Female sexual dysfunction in chronic obstructive pulmonary disease

Background: Sexual life of women with chronic obstructive pulmonary disease (COPD) can be affected by breathing difficulties, a decrease in functional status, depressive mood and fatigue. Objetive: To evaluate the sexual dysfunction in female COPD patients and the possible explanatory mechanisms or correlations between these conditions. Methods: The study included 70 female patients with COPD aged between 36-65 and 70 age-matched controls. All the subjects completed questionnaires for the Female Sexual Functional Index (FSFI), BECK depression inventory and, spirometry. Results: Statistically significant sexual dysfunction was noted in COPD patients compared to the non-COPD group (p0.005). In linear regression analysis determining depression, no statistically significant factor was found among age, number of comorbidities, and FEV1/ forced vital capacity (FVC) % predicted (p>0.05). In multivariable analysis, only fatigue during intercourse was found to be a statistically significant factor in predicting sexual dysfunction among factors like age, presence of comorbidities, duration of the disease, smoking status, FEV1%, m MRCpoints, 6-minutes walk test, BECK depression scores (p=0.008). Conclusion: Sexual dysfunction is reported in many COPD females and seems to be related not to spirometric measures or exercise capacity but to fatigue. Depression is also a common comorbidity, of which both disorders are often neglected.

Antecedentes: La vida sexual en mujeres con enfermedad pulmonar obstructiva crónica (EPOC) es afectada por dificultades respiratorias, disminución del estado funcional, estado de ánimo depresivo y fatiga. Objetive: Evaluar la disfunción sexual en mujeres con EPOC y posibles mecanismos explicativos de esas dos condiciones Métodos: Participaron 70 pacientes mujeres con EPOC, rango edad 36-65 años y 70 controles emparejados por edad. Todos los sujetos respondieron un cuestionario para el índice funcional sexual femenino e inventario de depresión de BECK, mas una espirometría. Resultados: Se observó disfunción sexual significativa en las pacientes con EPOC comparado con el grupo sin EPOC. Las puntuaciones del inventario de depresión BECK fueron significativamente inferiores a las del grupo control. No hubo correlación entre las puntuaciones del FSFI y la depresión BECK con las características de las "mujeres" (r=-0.055). No se encontraron diferencias significativas en edad, FEV1% y antecedentes de exacerbación del año anterior según la gravedad de la depresión. En la regresión lineal para determinar la depresión, no hubo ningún factor estadísticamente significativo entre edad, número de comorbilidades y FEV1/FVC% predicho. En el multivariado, sólo la fatiga durante el coito resultó ser un factor significativo para predecir la disfunción sexual entre factores como edad, presencia de comorbilidades, duración de la enfermedad, hábito tabáquico, FEV1%, m MRCpoints, prueba de la marcha de 6 minutos y puntuaciones de depresión de BECK. Conclusiones: La disfunción sexual parece no estar relacionada con las medidas espirométricas o la capacidad de ejercicio, pero si con la fatiga. La depresión es una comorbilidad frecuente, de la que a menudo se descuidan ambos trastornos.

EVALUATION OF FEMALE SEXUAL DYSFUNCTION IN THE DIABETIC WOMEN IN A TERTIARY CARE MEDICAL COLLEGE AND HOSPITAL IN EASTERN INDIA

Background: In women, the evidences regarding the association between diabetes and sexual dysfunction are less conclusive as compared to males. Diabetes-induced vascular and nerve dysfunctions may impair the sexual response by producing structural and functional changes in the female genitalia. The present study is significant in this regard that it has been conducted among individuals hailing from urban, suburban and rural areas of the state of West Bengal making questionnaires in vernacular languages to reach maximum number of individuals possible. The data obtained was analysed statistically to derive conclusions. In this cross- Methods: sectional 100 female patients with type 2 diabetes mellitus attending the diabetes clinic in Endocrine OPD of Medical College and Hospital Kolkata were screened and included as the study population. Sexual dysfunctions in women was measured here using the standard questionnaire and the FSFI score <24 was taken as the criteria for accepting the presence of sexual dysfunction. The FSD score was compared against parameters like age, duration of diabetes, Body mass index (BMI), blood sugar (glycemic status) fasting and post-prandial , diabetes-related complications and addiction and prevalence was calculated. Prevalence of se Results : xual dysfunction in the study population is 51% showing association between diabetes and female sexual dysfunction.The prevalence of FSD was found to be maximum (75%) in the age group 41- 50years. Strong association of FSD with age is found as p-value is 0.002. the prevalence of FSD was maximum (92.31%) in the participants whose Duration of diabetes more than equal to 11 years. Very Strong association of FSD with Duration of diabetes is found as p-value < 0.001. The prevalence of FSD was found to be maximum (94.74%) in the group (19% of the study population) who are on insulin. Extremely strong association of FSD with insulin usage is found as p-value is 0.000. The prevalence of FSD was found to be maximum (71.43%) in the group (42% of the study population) who do not have controlled ppbg (>180 mg/dl). Quite strong association of FSD with ppbg control is found as p-value is 0.001. The prevalence of FSD was found to be maximum (72.5%) in the participants who were overweight.11% of the population is obese and in them prevalence of FSD is 63.64. Very strong association of FSD with BMI of the participant is found as p-value is 0.000.Major association of FSD was seen absent with addiction, OHA intake, micro and macrovascular compications in the patients. Of all the six domains evaluated to reach FSFI score, majority of the patients had decreased desire. Prevalence Conclusion: of sexual dysfunction in the study population is 51%. Longer duration of diabetes, inadequate diabetes control, insulin intake, obesity (higher BMI) and higher age of the participant has a role to play in the development of FSD as per this study. The ability to diagnose and treat FSD in unsuspecting diabetics will result in long term improvement in quality of life

Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study

Abstract Background: Hypoactive Sexual Desire Disorder (HSDD) is a very prevalent sexual problem, with limited options for treatment. Given that psychological factors are major contributors to the disorder, a therapy such as Cognitive-Behavioral Therapy (CBT) may be useful to treat HSDD. Objective: To evaluate the effects of group CBT on women with HSDD. Method: Clinical trial randomized study with 106 women diagnosed with HSDD, who were divided as follows: Group 1 (n = 53) underwent group CBT for 8-weeks, and Group 2 (n = 53), were put on a waiting list and used as a control group. Sexual function was assessed by the Female Sexual Quotient (FSQQ) at the initial interview and after 6-months. Mann Whitney test was used for group comparison. Main Outcome Measures: demographics, education, sexual history, FSQQ and its domains for sexual function assessment. Results: Both groups had similar characteristics regarding sexual response, self-image, and relationship with a partner at the initial interview. Women undergoing therapy showed significant improvement in sexual function when compared with the control group. The overall FSQQ result showed an average growth of 18.08 points (95% CI 12.87‒23.28) for the therapy group against a decrease of 0.83 points (95% CI 3.43‒1.77) for controls (p < 0.001). The five domains of the questionnaire also exhibited significant improvement in the therapy group: desire and interest (p = 0.003), foreplay (p = 0.003), excitation and tuning (p < 0.001), comfort (p < 0.001), and orgasm and satisfaction (p < 0.001). Conclusion: Group CBT was shown to be an effective tool for treating HSDD.

Disfunción sexual en mujeres de 60 años y más / Sexual dysfunction in women age 60 and older

La sexualidad es un aspecto importante en la calidad de vida de la mujer, sin embargo, los estudios sobre sexualidad dedicados a las mujeres de 60 años y más son escasos. El objetivo de este estudio fue determinar la prevalencia de la disfunción sexual femenina y sus dominios en mujeres de 60 años y más, e identificar la asociación entre enfermedades asociadas y consumo de medicamentos con la disfunción sexual. Se realizó un estudio descriptivo y transversal, en mujeres de 60 años y más, de La Habana, Cuba. Participaron 112 mujeres a las cuales se les aplicaron dos encuestas: el Índice de Función Sexual Femenino (IFSF) y otra que recogía antecedentes médicos y sociales. El 66,1% de las mujeres presentó algún grado de disfunción sexual, la prevalencia aumentaba con la edad. Los dominios más afectados fueron el deseo, la excitación y la lubricación. Se identificó una fuerte asociación entre la enfermedad de Parkinson, la depresión y la artrosis con la aparición de disfunción sexual en la población estudiada, así como el uso de antidepresivos, hipoglicemiantes orales y diuréticos. La disfunción sexual estuvo presente en el 100% de las mujeres octogenarias. Todas las mujeres con enfermedad de Parkinson presentaron disfunción sexual.

Sexuality is an important aspect in women's quality of life, however, sexuality studies dedicated to women age 60 and older are scarce. The objective of this study was to determine the prevalence of female sexual dysfunction and its domains in women age 60 and older, and to identify the association between diseases and drug use with sexual dysfunction. A descriptive and cross-cutting study was conducted, in women 60 years and older, in Havana, Cuba. Two surveys participated in 112 women: The Female Sexual Function Index (IFSF) and another who collected a medical and social history. 66.1% of women had some degree of sexual dysfunction, the prevalence increased with age. The domains most affected were desire, excitement, and lubrication. A strong association between Parkinson's disease, depression and osteoarthritis was identified with the onset of sexual dysfunction in the studied population, as well as the use of antidepressants, oral hypoglycemics and diuretics. Sexual dysfunction was present in 100% of octogenary women. All women with Parkinson's disease had sexual dysfunction.

Evaluation of factors affecting sexual dysfunction in female patients with diabetes mellitus

ABSTRACT Objective Our objective in this study was to evaluate the factors predicting female sexual dysfunction (FSD) in patients with diabetes mellitus (DM). Subjects and methods The study included 149 women with DM. Sexual function was evaluated with the Female Sexual Function Index (FSFI) questionnaire, in which total scores under 26.55 characterized the occurrence of FSD (Group 1 > 26.55, Group 2 < 26.55). We recorded the patients' demographic, metabolic, and hormonal data. Ophthalmologic, neurologic, and renal complications were also evaluated. The antioxidant status of the patients in both groups was determined by measuring the activity of the enzymes paraoxonase-1 (PON-1) and arylesterase (ARE). Results Based on the FSFI scores, 60 patients were allocated to Group 1 (26.6 ± 12.3) and 89 to Group 2 (22.6 ± 9.5). Group 2 compared with Group 1 had significantly (p < 0.05) higher mean concentrations of glycated hemoglobin (HbA1c), glucose, triglycerides, and insulin, along with higher rates of metformin use, smoking, retinopathy, and nephropathy. The mean serum ARE concentrations were significantly lower in Group 2 compared with Group 1 (p = 0.000), but the mean serum PON-1 concentrations were similar between both groups (p = 0.218). On multivariable regression analysis, age, ARE activity, Beck Depression Inventory (BDI) score, and menopause were significant independent predictors of FSD (p < 0.05). Conclusions In this study, we evaluated the predictive factors determining FSD caused by DM. Despite the significant results found in our study, future randomized controlled studies with a long follow-up and a larger number of patients are required to determine how DM affects FSD.

