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The International Journal of Eating... Sep 2020Research suggests that a variety of biological and psychosocial factors are associated with the sexual health of women diagnosed with anorexia nervosa (AN). This...
OBJECTIVE
Research suggests that a variety of biological and psychosocial factors are associated with the sexual health of women diagnosed with anorexia nervosa (AN). This systematic scoping review, conducted in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines, synthesizes the current literature concerning sexual function and dysfunction in women with AN.
METHOD
We searched PubMed, EMBASE, and PsychInfo for literature published until April 2020. All study designs were eligible for inclusion, providing they focused on sexual function and dysfunction in women with AN. Studies that only included outcomes related to gender identity or sexual orientation were excluded.
RESULTS
N = 28 studies met criteria for inclusion in the review. All studies were conducted in Western countries and the majority employed either a cohort or cross-sectional design. Although measures of sexual function and dysfunction varied markedly across studies, most studies adopted a biopsychosocial framework. Libido may be linked to body mass index (BMI), while other aspects of sexual functioning and behavior might not be specifically associated with weight status. Limited data are available on evidence-based interventions.
DISCUSSION
Sexual dysfunction in women with AN is common. Although some of the variance is explained by low BMI, associated physiological sequelae and other psychosocial factors are also involved. Sexual dysfunction is a relevant clinical problem and clinicians should sensitively incorporate questions related to sexual function into their eating disorder assessments. Future research, using more robust designs and validated outcome measures, is needed to better understand causal pathways between the biological and psychosocial correlates of AN and sexual dysfunction. Identifying predictors of sexual function and dysfunction in more diverse groups of people with AN will support the development of evidence-based therapies.
Topics: Adult; Anorexia Nervosa; Cross-Sectional Studies; Female; Humans; Sexual Dysfunctions, Psychological
PubMed: 32449544
DOI: 10.1002/eat.23299 -
The Annals of Pharmacotherapy Jul 2020To review data regarding bremelanotide, a recently approved therapy for hypoactive sexual desire disorder (HSDD). Literature search of Medline, SCOPUS, and EMBASE was...
To review data regarding bremelanotide, a recently approved therapy for hypoactive sexual desire disorder (HSDD). Literature search of Medline, SCOPUS, and EMBASE was performed using the search terms , and between January 1, 1996, and December 15, 2019. Reference lists from included articles were also reviewed for pertinent citations. We included phase 2 and 3 trials of bremelanotide. There were 2 reports of phase 3 trials and 2 reports of phase 2 trials. Additional information from supplementary analyses was also referenced. Bremelanotide demonstrates significant improvement in desire and a significant decrease in distress related to lack of desire. The most common adverse effects include nausea (39.9%), facial flushing (20.4%), and headache (11%). Bremelanotide is the second Food and Drug Administration-approved medication for the treatment of HSDD. Bremelanotide's place in therapy is unknown, as the HSDD guidelines were last updated in 2017. Although the trials met statistical significance for change in sexual desire elements and distress related to sexual desire, the clinical benefit may only be modest. Bremelanotide is a subcutaneous injection that can be administered as needed approximately 45 minutes prior to sexual activity. Bremelanotide is safe and has limited drug-drug interactions, including no clinically significant interactions with ethanol. Prescribing guidelines recommend no more than 1 dose in 24 hours and no more than 8 doses per month. Individuals should discontinue use after 8 weeks without benefit.
Topics: Clinical Trials as Topic; Drug Interactions; Female; Humans; Injections, Subcutaneous; Libido; Nausea; Peptides, Cyclic; Receptor, Melanocortin, Type 3; Receptor, Melanocortin, Type 4; Sexual Dysfunctions, Psychological; Treatment Outcome; alpha-MSH
PubMed: 31893927
DOI: 10.1177/1060028019899152 -
Sexual Medicine Reviews Jan 2020The puerperium is a period of adaptation in which various transformations take place in the lives of women and men on their way to becoming mothers and fathers. These...
INTRODUCTION
The puerperium is a period of adaptation in which various transformations take place in the lives of women and men on their way to becoming mothers and fathers. These changes can also have repercussions on their sexual relations. How the couple deals with this transition is crucial to the well-being of the couple and affects how parents relate to the baby.
AIM
This study aimed to explore the factors that influence sexuality in both women and men during postpartum.
METHODS
We conducted a bibliographic review of 236 articles found on the PubMed database and published from 2008 to January 2019.
MAIN OUTCOME MEASURE
The main outcome measure was the impact of various physical, psychological, and sociocultural factors on couples' sexual functioning during postpartum.
