Sexual dysfunction in women with type 2 diabetes mellitus: A single-centre cross-sectional study from Bangladesh

ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.

Sexual functioning in females with depression in remission receiving escitalopram

Background & objectives: Sexual functioning is a strong determinant of quality of life. Sexual dysfunction has been widely reported due to depressive disorder as well as selective serotonin reuptake inhibitors. Thus, treatment with antidepressants can culminate in a double-edged sword, leading to drug discontinuation and symptom relapse. The objective of this study was to assess the sexual functioning of sexually active females with depression, currently in remission, receiving escitalopram and to compare with healthy controls. Methods: Fifty female patients with depression, currently in remission, with self-reported normal pre-morbid sexual function and receiving escitalopram for at least three months, were assessed on female sexual function index (FSFI) questionnaire and compared with healthy controls. Results: Half of the patients (n=25, 50%) in group A were found to have sexual dysfunction (FSFI score <26.55), while, 90 per cent (n=45) had decreased desire, 86 per cent (n=43) had decreased arousal, 54 per cent (n=27) had decreased lubrication, 68 per cent (n=34) had decreased orgasm, 62 per cent (n=31) had decreased satisfaction and 32 per cent (n=16) had pain during sexual activity. Patients receiving escitalopram had significantly higher sexual dysfunction as compared to healthy controls in mean total FSFI score (P < 0.001) and all mean domain scores of FSFI except pain. Interpretation & conclusions: A significant proportion of sexually active females with depression currently in remission, receiving escitalopram, reported dysfunction in all domains of sexual function; thus, routine screening for sexual dysfunction during follow up is advisable for early identification and prompt treatment.

Vaginal anatomical and functional outcomes of 49 patients with Mayer-Rokitansky-Küster-Hauser syndrome undergoing modified laparoscopic sigmoid vaginoplasty / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the anatomy and sexual outcomes of patients with Mayer-Rokitansky-KüsterHauser(MRKH)syndrome undergoing modified laparoscopic sigmoid vaginoplasty.METHODS: From January 2010 to January 2017,49 MRKH syndrome patients underwent the modified laparoscopic sigmoid vaginoplasty in Guangdong Women and Children's Hospital.Analysis of the anatomy and the sexual outcomes of the neovagina was conducted.The sexual functional outcomes were assessed using the Female Sexual Function Index(FSFI)questionnaire.45 cases of similar-aged women with normal sexual life were selected as controls.RESULTS: Modified laparoscopic sigmoid vaginoplasty was successfully performed in all 49 patients.The mean operative time and intraoperative blood loss was(186±53.7)minutes and(63.8±10.6)mL respectively.The mean length and width of the neovagina at the 6-month followup examination was(12.9±1.56)cm and(3.32±0.33)cm respectively.FSFI score between the MRKH group and the control group:Desire[(4.40±0.59)vs.(4.04±0.71),P0.05],Lubrication[(4.90 ± 0.58)vs.(4.67 ± 0.79),P>0.05],Orgasm[(4.29 ± 0.70)vs.(4.20 ± 0.79),P>0.05],Satisfaction[(4.51 ± 0.82)vs.(4.45 ± 0.91),P>0.05],Comfort[(4.71 ± 0.81)vs.(4.78 ± 0.72),P>0.05],Total score[(27.08 ± 2.83)vs.(26.53 ± 2.98),P>0.05].CONCLUSION: Modified laparoscopic sigmoid vaginoplasty is an effective and safe technique for MRKH syndrome patients,which provides a nearly normal sexual function for patients with MRKH syndrome.