Uso de testosterona en mujeres: un comentario sobre el consenso global sobre el uso de la terapia de testosterona para mujeres / Global consensus position statement on the use of testosterone therapy for women

Las mujeres han sido tratadas por décadas con testosterona intentando aliviar una gran variedad de síntomas con riesgos y beneficios inciertos. En la mayoría de los países, la testosterona se prescribe "off-label", de modo que las mujeres están utilizando compuestos y dosis ideadas para tratamientos en hombres. En este sentido, varias sociedades médicas de distintos continentes adoptaron recientemente por consenso una toma de posición sobre los beneficios y potenciales riesgos de la terapia con testosterona en la mujer, explorar las áreas de incertidumbre e identificar prácticas de prescripción con potencial de causar daño. Las recomendaciones con respecto a los beneficios y riesgos de la terapia con testosterona se basan en los resultados de ensayos clínicos controlados con placebo de al menos 12 semanas de duración. A continuación se comentan las recomendaciones. (AU)

There are currently no clear established indications for testosterone replacement therapy for women. Nonetheless, clinicians have been treating women with testosterone to alleviate a variety of symptoms for decades with uncertainty regarding its benefits and risks. In most countries, testosterone therapy is prescribed off-label, which means that women are using testosterone formulations or compounds approved for men with a modified dose for women. Due to these issues, there was a need for a global Consensus Position Statement on testosterone therapy for women based on the available evidence from placebo randomized controlled trials (RCTs). This Position Statement was developed to inform health care professionals about the benefits and potential risks of testosterone therapy intended for women. The aim of the Consensus was to provide clear guidance as to which women might benefit from testosterone therapy; to identify symptoms, signs, and certain conditions for which the evidence does not support the prescription of testosterone; to explore areas of uncertainty, and to identify any prescribing practices that have the potential to cause harm. (AU)

Evaluation of obesity influence in the sexual function of postmenopausal women: A cross- sectional study / Avaliação da influência da obesidade na função sexual de mulheres após a menopausa: um estudo transversal

Abstract Objective The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. Methods This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0- 29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). Results The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p=0.028 and p=0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p<0.05). The total FSFI score statistically differed among the BMI categories (p=0.027). Conclusion In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.

Resumo Objetivo A incidência de obesidade, que é uma condição crônica, aumentou nos últimos anos. A associação entre obesidade e disfunção sexual feminina ainda não está clara, particularmente emmulheres após amenopausa. No presente estudo, avaliamos se a obesidade é um fator de risco para disfunção sexual em mulheres após a menopausa. Métodos Este é umestudo transversal que analisou dados de entrevistas demulheres após a menopausa no Ambulatório de Climatério a partir de 2015 até 2018. Após a aplicação dos critérios de inclusão e exclusão, 221 mulheres com idade entre 40 e 65 anos foram selecionadas e convidadas a participar do estudo. Obesidade foi diagnosticada de acordo com o índice de massa corpórea (IMC). Os participantes foram agrupados nas seguintes categorias de IMC: grupo 1: 18,5-24,9 kg/m2 (normal); grupo 2: 25,0-29,9 kg/m2 (sobrepeso); e grupo 3: ≥30,0 kg/m2 (obesidade). A função sexual foi avaliada através do questionário Female Sexual Function Index (FSFI, na sigla em inglês). Pontos de corte de ≥23 e ≥26,5 foram adotados para definir um diagnóstico de disfunção sexual feminina (DSF) com base no Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª Edição, Texto Revisto DSM-IV-TR. Resultados Os escores de desejo e excitação foram estatisticamente maiores no grupo com IMC normal do que no grupo obesidade (p=0,028 e p=0,043, respectivamente). Os escores de satisfação foram estatisticamente maiores no grupo com IMC normal do que nos grupos comsobrepeso e obesidade (p<0,05). A pontuação total do FSFI diferiu estatisticamente entre as categorias de IMC (p=0,027). Conclusão No presente estudo,mulheres após a menopausa obesas e com sobrepeso tiveram escores totais mais altos do que mulheres com IMC normal. Nossos resultados mostram que mulheres obesas e com sobrepeso após a menopausa apresentaram índices mais altos de disfunção no desejo e excitação e menor satisfação sexual do que mulheres com peso normal.

Sexual function of women with infertility / Função sexual de mulheres com infertilidade

Abstract Objective To assess the sexual function, anxiety, and depression of infertile women relative to a control group. Methods Infertile women (infertile group, IG) of reproductive age were invited to participate in this controlled study. A control group (CG) of women was recruited from the general population of the same city. Sexual function was assessed by the Female Sexual Function Index (FSFI), and anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Results A total of 280 women participated in the present study, 140 in the IG and 140 in the CG. The analysis of the FSFI scores showed that 47 women (33.57%) in the IG and 49 women (35%) in the CG had sexual dysfunction (FSFI ≤ 26.55; p = 0.90). Women with anxiety or depression had a greater risk of sexual dysfunction, and sexual dysfunction increased the risk of anxiety and depression. Married women had a lower risk of depression than single women who were living with their partners. Conclusion Infertilewomenhadno increased riskof sexual dysfunction relativetocontrols. Anxiety and depression increased the risk of sexual dysfunction in the studied population.