RESULTS
The main problems that couples face after childbirth can be classified as (i) psychological changes, such as loss of a sense of self, transitioning to parenthood, taking on the new roles of mother and father, and feelings of abandonment among men; (ii) body changes in women that affect their self-image and perineal trauma; (iii) hormonal changes in women and men that can lead to reduced sexual desire in both and vaginal dryness or dyspareunia in women; (iv) changes in the marital relationship, including changes in each other's roles, taking time for intimacy, and initiating sexual intercourse; (v) sociocultural influences, such as social support, culturally expected roles, and beliefs regarding when to resume sex; and (vi) lifestyle changes, especially with regard to baby care.
CONCLUSION
Sexuality during postpartum is influenced by multiple factors: physical, psychological, and sociocultural. Our findings offer a deeper understanding of how the transition to parenthood affects sexual relationships during the postpartum period. Implications regarding caring for and promoting the sexual health of individuals and couples after childbirth are discussed, and some medical recommendations for parents are offered. Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, et al. Factors Influencing Couples' Sexuality in the Puerperium: A Systematic Review. Sex Med Rev 2020;8:38-47.
Topics: Dyspareunia; Female; Humans; Libido; Male; Postpartum Period; Sexual Behavior
PubMed: 31447412
DOI: 10.1016/j.sxmr.2019.07.002 -
Current Neuropharmacology 2022Although few clinical trials examined the efficacy of bupropion to treat sexual dysfunction among female patients, a comprehensive and objective synthesis of the best... (Meta-Analysis)
Meta-Analysis
Although few clinical trials examined the efficacy of bupropion to treat sexual dysfunction among female patients, a comprehensive and objective synthesis of the best available evidence is still lacking. To date, to the best of our knowledge, there are no published systematic reviews or meta-analyses specifically focusing on the role of bupropion in the treatment of female sexual dysfunction. The main objective of the present study was to evaluate the efficacy of bupropion in the treatment of female sexual dysfunction, and we hypothesized that bupropion is efficient in treating female patients with sexual dysfunction. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search for published literature was performed using Ovid, Medline, Scopus, Cochrane Library, Science Direct, and PubMed databases. In our study, we found that bupropion was almost three-fold more favorable in improving problems with sexual desire (pool estimate 2.845, 95% CI: 0.215 to 5.475, I2= 95.6%, p=0.034). A meta-regression was performed to explore heterogeneity and we found that only the dosage of bupropion was statistically significant in explaining the variance, i.e., the lower the dosage (150 mg vs. 300 mg), the better the improvement in the sexual desire of women with hypoactive sexual desire disorder (HSDD). Based on the results of this systematic review and metaanalysis, there is a potential role of bupropion as an effective treatment for women with HSDD.
Topics: Bupropion; Female; Humans; Libido; Sexual Dysfunctions, Psychological; Treatment Outcome
PubMed: 35193485
DOI: 10.2174/1570159X20666220222145735 -
Sexual Medicine Reviews Oct 2019Overactive bladder (OAB) is subtyped into OAB-wet and OAB-dry, based on the presence or absence, respectively, of urgency incontinence. Although women with OAB... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Overactive bladder (OAB) is subtyped into OAB-wet and OAB-dry, based on the presence or absence, respectively, of urgency incontinence. Although women with OAB frequently have a higher risk for sexual dysfunction, a systematic review on the impact of OAB-wet on female sexuality is lacking. This may be evaluated by measuring the effect of the bladder condition on sexuality per se, or by the effect of OAB treatment on female sexual dysfunction.
AIM
To assess the role of OAB-wet on female sexual function.
METHODS
A systematic review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement recommendations. Research on PubMed, EMBASE, and SCOPUS was performed and concluded on October 15, 2018. A systematic computerized search was conducted on published literature from January 1, 2000-2018. Meta-analysis was performed with a meta-analysis program.
MAIN OUTCOMES MEASURES
The following search terms were used: ((("female sexual function") OR ("female sexual dysfunction") OR ("female sexuality") OR ("dyspareunia")) AND (("overactive bladder") OR ("coital incontinence") OR ("detrusor instability") OR ("detrusor overactivity") OR ("urge urinary incontinence") OR (onabotulinumtoxinA) OR ("botulinum") OR ("sacral neuromodulation") OR (SNM) OR (PTNS) OR ("stoller afferent neuro-stimulation") OR ("SANS") OR ("antimuscarinic drugs") OR ("anticholinergic") OR ("peripheral neuromodulation") OR (beta-agonist))).
