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Scandinavian Journal of Surgery : SJS :... 2022Obesity is prevalent and has a negative impact on women's health, including sexual dysfunction. Recent review articles suggest improvement in Female Sexual Function... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
Obesity is prevalent and has a negative impact on women's health, including sexual dysfunction. Recent review articles suggest improvement in Female Sexual Function Index (FSFI) and proportion of female sexual dysfunction (FSD) among women with obesity after bariatric surgery.
METHODS
We pooled data from 16 observational studies involving 953 women. The study outcomes were mean FSFI scores and proportion of FSD before and after bariatric surgery. We also sub-analyzed whether age and duration of follow-up affected these outcomes.
RESULTS
The mean age of the subjects was 39.4 ± 4.2 years. Body mass index (BMI) showed significant reduction postoperatively ( < 0.0001). Bariatric surgery led to significant improvement in total FSFI score ( = 0.0005), and all sexual domains except pain. Bariatric surgery reduced the odds of having FSD by 76% compared with those who did not undergo operation (OR 0.24, 95% CI = 0.17, 0.33, < 0.0001). Our sub-analysis demonstrated a significant reduction in the proportion of FSD for patients <40 years of age. The improvement of total FSFI scores and reduction in proportion of FSD remained significant within the first 12 months after surgery. Univariate meta-regression showed that BMI was not a significant covariate for improvement of FSFI scores ( = 0.395, = 0.1, 95% CI = 0.884, 0.095).
CONCLUSIONS
Bariatric surgery is shown to improve sexual function scores and prevalence of FSD. This is especially significant among women <40 years of age. This benefit remained significant within the first year after surgery. This appears to be an additional benefit for these patients.
Topics: Adult; Bariatric Surgery; Female; Humans; Obesity; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Surveys and Questionnaires
PubMed: 35253540
DOI: 10.1177/14574969211072395 -
Acta Clinica Croatica Mar 2018The purpose of the current study was to evaluate the prevalence of female sexual dysfunction in Slovenia. We aimed to explore the prevalence itself, comparison among...
The purpose of the current study was to evaluate the prevalence of female sexual dysfunction in Slovenia. We aimed to explore the prevalence itself, comparison among demographic groups and potential correlations. Data were collected based on the validated standardized Female Sexual Function Index (FSFI) (N=605). Most participants had sexual intercourse with one partner (n=523), and the majority of sexual relationships were heterosexual (n=584). University educated subjects had the highest claims of arousal, followed by those with master/doctoral degrees and college educated ones. The lowest level was expressed by subjects with elementary school. The youngest subjects (18-23 years) expressed the highest levels of desire and arousal, followed by the 24-29 age group. The 42-47 age group reported higher levels of lubrication and orgasm. The claim of satisfaction was highest in the 24-29 age group, while the pain was highest in the 42-47 age group. Strong correlation was found between the claims of desire and arousal (r=0.585), arousal and lubrication (r=0.879), lubrication and pain (r=0.856), orgasm and lubrication (r=0.856), satisfaction and orgasm (r=0.782), and pain and arousal (r=0.776) (p<0.001). We identified a 31% prevalence of female sexual dysfunction in Slovenia.
Topics: Coitus; Cross-Sectional Studies; Female; Humans; Orgasm; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Slovenia; Surveys and Questionnaires
PubMed: 30256011
DOI: 10.20471/acc.2018.57.01.06 -
Maturitas May 2016A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to... (Review)
Review
A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.
Topics: Aging; Female; Humans; Longitudinal Studies; Menopause; Middle Aged; Models, Theoretical; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 27013288
DOI: 10.1016/j.maturitas.2016.02.009 -
International Journal of Medical... 2021Sexual dysfunction is a common condition in the opioid substitution therapy (OST) population. We aimed to determine the efficacy and safety of treatment for sexual... (Meta-Analysis)
Meta-Analysis
Sexual dysfunction is a common condition in the opioid substitution therapy (OST) population. We aimed to determine the efficacy and safety of treatment for sexual dysfunction in the OST population. We searched for interventional studies from Medline, PubMed, and Scopus. Three independent authors conducted a risk-of-bias assessment (RoB 2). A total of seven studies (five randomized-controlled trials, two quasi-experimental), including 473 patients with sexual dysfunction, were identified. Among these, three bupropion (n=207), one trazodone (n=75), two rosa Damascena (n=100), and one ginseng (n=91) studies had reported significantly improve various sexual functioning domains in both genders. In a meta-analysis, bupropion significantly increased male sexual function with standardized mean difference of 0.53; 95% confidence interval of 0.19-0.88; P < 0.01; I=0. The adverse effects were minor for all agents, and no significant difference between treatment and placebo groups in randomized-controlled trials. These agents have a promising future as therapy for sexual dysfunction in the OST population. However, given the limited sample size and number of studies, further studies should be conducted to confirm the use of these agents.