Resumo Objetivo Avaliar a função sexual, ansiedade e depressão de mulheres inférteis em relação a um grupo controle. Métodos Mulheres inférteis (grupo infértil, GI) em idade reprodutiva foram convidadas a participar deste estudo. Um grupo controle (GC) de mulheres foi recrutado da população geral da mesma cidade. A função sexual foi avaliada pelo Índice de Função Sexual Feminina (FSFI, na sigla eminglês), e ansiedade e depressão foram medidas pela Escala Hospitalar de Ansiedade e Depressão (HADS, na sigla em inglês). Resultados Um total de 280 mulheres participaram deste estudo, sendo 140 no GI e 140 no GC. A análise dos escores do FSFI mostrou que 47 mulheres (33,57%) no GI e 49 mulheres (35%) no GC apresentaram disfunção sexual (FSFI≤ 26,55; p = 0,90). Mulheres com ansiedade ou depressão tiveram um risco maior de disfunção sexual e a disfunção sexual aumentava o risco de ansiedade e depressão. Asmulheres casadas tiveram um risco menor de depressão do que as mulheres amasiadas. Conclusão As mulheres inférteis não apresentaram risco aumentado de disfunção sexual em relação aos controles. Ansiedade e depressão aumentaram o risco de disfunção sexual na população estudada.

O impacto da disfunção sexual na qualidade de vida feminina: um estudo observacional / The impact of sexual dysfunction on the quality of life of women: an observational study

INTRODUÇÃO: A saúde sexual envolve diversos componentes em relação à sexualidade, como biológico, cultural, psicológico e social. Quando alguns desses fatores são atingidos, pode-se originar um quadro de disfunção sexual. OBJETIVO: investigar a qualidade de vida em mulheres com disfunção sexual. MATERIAIS E MÉTODOS: Estudo observacional comparativo, de corte transversal, realizado em mulheres de 18 a 59 anos do CAAP da EBMSP. Excluídas: mulheres com histórico de doença psiquiátrica grave, portadoras de doenças crônico-degenerativas neurológicas, com dispareunia de causas orgânicas, em tratamento fisioterapêutico e gestantes. Foi utilizado a FSFI ≥ 26 para o grupo com disfunção e < 26 para o grupo comparação. Instrumentos de avaliação aplicados: FSFI e 36-Item Short-Form Health Survey (SF-36). A comparação das medianas dos domínios do SF-36 e FSFI entre os grupos foi realizada pelo teste Mann-Whitney (teste não paramétrico), e das variáveis categóricas com a disfunção sexual foi feita a partir do teste qui-quadrado. RESULTADOS: Amostra 36 paciente,18 em cada grupo. As variáveis sociodemográficas e clínicas que apresentaram diferença estatística foram renda (0,001) e escolaridade (0,011). No FSFI, todos os domínios apresentaram significância (0,00). No SF-36, ao comparar os dois grupos, 06 domínios apresentaram significância estatística. CONCLUSÃO: Os resultados mostram que mulheres com disfunção sexual apresentam um impacto negativo em alguns dos aspectos da qualidade de vida. Importante salientar que, a escolaridade e a renda familiar não foram homogêneas entre os grupos, sendo assim, diante da característica do estudo, não é possível aferir relação causa e consequência na disfunção sexual com a qualidade vida das participantes. [AU]

INTRODUCTION: Sexual health involves several components in relation to sexuality, such as biological, cultural, psychological and social. When some of these factors are reached, a picture of sexual dysfunction may result. OBJECTIVE: To investigate quality of life in women with sexual dysfunction. MATERIALS AND METHODS: A cross-sectional, observational, observational study of 18- to 59-year-old women from the EBMSP CAAP. Excluded: women with a history of severe psychiatric illness, carriers of neurological chronic degenerative diseases, with dyspareunia of organic causes, in physiotherapeutic treatment and pregnant women. FSFI ≥ 26 was used for the group with dysfunction and <26 for the comparison group. Assessment instruments applied: FSFI and 36-Item Short-Form Health Survey (SF-36). The comparison of the medians of the SF-36 and FSFI domains between the groups was performed by the Mann-Whitney test (non-parametric test), and the categorical variables with the sexual dysfunction were done using the chi-square test. RESULTS: Sample 36 patient, 18 in each group. The sociodemographic and clinical variables that presented statistical difference were income (0.001) and schooling (0.011). In the FSFI, all domains presented significance (0.00). In the SF-36, when comparing the two groups, 06 domains presented statistical significance. CONCLUSION: The results show that women with sexual dysfunction have a negative impact on some aspects of quality of life. It is important to emphasize that schooling and family income were not homogeneous between the groups, so, due to the characteristics of the study, it is not possible to measure cause and consequence relationship in sexual dysfunction with quality of life of the participants. [AU]

Disfunção sexual em jovens universitárias: prevalência e fatores associados / Sexual dysfunction in young graduation students: prevalence and risk factors