Função sexual de idosas com incontinência urinária / Sexual function of elderly with urinary incontinence / Función sexual de las personas mayores con incontinencia urinaria

Objetiva-se comparar a função sexual de idosas com e sem incontinência urinária. Pesquisa transversal quantitativa, descritiva. População participante com 16 idosas, entre 65 e 75 anos de idade, sexualmente ativas, divididas em 2 grupos: um com queixas referidas de perdas urinárias (n=8); e outro, sem queixas (n=8). Incluídas: mulheres fisicamente ativas, cf. o Questionário Internacional de Atividade Física (IPAQ). Excluídas: mulheres com patologias neurológicas que comprometessem a sensibilidade da musculatura do assoalho pélvico. Entrou-se em contato com as participantes da pesquisa durante os projetos oferecidos pelo Núcleo Integrado de Estudos e Apoio à Terceira Idade (NIEATI). Assinado o Termo de Consentimento Livre e Esclarecido (TCLE), aplicaram-se os questionários (ficha de avaliação, FSFI e IPAQ). Como resultados: a totalidade da amostra era fisicamente ativa. O escore do FSFI variou de 22,5 a 33,7, com predição para disfunção sexual para 1 (12,5%) das idosas incontinentes. Dentre o grupo continente (G2), o escore do FSFI variou de 8 a 36, com predição para disfunção sexual em 4 (50%) idosas. Os grupos G1 e G2 foram homogêneos em relação à caracterização da amostra, em todos os domínios: idade, idade da menarca, idade da menopausa, número de gestações e de partos vaginais, número de partos cesáreos e de abortos. No total da amostra, 5 idosas apresentaram disfunção sexual (sendo 1 idosa do G1 e 4, do G2), e todas evidenciaram ao menos um domínio específico negativamente afetado no FSFI. Ainda assim, não houve diferença significativa nos resultados, no que diz respeito à comparação da função sexual de idosas com e sem incontinência urinária, o que, neste estudo, pode ter ocorrido pelo fato de toda a amostra ser fisicamente ativa segundo o IPAQ. Não houve diferença significativa entre os grupos de idosas incontinentes e continentes, quanto à presença de disfunção sexual. Sugere-se que isso tenha ocorrido pelo fato de a amostra ter sido homogênea e todas as participantes serem fisicamente ativas.

To compare sexual function in elderly with and without urinary incontinence. Method: Quantitative cross-sectional, descriptive type. The research participant population consisted of 16 elderly women, aged between 65 and 75 years of age and sexually active. Were divided into two groups, one with such complaints of urinary incontinence (n = 8) and one without complaints (n = 8). They were included: physically active women, according to the International Physical Activity Questionnaire (IPAQ). Exclusion criteria were: women with neurological conditions that compromised the sensitivity of the pelvic floor muscles. The researchers contacted the survey participants for the projects offered by the Integrated Center for Studies and Support for Elderly (NIEATI). After signing the informed consent term (IC) questionnaires (evaluation form, FSFI and IPAQ) was applied by the researchers. The entire sample was physically active. The FSFI score ranged from 22.5 to 33.7, with prediction for sexual dysfunction to 1 (12.5%) of incontinent elderly. Among continents the group (G2) FSFI score ranged from 8.0 to 36, with prediction for sexual dysfunction 4 (50%) elderly. In this study, the G1 and G2 groups were homogeneous with respect to the characterization of the sample, in all domains, namely: age, age at menarche, menopause age, number of pregnancies, number of vaginal deliveries, cesarean deliveries and abortions. In the total sample, 5 older reported sexual dysfunction (being one of the older G1 and G2 4 elderly), and all of them showed at least one specific area adversely affected the FSFI. Still, there was no significant difference in results with respect to the comparison of sexual function in elderly with or without urinary incontinence, which in this study may have occurred because the entire sample being physically active according to the IPAQ. There was no significant difference between the incontinent elderly groups and continents, with regard to the presence of sexual dysfunction. It is suggested that this has occurred because the sample was homogeneous and all participants are physically active.