Topics: Antidepressive Agents, Second-Generation; Bupropion; Humans; Opiate Substitution Treatment; Panax; Plant Extracts; Quality of Life; Randomized Controlled Trials as Topic; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Trazodone; Treatment Outcome
PubMed: 33967614
DOI: 10.7150/ijms.57641 -
American Family Physician Mar 2008Female sexual complaints are common, occurring in approximately 40 percent of women. Decreased desire is the most common complaint. Normal versus abnormal sexual... (Review)
Review
Female sexual complaints are common, occurring in approximately 40 percent of women. Decreased desire is the most common complaint. Normal versus abnormal sexual functioning in women is poorly understood, although the concept of normal female sexual function continues to develop. A complete history combined with a physical examination is warranted for the evaluation of women with sexual complaints or concerns. Although laboratory evaluation is rarely helpful in guiding diagnosis or treatment, it may be indicated in women with abnormal physical examination findings or suspected comorbidities. The PLISSIT (Permission, Limited Information, Specific Suggestions, Intensive Therapy) or ALLOW (Ask, Legitimize, Limitations, Open up, Work together) method can be used to facilitate discussions about sexual concerns and initiation of treatment. Developments in the treatment of male erectile dysfunction have led to investigation of pharmacotherapy for the treatment of female sexual dysfunction. Although sexual therapy and education (e.g., cognitive behavior therapy, individual and couple therapy, physiotherapy) form the basis of treatment, there is limited research demonstrating the benefit of hormonal and nonhormonal drugs. Testosterone improves sexual function in postmenopausal women with hypoactive sexual desire disorder, although data on its long-term safety and effectiveness are lacking. Estrogen improves dyspareunia associated with vulvovaginal atrophy in postmenopausal women. Phosphodiesterase inhibitors have been shown to have limited benefit in small subsets of women with sexual dysfunction.
Topics: Diagnosis, Differential; Female; Hormone Replacement Therapy; Humans; Practice Guidelines as Topic; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Treatment Outcome
PubMed: 18350761
DOI: No ID Found -
The Journal of Sexual Medicine Mar 2023Anodyspareunia may be an adverse outcome of prostate cancer (PCa) treatment for gay, bisexual, and other men who have sex with men (GBM). (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Anodyspareunia may be an adverse outcome of prostate cancer (PCa) treatment for gay, bisexual, and other men who have sex with men (GBM).
AIM
The aims of this study were to (1) describe the clinical symptoms of painful receptive anal intercourse (RAI) in GBM following PCa treatment, (2) estimate the prevalence of anodyspareunia, and (3) identify clinical and psychosocial correlates.
METHODS
This was a secondary analysis of baseline and 24-month follow-up data from the Restore-2 randomized clinical trial of 401 GBM treated for PCa. The analytic sample included only those participants who attempted RAI during or since their PCa treatment (N = 195).
OUTCOMES
Anodyspareunia was operationalized as moderate to severe pain during RAI for ≥6 months that resulted in mild to severe distress. Additional quality-of-life outcomes included the Expanded Prostate Cancer Index Composite (bowel function and bother subscales), the Brief Symptom Inventory-18, and the Functional Assessment of Cancer Therapy-Prostate.
RESULTS
Overall 82 (42.1%) participants reported pain during RAI since completing PCa treatment. Of these, 45.1% experienced painful RAI sometimes or frequently, and 63.0% indicated that the pain was persistent. The pain at its worst was moderate to very severe for 79.0%. The experience of pain was at least mildly distressing for 63.5%. Painful RAI worsened for a third (33.4%) of participants after completing PCa treatment. Of the 82 GBM, 15.4% were classified as meeting criteria for anodyspareunia. Antecedents of anodyspareunia included a lifelong history of painful RAI and bowel dysfunction following PCa treatment. Those reporting symptoms of anodyspareunia were more likely to avoid RAI due to pain (adjusted odds ratio, 4.37), which was negatively associated with sexual satisfaction (mean difference, -2.77) and self-esteem (mean difference, -3.33). The model explained 37.2% of the variance in overall quality of life.
CLINICAL IMPLICATIONS
Culturally responsive PCa care should include the assessment of anodyspareunia among GBM and explore treatment options.
STRENGTHS AND LIMITATIONS
This is the largest study to date focused on anodyspareunia among GBM treated for PCa. Anodyspareunia was assessed with multiple items characterizing the intensity, duration, and distress related to painful RAI. The external validity of the findings is limited by the nonprobability sample. Furthermore, the cause-and-effect relationships between the reported associations cannot be established by the research design.
CONCLUSIONS
Anodyspareunia should be considered a sexual dysfunction in GBM and investigated as an adverse outcome of PCa treatment.
Topics: Male; Female; Humans; Homosexuality, Male; Sexual and Gender Minorities; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Dyspareunia; Prostatic Neoplasms; Pain
PubMed: 36796863
DOI: 10.1093/jsxmed/qdad009 -
Obstetrics and Gynecology Clinics of... Dec 2018Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition... (Review)
Review
Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking.