RESULTS
1,033 references were reviewed for inclusion and exclusion criteria. Final analysis identified 12 articles for systematic review. OAB-wet was reported as the most affecting factor on sexuality. OAB treatments showed improvement of both the OAB-wet and the sexual function. Results of the meta-analysis suggested that OAB therapies improving OAB-wet significantly reduced female sexual dysfunction (odds ratio 0.19; 95% CI 0.26-0.45).
CONCLUSION
OAB-wet represents a risk for sexual dysfunction; however, data available show low-quality evidence of the impact of OAB-wet on sexual dysfunction. Balzarro M, Rubilotta E, Mancini V, et al. Impact of Overactive Bladder-Wet Syndrome on Female Sexual Function: A Systematic Review and Meta-Analysis. Sex Med Rev 2019;7:565-574.
Topics: Adult; Aged; Arousal; Botulinum Toxins, Type A; Cholinergic Antagonists; Electric Stimulation Therapy; Epidemiologic Methods; Female; Humans; Libido; Lumbosacral Plexus; Middle Aged; Muscarinic Antagonists; Sexual Behavior; Sexual Dysfunction, Physiological; Urinary Bladder, Overactive; Urinary Incontinence; Young Adult
PubMed: 31326358
DOI: 10.1016/j.sxmr.2019.05.002 -
The Journal of Sexual Medicine Jun 2022Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire.
BACKGROUND
Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire.
AIM
To perform a scoping review of the proposed treatments for PGAD and their efficacy.
METHODS
A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed.
OUTCOMES
Three different effective treatments were found (Physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies).
RESULTS
Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive-behavioral strategies with pharmacological treatment.
CLINICAL IMPLICATIONS
Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients.
STRENGTHS AND LIMITATIONS
This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men.
CONCLUSIONS
To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD. Martín-Vivar M, Villena-Moya A, Mestre-Bach G, et al. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022;19:961-974.
Topics: Arousal; Female; Genitalia; Humans; Libido; Male; Sexual Dysfunctions, Psychological; Urogenital Diseases
PubMed: 35396171
DOI: 10.1016/j.jsxm.2022.03.220 -
Progress in Neuro-psychopharmacology &... Mar 2020Sexual dysfunctions (SD) in schizophrenia are frequent with strong impact on adherence and quality of life. Current recommendations stipulate to switch to...
BACKGROUND
Sexual dysfunctions (SD) in schizophrenia are frequent with strong impact on adherence and quality of life. Current recommendations stipulate to switch to prolactin-sparing antipsychotic in case of SD.
OBJECTIVES
To synthetize in a systematic review data on the SD prevalence and the associated risk factors in schizophrenia (SZ).
METHODS
Medline, Google Scholar, PsychInfo, and Cochrane were explored, without any year or language restriction.
RESULTS
Overall, 89 studies and 25,490 participants were included in the present review. SZ subjects aged 18-70 reported high SD frequency [30%-82%] (men [33%- 85%]; women [25%- 85%]). For SZ men erectile dysfunction [31%-95%] was the most frequent SD vs. loss of libido for women [31%-100%]. The following risk factors were associated with increased SD: 1. Illness severity (including psychotic symptomatology, early age at SZ onset, negative symptomatology, and continuous illness course), 2. Depressive symptomatology 3. Antipsychotics (especially first generation antipsychotics, risperidone and antipsychotic polytherapy). Switching to prolactin-sparing antipsychotics has shown effectiveness in some studies (especially aripiprazole). Antidepressants were not found to be associated with SD in SZ subjects.
CONCLUSION
The prevalence of SD is high in SZ subjects. In addition to the current guidelines, the present review suggests that treating depressive symptoms may be a major intervention to improve SD in SZ subjects. Sociodemographic variables, physical illnesses, metabolic syndrome and peripheral inflammation have been poorly or never explored and should be included in future studies.
Topics: Adolescent; Adult; Aged; Antipsychotic Agents; Depression; Female; Humans; Male; Middle Aged; Prevalence; Schizophrenia; Schizophrenic Psychology; Sexual Dysfunction, Physiological; Young Adult
PubMed: 31711954
DOI: 10.1016/j.pnpbp.2019.109804 -
Journal of Menopausal Medicine Aug 2019The present systematic review was conducted to compare the effect of lavender on the quality of sleep, sexual desire, and vasomotor, psychological and physical symptoms...
OBJECTIVES
The present systematic review was conducted to compare the effect of lavender on the quality of sleep, sexual desire, and vasomotor, psychological and physical symptoms among menopausal and elderly women.
METHODS
There were five electronic databases which selected to search respective articles which included were Scopus, PubMed, Web of Science, Google Scholar, and the Cochrane Library without any language restriction since the study inception to March 10, 2018. The quality of studies was assessed in accordance with a jaded scale.
