxm.2021.100364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/21/2021] [Accepted: 03/20/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Recent studies have reported that the quarantine imposed in several countries around the world due to Covid-19 affected the sexual function and relationship quality. On the March 23, 2020 the Greek government imposed a national quarantine to contain the spread of the pandemic. The impact of such conditions on sexual function and relationship quality of couples is unknown. AIM To investigate sexual function and relationship quality of couples during the quarantine. METHODS An online anonymous survey was conducted one month post-impose of the quarantine, between the April 21 and the May 3, 2020. Adult respondents in a relationship completed a questionnaire including sociodemographic characteristics, structured inquiries regarding sexual activity and quality of relationship, anxiety level, and mood during the quarantine, as well as the IIEF and FSFI indices. OUTCOMES Sexual function was assessed using the Greek versions of the FSFI and IIEF for females and males respectively. Sexual activity using 5 statements regarding frequency of sexual thoughts, masturbation, and intercourse, quality of intercourse and general estimation of the level of sexual function. Participants graded their level of agreement. Relationship quality was assessed using 5 questions regarding communication, company, understanding, tension and general estimation of companionship. Participants graded their level of agreement. Two additional statements were used in order to evaluate mood and the level of anxiety. RESULTS A sum of 299 adult heterosexual participants in a relationship participated. Little or no negative impact on sexual function was reported. Increased anxiety and deficient mood were reported only for those with no access to their partner. Being in a steady relationship and living with their partner, but only for couples without children, resulted in satisfaction by sexual activity and enhanced emotional security. CONCLUSION Sexual function and relationship quality appeared as not affected by the quarantine and by the measures of social distancing. Sotiropoulou P, Ferenidou F, Owens D, et al. The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece. Sex Med 2021;9:100364.
Collapse
Affiliation(s)
- Paraskevi Sotiropoulou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Fotini Ferenidou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Dimitra Owens
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Ioulia Kokka
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health; Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Eirini Minopoulou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Evangelia Koumantanou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Iliana Pavlopoulou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Panagiotis Apotsos
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Maria Karvouni
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Elli Koumantarou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Iraklis Mourikis
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Nikos Vaidakis
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| | - Charalambos Papageorgiou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece. Outpatient Specialty Clinic for Sexual Health
| |
Collapse
|
24
|
Kudesia R, Alexander M, Gulati M, Kennard A, Tollefson M. Dietary Approaches to Women's Sexual and Reproductive Health. Am J Lifestyle Med 2021; 15:414-424. [PMID: 34366740 DOI: 10.1177/15598276211007113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 12/26/2022] Open
Abstract
Over the course of the reproductive life span, it is common for women to experience one or more of the most common gynecologic conditions, including sexual dysfunction, polycystic ovary syndrome, fibroids, endometriosis, and infertility. Although current management guidelines often turn to the established pharmaceutical approaches for each of these diagnoses, the scientific literature also supports an evidence-based approach rooted in the paradigm of food as medicine. Achieving healthy dietary patterns is a core goal of lifestyle medicine, and a plant-forward approach akin to the Mediterranean diet holds great promise for improving many chronic gynecologic diseases. Furthermore, creating an optimal preconception environment from a nutritional standpoint may facilitate epigenetic signaling, thus improving the health of future generations. This state-of-the-art review explores the literature connecting diet with sexual and reproductive health in premenopausal women.
Collapse
Affiliation(s)
- Rashmi Kudesia
- Houston Methodist Hospital and CCRM Fertility Houston, Texas
| | | | - Mahima Gulati
- Division of Endocrinology, Diabetes, and Metabolism, Middlesex Health, Middletown, Connecticut
| | - Anne Kennard
- Marian Regional Medical Center, San Luis Obispo, California
| | | |
Collapse
|
25
|
Gürlek B, Zihni Korkmaz M, Kurt Bayrakdar S, Alan Y, Akça N, Uzun H. Is sexual dysfunction associated with periodontal status in perimenopausal women?: A pilot study. Oral Dis 2021; 28:1270-1278. [PMID: 33660899 DOI: 10.1111/odi.13815] [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: 07/01/2020] [Revised: 02/09/2021] [Accepted: 02/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The current study aimed to investigate the possible relationship between periodontal status and sexual dysfunction in perimenopausal women. MATERIALS AND METHODS This study was conducted on 106 participants. After the evaluation of the sexual functioning of participants with the Female Sexual Function Index (FSFI), their periodontal status and decayed-missing-filled teeth (DMFT) were assessed using appropriate indexes and obtained results were recorded for comparisons. Participants were divided into two groups by the periodontal status. Patients with periodontitis were grouped by the stage and the extent of the disease. Besides, participants were grouped according to the bleeding on probing (BOP) ratios for more detailed analyses. RESULTS A negative significant correlation was observed between total FSFI scores and each of the clinical periodontal parameters. Total FSFI scores and the scores of arousal, lubrication, orgasm, satisfaction, and pain domains were significantly lower in periodontitis patients (p < .05). When the patients were grouped as having localized or generalized periodontitis or whether they had stage-I, -II, and -III periodontitis, no statistically significant differences were observed in the distribution of general sexual dysfunction parameters across the groups (p > .05). CONCLUSION Periodontal status in perimenopausal women may be associated with sexual dysfunction.
