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

Disfunción sexual en cáncer de mama: Efecto colateral / Sexual dysfunction in breast cancer: A side effect

Introducción: La disfunción sexual femenina (DSF) incluye un grupo de alteraciones en el deseo sexual, excitación, lubricación, satisfacción, orgasmo, y dispareunia, de carácter multifactorial, involucrando tanto procesos orgánicos y psicológicos como socioculturales. Los diversos tratamientos médico-quirúrgicos, tienen impacto en la función sexual. La disfunción sexual femenina afecta la calidad de vida, con una prevalencia de hasta 45-90% en las pacientes con diagnóstico de cáncer de mama. Objetivo: Evaluar la función sexual en mujeres con cáncer de mama, con seguimiento oncológico mayor al año, evaluando el impacto de los diferentes tratamientos médico-quirúrgicos en el índice de función sexual femenina. Material y método: Estudio observacional, descriptivo y transversal, donde se incluyeron 102 pacientes entre agosto 2019 y febrero de 2020 con cáncer de mama en el Hospital Municipal de Oncología María Curie. Como instrumento de medida se utilizó el cuestionario *Índice De Función Sexual Femenina* (FSFI), asociado a una encuesta para la obtención de datos sociodemográficos e información sobre los procedimientos medico-quirúrgicos realizados para el tratamiento del cáncer de mama. Resultados: La media de edad de las pacientes fue 54.86 años (SD 9.19). El 69.6% de ellas habían realizado tratamiento quirúrgico conservador, mientras que el 30.4% estaban mastectomizadas, no evidenciándose diferencias estadísticamente significativas en relación a la disfunción sexual en ambos grupos. Se realizó tratamiento quimioterápico en 69.6% del total de las pacientes y 75.5% hormonoterapia, observándose diferencia en el score FSFI al cotejar el tipo de hormonoterapia recibida. La prevalencia de disfunción sexual en este grupo fue de 82,35%. Los resultados evidenciaron valores bajos en la escala FSFI, siendo la media 19.6, lo que demuestra alteraciones en la función sexual en esta población. Conclusiones: El cáncer de mama posee un impacto multidimensional en la salud sexual de mujeres con cáncer de mama, constituyendo un elemento que influye en la calidad de vida. Los diversos tratamientos médico-quirúrgicos alteran la sexualidad, no pudiendo aún establecerse la relación directa que tienen sobre esta esfera

Introduction: Female sexual dysfunction (FSD) includes a group of alterations in sexual desire, arousal, lubrication, satisfaction, orgasm, and dyspareunia, of multifactorial character, involving organic and psychological as well as sociocultural processes. The various medical-surgical treatments have an impact on sexual function. Female sexual dysfunction affects quality of life, with a prevalence of up to 45-90% in patients diagnosed with breast cancer. Objective: To evaluate sexual function in women with breast cancer, with oncologic followup of more than one year, evaluating the impact of different medical-surgical treatments on the index of female sexual function. Material and method: Observational, descriptive and cross-sectional study, where 102 pa- tients were included between August 2019 and February 2020 with breast cancer at the Maria Curie Municipal Oncology Hospital. As a measurement instrument, the questionnaire *Female Sexual Function Index* (FSFI) was used, associated with a survey to obtain sociodemographic data and information on the medical-surgical procedures performed for the treatment of breast cancer. Results: The mean age of the patients was 54.86 years (SD 9.19). Of these, 69.6% had undergone conservative surgical treatment, while 30.4% were mastectomized, with no statistically significant differences in relation to sexual dysfunction in the two groups. Chemotherapy treatment was performed in 69.6% of the total patients and 75.5% hormone therapy, showing a difference in the FSFI score when comparing the type of hormone therapy received. The prevalence of sexual dysfunction in this group was 82.35%. The re- sults showed low values on the FSFI scale, with a mean of 19.6, which demonstrates alterations in sexual function in this population. Conclusions: Breast cancer has a multidimensional impact on the sexual health of women with breast cancer, constituting an element that influences the quality of life. The various medical-surgical treatments alter sexuality, although the direct relationship they have on this sphere cannot yet be established

Sexual dysfunction among patients with endometrial cancer at a tertiary training public institution: A cross-sectional study / Philippine Journal of Obstetrics and Gynecology