RESULTS
According to three trials, the lavender as utilized in a capsule form or aromatherapy could significantly improve the measured Pittsburgh Sleep Quality Index score ( < 0.05) in the menopausal and elderly women. The aromatherapy with lavender improved sexual function ( < 0.001), depression ( < 0.001), anxiety ( < 0.001), and physical ( < 0.001) symptoms. Based on a trial, 66.7%, 70.0%, and 53.3% of subjects reported feelings of relaxation, happiness, and cleanness effects of having used lavender respectively.
CONCLUSIONS
The results suggested the effectiveness of the use of lavender either in capsule form or aromatherapy on the improved quality of sleep, depression, anxiety, sexual desire, and psychological and physical symptoms. These results, however, should be interpreted with caution considering the limitations of the study.
PubMed: 31497578
DOI: 10.6118/jmm.18158 -
The Journal of Sexual Medicine Oct 2019Mindfulness-based therapies (MBT) are more and more frequently used in the treatment of sexual dysfunctions; therefore, it seems very important to assess evidence-based... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Mindfulness-based therapies (MBT) are more and more frequently used in the treatment of sexual dysfunctions; therefore, it seems very important to assess evidence-based data on the clinical efficacy of these interventions.
AIM
To provide a systematic review of published studies into the efficacy of MBT in the treatment of sexual dysfunctions.
METHODS
The material for the analysis was obtained by searching 3 internet databases: EBSCO, PubMed, and ResearchGate. Articles describing therapeutic interventions on the basis of mindfulness and their efficiency in reducing sexual dysfunction symptoms in men and women were sought.
MAIN OUTCOME MEASURES
15 original research articles were included to the review: 4 articles were devoted to the analysis of the efficiency of the mindfulness-based therapy in the reduction of sexual dysfunction related to pain in the genital-pelvic area, 10 to desire or sexual arousal disorders or both in women, and 1 to erectile dysfunction in men.
RESULTS
Studies indicate that MBT led to improvement in subjectively evaluated arousal and desire, sexual satisfaction, and a reduction of fear linked with sexual activity, as well as improving the consistency between the subjectively perceived arousal and genital response in women. The research indicated that MBT did not make a significant change in a reduction of pain during sexual activities. Evidence-based data were found on the efficacy of MBT in the treatment of male erectile dysfunction in 1 study.
CLINICAL IMPLICATIONS
MBT could be effectively used in the treatment of female sexual dysfunction, specifically to improve sexual arousal/desire and satisfaction and to reduce sexual dysfunction associated with anxiety and negative cognitive schemas.
STRENGTHS & LIMITATIONS
The few studies available are affected by several methodologic limitations, including small numbers of participants, patient selection, application of complex therapeutic interventions, and a lack of homework assessment, which makes definite conclusions difficult to draw.
CONCLUSION
The effects of MBT in female sexual dysfunctions are promising. In future studies, the mindfulness-based monotherapies should be implemented to verify their potential in reducing symptoms of sexual dysfunction. More research is needed to explore the potential of MBT in the treatment of male sexual dysfunction. Jaderek I, Lew-Starowicz M. A Systematic Review on Mindfulness Meditation-Based Interventions for Sexual Dysfunctions. J Sex Med 2019;16:1581-1596.
Topics: Adult; Aged; Arousal; Erectile Dysfunction; Female; Humans; Libido; Male; Meditation; Middle Aged; Mindfulness; Orgasm; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Treatment Outcome
PubMed: 31570137
DOI: 10.1016/j.jsxm.2019.07.019 -
Current Drug Discovery Technologies 2021Sexual health plays an important role in women's health and quality of life. Sexual health management is a prerequisite for physical and psychological health of women....
BACKGROUND
Sexual health plays an important role in women's health and quality of life. Sexual health management is a prerequisite for physical and psychological health of women. Sexual desire, arousal, and orgasm are three factors of female sexual response.
OBJECTIVES
This study aimed at the evaluation of the studies focusing on herbal medicine on women's sexual function and the assessment of its effectiveness.
METHODS
So far, many different methods have been known for the treatment of female sexual dysfunction, however, none of them are not efficacious therapy.
RESULTS
Generally, the use of herbal medicine is a safe and effective therapeutic method in the treatment of women with sexual dysfunction.
CONCLUSION
The role of herbal and nutritional supplementation in female sexual function has attracted researchers' interest in recent years.
Topics: Female; Humans; Libido; Orgasm; Quality of Life; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 33076811
DOI: 10.2174/1570163817666201019130139