Collapse
Affiliation(s)
- Beril Gürlek
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Meltem Zihni Korkmaz
- Department of Periodontology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Sevda Kurt Bayrakdar
- Department of Periodontology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Yasemin Alan
- Department of Obstetrics and Gynecology, İzmir Metropolitan Municipality Eşrefpaşa Hospital, İzmir, Turkey
| | - Nezih Akça
- Department of Urology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hakkı Uzun
- Department of Urology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| |
Collapse
|
26
|
Sansone A, Limoncin E, Colonnello E, Mollaioli D, Ciocca G, Corona G, Jannini EA. Harm Reduction in Sexual Medicine. Sex Med Rev 2021; 10:3-22. [DOI: 10.1016/j.sxmr.2021.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
|
27
|
Liu S, Cao D, Ren Z, Li J, Peng L, Zhang Q, Cheng B, Cheng Z, Ai J, Zheng X, Liu L, Wei Q. The relationships between bariatric surgery and sexual function: current evidence based medicine. BMC Urol 2020; 20:150. [PMID: 33008406 PMCID: PMC7532646 DOI: 10.1186/s12894-020-00707-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/26/2020] [Indexed: 02/08/2023] Open
Abstract
Background Controversy remains despite several studies have discussed the role of bariatric surgery in improving male’s sexual function. This study aims to evaluate the efficacy of bariatric surgery in promoting male’s erectile function. Methods PubMed, EMbase, The Cochrane Library, CNKI and Clinical Trails.gov were searched from database inception to May 2019. The language of publication was limited in English. The International Index of Erectile Function (IIEF) score and Brief Male Sexual Function Inventory (BSFI) score were set as the primary outcome. Results Eleven studies with a total of 370 patients were enrolled in this meta-analysis. The results showed significant improvement in the IIEF score (erectile function: MD = 5.33, 95% CI 4.12–6.54; intercourse satisfaction: MD = 2.57, 95% CI 1.19–3.94; orgasmic function: MD = 0.50, 95%CI 0.60–0.94; overall satisfaction: MD = 1.67, 95% CI 0.78–2.56; sexual desire: MD = 1.27, 95% CI 0.61–1.93; total erectile function: MD = 7.21, 95% CI 4.33–10.10) and the BSFI score (erection: MD =2.53, 95% CI 2.39–2.67; ejaculation: MD = 1.40, 95% CI 1.28–1.51; desire: MD =1.40, 95% CI 1.32–1.49; problem assessment: MD = 2.20, 95% CI 2.06–2.34; sexual satisfaction: MD = 0.70, 95% CI 0.60–0.76) in obese individuals after bariatric surgery. Conclusions This systematic review and meta-analysis indicated that bariatric surgery could be effective in promoting males’s sexual function for obese individuals.
Collapse
Affiliation(s)
- Shengzhuo Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dehong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhengju Ren
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinze Li
- DepartmentofUrology, Nanchong CentralHospital, The Second ClinicalMedical College, NorthSichuanMedicalCollege (University), Nanchong, Sichuan, China
| | - Lei Peng
- DepartmentofUrology, Nanchong CentralHospital, The Second ClinicalMedical College, NorthSichuanMedicalCollege (University), Nanchong, Sichuan, China
| | - Qin Zhang
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Bo Cheng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zheyu Cheng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jianzhong Ai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaonan Zheng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liangren Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
28
|
Pastoor H, Both S, Timman R, Laan ETM, Laven JSE. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study. Sex Med 2020; 8:718-729. [PMID: 32798148 PMCID: PMC7691880 DOI: 10.1016/j.esxm.2020.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 12/23/2022] Open
Abstract
Introduction The prevalence of polycystic ovary syndrome (PCOS) is 10–15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular disease. Treatment commonly entails oral contraceptive use to lower endogenous androgen levels. Androgen levels and comorbidities may affect sexual function. Previous studies have addressed a limited range of possible contributing factors. We will assess sexual function as well as genital and self-reported sexual arousal in a laboratory setting in women with PCOS compared to an age-matched healthy control group. Modulation by biopsychosocial factors mentioned will be studied. Methods This is a multicenter prospective case control study. The study population includes healthy women with and without PCOS, aged 18–40 years, in a stable heterosexual relationship for at least 6 months. Power is calculated at 67 participants in each group. Anticipating a drop out of 10%, 150 participants will be recruited. Main outcome measures The main outcomes measured are sexual function using the Female Sexual Function Index, Sexual Desire Inventory, and Female Sexual Distress Scale-Revised; genital sexual arousal measured as vaginal pulse amplitude; and self-reported sexual arousal in response to erotic stimuli in a laboratory setting. The mediators that will be investigated include testosterone, free androgen levels, oral contraceptive use, sensitivity to androgens (using CAG repeat length), body mass index, body image, mental health, and self-esteem. Conclusion Strengths of this study are the inclusion of a broad range of biopsychosocial outcome measures including DNA analysis, a healthy control group, and standardized assessment of genital and self-reported sexual arousal in a laboratory setting. With the design of this study we aim to provide an insight into which biopsychosocial factors associated with PCOS are related to sexual function, and how sexual function may be affected by treatment. These new insights may help to improve clinical management of PCOS while improving the quality of life. Pastoor H, Both S, Timman R, et al. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter Case Control Study. Sex Med 2020;8:718–729.
