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.

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Impacto del tratamiento antirretroviral en la función sexual de mujeres con VIH / Impact of antiretroviral treatment on sexual function of HIV-infected women

Objetivo. Describir la función sexual de un grupo de mujeres con VIH bajo tratamiento antirretroviral. Evaluar si existe diferencia entre las tratadas con un esquema que contiene Inhibidores No Nucleósidos de la Transcriptasa Inversa (INNTI) y aquéllas que reciben Inhibidores de la Proteasa (IP). Material y métodos. Estudio descriptivo, transversal. Muestra: 92 pacientes mujeres con VIH bajo tratamiento antirretroviral, que son asistidas en el Instituto Centralizado de Asistencia e Investigación Clínica Integral (CAICI). Instrumento: Se les realizó una encuesta que consta de características demográficas, preguntas referidas al VIH y al The Female Sexual Function Index (FSFI). Análisis estadístico: se utilizó ANOVA, Kruskall-Wallis, Chi cuadrado, regresión logística y alpha de Cronbach. Resultados. Edad media: 42±10 años; 65% tenían pareja estable, siendo el 73% de estas sero-discordantes. La mayoría (45,7%) estaban en tratamiento antirretroviral por más de dos años, con una media de CD4 mayor a 500 cél/ml y el 90% con carga viral plasmática indetectable. El 64,1% presentaba otra enfermedad asociada, por lo que el 55,4% tomaba medicación concomitante. El 27,2% continuó con su actividad sexual luego del diagnóstico de VIH, pero el 26,1% nunca la retomó. La puntuación total alcanzada por medio del FSFI fue de 20,4±10,1 para las tratadas con IP y 20±10,6 para las tratadas con INNTI (p <0,005). Conclusiones. La muestra analizada presentó un puntaje compatible con disfunción sexual. No hubo diferencia estadísticamente significativa en la función sexual de las mujeres tratadas con IP y las tratadas con INNTI

Summary Objective: To describe the sexual function in a group of women with HIV on antiretroviral treatment. To assess whether there is a difference between those treated with Non-nucleoside Inhibitors of he Reverse Transcriptase (NNRTI) and those receiving protease inhibitors (PIs). Material and methods: Descriptive, transversal study. Study sample: 92 women with HIV on antiretroviral therapy who are assisted in the Central Institute of Integral Assistance and Clinical Research (CAICI). Instrument: They completed a survey consisting of questions about demographic characteristics, HIV, and The Female Sexual Function Index (FSFI). Statistical analysis: ANOVA, Kruskal-Wallis, Chi-square, logistic regression and Cronbach’s alpha. Results: Average age was 42±10 years; 65% had a steady partner, of which 73% were sero-discordant. Most patients (45.7%) had been on antiretroviral treatment for more than two years, with a mean CD4 greater than 500 cells/ml and 90% with undetectable plasma viral load. Other illnesses were present in 64.1%, and 55.4% were taking concomitant medication. Sexual activity after HIV diagnosis was continued by 27.2%, while 26.1% never resumed it. The total score achieved by the FSFI was 20.4±10.1 among those treated with IP and 20.0±10.6 among those treated with NNRTI(p<0.005). Conclusions: The score in the present sample supports the existence of sexual dysfunction. There was no statistically significant difference in the sexual function of women treated with either PI or NNRTI

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.

Efectos de la terapia de reemplazo hormonal sobre la función sexual de mujeres con menopausia natural o quirúrgica / Effects of hormone replacement therapy on sexual function of women with natural menopause or surgical

Objetivo: Determinar los efectos de la terapia de reemplazo hormonal sobre la función sexual de mujeres con menopausia natural o quirúrgica, en la consulta de ginecología del Hospital “Dr. Pedro García Clara”; Municipio Lagunillas, Estado Zulia. Métodos: Investigación de tipo comparativa y aplicada, con diseño no experimental, contemporáneo y de campo, que incluyó una muestra de 80 pacientes con diagnóstico de menopausia, dividida en dos grupos de acuerdo a la toma o no de la terapia de reemplazo hormonal y a su vez en dos subgrupos de acuerdo al tipo de menopausia; las cuales fueron evaluadas mediante el índice de función sexual. Resultados: Se encontraron diferencias significativas (P< 0,05) a favor de la terapia de reemplazo hormonal en menopáusicas naturales e histerectomizadas en cuanto al deseo, frecuencia de la excitación, satisfacción y dolor posterior a la penetración; además de encontrarse diferencias altamente significativas en cuanto a la lubricación y a la frecuencia del orgasmo (P< 0,001). Asimismo se determinó una alta prevalencia de disfunción sexual (63,75 %) representando la ausencia de la terapia de reemplazo hormonal un riesgo significativo para disfunción sexual (OR (IC95 %)= 11,94 (3,953-36,081); P= 0,000), mientras que el tipo de menopausia no (OR (IC95 %)= 0,897 (0,360-2,234); P= 0,179). Conclusión: La puntuación total alcanzada en ambos grupos mostró diferencias significativas entre ellos, por lo cual se concluye que la terapia de reemplazo hormonal mostró ser beneficiosa para la función sexual femenina, sin repercusión aparente de la remoción o no del útero.