Objetivo: Estudar a prevalência de disfunção sexual e fatores de risco associado em universitárias jovens do sul brasileiro. Métodos: A função sexual de estudantes de fisioterapia de três cidades foi avaliada por meio do Female Sexual Function Index (FSFI). A associação entre a disfunção sexual (DS) em cada domínio e variáveis sociodemográficas foi verificada pelo teste qui-quadrado ou Exato de Fisher. Regressões logísticas binárias, bruta e ajustada, examinaram as associações. Resultados: Foram incluídas 244 estudantes, média etária 23 ± 6 anos, heterossexual (93,9%), solteira (68,9%), nuligesta (79,5%), usuária de anticoncepcional hormonal (75%), vivendo com mais três a cinco pessoas (64,6%), renda conjunta de R$ 3.600,00 a R$ 5.500,00 (26,4%), sendo 13,1 mães e 10% gestantes. Média etária dos parceiros 25,9 ± 6 anos, a maioria (58,2%) com nível superior de escolaridade, média etária do relacionamento atual 3,9 ± 3 anos. A prevalência total de DS foi de 25%, mas 90% das não afetadas apresentaram ao menos um domínio do FSFI afetado. Para as 244 voluntárias os domínios mais afetados foram lubrificação (61,7%), dor (58,8%), desejo (57,6%), orgasmo (54,3%), excitação (50,6%) e satisfação (31,7%). União estável, idade do parceiro (p = 0,01) e da mulher (p = 0,00) estiveram associadas à DS. A DS da excitação e lubrificação esteve associada à renda (p = 0,01). DS do orgasmo foi associada à união estável (p = 0,01), idade da mulher (p = 0,03) e do parceiro (p = 0,01) e do relacionamento (p = 0,04) e o uso de anticoncepcionais hormonais (p = 0,04). A DS da satisfação foi associada à união estável (p = 0,00), idade da mulher (p = 0,03), relacionamentos recentes (p = 0,00) e a gestação (p = 0,00). Dor sexual foi associada ao maior número de pessoas vivendo na mesma casa (p = 0,00). Conclusão: A DS feminina é prevalente em jovens universitárias no sul do país, sendo o problema associado ao estado civil, idades mais jovens da mulher e do parceiro, relacionamentos recentes, falta de privacidade, anticoncepcionais hormonais, gestação.(AU)

Purpose: To study the prevalence of sexual dysfunction and associated risk factors in young graduation students in southern Brazil. Methods: The sexual function of physical therapy students from three different cities was evaluated by the Female Sexual Function Index (FSFI). Association between sexual dysfunction (SD) in each domain and sociodemographic data was tested by chi-square test or Fisher's exact. Binary logistic regressions examined the associations. Results: 244 students were included, mean age 23 ± 6 years old, heterosexual (93.9%), single (68.9%), nuligesta (79.5%), users of hormonal contraceptives (75%), living with three to five people (64.6%), income between R$ 3,600.00 to R$ 5,500.00 (26.4%), 13.1% mothers and 10% pregnant. Mean age of partner 25.9 ± 6 years old, mainly (58.2%) with higher level of education. Average age of the current relationship was 3.9 ± 3 years. Total prevalence of SD was 25%, but 90% of unaffected women showed at least one domain of FSFI affected. For 244 volunteers the most affected domains were lubrication (61.7%), pain (58.8%), desire (57.6%), orgasm (54.3%), arousal (50.6%) and satisfaction (31.7%). Stable union, partner's age (p = 0.01) and women (p = 0.00) were associated with DS. The arousal and lubrication SD were associated with income (p = 0.01). Orgasm SD was associated with stable union (p = 0.01), woman's (p = 0.03) and partner's (p = 0.01) age, recent relationship (p = 0.04), use of hormonal contraceptives (p = 0.04). Satisfaction SD was associated with stable union (p = 0.00), woman's age (p = 0.03), recent relationship (p = 0.00) and pregnancy (p = 0.00). Sexual pain was associated with high number of people living in the same household (p = 0.00). Conclusion: SD is prevalent in female graduation students in southern Brazil, and the problem is associated with marital status, young age of woman and partner, recent relationships, lack of privacy, hormonal contraceptives and pregnancy.(AU)

Prevalencia y factores de riesgo de la disfunción sexual femenina: revisión sistemática / Prevalence and risk factors of female sexual dysfunction: a systematic review

ANTECEDENTES: La disfunción sexual femenina (DSF) se define como un trastorno en el deseo, excitación, orgasmo y/o dolor durante la relación sexual, que genera estrés personal y tiene impacto en la calidad de vida. OBJETIVO: Analizar datos epidemiológicos sobre prevalencia y factores de riesgo de DSF que permita disponer de un conocimiento unificado sobre estos. MÉTODOS: Se revisaron bases de datos: PubMed y LILACS, entre el 01/01/2004 al 12/10/2014. Se incluyeron estudios de corte transversal que garantizaran los datos de prevalencia y de frecuencia de factores de riesgo. Se evaluó la calidad metodológica utilizando los criterios del STROBE (Strengthening the Reporting of Observational Studies in Epidemiology); se publicaron los resultados en tablas, reportando prevalencia y factores de riesgo con sus respectivos OR. RESULTADOS: Se incluyeron quince artículos, todos cumplieron con más del 70% de los ítems evaluados por el STROBE. La prevalencia de DSF se encontró entre 5,5 - 73,2%. El dominio más afectado fue el deseo, con prevalencias entre 10,4% - 52%. Al combinar los datos las variables asociadas a la presencia de DSF fueron: baja frecuencia de relaciones, edad >40 años, bajo nivel educativo, posmenopausia, pareja con disfunción eréctil, entre otros. CONCLUSIÓN: La DSF posee una alta prevalencia a nivel mundial; la presencia de los múltiples factores de riesgo que presentan las mujeres son motivo de estudio exhaustivo. Un mejor entendimiento de la epidemiologia es vital para planear estrategias de prevención y esquemas de tratamientos efectivos.