Collapse
Affiliation(s)
- Hester Pastoor
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, the Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic OBGYN, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
29
|
Faubion SS, Fairbanks F, Kuhle CL, Sood R, Kling JM, Vencill JA, Mara KC, Kapoor E. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020; 17:1971-1980. [PMID: 32771351 DOI: 10.1016/j.jsxm.2020.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/24/2020] [Accepted: 07/02/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Obesity and female sexual dysfunction (FSD) are prevalent conditions, and both are associated with significant adverse effects on health and well-being. AIM To investigate the association between body mass index and FSD, as well as potential moderators. METHODS This cross-sectional study was performed by analyzing medical records of 6,688 women seeking consultation for menopause-related or sexual health-related concerns at women's health clinics at Mayo Clinic Rochester, MN, and Scottsdale, AZ, between May 1, 2015, and September 15, 2019. OUTCOMES Female sexual function was assessed by the Female Sexual Function Index, and sexual distress was assessed by the Female Sexual Distress Scale-Revised. RESULTS Being overweight or obese was associated with a lack of sexual activity. Among sexually active women, those who were overweight or obese had lower Female Sexual Function Index total scores and sexual function domain scores (indicating worse sexual function), including sexual arousal, lubrication, satisfaction, orgasm, and pain, and higher levels of sexual distress than those with normal weight. However, on multivariable analysis, these associations were found to be mediated by other factors, including age, level of education, reproductive stage, medication use, and mood disturbances, which are known to impact body weight and sexual function in women. CLINICAL IMPLICATIONS Overweight and obesity were associated with sexual inactivity and greater odds of having FSD, which should prompt proactive assessment of sexual function. STRENGTHS AND LIMITATIONS The strengths of this study include the large cohort size and assessment of sexual problems in addition to sexual distress, a key component of the definition of sexual dysfunction. This study also took into account multiple potential moderating factors. Limitations include the cross-sectional design, which precludes determination of causality as well as lack of diversity in the cohort, potentially limiting generalizability of results. In addition, sexual function was not assessed in women reporting no recent sexual activity, which may confound results. CONCLUSION Overweight/obesity and FSD are highly prevalent conditions, which appear to be indirectly associated. These results highlight the need to identify and address FSD in all overweight and obese women, with particular attention to potential contributing factors. Faubion SS, Fairbanks F, Kuhle CL, et al. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020;17:1971-1980.
Collapse
Affiliation(s)
- Stephanie S Faubion
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
| | - Flavia Fairbanks
- Department of Obstetrics and Gynecology and PROSEX, University of Sāo Paulo School of Medicine, Sao Paulo, Brazil
| | - Carol L Kuhle
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Richa Sood
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Jennifer A Vencill
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
30
|
Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020; 17:1229-1236. [PMID: 32411271 PMCID: PMC7221385 DOI: 10.1016/j.jsxm.2020.05.001] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/27/2020] [Accepted: 05/03/2020] [Indexed: 11/21/2022]
Abstract
Background On 23rd March 2020, the UK government released self-isolation/social distancing guidance to reduce the risk of transmission of SARS-CoV-2. The influence such guidance has on sexual activity is not known. Aim To investigate levels and correlates of sexual activity during COVID-19 self-isolation/social distancing in a sample of the UK public. Methods This paper presents preplanned interim analyses of data from a cross-sectional epidemiological study, administered through an online survey. Outcomes Sexual activity was measured using the following question: “On average after self-isolating how many times have you engaged in sexual activity weekly?” Demographic and clinical data were collected, including sex, age, marital status, employment, annual household income, region, current smoking status, current alcohol consumption, number of chronic physical conditions, number of chronic psychiatric conditions, any physical symptom experienced during self-isolation, and number of days of self-isolation/social distancing. The association between several factors (independent variables) and sexual activity (dependent variable) was studied using a multivariable logistic regression model. Results 868 individuals were included in this study. There were 63.1% of women, and 21.8% of adults who were aged between 25 and 34 years. During self-isolation/social distancing, 39.9% of the population reported engaging in sexual activity at least once per week. Variables significantly associated with sexual activity (dependent variable) were being male, a younger age, being married or in a domestic partnership, consuming alcohol, and a higher number of days of self-isolation/social distancing. Clinical Implications In this sample of 868 UK adults self-isolating owing to the COVID-19 pandemic, the prevalence of sexual activity was lower than 40%. Those reporting particularly low levels of sexual activity included females, older adults, those not married, and those who abstain from alcohol consumption. Strength and Limitations This is the first study to investigate sexual activity during the UK COVID-19 self-isolation/social distancing. Participants were asked to self-report their sexual activity potentially introducing self-reporting bias into the findings. Second, analyses were cross-sectional and thus it is not possible to determine trajectories of sexual activity during the current pandemic. Conclusion Interventions to promote health and well-being during the COVID-19 pandemic should consider positive sexual health messages in mitigating the detrimental health consequences in relation to self-isolation/social distancing and should target those with the lowest levels of sexual activity. Jacob L, Smith L, Butler L, et al. Challenges in the Practice of Sexual Medicine in the Time of COVID-19 in the United Kingdom. J Sex Med 2020;17:1229–1236.