Objective: To determine the effects of hormone replacement therapy on sexual function in women with natural or surgical menopause at the outpatient clinic of gynecology of the Hospital “Dr. Pedro Garcia Clara”; Municipio Lagunillas, Estado Zulia. Methods: Comparative and applied type research with non-experimental, contemporary and field design, which included a sample of 80 patients diagnosed with menopause, divided into two groups according to whether or not taking hormone replacement therapy and into two subgroups according to type of menopause; measured by the female sexual function index. Results: It’s found significant differences (P <0.05) in favor of hormone replacement therapy in natural menopausal and hysterectomy in terms of desire, frequency of arousal, satisfaction and pain after penetration, in addition to being highly significant differences in terms of lubrication and orgasm frequency (P< 0.001). It also determined a high prevalence of sexual dysfunction (63.75 %) representing the absence of hormone replacement therapy a significant risk for sexual dysfunction (OR (95 %) = 11.94 (3.953 to 36.081), P = 0.000), while not the type of menopause (OR (95 %) = 0.897 (0.360 to 2.234), P = 0.179). Conclusion: The total score achieved in both groups showed significant differences between them, it was concluded that hormone replacement therapy showed to be beneficial for female sexual function, without apparent impact of the removal of the uterus or not.

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.

Impact of transvaginal natural orifice transluminal endoscopic surgery-assisted laparoscopic nephrec-tomy on female sexual function and quality of life / 中华泌尿外科杂志

Objective To investigate the impact of transvaginal natural orifice transluminal endo-scopic surgery(NOTES)-assisted laparoscopic nephrectomy on female sexual function and quality of life . Methods This was a prospective study on the change of female sexual function and quality of life of female patients who underwent transvaginal NOTES-assisted laparoscopic nephrectomy from May .2011 to Nov. 2012.A total of 42 cases were included in this study (28 of them with severe hydronephrosis , non-functio-ning kidney , 11 with pyelonephrosis , 1 with renal tuberculosis , 1 with duplex kidney complicated with hy-dronephrosis, and 1 with renal angiomyolipoma ).The mean age was 36.9±5.3 (26-45) years, and the mean body mass index was 21.7±2.6 (14.7 to 27.1) kg/m2.Twenty-four cases were operated on the left side, 18 cases on the right .The female sexual function and quality of life were assessed before and 4 months, 7 months and 1 year after surgery using the Female Sexual Function Index (FSFI) questionnaire and the MOS 36-item Short-Form Health Survey (SF-36), respectively. Results The mean FSFI of 42 cases preoperatively and 4 months, 7 months and 1 yr postoperatively were 27.74 ±4.34, 27.19 ±4.49, 28.54±4.23, and 28.68 ±4.19, respectively.There was no statistically significant difference among them (F=1.111, P=0.346).Compared with that of preoperation , the physical function, vitality, metal health, body pain, and general health of the patients were improved , but the role-physical, role-emotion and social function were not improved at postoperative month 4 and month 7 (P<0.05).Each item of SF-36 was im-proved after postoperative 1 year ( P<0.05) . Conclusions Transvaginal NOTES-assisted laparoscopic ne-phrectomy does not cause negative effect on the female sexual function .The quality of life can be improved after operation .The physical function is improved at early stage , and the psychological function as well .