Se pretende comparar la función sexual de las personas mayores con y sin incontinencia urinaria. La investigación transversal cuantitativa, del tipo descriptivo. La población fue de 16 mujeres mayores, entre 65 y 75 años y sexualmente activas. En dos grupos: uno con quejas referidas de pérdidas urinarias (n = 8 ); Y otro sin quejas (n = 8). Se incluyeron: mujeres físicamente activas, según el Cuestionario Internacional de Actividad Física (IPAQ). Se excluyeron: mujeres con patologías neurológicas que comprometían la sensibilidad de la musculatura del piso pélvico. Las investigadoras entraron en contacto con las participantes de la investigación durante los proyectos ofrecidos por el Núcleo Integrado de Estudios y Apoyo a la Tercera Edad (NIEATI). Después de la firma del Término de consentimiento libre y esclarecido (TCLE), los cuestionarios (ficha de evaluación, FSFI e IPAQ) fueron aplicados. La totalidad de la muestra era físicamente activa. La puntuación del FSFI varió de 22,5 a 33,7, con predicción para disfunción sexual para 1 (12,5%) de las ancianas incontinentes. Entre el grupo continental (G2), el puntaje del FSFI varió de 8 a 36, con predicción para disfunción sexual para 4 (50%) ancianas. Los grupos G1 y G2 fueron homogéneos en relación a la caracterización de la muestra, en todos sus dominios: edad, edad de la menarca, edad de la menopausia, número de gestaciones, número de partos vaginales, número de partos cesáreos Y el número de abortos. En el total de la muestra, 5 ancianas presentaron disfunción sexual (siendo 1 anciana del G1 y 4 ancianas del G2), y todas ellas evidenciaron al menos un dominio específico negativamente afectado en el FSFI. Sin embargo, no hubo diferencia significativa en los resultados, en lo que se refiere a la comparación de la función sexual de ancianos con y sin incontinencia urinaria, lo que puede haber ocurrido por el hecho de que toda la muestra es físicamente activa según el IPAQ. No hubo diferencia significativa entre los grupos de ancianos incontinentes y continentes, en lo que se refiere a la presencia de disfunción sexual. Se sugiere que esto haya ocurrido por el hecho de que la muestra ha sido homogénea y todas las participantes son físicamente activas.

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.

Translation of Female Sexual Function Index (FSFI) into Chinese and its reliability and validity evaluation / 中国实用护理杂志

Objective To translate the Female Sexual Function Index(FSFI) into Chinese and establish its psychometric properties among ordinary Chinese people and diabetes patients.Methods A two-phase study design was applied.The Chinese version of FSFI was established by translation and back translation,then the reliability and validity of the FSFI were evaluated.Results The content validity coefficient of FSFI was 0.953.The test-retest reliability in each dimension had good correlations (r value was 0.817～0.922),with the highest correlation coefficient in vaginal lubrication dimension (0.922) and arousal dimension the minimum (0.817).In all samples (including diabetes and non diabetes) a reliability coefficients of the Cronbach alpha of each dimension was from 0.760 to 0.874.The Cronbach alpha of each dimension for the diabetic group was from 0.783 to 0.882,and from 0.757 to 0.865 in the non-diabetes group.Pearson correlation of each dimension was very good in total samples,the diabetes group,and the non-diabetes group.Conclusions The psychometric properties of the FSFI demonstrated satisfactory validity and reliability.The Chinese version of FSFI is a reliable and valid measure to evaluate the sexual function in Chinese women.

Development of the Korean-version of Female Sexual Function Index (FSFI) / 대한남성과학회지

PURPOSE: To develop a Korean version of FSFI for measuring the female sexual dysfunction and to verify both reliability and validity of the Korean version. MATERIALS AND METHODS: The FSFI English version was translated and back-translated with modification. Data from 116 married women residing in Gwangju city were collected through a questionnaire survey. The first and second surveys were conducted at two weeks interval for test-retest reliability. Content validity, constructvalidity, internal consistency reliability, and test-retest reliability of the FSFI Korean version were evaluated. RESULTS: Through Korean language localization of the English-version questionnaire, translations from English MATERIALS, content validity, preliminary survey and specialist panel discussions, the 19-section Korean-version questionnaire was completed. As a result of factor analysis by designating five as the number of its extracted factor, it is extracted five factors (six domains) as 'desire & arousal', 'lubrication', 'orgasm', 'satisfaction' and 'pain'. The total variance explained was 81.7%. The Cronbach's alpha coefficient for internal consistency was 0.96 and test-retest reliability was r=0.973 (p<0.001). CONCLUSIONS: The Korean version of FSFI is thought to have reliability and validity that may be used for Korean women subjects.