Collapse
|
31
|
Evaluation of sexual functions in female rosacea patients: a prospective, case-control study. Int J Impot Res 2020; 32:628-634. [DOI: 10.1038/s41443-020-0275-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/22/2020] [Accepted: 03/31/2020] [Indexed: 01/23/2023]
|
32
|
Mollaioli D, Ciocca G, Limoncin E, Di Sante S, Gravina GL, Carosa E, Lenzi A, Jannini EAF. Lifestyles and sexuality in men and women: the gender perspective in sexual medicine. Reprod Biol Endocrinol 2020; 18:10. [PMID: 32066450 PMCID: PMC7025405 DOI: 10.1186/s12958-019-0557-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 10/17/2018] [Indexed: 01/13/2023] Open
Abstract
Sexual health is strictly related with general health in both genders. In presence of a sexual dysfunction, the expert in sexual medicine aims to discover the specific weight of the physical and psychological factors can cause or con-cause the sexual problem. At the same time, a sexual dysfunction can represent a marker of the future development of a Non-communicable diseases (NCDss) as cardiovascular or metabolic diseases.In the evaluation phase, the sexual health specialist must focus on these aspects, focusing especially on the risk and protective factors that could impact on both male and female sexuality.This article presents a review of researches concerning healthy and unhealthy lifestyles and their contribute in the development of sexual quality of life in a gender-dependent manner.Among the unhealthy lifestyle, obesity contributes mostly to the development of sexual dysfunctions, due to its negative impact on cardiovascular and metabolic function. Tobacco smoking, alcohol - substance abuse and chronic stress lead to the development of sexual dysfunction in a med-long term.In order to guarantee a satisfying sexual quality of life, sexual health specialists have the responsibility to guide the patient through the adoption of healthy lifestyles, such as avoiding drugs, smoke and excessive alcohol, practicing a regular physical activity, following a balanced diet and use stress-management strategies, even before proposing both pharmaco- and/or psychotherapies.
Collapse
Affiliation(s)
- Daniele Mollaioli
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giacomo Ciocca
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Erika Limoncin
- grid.6530.00000 0001 2300 0941Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Stefania Di Sante
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
| | - Giovanni Luca Gravina
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Eleonora Carosa
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio (Coppito 2), L’Aquila, 67100 Italy
| | - Andrea Lenzi
- grid.7841.aDepartment of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, Rome, 00161 Italy
| | | |
Collapse
|
33
|
Xiang Y, Tang Y, Li J, Li D. How Is the Sexual Function of Premenopausal Chinese Women Without Hyperlipidemia? Sex Med 2019; 8:65-75. [PMID: 31837966 PMCID: PMC7042168 DOI: 10.1016/j.esxm.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/05/2019] [Accepted: 10/26/2019] [Indexed: 01/23/2023] Open
Abstract
Introduction Most premenopausal women in China have normal lipid profiles while the sexual function among them was scarcely demonstrated. Aim To find out the characteristics of the sexual function in premenopausal Chinese women without hyperlipidemia using the Female Sexual Function Index (FSFI) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). Methods This cross-sectional study was performed to find out the characteristics of sexual function in premenopausal Chinese women without hyperlipidemia. Between January 2019 and March 2019, we recruited 216 women, 25–49 years of age. Data from questionnaires and health checkups were collected and analyzed. Main Outcome Measure We report the prevalence of and factors related to female sexual dysfunction (FSD) in premenopausal Chinese women without hyperlipidemia in accordance with the FSFI and the GRISS. Results The prevalence of FSD in our study was 46.2%. The mean age was 38.07 ± 6.94 years. More highly educated women suffered from FSD than those in the control group (61.1% vs 35.2%, P < .05). Binge eating was significantly different between the groups (P = .023). Multiple logistic regression analyses demonstrated that total cholesterol level was positively associated with low desire (OR, 2.13; 95% CI, 1.10–4.13; P = .025) and so was the low-density lipoprotein level (OR, 2.18; 95% CI, 1.03–4.62; P = .0.041). The high-density lipoprotein level was inversely associated with infrequency (OR, 0.18; 95% CI, 0.06–0.59; P = .004). More women with FSD had orgasm disorder than those in the control group, for 83.3% vs 35.2% in the FSFI (P < .001), 88.9% vs 54.3% in the GRISS (P < .001), respectively. Dissatisfaction remained the most common issue for the control group in both the FSFI and the GRISS (90.50% and 58.10%, respectively). Conclusions FSD is frequent in premenopausal Chinese women without hyperlipidemia. Dissatisfaction as the common problem influenced over half of them and orgasm disorder is a severe sexual issue for women with FSD. Xiang Y, Tang Y, Li J, et al. How Is the Sexual Function of Premenopausal Chinese Women Without Hyperlipidemia. J Sex Med 2019;8:65–75.
Collapse
Affiliation(s)
- Yali Xiang
- Health Management Center, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Yuxin Tang
- Department of Urology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Jiaqun Li
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China.
| | - Dongjie Li
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, P.R. China; National Clinical Research Center for Geriatric Disorders, Changsha, P.R. China.
| |
Collapse
|
34
|
Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Medical conditions and sexual dysfunction in post-menopausal women. SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2019.1672866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
35
|
Sexual Health in Menopause. ACTA ACUST UNITED AC 2019; 55:medicina55090559. [PMID: 31480774 PMCID: PMC6780739 DOI: 10.3390/medicina55090559] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40–55%), poor lubrication (25–30%) and dyspareunia (12–45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.