Índice de función sexual en trabajadoras de la salud / Sexual function index in health workers

Objetivo: Determinar la función sexual femenina de trabajadoras de la salud. Método: Estudio cuantitativo, descriptivo, transversal. Universo formado por mujeres que se desempeñan en un hospital de alta complejidad, cuyas edades fluctúan entre 20 a 64 años. Se caracterizó el perfil biosociodemográfico de la trabajadora junto al Índice de Función Sexual Femenina (IFSF). El análisis estadístico se realizó aplicando análisis univariados y bivariados, coeficiente de correlación de Pearson o Spearman y análisis de varianza. Resultados: El puntaje del IFSF logra su máxima expresión alrededor de los 35 a 39 años (29,7 +/- 4,9) y luego disminuye progresivamente (23,0 +/- 8,9). Se observa un 32,6 por ciento de disfunción sexual, 29 por ciento de desorden del deseo, 10,4 por ciento de dificultades de excitación, 5,6 por ciento de problemas de lubricación, 9,7 por ciento de desorden en el orgasmo, 14 por ciento de problemas de satisfacción sexual y 9,9 por ciento de dispareunia. Conclusiones: El IFSF en trabajadoras de la salud varió en concordancia con la edad, menopausia, educación y problemas de sexualidad en la pareja. El estamento auxiliar de servicio alcanzó mayores índices de disfunción sexual.

Objective: To determine the female sexual function of health workers. Method: quantitative, descriptive, cross-sectional study. The universe is made by women who work in a high complexity hospital, ranging from 20 to 64 years old. The biosociodemographic profile of the worker was characterized by the Female Sexual Function Index (FSFI). Statistical analysis was performed using univariate and bivariate analysis. Pearson or Spearman correlation coefficient was used and analysis of variance was applied. Results: The FSFI score achieved its best around 35-39 years (29.7 +/- 4.9) and then it decreases progressively (23.0 +/- 8.9). It shows 32.6 percent of sexual dysfunction, 29 percent of desire disorder, 10.4 percent of arousal difficulties, 5.6 percent of lubrication problems, 9.7 percent of orgasm disorder, 14 percent of problems of sexual satisfaction and 9.9 percent of dyspareunia. Conclusions: The FSFI in health female workers vary in accordance with age, menopause, education and sexual problems in couples. The auxiliary service establishment reached higher rates of sexual dysfunction.

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.

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.

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.

Función sexual autoinformada en mujeres venezolanas con menopausia natural y quirúrgica / Sexual function in Venezuelan women with natural and surgical menopause

Antecedentes: La función sexual femenina es un importante indicador de la calidad de vida, la cual puede verse afectada al llegar la menopausia. Objetivos: Comparar la función sexual en mujeres con menopausia natural y quirúrgica que acuden a la consulta de ginecología del Hospital "Doctor Pedro García Clara", Estado Zulia, Venezuela. Método: Investigación de tipo comparativa y aplicada, con diseño no experimental, contemporáneo y de campo; que incluyó una muestra de 80 pacientes con diagnóstico de menopausia, divididas en dos grupos de acuerdo al tipo de menopausia y evaluadas mediante el Índice de Función Sexual Femenina (IFSF). Resultados: Hubo diferencias significativas (p<0,05) a favor de las histerectomizadas en cuanto a los indicadores: frecuencia de la excitación, frecuencia del orgasmo y dolor posterior a la penetración, así como a las dimensiones deseo, orgasmo y dolor. Si bien la puntuación total alcanzada en ambos grupos no mostró diferencias significativas entre ellos, las mujeres histerectomizadas presentaron mejores puntuaciones. Conclusiones: No existen diferencias en la función sexual general entre las menopáusicas naturales o quirúrgicas, salvo para el deseo, el orgasmo y dolor.

Background: Female sexual function is an important indicator of quality of life, which may be affected to reach menopause. Aims: To compare sexual function in women with natural and surgical menopause attending at the gynecology consultation in the "Doctor Pedro García Clara" Hospital, Zulia state, Venezuela. Methods: A comparative and applied type research with non-experimental, contemporary and field design, which included a sample of 80 patients diagnosed with menopause, divided into two groups according to type of menopause and evaluated by the Female Sexual Function Index (FSFI). Results: We found a significant differences (p<0.05) in hysterectomized women as to indicators excitation frequency, frequency of orgasm and pain after penetration, as well as the dimensions desire orgasm and pain. While the points achieved in both groups showed no significant differences between them, hysterectomized women showed better scores. Conclusion: It is concluded that there are no differences in the general sexual function between natural or surgical menopause, except for desire, orgasm and pain.