BACKGROUND: Female sexual dysfunction (FSD) is defined as a disorder in desire, arousal, orgasm and / or pain during intercourse, which generates personal stress and impacts the quality of life. AIMS: The objective of this review is to analyze epidemiological data on prevalence and risk factors of FSD to provide a unified knowledge. METHOD: Databases such as PubMed and LILACS were reviewed, from January first of 2004 to October twelve of 2014; cross-sectional studies that ensured information about prevalence and frequen-cy of risk factors were included. Methodological quality was assessed using the criteria of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology); the results were published in ta-bles, reporting prevalence and risk factors with their respective OR. RESULTS: Fifteen items were included, all met over 70% of the items evaluated by the STROBE. The prevalence of FSD was found between 5.5 to 73.2%. The most affected domain was the desire with a prevalence between 10.4% - 52%. The variables associated with the presence of FSD were: low frequency of intercourse, age> 40 years, low education level, menopause, couples with erectile dysfunction (ED), among others. CONCLUSION: The FSD has a high prevalence worldwide; the múltiple risk factors presented by women require further study, because a better understanding of the epidemiology is vital for planning prevention strategies and effective treatment regimens.

Disfunción sexual en la mujer diabética pre y postmenopáusica / Sexual dysfunction in women with diabetes in pre and postmenopausic state

Objective: female sexual dysfunction (FSD) in diabetic women, is a topic poorly studied. The aim of this study is to determine the prevalence of FSD in typ1 1 and typ2 diabetic patients (T1D and T2D) compared with non diabetic controls. Patients and Method: interview under written consent 24 diabetic patients attended at Diabetes Unit of the San Juan de Dios Hospital and 24 healthy controls. Inclusion criteria: diagnosis of diabetes mellitus over one year, age 18-75 years old and stable partner for over a year. Exclusion criteria: antidepressants treatment. The validated survey by Rosen et al. was applied. Female Sexual Function Index (FSFI), of 19 questions that assess 6 areas of sexual function: desire, lubrication, excitement, orgasm, satisfaction and pain. A total score of 26.55 or less diagnosed DSF. In diabetic patients the metabolic control, lipid profile, creatinine and glycated hemoglobin A1c (HbA1c) was recorded. Statistical analysis was performed using median, range and Mann Whitney test. Percentages of sexual dysfunction was analysed by chi². It was considered significant at p < 0.05. Results: the results of the FSFI survey were divided and related to menopause. In premenopausal diabetic group (n = 11), the average score was 31.1 versus 32.5 in controls (NS) and in postmenopausal diabetic group (n = 13) the average score was 23,1 versus 28,5 (p = 0.05). The overall frequency of DSF in premenopausal diabetic women was 27.3 percent and 6.3 percent in controls (NS), in postmenopausal reached 69.2 percent and25.0 percent in controls (p = 0.01 ). Conclusion: in diabetic patients sexual dysfunction was more frequent than in controls; in premenopausal women the most affected area is the excitement and in postmenopausal women was lubrication.

Prevalence and Predictive Factors of Sexual Dysfunction in Iranian Women: Univariate and Multivariate Logistic Regression Analyses / 가정의학회지

BACKGROUND: Female sexual dysfunction, which can occur during any stage of a normal sexual activity, is a serious condition for individuals and couples. The present study aimed to determine the prevalence and predictive factors of female sexual dysfunction in women referred to health centers in Ilam, the Western Iran, in 2014. METHODS: In the present cross-sectional study, 444 women who attended health centers in Ilam were enrolled from May to September 2014. Participants were selected according to the simple random sampling method. Univariate and multivariate logistic regression analyses were used to predict the risk factors of female sexual dysfunction. Diffe rences with an alpha error of 0.05 were regarded as statistically significant. RESULTS: Overall, 75.9% of the study population exhibited sexual dysfunction. Univariate logistic regression analysis demonstrated that there was a significant association between female sexual dysfunction and age, menarche age, gravidity, parity, and education (P<0.05). Multivariate logistic regression analysis indicated that, menarche age (odds ratio, 1.26), education level (odds ratio, 1.71), and gravida (odds ratio, 1.59) were independent predictive variables for female sexual dysfunction. CONCLUSION: The majority of Iranian women suffer from sexual dysfunction. A lack of awareness of Iranian women's sexual pleasure and formal training on sexual function and its influencing factors, such as menarche age, gravida, and level of education, may lead to a high prevalence of female sexual dysfunction.