Collapse
|
36
|
Plant-Derived Supplements for Sexual Health and Problems, Part 2: Further Evidence for Specific Herbal Effects. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
37
|
Calmasini FB, Klee N, Webb RC, Priviero F. Impact of Immune System Activation and Vascular Impairment on Male and Female Sexual Dysfunction. Sex Med Rev 2019; 7:604-613. [PMID: 31326360 DOI: 10.1016/j.sxmr.2019.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/03/2019] [Accepted: 05/30/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Male and female sexual dysfunction (SD) is considered a multifactorial condition. Numerous studies have shown the involvement of inflammatory processes in this pathological condition. Sexual intercourse requires healthy and functioning vessels to supply the pelvic region in both males and females, generating penile erection and clitoral and vaginal lubrication, respectively. Cardiovascular diseases and associated risk factors may contribute negatively to pelvic blood flow, possibly through immune system activation. AIM The study aimed to address the correlation between vascular inflammation driven by immune system activation and SD in males and females. METHODS A literature review was performed to identify articles addressing male and female SD and vascular inflammation. Key words included "male and female sexual dysfunction," "vascular inflammation," "iliac and pudendal arteries dysfunction," "genitourinary tract," and "blood flow." MAIN OUTCOME MEASURES Management of systemic and local inflammation may be a useful alternative to improve SD and reduce the risk of cardiovascular diseases in the future. RESULTS Increased levels of cytokines and chemokines have been detected in humans and animals with hypertension, obesity, and diabetic conditions. Chronic activation of the innate immune system, especially by pathogen- or damage-associated molecular patterns, and metabolic-related disorders may act as triggers further contributing to an increased inflammatory condition. Due to the reduced size of vessels, SD and retinal vascular impairments have been shown to be predictive factors for cardiovascular diseases. Therefore, considering that blood flow to the genitalia is essential for sexual function, endothelial dysfunction and vascular remodeling, secondary to chronic immune system activation, may be implicated in male and female vasculogenic SD. CONCLUSIONS Several conditions appear to play a role in SD. In the present review, we have identified a role for the immune system in generating vascular and tissue impairments contributing to erectile dysfunction and female SD. Calmasini FB, Klee N, Webb RC, et al. Impact of Immune System Activation and Vascular Impairment on Male and Female Sexual Dysfunction. Sex Med Rev 2019;7:604-613.
Collapse
Affiliation(s)
- Fabiano B Calmasini
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA; Deparment of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - Nicole Klee
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - R Clinton Webb
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Fernanda Priviero
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| |
Collapse
|
38
|
Flotynska J, Uruska A, Michalska A, Araszkiewicz A, Zozulinska-Ziolkiewicz D. Sexual Dysfunction Is a More Common Problem in Young Women with Type 1 Diabetes than in Healthy Women. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:643-651. [PMID: 31007158 DOI: 10.1080/0092623x.2019.1610121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the study was to analyze the relationship between the presence of type 1 diabetes and sexual dysfunction among young women. The study group consisted of 230 women, including 70 healthy and 160 with diabetes mellitus type 1 (DM1). All the participants voluntarily filled anonymous questionnaire. The results regarding sexual function were obtained using a Female Sexual Function Index (FSFI) questionnaire. Statistical analysis was performed for sexually active people. In the study group, 180 women declared sexual activity: 62 healthy (88%) and 118 with DM1 (82.5%). Women with DM1 in comparison with healthy women were older, had higher BMI, weight, and had more pack-years of cigarette smoking. Women with DM1 had lower results in FSFI and more often achieved scores below the clinical cutoff point. In a multiple linear regression model, the presence of diabetes predicted lower FSFI results. DM1 is independently associated with the presence of impaired sexual function. Sexual dysfunctions are more common among young women with DM1 than in healthy controls. The relationship is significant despite of the age, duration of diabetes, body weight, and presence of angiopathy.
Collapse
Affiliation(s)
- Justyna Flotynska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital , Poznan , Poland
| | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital , Poznan , Poland
| | - Anna Michalska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital , Poznan , Poland
| | - Aleksandra Araszkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital , Poznan , Poland
| | - Dorota Zozulinska-Ziolkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital , Poznan , Poland
| |
Collapse
|
39
|
Yoldemir T, Garibova N, Atasayan K. The association between sexual dysfunction and metabolic syndrome among Turkish postmenopausal women. Climacteric 2019; 22:472-477. [PMID: 30889983 DOI: 10.1080/13697137.2019.1580256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective: The aim of this study is to determine the association between sexual dysfunction and metabolic syndrome (MS) among Turkish postmenopausal women Methods: In total, 290 postmenopausal women between the ages of 50 and 70 years and 265 premenopausal women between the ages of 30 and 49 years who applied to Menopause and Gynecology Clinics at Marmara University-affiliated Pendik Education and Research Hospital, Istanbul, Turkey were included in this prospective survey. Sexual function was assessed using the Female Sexual Function Index (FSFI). A FSFI total score of <26.5 was suggestive of sexual dysfunction. MS was assessed by the National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Sexual dysfunction prevalence among postmenopausal women was 64.6% in relation to 42.1% in premenopausal women (p = 0.001). MS prevalence was 13.5% among premenopausal women and 15.5% among postmenopausal women (p = 0.57). The total FSFI score and each score in the desire, arousal, lubrication, orgasm, satisfaction, and dyspareunia domains of the FSFI did not differ between premenopausal and postmenopausal women, regarding the MS status. In the premenopausal group, 45.7% of women without MS and 37% of women with MS had lower sexual dysfunction (p = 0.40); whereas in the postmenopausal group, 62.2% of women without MS and 77.4% of women with MS had lower sexual function (p = 0.22). Conclusion: In our study population, the rate of sexual dysfunction increased in postmenopausal women in contrast to premenopausal women. The MS status did not make a difference in terms of sexual dysfunction either in premenopausal or postmenopausal women. Since our survey was conducted in a tertiary medical center which gave medical care service to women from middle and low socioeconomic classes, our results should be confirmed by a large multicenter survey enrolling women from all different socioeconomic classes.