Topics: Administration, Intravaginal; Dyspareunia; Estrogen Replacement Therapy; Female; Gonadal Hormones; Humans; Lubricants; Menopause; Middle Aged; Postmenopause; Quality of Life; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Women's Health
PubMed: 30401552
DOI: 10.1016/j.ogc.2018.07.013 -
Andrology Jul 2017Despite their efficacy in the treatment of benign prostatic hyperplasia, the popularity of inhibitors of 5α-reductase (5ARIs) is limited by their association with... (Meta-Analysis)
Meta-Analysis Review
Despite their efficacy in the treatment of benign prostatic hyperplasia, the popularity of inhibitors of 5α-reductase (5ARIs) is limited by their association with adverse sexual side effects. The aim of this study was to review and meta-analyze currently available randomized clinical trials evaluating the rate of sexual side effects in men treated with 5ARIs. An extensive Medline Embase and Cochrane search was performed including the following words: 'finasteride', 'dutasteride', 'benign prostatic hyperplasia'. Only placebo-controlled randomized clinical trials evaluating the effect of 5ARI in subjects with benign prostatic hyperplasia were considered. Of 383 retrieved articles, 17 were included in this study. Randomized clinical trials enrolled 24,463 in the active and 22,270 patients in the placebo arms, respectively, with a mean follow-up of 99 weeks and mean age of 64.0 years. No difference was observed between trials using finasteride or dutasteride as the active arm considering age, trial duration, prostate volume or International Prostatic Symptoms Score at enrollment. Overall, 5ARIs determined an increased risk of hypoactive sexual desire [OR = 1.54 (1.29; 1.82); p < 0.0001] and erectile dysfunction [OR = 1.47 (1.29; 1.68); p < 0.0001]. No difference between finasteride and dutasteride regarding the risk of hypoactive sexual desire and erectile dysfunction was observed. Meta-regression analysis showed that the risk of hypoactive sexual desire and erectile dysfunction was higher in subjects with lower Q at enrollment and decreased as a function of trial follow-up. Conversely, no effect of age, low urinary tract symptom or prostate volume at enrollment as well as Q at end-point was observed. In conclusion, present data show that the use of 5ARI significantly increases the risk of erectile dysfunction and hypoactive sexual desire in subjects with benign prostatic hyperplasia. Patients should be adequately informed before 5ARIs are prescribed.
Topics: 5-alpha Reductase Inhibitors; Adult; Aged; Dutasteride; Erectile Dysfunction; Finasteride; Humans; Libido; Male; Middle Aged; Penile Erection; Prostatic Hyperplasia; Randomized Controlled Trials as Topic; Risk Factors; Sexual Behavior; Sexual Dysfunctions, Psychological; Treatment Outcome
PubMed: 28453908
DOI: 10.1111/andr.12353 -
Australian Family Physician 2017As sexual wellbeing is an important aspect of good general health, and sexual difficulties are a concern for 20-40% of the adult population, general practitioners (GPs)...
BACKGROUND
As sexual wellbeing is an important aspect of good general health, and sexual difficulties are a concern for 20-40% of the adult population, general practitioners (GPs) have a key role to play in initiating discussions about sex and sexual difficulties with their patients.
OBJECTIVE
This article encourages GPs to take the lead in initiating a conversation about sex and sexual difficulties with their patients by taking a brief sexual history as a routine part of a medical history. If any sexual concerns are identified, a longer appointment can be arranged for a detailed history and examination, and to discuss treatment options, including referral.
DISCUSSION
Sexual difficulties are common and can affect a patient's quality of life. There is a high risk of sexual difficulties arising from illness, medication, and personal and relationship difficulties. Erectile dysfunction is particularly important to identify as it is a predictor of cardiovascular and other microvascular disease.
Topics: Female; General Practice; Humans; Male; Medical History Taking; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 28189125
DOI: No ID Found -
Acta Clinica Croatica Mar 2018In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure,... (Review)
Review
In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure, structural heart diseases, arrhythmias, implanted pacemakers or cardioverter defibrillators, as well as on treatment options of sexual dysfunction. Sexual activities are similar to mild/moderate physical activity during a short period. Most patients are recommended to involve in sexual activity after prior comprehensive evaluation of physical condition. Those with stable cardiac symptoms and good functional capacity are at a low risk of adverse cardiovascular events, and others require treatment or stabilization before involving in sexual activity. Stress testing is useful in evaluating safety of sexual activity in patients with questionable or undetermined risk. Treatment of sexual dysfunction includes counseling of patients and their sexual partners, and drug treatment with phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil) which have been demonstrated to be safe and effective, in men, and with serotonin reuptake inhibitors (flibanserin) and local vaginal estrogen administration in women. In conclusion, in routine clinical practice, patients should be approached individually and multidisciplinarily in order to detect and eliminate the factors that interfere with normal sexual activities and disturb the quality of life.
Topics: Coronary Artery Disease; Erectile Dysfunction; Estrogens; Female; Humans; Male; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Vasodilator Agents
PubMed: 30256023
DOI: 10.20471/acc.2018.57.01.18