Sexual Function and Sexual Frequency among Chinese Women in Hong Kong: Implications for Public Health Services

Female sexual dysfunction (FSD) is a public health problem because of its high prevalence and harmful impacts on women’s physical health, psychological well-being, and overall quality of life. The objective of this exploratory study was to identify risk factors of sexual dysfunction and assess the sexual function of Hong Kong Chinese women. Results were compared with findings on American women. A questionnaire survey was conducted to collect data via convenience sampling. Participants of the study (N = 1011) were women (aged 18 or above) from diverse demographic backgrounds. Sexual function of Hong Kong Chinese women was generally adequate, but significantly lower than that of American women. Women of older age (41 years old or above), lower education (primary or below), divorced, in menopause or with oophorectomy were at risk of FSD. Women at risk of FSD also exhibited a decline of sexual frequency which implicated poor sexual health. With the risk factors identified, public health professionals could implement targeted health services that would tackle the problems of FSD in good time and promote the sexual health of women who are distressed by the problems.​

Factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana / Biopsychosocial factors associated with female sexual dysfunction in a mexican population

Objetivo: Determinar los factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana. Métodos: Estudio comparativo en mujeres que acudieron como acompañantes a una Unidad de Medicina Familiar de Querétaro, México. Se aplicaron las encuestas de Laumman, Chávez y Velazco, Faces III, y Grajales para valorar sexualidad, funcionalidad conyugal, funcionalidad familiar y estado de la autoestima. Los resultados fueron analizados con Odds Ratios, Chi cuadrado y t de Student. Resultados: De 110 mujeres entrevistadas, 65 (59 por ciento) refirieron alguna disfunción sexual y 45 (41 por ciento) lo negaron. Se formaron aleatoriamente dos grupos de 44 mujeres: con y sin disfunción sexual. Los factores que se asociaron significativamente a las alteraciones sexuales fueron: edad mayor a 40 años, laborar fuera del hogar, presencia de obesidad y/o sobrepeso, hipertensión arterial, diabetes mellitus, histerectomía previa, maternidad, disfuncionalidad conyugal, autoestima alta, depresión leve a severa, familia disfuncional, estrato socioeconómico bajo. Las alteraciones sexuales más frecuentes fueron: disminución en el deseo sexual (34,1 por ciento), disfunción eréctil de la pareja (22,7 por ciento), dispareunia y falta de excitación (20,5 por ciento), sexo referido como desagradable e incapacidad para llegar al orgasmo (13,6 por ciento), ansiedad por el desempeño sexual (6,8 por ciento) y eyaculación precoz (4,5 por ciento). Conclusiones: Es importante identificar los factores que afectan la sexualidad femenina para ofrecer un manejo multidisciplinario y prevenir implicaciones a nivel del entorno familiar y conyugal.

Objective: To determine the biopsychosocial factors associated with female sexual dysfunction in a Mexican population. Methods: A comparative study in women who were attended at a Family Medicine Unit of Queretaro, Mexico. Surveys of Laumman, Chavez and Velazco, Faces III, and Grajales, were applied to assess sexuality, marital functionality, familiar functionality and state self-esteem. The results were analyzed with Odds Ratios, chi-square and Student t test. Results: Of 110 women interviewed, 65 (59 percent) reported sexual dysfunction and 45 (41 percent) denied. They formed two groups randomly from 44 women with and without sexual dysfunction. Factors that were significantly associated with sexual disorders were: age greater than 40 years, labor outside the home, presence of obesity and/or overweight, hypertension, diabetes mellitus, prior hysterectomy, maternity, marital dysfunction, high self-esteem, mild to severe depression, dysfunctional family, low socioeconomic status. The most common sexual dysfunction were: decrease in sexual desire (34.1 percent), erectile dysfunction couples (22.7 percent), dyspareunia and lack of arousal (20.5 percent), referred to as unpleasant sex and inability to reach orgasm 13.6 percent) sexual performance anxiety (6.8 percent) and premature ejaculation (4.5 percent). Conclusions: It is important to identify the factors affecting female sexuality to offer multidisciplinary management and prevention implications at the level of family and marital environment.

Changes in Sexual Function and Comparison of Questionnaires Following Surgery for Pelvic Organ Prolapse

PURPOSE: The aim of this study was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function and to assess correlations between the two using two current standardized questionnaires. MATERIALS AND METHODS: From October 2009 to September 2010, 143 patients with posterior compartment or combined vaginal prolapse were included. We assessed surgical outcomes according to anatomical change in the vagina and results of the Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12) both pre- and postoperatively. RESULTS: Among the 143 preoperative patients, 99 and 84 patients responded to the PISQ-12 and FSFI, respectively. The mean PISQ-12 score increased after surgery (p<0.001). Specifically, postoperative scores for questions 8 and 12 were higher than their respective preoperative scores (p<0.001). Postoperatively, mean FSFI score changed only slightly (p=0.76), and only the score for the satisfaction domain was improved (p=0.023). In regards to vaginal anatomy, vaginal length was significantly greater postoperatively (6.99+/-0.18 vs. 7.56+/-1.08, p<0.001), and postoperative vaginal caliber was narrowed to a two-finger width. CONCLUSION: In this study, surgery for pelvic organ prolapse was shown to affect female sexual function. Moreover, menopause was associated with a change in postoperative sexual function.

The Prevalence and Associated Factors of Female Sexual Dysfunction in Korean Premenopausal Women: A Community-Based Study / 대한남성과학회지

PURPOSE: To estimate the prevalence of and factors associated with female sexual dysfunction (FSD) in Korean women. MATERIALS AND METHODS: A total of 629 married women in the Chonnam and Gwangju area were randomly included in this study. They were asked to complete a questionnaire on FSD, which consisted of the Female Sexual Function Index (FSFI), as well as psychological, physiological, and demographic factors. RESULTS: The mean age of the women was 36.97 years and the mean FSFI score was 25.56 out of a total score of 36. Based on the total FSFI score, 42.9% of the women had scores less than the cut-off point of 25, the assessed definition of FSD. The prevalence of FSD by age group was: 31.3% for 20~29 year olds, 41.6% for 30~39 year olds, and 51.8% for 40~49 year olds. A stepwise regression analysis found that women with higher levels of sexual distress, lower frequency of sexual intercourse, lower levels of life satisfaction, a less important appraisal of sex, a higher likelihood of depression, more conservative attitude toward sex, irregular menstrual cycle, higher age, chronic disease, and a smoking habit were more likely to suffer from FSD. CONCLUSIONS: The prevalence of FSD in Korean women was common and comparable to those reported worldwide. Sexual distress, frequency of sexual intercourse, and life satisfaction were important associated factors of FSD.