Sexual function of malay women with type 2 diabetes mellitus: A preliminary study

Objective: Female sexual dysfunction is a known complication of diabetes mellitus. The aims of this study is to estimate the prevalence of sexual dysfunction and the types of sexual dysfunction experienced by Malay women with type 2 diabetes mellitus. Methods: Cross sectional study was conducted on married Malay women with type 2 diabetes mellitus, receiving treatment from two community clinics in Selangor, Malaysia. Female sexual function was assessed using Malay version of Female Sexual Function Index. Results: This study found that sexual dysfunction was present among 18.2% women. Lack of libido was the commonest symptom among these women and was observed in 40.9% of women followed by sexual dissatisfaction (36.4%). Sexual arousal disorder was observed in 22.7%, 18.2% complained of lack of lubrication, and 22.7% had vaginal discomfort. Orgasmic dysfunction was found in only 4.5% of these women. Conclusion: This preliminary research showed sexual desire disorder was the commonest type of sexual disorder among diabetic women.

Effect of Menopause on the Expression of Androgen Receptors in Human Vagina / 대한남성과학회지

PURPOSE: Many women complain of various pattern of sexual dysfunction after surgical or natural menopause. This study aimed to investigate the effect of menopause on the expression of androgen receptors in the human vagina and sexual functions. MATERIALS AND METHODS: The subjects were women aged from their 30's to 70's who required transvaginal surgery. Subjects were divided into three groups: premenopausal, postmenopausal without hormone replacement therapy, and postmenopausal with hormone replacement therapy. Tissues from the proximal and distal thirds of the vagina were collected during the operation. The expression of androgen receptors was examined using RT-PCR and immunohistochemical techniques. RESULTS: In tissue from the distal third of the vagina, androgen receptor expression decreased after menopause compared with the premenopausal group. In the hormone replacement group, androgen receptor expression was decreased compared with non-hormone replacement group. Androgen receptor expression correlated with sexual function independent of hormonal status. CONCLUSIONS: Clinically, significant numbers of postmenopausal women show changes of sexual function. Androgen is thought to be one of the major factors controlling female sexual function. This study supports that the androgen receptor expression could be changed by the hormonal status and we should consider this change when managing sexual dysfunction in female.

Effects of Ginsenosides on Relaxation of Rabbit Vaginal Smooth Muscle / 대한남성과학회지

PURPOSE: Ginseng has been used throughout the Far East, including Korea and China, as a tonic and restorative agent to maintain physical vitality. The main pharmacoactive molecules of ginseng are ginsenosides. The present study was designed to investigate whether ginsenosides relax rabbit vaginal smooth muscle and whether this effect is modulated by nitric oxide(NO) and the cGMP pathway. MATERIALS AND METHODS: Strips of rabbit vagina were mounted in organ chambers to measure isometric tension. The strips were contracted with phenylephrine(5 X 10(-5) M), and the responses to acetylcholine, nitric oxide inhibitor, and ginsenosides were examined. The cGMP content of the strips was measured by radioimmunoassay after various doses of ginsenosides. RESULTS: Ginsenosides(100~500microgram/mL) relaxed vaginal smooth muscle in a dose-dependent manner(5~25%). Acetylcholine-induced relaxation was significantly increased in the presence of ginsenosides(100, 200microgram/mL)(p0.05). Ginsenosides(400microgram/mL for 7 min) increased the accumulation of cGMP. CONCLUSIONS: These data suggest that ginsenosides have a relaxing effect on rabbit vaginal smooth muscle. This effect is at least in part mediated by the NO-cGMP pathway.

The Development of Female Sexual Function Questionnaire in Family Medicine Outpatients

BACKGROUND: Currently, the high quality of life associated with women's rights is strongly supported and has become an important social issue. As a result, there is an increasing need for studies concerning female sexual function. The objectives of this study was to develop a questionnaire to evaluate sexual function evaluation in Korean women. METHODS: A total of 100 married women, who visited an outpatient clinic of family medicine department of a university hospital in Seoul, were studied. After filling out the self-administered questionnaire, a face-to- face interview was done on all study subjects. The items of this questionnaire were adopted from questionnaires with proven validity and reliability. Factor analysis was done and Crohnbach's alpha was calculated. RESULTS: The items of this questionnaire were classified into 5 parts: Drive, Excitement, Sexual activity, Satisfaction, and Spouse. The total variance was 51.5%. The total Crohnbach's alpha was 0.82. The internal consistency was high. Study subjects were able to complete this questionnaire within 10 minutes. CONCLUSION: The validity and reliability of this female sexual function questionnaire was found to be acceptable. This questionnaire can be utilized as a diagnostic adjunctive tool and feedback for treatment through further studies.