Collapse
Affiliation(s)
- T Yoldemir
- Department of Obstetrics and Gynaecology, Marmara University Hospital , Istanbul , Turkey
| | - N Garibova
- Obstetrics and Gynaecology Clinic, Baku Medical Center , Baku , Azerbaijan
| | - K Atasayan
- Department of Obstetrics and Gynaecology, Maltepe University Hospital , Istanbul , Turkey
| |
Collapse
|
40
|
Di Francesco S, Caruso M, Robuffo I, Militello A, Toniato E. The Impact of Metabolic Syndrome and Its Components on Female Sexual Dysfunction: A Narrative Mini-Review. Curr Urol 2019; 12:57-63. [PMID: 31114461 DOI: 10.1159/000489420] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/09/2018] [Indexed: 02/06/2023] Open
Abstract
Background The impact of metabolic syndrome on female sexual dysfunction received modest consideration in clinical practice. The aim of the research was to analyze the international literature to determine the relationship between the metabolic syndrome, its components and female sexual disorders. Methods We identified relevant full-length papers by electronic databases as Index Medicus/Medline, Scopus, Life Science Journals, from 2005 to the present. Studies were searched using the following as search query: metabolic syndrome, female sexual dysfunction, obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia. Results Women with metabolic syndrome showed higher prevalence of sexual inactivity and low sexual desire, orgasm and satisfaction respect to women without metabolic syndrome. Particularly metabolic components as diabetes mellitus, dy-slipidemia, systemic arterial hypertension were strongly associated with lower sexual desire, activity and Female Sexual Function Index total score. In contrast, other studies showed no relationship. Conclusion Our study showed that in the clinical evaluation of women with metabolic syndrome routine inquiring about female sexual dysfunction should be recommended to ameliorate sexual function and quality of life. However more prospective and longitudinal studies on the sexual effects of metabolic syndrome should also be suggested to know the factors related to women's sexuality better.
Collapse
Affiliation(s)
- Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, Chieti
| | - Marika Caruso
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, Chieti
| | - Iole Robuffo
- Institute of Molecular Genetics, National Research Council, Section of Chieti, Chieti
| | - Andrea Militello
- Urology and Andrology Section, Villa Immacolata Hospital, Viterbo, Italy
| | - Elena Toniato
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, Chieti
| |
Collapse
|
41
|
Lechmiannandan S, Panirselvam M, Muninathan P, Hussin N, Rajan R, Sidi H, Kosai NR, Vinayak CR. Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia. Obes Surg 2019; 29:1571-1575. [PMID: 30706310 DOI: 10.1007/s11695-019-03722-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery. MATERIAL AND METHODS This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared. RESULTS Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value < 0.001). The rate of FSD among the obese is 75.0% pre-surgery compared to 36.0% post-surgery. There was a significant improvement in mean FSFI score pre- and post-surgery: 18.73 and 25.93 respectively and in each of all 6 domains (p value < 0.001). There was a significant association between BMI reduction and improvement in FSFI score (p = 0.019). There was no difference in outcomes between types of surgery. CONCLUSION FSD is highly prevalent among the obese multiethnic Malaysian women. Bariatric surgery has proven benefit in resolving FSD across all sexual domains and should be considered as a management option in this group of women.
Collapse
Affiliation(s)
| | - Mayurran Panirselvam
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Prema Muninathan
- Clinical Research Centre, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| | - Narwani Hussin
- Clinical Research Centre, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| | - Reynu Rajan
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Nik Ritza Kosai
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - C Rajkumar Vinayak
- Bariatric Surgery Unit, Department of Surgery, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| |
Collapse
|
42
|
Nappi RE, Martini E, Cucinella L, Martella S, Tiranini L, Inzoli A, Brambilla E, Bosoni D, Cassani C, Gardella B. Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women. Front Endocrinol (Lausanne) 2019; 10:561. [PMID: 31496993 PMCID: PMC6712495 DOI: 10.3389/fendo.2019.00561] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022] Open
Abstract
Vaginal health is an essential component of active and healthy aging in women at midlife and beyond. As a consequence of hormonal deprivation and senescence, the anatomy and function of urogenital tissues are significantly affected and vulvovaginal atrophy (VVA) may occur. In a high proportion of postmenopausal women, progressive and chronic VVA symptoms have a strong impact on sexual function and quality of life. The new definition of genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections). Many variables (age, sexual activity and partnership status) influence the clinical impact VVA/GSM symptoms and attitudes of elderly women to consult for receiving effective treatments. Psychosocial factors play a critical role in sexual functioning, but the integrity of the urogenital system is as well important affecting many domains of postmenopausal women's health, including sexual function. Several international surveys have extensively documented the need to improve VVA/GSM management because of the strong impact on women's daily life and on couple's intimacy. Health care providers (HCPs) need to be proactive in the early recognition of VVA/GSM in order to preserve urogenital and sexual longevity, by using hormonal and non-hormonal strategies. The clinical diagnosis is based on genital examination to identify objective signs and on the use of subjective scales to rate most bothersome symptoms (MBS), especially vaginal dryness. Recent studies point to the importance of addressing VVA/GSM as a potential early marker of poor general health in analogy with vasomotor symptoms. Therefore, a standard of VVA/GSM care in elderly women is desirable to enhance physical, emotional and mental well-being.