Objective@#Studies on Sexual dysfunctions among gynecologic cancer after treatment are sparse in the Philippines and data on sexual dysfunction varies greatly within the gynecologic oncology literature. This study aims to determine the sexual dysfunction among patients with endometrial cancer managed at a tertiary training public institution.@*Method@#This research was a cross-sectional study, which utilized a self-administered, validated Filipino version of the Female Sexual Function Index (FSFI) questionnaire in assessing the different domains such as desire, arousal, lubrication, orgasm, satisfaction and pain. Descriptive statistics such as frequency and percentages were used in determining the prevalence of sexual dysfunction in patients with endometrial carcinoma while Kruskal Wallis test and Spearman Rank Correlations were used to determine the association of sexual dysfunction with age, body mass index (BMI), duration and stage of endometrial cancer, presence of comorbidities and mode of treatment.@*Results@#Between May 2020 and January 2021, there were 53 women who participated in this study. Forty-one (77.36%) have sexual dysfunction. Majority of the respondents either reached up to high school level (22.6%) or are college graduates (22.6%). Most of them are also self-employed (58.1%). Fifty eight percent have only 1–3 child/children. Analysis showed no significant correlation of presence of sexual dysfunction to stage of cancer, BMI, presence of comorbidities, period of diagnosis and type of treatment received by the patients. @*Conclusion@#The study showed that there was high prevalence of sexual dysfunction among endometrial cancer patients in this study institution. Furthermore, presence of sexual dysfunction is irregardless of BMI, presence of comorbidities, stage of diagnosis, length of diagnosis and type of treatment. Hence, proper screening, diagnosis and counselling should be done to all patients upon diagnosis to promote better quality of life.

The effectiveness of psycho-educational and cognitive-behavioral counseling on female sexual dysfunction

Abstract Introduction Sexual function is a multidimensional phenomenon that is affected by many biological and psychological factors. Cognitive-behavioral sex therapies are among themost common nonpharmacological approaches to psychosexual problems. The purpose of the present study was to investigate the effectiveness of psychoeducational and cognitive-behavioral counseling on female sexual dysfunction. Methods The present study was a clinical trial with intervention and control groups. The study population consisted of women referring to the general clinic of a governmental hospital in Iran. After completing the demographic questionnaire and Female Sexual Function Index (FSFI), those who obtained the cutoff score ≤ 28 were contacted and invited to participate in the study. Convenience sampling method was used and 35 subjects were randomly allocated for each group. Eight counseling sessions were held for the intervention group (two/week/1.5 hour). Post-test was taken from both groups after 1 month, and the results were statistically analyzed by PASW Statistics for Windows, Version 18 (SPSS Inc., Chicago, IL, USA). Results The total mean scores of FSFI and the subscales of sexual desire, arousal, orgasm, and satisfaction were significantly higher in the intervention group than in the control group after the intervention. In addition, postintervention pain mean scores in the intervention group were significantly lower than in the control group (p < 0.05). Conclusion The results of the present study indicate that psychoeducational cognitive- behavioral counseling is effective in improving female sexual function. It is recommended to compare the effects of psychoeducational cognitive-behavioral counseling on sexual dysfunctions of couples and with a larger sample size in future research.

Investigation on female sexual status and its influence factors during the second trimester of pregnancy / 中国实用护理杂志

Objective To survey the female sexual status and its influence factors during the second trimester of pregnancy.Methods The Chinese Version of Female Sexual Function Index (FSFI) and self-administered questionnaires were used to collect the data of 304 women during the second trimester of pregnancy.The investigation results were analyzed.Results Most women reported a decrease in sexual desire(74.7％,227/304),intercourse frequency(90.8％,276/304) and sexual satisfaction(41.1％,125/304).FSFI all dimensions mean scores of these 304 women during the second trimester of pregnancy were less than the critical value,and total FSFI was (20.82±3.74) scores.The female sexual status during the second trimester of pregnancy were affected by age,duration of marriage,education,the way of pregnancy,F=21.974,12.288,3.345,7.748,the differences were statistically significant,P＜0.05.Conclusion Pregnant women are in a low level sexual function during the relative safety stage for sexual behavior during the second trimester of pregnancy,so providing some sexual education is necessary to improve couples' sexual health.