Tratamento fisioterapêutico das disfunções sexuais femininas - Revisão de literatura / Physiotherapy treatment for Female Sexual Dysfunctions - Literature review

A disfunção sexual tem alta prevalência entre as mulheres. Constitui um problema que afeta a qualidade de vida e a saúde física e mental, não somente dos indivíduos que sofrem da disfunção, mas também de seus parceiros, justificando o tratamento e o estudo dessa disfunção com a sua devida importância pelos serviços de saúde. A fisioterapia é um avanço relativamente recente no tratamento dessas mulheres, e seu papel exato é pouco conhecido pela população e pelos profissionais de saúde. O presente estudo constitui um levantamento bibliográfico sobre o papel da fisioterapia no tratamento da disfunção sexual feminina

Sexual dysfunction is highly prevalent among women. It is a problem that affects the quality of life, physical and mental health, not only of individuals who suffer from the dysfunction, but also their partners, justifying the treatment and study of this dysfunction due to its importance by the health services. Physical therapy is a relatively recent development in the treatment of these women, and its exact role is little known by the population and health professionals. This study is a literature survey on the role of physiotherapy in the treatment of female sexual dysfunction

Evaluación de la función sexual en mujeres sometidas a histerectomía total y supracervical por vía laparoscópica / Evaluation of sexual function in women undergoing total and supracervical laparoscopic hysterectomy

Objetivo: Determinar si la histerectomía total o supracervical laparoscópica tiene repercusión en la función sexual de la mujer y cuál de estas técnicas quirúrgicas se debe emplear para preservar la función sexual, evaluando si las alteraciones en dicha función se comportan como variables independientes al procedimiento quirúrgico. Método: Se realizó un estudio longitudinal, prospectivo y analítico en pacientes del servicio de ginecología del Instituto Nacional de Perinatología, para evaluar la función sexual de pacientes que fueron sometidas a histerectomía laparoscópica por patología benigna. La evaluación de la función sexual se realizó de forma preoperatoria y seis meses después del evento. Se utilizó dos instrumentos para evaluar la función sexual de las pacientes: la historia clínica codificada femenina y el índice de función sexual femenina. Resultados: No hubo diferencia significativa en la función sexual de las mujeres antes y después de la histerectomía (z= -1,603; p>0,109). No hubo diferencia significativa entre las mujeres con y sin disfunción sexual en relación con la edad, escolaridad, inicio de actividad coital, temores hacia la sexualidad y experiencias sexuales traumáticas en la infancia. Conclusiones: La función sexual de las mujeres antes y después de la histerectomía no se ve afectada por la histerectomía total laparoscópica ó la histerectomía subtotal laparoscópica.

Objective: To determine whether total or supracervical laparoscopic hysterectomy has an impact on female sexual function and which of these surgical techniques should be used to preserve sexual function, evaluating whether the alterations in the function behave as independent variables to surgical procedure. Method: We conducted a longitudinal study, prospective and analytical at the National Institute of Perinatology in assessing sexual function of patients who underwent laparoscopic hysterectomy for benign disease, assessment of sexual function was conducted preoperatively and six months after the event. Two instruments for assessing sexual function of patients was used: medical history and the female sexual functionindex. Results: In applying the test of Wilcoxon signed ranks two related samples, no significant difference in sexual function in women before and after hysterectomy (z = -1.603; p>0.109). By applying the statistical test of Chi2 to see if there was a difference between women with and without sexual dysfunction in relation to other variables such as age, education, initiation of coital activity, fears about sexuality, traumatic sexual experiences in childhood, no significant differences were found. Conclusions: Sexual function in women before and after hysterectomy is not affected significantly. The result of the hysterectomy is independent of the type of surgery (total laparoscopic hysterectomy or supracervical laparoscopic hysterectomy).

Predictors of Sexual Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain in Women with Gynecologic Cancer

PURPOSE: This study was done to identify psychosocial factors that might be predictive of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain in women with gynecologic cancer. METHODS: Two hundred and twelve women with cervical, ovarian, or endometrial cancer completed questionnaires on the Female Sexual Function Index including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain, and data on their psychosocial factors including body image, sexual attitude, sexual information, depression, and marital intimacy. Stepwise multivariable regression analysis was performed to explore psychosocial predictors of women's sexual function domains. RESULTS: Predictors were identified as sexual attitude, depression, sexual information, and body image for sexual desire; sexual information, depression, and sexual attitude for sexual arousal; sexual information, marital intimacy, and depression for lubrication; sexual information, marital intimacy, depression, and body image for orgasm; marital intimacy, sexual information, sexual attitude, and depression for satisfaction; sexual information, depression, and marital intimacy for pain. CONCLUSION: The results indicate that women's sexual function needs to be approached to domains of female sexual function psychosocially as well as to general sexual function. These factors should be considered in future interventions to positively promote sexual function in women with gynecologic cancer.