Collapse
Affiliation(s)
- Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Rossella E. Nappi
| | - Ellis Martini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
| | - Laura Cucinella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvia Martella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Alessandra Inzoli
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Emanuela Brambilla
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - David Bosoni
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Chiara Cassani
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| |
Collapse
|
43
|
Natarajan P, Khan SD. Sexual Dysfunction and Infertility. Sex Med 2019. [DOI: 10.1007/978-981-13-1226-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
44
|
Maiorino MI, Bellastella G, Giugliano D, Esposito K. From inflammation to sexual dysfunctions: a journey through diabetes, obesity, and metabolic syndrome. J Endocrinol Invest 2018; 41:1249-1258. [PMID: 29549630 DOI: 10.1007/s40618-018-0872-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/09/2018] [Indexed: 12/20/2022]
Abstract
Metabolic diseases are associated with chronic low-grade inflammation, which has been indicated as a potential mediator of endothelial dysfunction and cardiovascular disease. Visceral adiposity is thought to be the starting condition of the inflammatory state through the release of inflammatory cytokines, including TNF-alpha, CRP, and IL-6, which in turn promote endothelial dysfunction, endothelial expression of chemokines (IL-1) and adhesion molecules (ICAM-1, VCAM-1, and P-selectin), and the inhibition of anti-atherogenic factors (adiponectin). Obesity, metabolic diseases, and diabetes, all conditions characterized by abdominal fat, are well-recognized risk factors for sexual dysfunction in both sexes. Evidence from randomized-controlled trials supports the association between inflammatory milieau and erectile dysfunction in men suffering from metabolic diseases, whereas, in women, this has to be confirmed in further studies. A healthy lifestyle based on dietary pattern with high content of whole grain, fruit, nuts and seeds, and vegetables and low in sodium and saturated fatty acids plus regular physical activity may help to modulate the pro-inflammatory state associated with metabolic diseases and the related burden of sexual dysfunctions.
Collapse
Affiliation(s)
- M I Maiorino
- Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy
| | - G Bellastella
- Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy
| | - D Giugliano
- Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy
| | - K Esposito
- Diabetes Unit, Department of Medical, Surgical, Neurological Metabolic Sciences and Aging, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy.
| |
Collapse
|
45
|
Wekker V, Karsten MDA, Painter RC, van de Beek C, Groen H, Mol BWJ, Hoek A, Laan E, Roseboom TJ. A lifestyle intervention improves sexual function of women with obesity and infertility: A 5 year follow-up of a RCT. PLoS One 2018; 13:e0205934. [PMID: 30352059 PMCID: PMC6198949 DOI: 10.1371/journal.pone.0205934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/02/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Obesity and infertility are associated with poorer sexual function. We have previously shown that a lifestyle intervention in women with obesity and infertility reduced weight and improved cardiometabolic health and quality of life, which may positively affect sexual function. We now report on sexual function 5 years after randomization. METHODS AND FINDINGS In total 577 women, between 18-39 years of age, with infertility and a BMI ≥29 kg/m2 were randomized to a six-month lifestyle intervention targeting physical activity, diet and behavior modification or prompt infertility care as usual. Intercourse frequency and sexual function were assessed with the McCoy Female Sexuality Questionnaire (MFSQ), 5.4±0.8 years after randomization. 550 women could be approached for the follow-up study, of whom 84 women in the intervention and 93 in the control group completed the MFSQ. Results were adjusted for duration of infertility, polycystic ovary syndrome and whether women were attempting to conceive. The intervention group more often reported having had intercourse in the past 4 weeks compared to the control group (aOR: 2.3 95% CI 0.96 to 5.72). Among women reporting intercourse in the past 4 weeks, the intervention group (n = 75) had intercourse more frequently (6.6±5.8 vs. 4.9±4.0 times; 95% CI 0.10 to 3.40) and had higher scores for vaginal lubrication (16.5±3.0 vs. 15.4±3.5; 95% CI 0.15 to 2.32) and total 'sexual function' score (96.5±14.2 vs. 91.4±12.8; 95% CI 0.84 to 9.35) compared to the control group (n = 72). Sexual interest, satisfaction, orgasm and sex partner scores did not differ statistically between the groups. The intervention effect on sexual function was for 21% mediated by the change in moderate to vigorous physical activity. CONCLUSION A six-month lifestyle intervention in women with obesity and infertility led to more frequent intercourse, better vaginal lubrication and overall sexual function 5 years after the intervention. (Trial Registration: NTR1530).
Collapse
Affiliation(s)
- Vincent Wekker
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Matty D. A. Karsten
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Rebecca C. Painter
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Cornelieke van de Beek
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ben Willem J. Mol
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, Monash Medical Centre, Monash University, Clayton, Australia
| | - Annemieke Hoek
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ellen Laan
- Department of Sexology and Psychosomatic Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tessa J. Roseboom
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| |
Collapse
|
46
|
Pastoor H, Timman R, de Klerk C, M Bramer W, Laan ET, Laven JS. Sexual function in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biomed Online 2018; 37:750-760. [PMID: 30420168 DOI: 10.1016/j.rbmo.2018.09.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 01/28/2023]
Abstract
We present the first systematic review and meta-analysis of sexual function in women with polycystic ovary syndrome (PCOS) compared with women without PCOS. Data on this topic are limited and often contradicting. Sexual function is influenced by endocrine, mental and social factors, which are often compromised in women with PCOS. The main outcome measures were validated sexual function questionnaires and visual analogue scales (VAS). We identified and assessed 1925 original articles; 18 articles were included. Significant small effect sizes were found on sexual function subscales (total score: P = 0.006; arousal: P = 0.019; lubrication: P = 0.023; satisfaction: P = 0.015; orgasm: P = 0.028), indicating impaired sexual function in women with PCOS. Large effect sizes for the effect of body hair on sex were shown on VAS (P = 0.006); social effect of appearance (P = 0.007); sexual attractiveness (P < 0.001). Satisfaction with sex life was impaired (P < 0.001), but sexual satisfaction was rated equally important in women with PCOS and controls. We conclude that a satisfying sex life is important for women with PCOS; however, sexual function and feelings of sexual attractiveness are impaired. The findings imply that sexual function, sexual satisfaction and psychosocial functioning need to be part of every clinical assessment of women with PCOS.