Evaluation to the Female Sexual Dysfunction in a Simple of Iranian Infertile Women.

Introduction: Female sexual dysfunction (FSD) is recognized as a widespread health problem. Infertility may result in increased sexual dysfunction. The aim of this study was to evaluate the prevalence of FSD and some demographic characteristic with female sexual function; detect predictors factors of female sexual domains on sexual dysfunction asample of Iranian infertile women. Methodology: The cross-sectional study was carried out between August 2013 and January 2014 on 208 women referring to Fatemeh Zahra Infertility & Reproductive Center, Babol, Iran. Each survey contains demographic information and one validated questionnaire, the Female Sexual Function Index (FSFI). A score≤ 26.55 is considered ‘‘at risk’’ for sexual dysfunction. Statistical analyses were performed using Independent sample t test, linear and logistic regression with P<.05 indicating statistical significance. All statistical analyses were performed using SPSS software (Version 17). Results: The percentage of sexual dysfunction was 46.6. The mean score of total sexual function was 26.18±4.14. The lowest mean of FSFI domains was related to desire and then arousal in infertile women. There was a significant association between all of the domains of sexual function with sexual function. All of the female sexual domains had the positive significant predictors of sexual function in infertile women. Standardized beta values showed that orgasm contributed to the greatest amount of unique variance to the model for infertile women sexual function, and followed by sexual satisfaction, sexual arousal, lubricant, sexual desire, and sexual pain (P<.001). There was a significant correlation between the domains of sexual function except pain and desire. The strongest correlation value was between the domains of sexual satisfaction and orgasm, and then arousal with orgasm. There was a significant association between sexual dysfunction and educational level, husband’s educational level, and infertility cause. Conclusions: With considering to the high prevalence of sexual dysfunction in selected infertile women, therefore, early screening is needed for detecting predictor's factors o sexual dysfunction.

Development and Validation of the Korean Version of the Female Sexual Function Index-6 (FSFI-6K)

PURPOSE: To evaluate the validity and reliability of the Korean version of the Female Sexual Function Index-6 (FSFI-6K). MATERIALS AND METHODS: Participants were recruited from February 2013 to July 2013. The primary survey was conducted for 220 participants, and a follow-up was conducted 3 weeks (+/-1 week) after the primary survey. The FSFI-6K data were analyzed and compared to the reference values in the original FSFI. RESULTS: Of the 220 participants, 199 (90.5%) returned to follow-up, 18 (8.2%) had no further contact, and 3 (1.4%) declined to respond. The internal consistency of the FSFI-6K as measured by Cronbach's alpha was 0.888 and the reliability based on test-retest intraclass correlation was 0.606; these values were acceptable. The cutoff used for diagnosis of female sexual dysfunction by an receiver operating characteristics (ROC) curve was a score of 21; the sensitivity and specificity for this curve are 0.89 and 0.86, respectively. The area under the receiver operating curve was 0.948. CONCLUSION: The FSFI-6K has high internal consistency and acceptable reliability. This validated questionnaire can be used for the Korean population.

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.

Female Sexual Function Index (FSFI):Application and Scoring System / 中国康复理论与实践

This paper summarized the application of Female Sexual Function Index (FSFI), and introduced its scoring system.

Efficacy of nursing intervention for improving the quality of sexual life for patients with cervical intraepithelial neoplasia / 中国实用护理杂志

ObjectiveTo discuss effective measures to improve postoperative sexual life quality of patients with cervical intraepithelial neoplasia (CIN).MethodsOne hundred and twenty patients with CIN were randomly assigned to the blue-ribbon club group, the friendship-support group and the control group. The blue-ribbon club patients were regarded as club members and received special education every two months. The friendship-support group patients received education one by one in the hospital setting and the control group patients received the same education as before participated into the trial. Female sexual function index (FSFI)was used to evaluate sexual function before and 6 months after intervention.ResultsExcept sexual pain, the total score of FSFI and the score of sub-domain in the blueribbon club were significantly higher than that in the control group. The total score of FSFI and score of sub-domain were significantly higher than that in the control group. There were no significant differences between both intervention groups.ConclusionsBoth education intervention modes of the blue-ribbon club group and the friendship- support group could effectively improve sexual function for post-operation patients with CIN.