Collapse
Affiliation(s)
- Hester Pastoor
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Na-1516, 3000 CA Rotterdam 2040, The Netherlands.
| | - Reinier Timman
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, 2300 RC, Leiden 9600, The Netherlands
| | - Cora de Klerk
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, 2300 RC, Leiden 9600, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Room Ae-324, 3000 CA Rotterdam 2040, The Netherlands
| | - Ellen Tm Laan
- Department of Sexology and Psychosomatic OBGYN, Academic Medical Center, University of Amsterdam, Room H4-140, Meibergdreef 9, Amsterdam, AZ 1105, The Netherlands
| | - Joop Se Laven
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Room Na-1516, 3000 CA Rotterdam 2040, The Netherlands
| |
Collapse
|
47
|
Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int Urogynecol J 2018; 30:377-383. [PMID: 30178126 DOI: 10.1007/s00192-018-3739-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/31/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Although medical comorbidities are widely recognized to be associated with erectile dysfunction, less research has been done on their association with female sexual dysfunction (FSD). The purpose of this study was to assess whether FSD is associated with comorbidities; we hypothesized that there is an association. METHODS This is a secondary analysis of the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a prospective stratified probability sample of individuals aged 16-74. We assessed for association between sexual function scores and heart attack, heart disease, hypertension, stroke, diabetes, chronic lung disease, depression, other mental health condition, other neurologic conditions, and incontinence, as well as menopause and smoking status. Correlation between comorbidities and specific domains of sexual function was also assessed. RESULTS A total of 6777 women, with an average age of 35.4 (14.1), responded to the survey and reported sexual activity in the past year. There was an association between sexual function score and age, menopause, hysterectomy, heart disease, hypertension, diabetes, obesity, smoking, depression, other mental health condition, stroke, other neurological condition, and homosexual attraction (p < 0.05). On multivariate analysis, age, sexual attraction, smoking status, depression, and other mental health conditions remained significantly correlated with sexual function (p < 0.05). Comorbidities were found to be correlated with specific domains. CONCLUSIONS Comorbidities were associated with FSD and specific comorbidities associated with dysfunction in specific domains. Urogynecologists and urologists must assess for comorbidities, as women presenting with sexual dysfunction may provide an opportunity for early diagnosis of life-threatening conditions.
Collapse
|
48
|
Jemec G. Hidradenitis suppurativa and intimacy. Int J Womens Dermatol 2018; 4:72-73. [PMID: 29872680 PMCID: PMC5986261 DOI: 10.1016/j.ijwd.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 03/04/2018] [Indexed: 10/30/2022] Open
Affiliation(s)
- G. Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| |
Collapse
|
49
|
Polland A, Davis M, Zeymo A, Venkatesan K. Comparison of Correlated Comorbidities in Male and Female Sexual Dysfunction: Findings From the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). J Sex Med 2018; 15:678-686. [DOI: 10.1016/j.jsxm.2018.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 12/27/2022]
|
50
|
Dusenbury W, Palm Johansen P, Mosack V, Steinke EE. Determinants of sexual function and dysfunction in men and women with stroke: A systematic review. Int J Clin Pract 2017; 71. [PMID: 28594462 DOI: 10.1111/ijcp.12969] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/05/2017] [Indexed: 11/28/2022] Open
Abstract
AIM The aim of this systematic review was to examine determinants of sexual function and dysfunction in men and women poststroke, and to evaluate effectiveness of interventions. METHODS A systematic review was conducted using the databases of PubMed, Medline, CINAHL, Cochrane, and Psychinfo, for studies published between January, 2000 and October, 2016. Included were original research, adult ≥18 years, English language, and experimental and non-experimental designs. Excluded were studies of stroke caused by sexual activity, stroke triggered unusual behaviours, and changes in sexual orientation. Studies were evaluated for quality using The Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Of 19 studies reviewed, 13 were descriptive, three case-controlled and three intervention/randomised controlled trials (RCTs) designs. RESULTS Participants across studies were predominantly men (90%), with moderate erectile dysfunction (ED), and mild depression. Changes in sexual activity, sexual dissatisfaction and sexual dysfunction were common, including decreased libido, orgasmic problems and ED, significantly worse from pre to poststroke. Results for side of hemiparesis and sexual dysfunction were inconclusive. Sexual rehabilitation interventions differed, but resulted in improved sexual satisfaction, sexual activity frequency and erectile function in two studies. CONCLUSIONS Sexual dysfunction commonly occurred poststroke, continuing for months or as long as 2 years. Intervention studies were limited, with only two RCTs, thus, firm conclusions cannot be made. Few studies included women or younger stroke patients, indicating the need for further RCTs with larger and more diverse samples.
Collapse
Affiliation(s)
- Wendy Dusenbury
- School of Nursing, Wichita State University, Wichita, KS, USA
| | - Pernille Palm Johansen
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Victoria Mosack
- School of Nursing, Wichita State University, Wichita, KS, USA
| | | |
Collapse
|